Reaching unanimous agreements within agent-based negotiation teams with linear and monotonic utility functions.

Science.gov (United States)

Sanchez-Anguix, Victor; Julian, Vicente; Botti, Vicente; García-Fornes, Ana

2012-06-01

In this article, an agent-based negotiation model for negotiation teams that negotiate a deal with an opponent is presented. Agent-based negotiation teams are groups of agents that join together as a single negotiation party because they share an interest that is related to the negotiation process. The model relies on a trusted mediator that coordinates and helps team members in the decisions that they have to take during the negotiation process: which offer is sent to the opponent, and whether the offers received from the opponent are accepted. The main strength of the proposed negotiation model is the fact that it guarantees unanimity within team decisions since decisions report a utility to team members that is greater than or equal to their aspiration levels at each negotiation round. This work analyzes how unanimous decisions are taken within the team and the robustness of the model against different types of manipulations. An empirical evaluation is also performed to study the impact of the different parameters of the model.

Staff Group Unanimity in the Care of Juveniles in Institutional Treatment: Routines, Rituals, and Relationships

Science.gov (United States)

Ahonen, Lia; Degner, Jurgen

2013-01-01

One prerequisite for effective institutional care is that staff agree on how to deliver treatment and have a unified view of how to achieve change--in other words, to have staff group unanimity (SGU). This study used the Correctional Program Assessment Inventory (CPAI) 2000, interviews with key staff, and observations of daily activities to…

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

Science.gov (United States)

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

2016-07-01

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

Spanish Consensus Statement: The Treatment of Muscle Tears in Sport.

Science.gov (United States)

Fernandez-Jaén, Tomas F; 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

2015-12-01

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.

Introducing a Clustering Step in a Consensus Approach for the Scoring of Protein-Protein Docking Models

KAUST Repository

Chermak, Edrisse; De Donato, Renato; Lensink, Marc F.; Petta, Andrea; Serra, Luigi; Scarano, Vittorio; Cavallo, Luigi; Oliva, Romina

2016-01-01

Correctly scoring protein-protein docking models to single out native-like ones is an open challenge. It is also an object of assessment in CAPRI (Critical Assessment of PRedicted Interactions), the community-wide blind docking experiment. We introduced in the field the first pure consensus method, CONSRANK, which ranks models based on their ability to match the most conserved contacts in the ensemble they belong to. In CAPRI, scorers are asked to evaluate a set of available models and select the top ten ones, based on their own scoring approach. Scorers' performance is ranked based on the number of targets/interfaces for which they could provide at least one correct solution. In such terms, blind testing in CAPRI Round 30 (a joint prediction round with CASP11) has shown that critical cases for CONSRANK are represented by targets showing multiple interfaces or for which only a very small number of correct solutions are available. To address these challenging cases, CONSRANK has now been modified to include a contact-based clustering of the models as a preliminary step of the scoring process. We used an agglomerative hierarchical clustering based on the number of common inter-residue contacts within the models. Two criteria, with different thresholds, were explored in the cluster generation, setting either the number of common contacts or of total clusters. For each clustering approach, after selecting the top (most populated) ten clusters, CONSRANK was run on these clusters and the top-ranked model for each cluster was selected, in the limit of 10 models per target. We have applied our modified scoring approach, Clust-CONSRANK, to SCORE_SET, a set of CAPRI scoring models made recently available by CAPRI assessors, and to the subset of homodimeric targets in CAPRI Round 30 for which CONSRANK failed to include a correct solution within the ten selected models. Results show that, for the challenging cases, the clustering step typically enriches the ten top ranked

Introducing a Clustering Step in a Consensus Approach for the Scoring of Protein-Protein Docking Models

KAUST Repository

Chermak, Edrisse

2016-11-15

Correctly scoring protein-protein docking models to single out native-like ones is an open challenge. It is also an object of assessment in CAPRI (Critical Assessment of PRedicted Interactions), the community-wide blind docking experiment. We introduced in the field the first pure consensus method, CONSRANK, which ranks models based on their ability to match the most conserved contacts in the ensemble they belong to. In CAPRI, scorers are asked to evaluate a set of available models and select the top ten ones, based on their own scoring approach. Scorers\\' performance is ranked based on the number of targets/interfaces for which they could provide at least one correct solution. In such terms, blind testing in CAPRI Round 30 (a joint prediction round with CASP11) has shown that critical cases for CONSRANK are represented by targets showing multiple interfaces or for which only a very small number of correct solutions are available. To address these challenging cases, CONSRANK has now been modified to include a contact-based clustering of the models as a preliminary step of the scoring process. We used an agglomerative hierarchical clustering based on the number of common inter-residue contacts within the models. Two criteria, with different thresholds, were explored in the cluster generation, setting either the number of common contacts or of total clusters. For each clustering approach, after selecting the top (most populated) ten clusters, CONSRANK was run on these clusters and the top-ranked model for each cluster was selected, in the limit of 10 models per target. We have applied our modified scoring approach, Clust-CONSRANK, to SCORE_SET, a set of CAPRI scoring models made recently available by CAPRI assessors, and to the subset of homodimeric targets in CAPRI Round 30 for which CONSRANK failed to include a correct solution within the ten selected models. Results show that, for the challenging cases, the clustering step typically enriches the ten top ranked

Consensus paper on post-operative pediatric cerebellar mutism syndrome

DEFF Research Database (Denmark)

Gudrunardottir, Thora; Morgan, Angela T; Lux, Andrew L

2016-01-01

-operative pediatric CMS" was formed, preliminary recommendations for diagnostic and follow-up procedures were created, two working groups on a new scoring scale and risk prediction and prevention were established, and areas were identified where further information is needed. DISCUSSION: The consensus process...... to provide a more solid foundation for future clinical and research work. It is thought as a consensus for moving forward and hopefully paves the way to developing a standard approach to this challenging problem with the advent of better scoring methods and ultimate goal of reducing the risk of CMS....

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

Failure mode and effects analysis: an empirical comparison of failure mode scoring procedures.

Science.gov (United States)

Ashley, Laura; Armitage, Gerry

2010-12-01

To empirically compare 2 different commonly used failure mode and effects analysis (FMEA) scoring procedures with respect to their resultant failure mode scores and prioritization: a mathematical procedure, where scores are assigned independently by FMEA team members and averaged, and a consensus procedure, where scores are agreed on by the FMEA team via discussion. A multidisciplinary team undertook a Healthcare FMEA of chemotherapy administration. This included mapping the chemotherapy process, identifying and scoring failure modes (potential errors) for each process step, and generating remedial strategies to counteract them. Failure modes were scored using both an independent mathematical procedure and a team consensus procedure. Almost three-fifths of the 30 failure modes generated were scored differently by the 2 procedures, and for just more than one-third of cases, the score discrepancy was substantial. Using the Healthcare FMEA prioritization cutoff score, almost twice as many failure modes were prioritized by the consensus procedure than by the mathematical procedure. This is the first study to empirically demonstrate that different FMEA scoring procedures can score and prioritize failure modes differently. It found considerable variability in individual team members' opinions on scores, which highlights the subjective and qualitative nature of failure mode scoring. A consensus scoring procedure may be most appropriate for FMEA as it allows variability in individuals' scores and rationales to become apparent and to be discussed and resolved by the team. It may also yield team learning and communication benefits unlikely to result from a mathematical procedure.

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.

Modified Chrispin-Norman chest radiography score for cystic fibrosis: observer agreement and correlation with lung function

International Nuclear Information System (INIS)

Jong, P.A. de; Achterberg, J.A.; Kessels, O.A.M.; Beek, F.J.; Ginneken, B. van; Hogeweg, L.; Terheggen-Lagro, S.W.J.

2011-01-01

To test observer agreement and two strategies for possible improvement (consensus meeting and reference images) for the modified Chrispin-Norman score for children with cystic fibrosis (CF). Before and after a consensus meeting and after developing reference images three observers scored sets of 25 chest radiographs from children with CF. Observer agreement was tested for line, ring, mottled and large soft shadows, for overinflation and for the composite modified Chrispin-Norman score. Correlation with lung function was assessed. Before the consensus meeting agreement between observers 1 and 2 was moderate-good, but with observer 3 agreement was poor-fair. Scores correlated significantly with spirometry for observers 1 and 2 (-0.72< R<-0.42, P < 0.05), but not for observer 3. Agreement with observer 3 improved after the consensus meeting. Reference images improved agreement for overinflation and mottled and large shadows and correlation with lung function, but agreement for the modified Chrispin-Norman score did not improve further. Consensus meetings and reference images improve among-observer agreement for the modified Chrispin-Norman score, but good agreement was not achieved among all observers for the modified Chrispin-Norman score and for bronchial line and ring shadows. (orig.)

Modified Chrispin-Norman chest radiography score for cystic fibrosis: observer agreement and correlation with lung function

Energy Technology Data Exchange (ETDEWEB)

Jong, P.A. de; Achterberg, J.A.; Kessels, O.A.M.; Beek, F.J. [Department of Radiology, University Medical Center Utrecht, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Ginneken, B. van; Hogeweg, L. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Image Sciences Institute, University Medical Center Utrecht, Utrecht (Netherlands); Terheggen-Lagro, S.W.J. [University Medical Center Utrecht, Wilhelmina Children' s Hospital, Department of Pediatric Pulmonology, Utrecht (Netherlands)

2011-04-15

To test observer agreement and two strategies for possible improvement (consensus meeting and reference images) for the modified Chrispin-Norman score for children with cystic fibrosis (CF). Before and after a consensus meeting and after developing reference images three observers scored sets of 25 chest radiographs from children with CF. Observer agreement was tested for line, ring, mottled and large soft shadows, for overinflation and for the composite modified Chrispin-Norman score. Correlation with lung function was assessed. Before the consensus meeting agreement between observers 1 and 2 was moderate-good, but with observer 3 agreement was poor-fair. Scores correlated significantly with spirometry for observers 1 and 2 (-0.72consensus meeting. Reference images improved agreement for overinflation and mottled and large shadows and correlation with lung function, but agreement for the modified Chrispin-Norman score did not improve further. Consensus meetings and reference images improve among-observer agreement for the modified Chrispin-Norman score, but good agreement was not achieved among all observers for the modified Chrispin-Norman score and for bronchial line and ring shadows. (orig.)

7th SOSORT consensus paper: conservative treatment of idiopathic & Scheuermann's kyphosis

Directory of Open Access Journals (Sweden)

Van Loon PJM

2010-05-01

Full Text Available Abstract Thoracic hyperkyphosis is a frequent problem and can impact greatly on patient's quality of life during adolescence. This condition can be idiopathic or secondary to Scheuermann disease, a disease disturbing vertebral growth. To date, there is no sound scientific data available on the management of this condition. Some studies discuss the effects of bracing, however no guidelines, protocols or indication's of treatment for this condition were found. The aim of this paper was to develop and verify the consensus on managing thoracic hyperkyphosis patients treated with braces and/or physiotherapy. Methods The Delphi process was utilised in four steps gradually modified according to the results of a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ, and during a Consensus Session at the SOSORT Lyon Meeting with a Meeting Questionnaire (MQ. Results There was an unanimous agreement on the general efficacy of bracing and physiotherapy for this condition. Most experts suggested the use of 4-5 point bracing systems, however there was some controversy with regards to physiotherapeutic aims and modalities. Conclusion The SOSORT panel of experts suggest the use of rigid braces and physiotherapy to correct thoracic hyperkyphosis during adolescence. The evaluation of specific braces and physiotherapy techniques has been recommended.

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.

When goals diverge: Staff consensus and the organizational climate.

Science.gov (United States)

Melnick, Gerald; Ulaszek, Wendy R; Lin, Hsiu-Ju; Wexler, Harry K

2009-08-01

A sample of correctional officers and prison substance abuse treatment staff collected by the National Criminal Justice Treatment Practices Survey is used to provide an exploratory study of an aspect of organizational culture consisting of consensus (agreement) among prison personnel regarding their beliefs about rehabilitation in the presence of conflicting organizational goals and aspects of the organizational climate important to change. Findings show that among those staff members responding to the survey, the belief in rehabilitation scale mean score was associated with higher levels of organizational commitment, and interdepartmental coordination. However, an hierarchical linear modeling (HLM) analysis that used an index score derived from the standard deviation for staff consensus regarding these same beliefs about rehabilitation produced a different pattern of results, showing that high levels of consensus were associated with job frustration, cynicism towards the ability of the institution to change, and lower levels of organizational commitment. The authors conclude that, although the sample may not express the beliefs of corrections officers or prison-based treatment staff at large, within the sample, consensus appeared to play a unique role in evaluating the effect of divergent goals on organizational climate as it relates to change, and warrants consideration when considering the effects of organizational climate.

Eschar removal by bromelain based enzymatic debridement (Nexobrid®) in burns: An European consensus.

Science.gov (United States)

Hirche, Christoph; Citterio, Antonella; Hoeksema, Henk; Koller, Ján; Lehner, Martina; Martinez, José Ramón; Monstrey, Stan; Murray, Alexandra; Plock, Jan A; Sander, Frank; Schulz, Alexandra; Ziegler, Benjamin; Kneser, Ulrich

2017-12-01

degree of consensus was remarkably high, with a unanimous consensus in 88.2% of statements, and lowest degree of consensus of 70% in only 3 statements. This consensus document may serve as preliminary guideline for the use of enzymatic debridement with user-oriented recommendations until further evidence and systematic guidelines are available. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Report from the UK consensus conference on radioactive waste management, May 1999

International Nuclear Information System (INIS)

Hiett, A.

2000-01-01

A Consensus Conference took place in the UK in May 1999 to address the issue of Radioactive Waste Management. Sixteen members of the public were invited, at random, to take part in the conference, and initially were unaware of the topic. After two preparation weekends, the citizen's panel held a two day conference at which they cross examined expert 'witnesses' on issues which they felt to be relevant to the topic. The remit of the panel was as follows: ''The Consensus Conference is to focus on the effective and publicly acceptable long term management of nuclear waste in the UK, both civil and military, concentrating particularly on intermediate and high level waste. This will be considered by the citizens' panel in their capacity as members of the public, taking into account what they see as the relevant issues''. Following the conference itself, the panel produced a report on their findings and conclusions. Retrievability was just one of the many areas that the panel covered. In relation to the area of public acceptance for long term management of radioactive waste, the recommendations of the panel were as follows: ''In conclusion the panel was unanimous that in order for a solution to be publicly acceptable, the waste MUST remain accessible and monitorable to give future generations a chance to deal with the problem if/when a solution is found''. (author)

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.

Consensus group sessions are useful to reconcile stakeholders’ perspectives about network performance evaluation

Directory of Open Access Journals (Sweden)

Marie-Eve Lamontagne

2010-12-01

Full Text Available Background: Having a common vision among network stakeholders is an important ingredient to developing a performance evaluation process. Consensus methods may be a viable means to reconcile the perceptions of different stakeholders about the dimensions to include in a performance evaluation framework.Objectives: To determine whether individual organizations within traumatic brain injury (TBI networks differ in perceptions about the importance of performance dimensions for the evaluation of TBI networks and to explore the extent to which group consensus sessions could reconcile these perceptions.Methods: We used TRIAGE, a consensus technique that combines an individual and a group data collection phase to explore the perceptions of network stakeholders and to reach a consensus within structured group discussions.Results: One hundred and thirty-nine professionals from 43 organizations within eight TBI networks participated in the individual data collection; 62 professionals from these same organisations contributed to the group data collection. The extent of consensus based on questionnaire results (e.g. individual data collection was low, however, 100% agreement was obtained for each network during the consensus group sessions. The median importance scores and mean ranks attributed to the dimensions by individuals compared to groups did not differ greatly. Group discussions were found useful in understanding the reasons motivating the scoring, for resolving differences among participants, and for harmonizing their values.Conclusion: Group discussions, as part of a consensus technique, appear to be a useful process to reconcile diverging perceptions of network performance among stakeholders.

Mesotherapy, definition, rationale and clinical role: a consensus report from the Italian Society of Mesotherapy.

Science.gov (United States)

Mammucari, M; Gatti, A; Maggiori, S; Bartoletti, C A; Sabato, A F

2011-06-01

Since its introduction in the 1950s, the use of mesotherapy has generated much interest among clinicians and patients. The Italian Society of Mesotherapy (SIM) brought together a panel of experts to review available evidence and to draw up a series of recommendations on the use of intradermal therapy (LIT) in clinical practice. There was overwhelming agreement among Consensus Group members that, when used correctly, LIT is a valuable therapeutic option in the treatment of painful, loco-regional conditions. They also emphasised that the clinical efficacy of LIT has been demonstrated in the management of chronic venous lymphatic insufficiency, oedematous fibrosclerotic panniculopathy and facial skin aging. The experts were unanimous on the use of LIT in vaccination. Mesotherapy is not a substitute for other therapeutic options and should only be used when the patient has been fully informed of its advantages and limitations. Likewise the procedure should only be carried out by an experienced qualified physician. Although there was widespread agreement among the Consensus Group on the place of LIT in several indications, the Authors reiterated the need for more large-scale clinical trials to determine the specific benefits and limitations in some areas of the application of intradermal therapy.

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.

Standardized computer-based organized reporting of EEG SCORE - Second version

DEFF Research Database (Denmark)

Beniczky, Sándor; Aurlien, Harald; Brøgger, Jan C

2017-01-01

Standardized terminology for computer-based assessment and reporting of EEG has been previously developed in Europe. The International Federation of Clinical Neurophysiology established a taskforce in 2013 to develop this further, and to reach international consensus. This work resulted in the se......Standardized terminology for computer-based assessment and reporting of EEG has been previously developed in Europe. The International Federation of Clinical Neurophysiology established a taskforce in 2013 to develop this further, and to reach international consensus. This work resulted...... in the second, revised version of SCORE (Standardized Computer-based Organized Reporting of EEG), which is presented in this paper. The revised terminology was implemented in a software package (SCORE EEG), which was tested in clinical practice on 12,160 EEG recordings. Standardized terms implemented in SCORE....... In the end, the diagnostic significance is scored, using a standardized list of terms. SCORE has specific modules for scoring seizures (including seizure semiology and ictal EEG patterns), neonatal recordings (including features specific for this age group), and for Critical Care EEG Terminology. SCORE...

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.

Scoring ultrasound synovitis in rheumatoid arthritis

DEFF Research Database (Denmark)

D'Agostino, Maria-Antonietta; Terslev, Lene; Aegerter, Philippe

2017-01-01

OBJECTIVES: To develop a consensus-based ultrasound (US) definition and quantification system for synovitis in rheumatoid arthritis (RA). METHODS: A multistep, iterative approach was used to: (1) evaluate the baseline agreement on defining and scoring synovitis according to the usual practice...

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

Consensus Paper: Towards a Systems-Level View of Cerebellar Function: the Interplay Between Cerebellum, Basal Ganglia, and Cortex.

Science.gov (United States)

Caligiore, Daniele; Pezzulo, Giovanni; Baldassarre, Gianluca; Bostan, Andreea C; Strick, Peter L; Doya, Kenji; Helmich, Rick C; Dirkx, Michiel; Houk, James; Jörntell, Henrik; Lago-Rodriguez, Angel; Galea, Joseph M; Miall, R Chris; Popa, Traian; Kishore, Asha; Verschure, Paul F M J; Zucca, Riccardo; Herreros, Ivan

2017-02-01

Despite increasing evidence suggesting the cerebellum works in concert with the cortex and basal ganglia, the nature of the reciprocal interactions between these three brain regions remains unclear. This consensus paper gathers diverse recent views on a variety of important roles played by the cerebellum within the cerebello-basal ganglia-thalamo-cortical system across a range of motor and cognitive functions. The paper includes theoretical and empirical contributions, which cover the following topics: recent evidence supporting the dynamical interplay between cerebellum, basal ganglia, and cortical areas in humans and other animals; theoretical neuroscience perspectives and empirical evidence on the reciprocal influences between cerebellum, basal ganglia, and cortex in learning and control processes; and data suggesting possible roles of the cerebellum in basal ganglia movement disorders. Although starting from different backgrounds and dealing with different topics, all the contributors agree that viewing the cerebellum, basal ganglia, and cortex as an integrated system enables us to understand the function of these areas in radically different ways. In addition, there is unanimous consensus between the authors that future experimental and computational work is needed to understand the function of cerebellar-basal ganglia circuitry in both motor and non-motor functions. The paper reports the most advanced perspectives on the role of the cerebellum within the cerebello-basal ganglia-thalamo-cortical system and illustrates other elements of consensus as well as disagreements and open questions in the field.

By Unanimous Decision? A Second Look at Consensus in the Film Industry

NARCIS (Netherlands)

E. Dekker (Erwin); Z. Popik (Zuzanna)

2014-01-01

textabstractAbstract This paper analyzes the verdicts of various film organizations that annually present awards to motion pictures and investigates whether they award/nominate the same movies in a given year. This research disputes previous findings which reported a high level of agreement

By Unanimous Decision? A Second Look at Consensus in the Film Industry

Science.gov (United States)

Dekker, Erwin; Popik, Zuzanna

2014-01-01

This article reports analyses of the verdicts of various film organizations that annually present awards to motion pictures and investigates whether they award/nominate the same movies in a given year. This research disputes previous findings that reported a high level of agreement between those juries, by the means of reliability analysis and the…

Fine-Tuning Nonhomogeneous Regression for Probabilistic Precipitation Forecasts: Unanimous Predictions, Heavy Tails, and Link Functions

DEFF Research Database (Denmark)

Gebetsberger, Manuel; Messner, Jakob W.; Mayr, Georg J.

2017-01-01

functions for the optimization of regression coefficients for the scale parameter. These three refinements are tested for 10 stations in a small area of the European Alps for lead times from +24 to +144 h and accumulation periods of 24 and 6 h. Together, they improve probabilistic forecasts...... to obtain automatically corrected weather forecasts. This study applies the nonhomogenous regression framework as a state-of-the-art ensemble postprocessing technique to predict a full forecast distribution and improves its forecast performance with three statistical refinements. First of all, a novel split...... for precipitation amounts as well as the probability of precipitation events over the default postprocessing method. The improvements are largest for the shorter accumulation periods and shorter lead times, where the information of unanimous ensemble predictions is more important....

Standardized Computer-based Organized Reporting of EEG: SCORE

Science.gov (United States)

Beniczky, Sándor; Aurlien, Harald; Brøgger, Jan C; Fuglsang-Frederiksen, Anders; Martins-da-Silva, António; Trinka, Eugen; Visser, Gerhard; Rubboli, Guido; Hjalgrim, Helle; Stefan, Hermann; Rosén, Ingmar; Zarubova, Jana; Dobesberger, Judith; Alving, Jørgen; Andersen, Kjeld V; Fabricius, Martin; Atkins, Mary D; Neufeld, Miri; Plouin, Perrine; Marusic, Petr; Pressler, Ronit; Mameniskiene, Ruta; Hopfengärtner, Rüdiger; Emde Boas, Walter; Wolf, Peter

2013-01-01

The electroencephalography (EEG) signal has a high complexity, and the process of extracting clinically relevant features is achieved by visual analysis of the recordings. The interobserver agreement in EEG interpretation is only moderate. This is partly due to the method of reporting the findings in free-text format. The purpose of our endeavor was to create a computer-based system for EEG assessment and reporting, where the physicians would construct the reports by choosing from predefined elements for each relevant EEG feature, as well as the clinical phenomena (for video-EEG recordings). A working group of EEG experts took part in consensus workshops in Dianalund, Denmark, in 2010 and 2011. The faculty was approved by the Commission on European Affairs of the International League Against Epilepsy (ILAE). The working group produced a consensus proposal that went through a pan-European review process, organized by the European Chapter of the International Federation of Clinical Neurophysiology. The Standardised Computer-based Organised Reporting of EEG (SCORE) software was constructed based on the terms and features of the consensus statement and it was tested in the clinical practice. The main elements of SCORE are the following: personal data of the patient, referral data, recording conditions, modulators, background activity, drowsiness and sleep, interictal findings, “episodes” (clinical or subclinical events), physiologic patterns, patterns of uncertain significance, artifacts, polygraphic channels, and diagnostic significance. The following specific aspects of the neonatal EEGs are scored: alertness, temporal organization, and spatial organization. For each EEG finding, relevant features are scored using predefined terms. Definitions are provided for all EEG terms and features. SCORE can potentially improve the quality of EEG assessment and reporting; it will help incorporate the results of computer-assisted analysis into the report, it will make

Debate on an energy consensus without a forum? On the limitations of journalism in bringing about a consensus; Energiekonsensdebatte ohne Forum? Zu den publizistischen Grenzen der Konsensbildung

Energy Technology Data Exchange (ETDEWEB)

Kocks, K.

1995-12-31

Encouragingly, unanimity is regularly seen to prevail at least on the notion that a consensus among the major political and social groups on our future energy policy is at all desirable, if not even necessary. The focus here is on the world of the media as the stage for the evolving debate. For the publicist things only start getting interesting at the transition between the stage of agreement among the leading economists and politicians and the ensuing formation of public opinion. Where does the discourse leading to a consensus within the political class (in the best and most inclusive sense of the term) and, ultimately, reaching the whole of our pluralistic society take place, and what is it actually about? While the financial columns of some dailies have remained splendid islands of classical journalism, the media world is changing so dramatically that it will inevitably lead to a radically different mode of opinion formation from that guided by reflected national policy. Pressed to bring about a consensus, the energy economy now sees the publicistic forum it needs for this purpose melting away. (orig./UA) [Deutsch] Dass ein Konsens der wesentlichen politischen und gesellschaftlichen Gruppen ueber die kuenftige Energiepolitik wuenschenswert, vielleicht sogar notwendig ist, darueber zumindest herrscht immer wieder Einigkeit. Es geht hier um die Medienwelt, in der sich die Debatte entfalten soll. Aus der Sicht der Publizisten stellt sich das Problem erst am Uebergang zwischen der Einigung von wirtschaftlichen und politischen Entscheidungstraegern einerseits und der dann einzunehmenden oeffentlichen Meinung andererseits. Wo und worueber findet innerhalb der politischen Klasse (im besten und weitesten Sinne des Wortes) und dann mit der Vielfalt unserer Gesellschaft der konsensbildende Diskurs statt? Waehrend die Wirtschaftsteile einiger Tageszeitungen noch Inseln klassischer Publizistik sind, wandelt sich die Medienwelt so dramatisch, dass sie radikal andere Gestade

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

[Mexican National Consensus on Assisted Reproduction Treatment].

Science.gov (United States)

Kably Ambe, Alberto; López Ortiz, Carlos Salazar; Serviere Zaragoza, Claudio; Velázquez Cornejo, Gerardo; Pérez Peña, Efrain; Santos Haliscack, Roberto; Luna Rojas, Martha; Valerio, Emilio; Santana, Héctor; Gaviño Gaviño, Fernando

2012-09-01

It is estimated that 15% of couples living in industrialized countries are infertile, ie have failed to conceive, reproductive age, after 12 months ormore of regular intercourse without contraception. During the past decade has increased the demand for fertility treatments because they believe are moreeffective now. To unify the therapeutic approach and service to patients and set a precedent for a Mexican Official Standard respect and support for the legislation of these procedures. Consensus by technical experts group panel with the participation of 34 national centers accredited for use in assisted reproduction. He organized seven workshops with the following themes: 1) selection of patients for assisted reproduction treatment, 2) schemes controlled ovarian stimulation for assisted reproduction techniques of high complexity, 3) preparation and egg retrieval technique, 4) transferembryo; 5) luteal phase supplementation; 6) indications and techniques of cryopreservation and 7) informed consent. Each table had a coordinator who wrote and presented the findings to the full, it made a number of observations until they reached unanimity of criteria, which are reflected in this document. Patient selection for assisted reproduction techniques is the first step of the process. Proper selection lead to success, in the same way that a bad pick up for failure. In the case of egg donation the most important recommendation is that only one to two embryos transferred in order to reduce multiple pregnancy rates and maintaining high pregnancy rates.

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

Reducing obesity stigma: the effectiveness of cognitive dissonance and social consensus interventions.

Science.gov (United States)

Ciao, Anna C; Latner, Janet D

2011-09-01

Obese individuals experience pervasive stigmatization. Interventions attempting to reduce obesity stigma by targeting its origins have yielded mixed results. This randomized, controlled study examined the effectiveness of two interventions to reduce obesity stigma: cognitive dissonance and social consensus. Participants were college undergraduate students (N = 64, 78% women, mean age = 21.2 years, mean BMI = 23.1 kg/m2) of diverse ethnicities. Obesity stigma (assessed with the Antifat Attitudes Test (AFAT)) was assessed at baseline (Visit 1) and 1 week later, immediately following the intervention (Visit 2). Participants were randomly assigned to one of three intervention groups where they received standardized written feedback on their obesity stigma levels. Cognitive dissonance participants (N = 21) were told that their AFAT scores were discrepant from their values (high core values of kindness and equality and high stigma), social consensus participants (N = 22) were told their scores were discrepant from their peers' scores (stigma much higher than their peers), and control participants (N = 21) were told their scores were consistent with both their peers' scores and their own values. Following the intervention, omnibus analyses revealed significant group differences on the AFAT Physical/Romantic Unattractiveness subscale (PRU; F (2, 59) = 4.43, P cognitive dissonance group means were significantly lower than control means for AFAT total, AFAT PRU subscale, and AFAT social/character disparagement subscale (all P cognitive dissonance interventions may be a successful way to reduce obesity stigma, particularly by changing attitudes about the appearance and attractiveness of obese individuals.

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

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

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

Science.gov (United States)

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

2017-08-01

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

Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences

Science.gov (United States)

2012-01-01

Sarcopenia, the age associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy on November 18, 2009 to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multi-factorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. While cachexia may be a component of sarcopenia, the two conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1.0 m·s−1. Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry (DXA) with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s−1 and an objectively measured low muscle mass (eg: appendicular mass relative to ht2 that is ≤ 7.23 kg/ m2 in men ≤ 5.67 kg/ m2 in men). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization and death. PMID:21527165

Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis

DEFF Research Database (Denmark)

Tolend, Mirkamal A; Twilt, Marinka; Cron, Randy Q

2017-01-01

OBJECTIVES: The temporomandibular joints (TMJs) are frequently affected in children with juvenile idiopathic arthritis (JIA). Early detection is challenging, as major variation is present in scoring TMJ pathology on Magnetic Resonance Imaging (MRI). Consensus-driven development and validation...... of a MRI scoring system for TMJs has important clinical utility in timely improvement of diagnosis, and serving as an outcome measure. We report on a multi-institutional collaboration towards developing a TMJ MRI scoring system for JIA. METHODS: Seven readers independently assessed MRI scans from 21...... preferable for assessing minor joint changes over time. Eight items were considered sufficiently reliable and/or important for integration into the consensus scoring system: bone marrow edema and enhancement (avICC=0.57-0.61; %SDD=±45-63% prior to re-defining), condylar flattening (0.95-0.96; ±23...

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

Cross-cultural adaptation and validation of the Danish consensus version of the 10-item Perceived Stress Scale

DEFF Research Database (Denmark)

Eskildsen, Anita; Dalgaard, Vita Ligaya; Nielsen, Kent Jacob

2015-01-01

with work-related stress complaints. METHODS: A consensus-building process was performed involving the authors of the three previous Danish translations and the consensus version was back-translated into English and pilot-tested. Psychometric properties of the final version were examined in a sample of 64...... patients with work-related stress complaints. RESULTS: The face validity, reliability, and internal consistency of the Danish consensus version of the PSS-10 were satisfactory, and convergent construct validity was confirmed. Receiver operating characteristic (ROC) curves of the change scores showed......OBJECTIVES: The aims of the present study were to (i) cross-culturally adapt a Danish consensus version of the 10-item Perceived Stress Scale (PSS-10) and (ii) evaluate its psychometric properties in terms of agreement, reliability, validity, responsiveness, and interpretability among patients...

Small renal mass biopsy - how, what and when: report from an international consensus panel

NARCIS (Netherlands)

Tsivian, Matvey; Rampersaud, Edward N.; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J.; Shingleton, William B.; Aron, Monish; Kim, Charles Y.; DeMarzo, Angelo M.; Desai, Mihir M.; Meler, James D.; Donovan, James F.; Klingler, Hans Christoph; Sopko, David R.; Madden, John F.; Marberger, Michael; Ferrandino, Michael N.; Polascik, Thomas J.

2014-01-01

To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the

IW-Scoring: an Integrative Weighted Scoring framework for annotating and prioritizing genetic variations in the noncoding genome.

Science.gov (United States)

Wang, Jun; Dayem Ullah, Abu Z; Chelala, Claude

2018-01-30

The vast majority of germline and somatic variations occur in the noncoding part of the genome, only a small fraction of which are believed to be functional. From the tens of thousands of noncoding variations detectable in each genome, identifying and prioritizing driver candidates with putative functional significance is challenging. To address this, we implemented IW-Scoring, a new Integrative Weighted Scoring model to annotate and prioritise functionally relevant noncoding variations. We evaluate 11 scoring methods, and apply an unsupervised spectral approach for subsequent selective integration into two linear weighted functional scoring schemas for known and novel variations. IW-Scoring produces stable high-quality performance as the best predictors for three independent data sets. We demonstrate the robustness of IW-Scoring in identifying recurrent functional mutations in the TERT promoter, as well as disease SNPs in proximity to consensus motifs and with gene regulatory effects. Using follicular lymphoma as a paradigmatic cancer model, we apply IW-Scoring to locate 11 recurrently mutated noncoding regions in 14 follicular lymphoma genomes, and validate 9 of these regions in an extension cohort, including the promoter and enhancer regions of PAX5. Overall, IW-Scoring demonstrates greater versatility in identifying trait- and disease-associated noncoding variants. Scores from IW-Scoring as well as other methods are freely available from http://www.snp-nexus.org/IW-Scoring/. © The Author(s) 2018. Published by Oxford University Press on behalf of Nucleic Acids Research.

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.

A core undergraduate curriculum in plastic surgery - a Delphi consensus study in Scandinavia

DEFF Research Database (Denmark)

Almeland, Stian K; Lindford, Andrew; Berg, Jais Oliver

2017-01-01

.00 on a 1-4 Likert scale. Final agreement in the third round resulted in a list of 68 competences with agreement above 80% (31 skills and 37 knowledge items). CONCLUSIONS: This study proposes the first scientifically developed undergraduate core curriculum in plastic surgery. It comprises of a consensus......, there appears to be a need to define the core competences that are to be taught. The aim of this study was to establish a Scandinavian core undergraduate curriculum of competences in plastic surgery, using scientific methods. METHODS: The Delphi technique for group consensus was employed. An expert panel...... of anonymous questionnaires; a final core curriculum competency list was agreed upon based on a consensus agreement level of 80%. RESULTS: Two hundred and ninety-five competences were suggested in the first round. In the second round, 76 competences (33 skills and 43 knowledge items) received a score ≥3...

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

International Nuclear Information System (INIS)

Taylor, S.A.; Torkzad, M.R.; Bhatnagar, G.; Avni, F.; Cronin, C.G.; Hoeffel, C.; Kim, S.H.; Laghi, A.; Napolitano, M.; Petit, P.; Rimola, J.; Tolan, D.J.; Zappa, M.; Puylaert, C.A.J.; Stoker, J.

2017-01-01

To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols. One hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached. These expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon. (orig.)

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

Energy Technology Data Exchange (ETDEWEB)

Taylor, S.A.; Torkzad, M.R.; Bhatnagar, G. [University College London, Centre for Medical Imaging, London (United Kingdom); Avni, F. [Lille University Hospitals, Department of Paediatric Imaging, Jeanne de Flandre Hospital, Lille (France); Cronin, C.G. [Mater Misericordiae University Hospital, Department of Radiology, Dublin (Ireland); Hoeffel, C. [Hopital Robert Debre, Department of Radiology, Reims (France); Kim, S.H. [Inje University College of Medicine, Haeundae Paik Hospital, Department of Radiology, Busan (Korea, Republic of); Laghi, A. [Sapienza University of Rome, I.C.O.T. Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Napolitano, M. [V. Buzzi Children' s Hospital, Department of Radiology and Neuroradiology, Milan (Italy); Petit, P. [Timone Enfant Hospital, Department of Paediatric Radiology, Marseille (France); Rimola, J. [University of Barcelona, Radiology Department, Hospital Clinic Barcelona, Catalonia (Spain); Tolan, D.J. [St James' s University Hospital, Leeds Teaching Hospitals NHS Trust (United Kingdom); Zappa, M. [Hopital Beaujon, AP-HP, Universite Paris 7, INSERM CRI U1149, Department of Radiology, Clichy (France); Puylaert, C.A.J.; Stoker, J. [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands)

2017-06-15

To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols. One hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached. These expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon. (orig.)

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.

Improving predicted protein loop structure ranking using a Pareto-optimality consensus method.

Science.gov (United States)

Li, Yaohang; Rata, Ionel; Chiu, See-wing; Jakobsson, Eric

2010-07-20

Accurate protein loop structure models are important to understand functions of many proteins. Identifying the native or near-native models by distinguishing them from the misfolded ones is a critical step in protein loop structure prediction. We have developed a Pareto Optimal Consensus (POC) method, which is a consensus model ranking approach to integrate multiple knowledge- or physics-based scoring functions. The procedure of identifying the models of best quality in a model set includes: 1) identifying the models at the Pareto optimal front with respect to a set of scoring functions, and 2) ranking them based on the fuzzy dominance relationship to the rest of the models. We apply the POC method to a large number of decoy sets for loops of 4- to 12-residue in length using a functional space composed of several carefully-selected scoring functions: Rosetta, DOPE, DDFIRE, OPLS-AA, and a triplet backbone dihedral potential developed in our lab. Our computational results show that the sets of Pareto-optimal decoys, which are typically composed of approximately 20% or less of the overall decoys in a set, have a good coverage of the best or near-best decoys in more than 99% of the loop targets. Compared to the individual scoring function yielding best selection accuracy in the decoy sets, the POC method yields 23%, 37%, and 64% less false positives in distinguishing the native conformation, indentifying a near-native model (RMSD Pareto optimality and fuzzy dominance, the POC method is effective in distinguishing the best loop models from the other ones within a loop model set.

Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity

DEFF Research Database (Denmark)

Zouboulis, C C; Tzellos, T; Kyrgidis, A

2017-01-01

BACKGROUND: A validated tool for the dynamic severity assessment of hidradenitis suppurativa/acne inversa (HS) is lacking. OBJECTIVES: To develop and validate a novel dynamic scoring system to assess the severity of HS. METHODS: A Delphi voting procedure was conducted among the members......, as well as examination for correlation (Spearman's rho) and agreement (Cohen's kappa) with existing scores, were engaged to recognize the variables for a new International HS4 (IHS4) that was established by a second Delphi round. RESULTS: Consensus HS4 was based on number of skin lesions, number of skin....... Three candidate scores were presented to the second Delphi round. The resulting IHS4 score is arrived at by the number of nodules (multiplied by 1) plus the number of abscesses (multiplied by 2) plus the number of draining tunnels (multiplied by 4). A total score of 3 or less signifies mild, 4...

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.

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

Consensus Based Definition of Growth Restriction in the Newborn.

Science.gov (United States)

Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

2018-05-01

To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight definition for growth restriction in the newborn. This definition recognizes that infants with birth weights 10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

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.)

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.

British Lung Foundation/United Kingdom Primary Immunodeficiency Network Consensus Statement on the Definition, Diagnosis, and Management of Granulomatous-Lymphocytic Interstitial Lung Disease in Common Variable Immunodeficiency Disorders.

Science.gov (United States)

Hurst, John R; Verma, Nisha; Lowe, David; Baxendale, Helen E; Jolles, Stephen; Kelleher, Peter; Longhurst, Hilary J; Patel, Smita Y; Renzoni, Elisabetta A; Sander, Clare R; Avery, Gerard R; Babar, Judith L; Buckland, Matthew S; Burns, Siobhan; Egner, William; Gompels, Mark M; Gordins, Pavels; Haddock, Jamanda A; Hart, Simon P; Hayman, Grant R; Herriot, Richard; Hoyles, Rachel K; Huissoon, Aarnoud P; Jacob, Joseph; Nicholson, Andrew G; Rassl, Doris M; Sargur, Ravishankar B; Savic, Sinisa; Seneviratne, Suranjith L; Sheaff, Michael; Vaitla, Prashantha M; Walters, Gareth I; Whitehouse, Joanna L; Wright, Penny A; Condliffe, Alison M

A proportion of people living with common variable immunodeficiency disorders develop granulomatous-lymphocytic interstitial lung disease (GLILD). We aimed to develop a consensus statement on the definition, diagnosis, and management of GLILD. All UK specialist centers were contacted and relevant physicians were invited to take part in a 3-round online Delphi process. Responses were graded as Strongly Agree, Tend to Agree, Neither Agree nor Disagree, Tend to Disagree, and Strongly Disagree, scored +1, +0.5, 0, -0.5, and -1, respectively. Agreement was defined as greater than or equal to 80% consensus. Scores are reported as mean ± SD. There was 100% agreement (score, 0.92 ± 0.19) for the following definition: "GLILD is a distinct clinico-radio-pathological ILD occurring in patients with [common variable immunodeficiency disorders], associated with a lymphocytic infiltrate and/or granuloma in the lung, and in whom other conditions have been considered and where possible excluded." There was consensus that the workup of suspected GLILD requires chest computed tomography (CT) (0.98 ± 0.01), lung function tests (eg, gas transfer, 0.94 ± 0.17), bronchoscopy to exclude infection (0.63 ± 0.50), and lung biopsy (0.58 ± 0.40). There was no consensus on whether expectant management following optimization of immunoglobulin therapy was acceptable: 67% agreed, 25% disagreed, score 0.38 ± 0.59; 90% agreed that when treatment was required, first-line treatment should be with corticosteroids alone (score, 0.55 ± 0.51). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

What Makes Children Defy Majorities? The Role of Dissenters in Chinese and Spanish Preschoolers' Social Judgments.

Science.gov (United States)

Enesco, Ileana; Sebastián-Enesco, Carla; Guerrero, Silvia; Quan, Siyu; Garijo, Sonia

2016-01-01

When many people say the same thing, the individual is more likely to endorse this information than when just a single person says the same. Yet, the influence of consensus information may be modulated by many personal, contextual and cultural variables. Here, we study the sensitivity of Chinese ( N = 68) and Spanish ( N = 82) preschoolers to consensus in social decision making contexts. Children faced two different types of peer-interaction events, which involved (1) uncertain or ambiguous scenarios open to interpretation (social interpretation context), and (2) explicit scenarios depicting the exclusion of a peer (moral judgment context). Children first observed a video in which a group of teachers offered their opinion about the events, and then they were asked to evaluate the information provided. Participants were assigned to two conditions that differed in the type of consensus: Unanimous majority ( non-dissenter condition) and non-unanimous majority ( dissenter condition). In the dissenter condition, we presented the conflicting opinions of three teachers vs. one teacher. In the non-dissenter condition, we presented the unanimous opinion of three teachers. The general results indicated that children's sensitivity to consensus varies depending both on the degree of ambiguity of the social events and the presence or not of a dissenter: (1) Children were much more likely to endorse the majority view when they were uncertain (social interpretation context), than when they already had a clear interpretation of the situation (moral judgment context); (2) The presence of a dissenter resulted in a significant decrease in children's confidence in majority. Interestingly, in the moral judgment context, Chinese and Spanish children differed in their willingness to defy a majority whose opinion run against their own. While Spanish children maintained their own criteria regardless of the type of condition, Chinese children did so when an "allied" dissenter was present

What makes children defy majorities? The role of dissenters in Chinese and Spanish preschoolers’ social judgments.

Directory of Open Access Journals (Sweden)

Ileana Enesco

2016-10-01

Full Text Available When many people say the same thing, the individual is more likely to endorse this information than when just a single person says the same. Yet, the influence of consensus information may be modulated by many personal, contextual and cultural variables. Here, we study the sensitivity of Chinese (N = 68 and Spanish (N = 82 preschoolers to consensus in social decision making contexts. Children faced two different types of peer-interaction events, which involved (1 uncertain or ambiguous scenarios open to interpretation (social interpretation context, and (2 explicit scenarios depicting the exclusion of a peer (moral judgment context. Children first observed a video in which a group of teachers offered their opinion about the events, and then they were asked to evaluate the information provided. Participants were assigned to two conditions that differed in the type of consensus: Unanimous majority (non-dissenter condition and non-unanimous majority (dissenter condition. In the dissenter condition, we presented the conflicting opinions of three teachers vs. one teacher. In the non-dissenter condition, we presented the unanimous opinion of three teachers. The general results indicated that children’s sensitivity to consensus varies depending both on the degree of ambiguity of the social events and the presence or not of a dissenter: 1 Children were much more likely to endorse the majority view when they were uncertain (social interpretation context, than when they already had a clear interpretation of the situation (moral judgment context; 2 The presence of a dissenter resulted in a significant decrease in children’s confidence in majority. Interestingly, in the moral judgment context, Chinese and Spanish children differed in their willingness to defy a majority whose opinion run against their own. While Spanish children maintained their own criteria regardless of the type of condition, Chinese children did so when an allied dissenter was

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

Science.gov (United States)

Chowriappa, Ashirwad J; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew; Wilding, Gregory; Kaouk, Jihad; Peabody, James O; Menon, Mani; Hassett, James M; Kesavadas, Thenkurussi; Guru, Khurshid A

2013-12-01

A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation. All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups. The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator. The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting

Energy Technology Data Exchange (ETDEWEB)

Beets-Tan, Regina G.H. [Maastricht University Medical Centre+, Maastricht (Netherlands); Maastricht University Medical Centre+, Department of Radiology, P.O. Box 5800, AZ, Maastricht (Netherlands); Lambregts, Doenja M.J.; Maas, Monique [Maastricht University Medical Centre+, Maastricht (Netherlands); Bipat, Shandra; Stoker, Jaap [Academic Medical Centre, Amsterdam (Netherlands); Barbaro, Brunella [Catholic University School of Medicine, Rome (Italy); Caseiro-Alves, Filipe; Curvo-Semedo, Luis [Coimbra University Hospitals, Coimbra (Portugal); Fenlon, Helen M. [Mater Misericordiae University Hospital, Dublin (Ireland); Gollub, Marc J. [Memorial Sloan-Kettering Cancer Center, New York (United States); Gourtsoyianni, Sofia [University Hospital of Heraklion, Crete (Greece); Guy' s and St. Thomas' NHS FT, London (United Kingdom); Halligan, Steve; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Hoeffel, Christine [Reims University Hospital, Reims (France); Kim, Seung Ho [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Laghi, Andrea [Sapienza - University of Rome, Rome (Italy); Maier, Andrea [Medical University of Vienna, Vienna (Austria); Rafaelsen, Soeren R. [Vejle Hospital, Vejle (Denmark); Torkzad, Michael R. [Uppsala University, Uppsala (Sweden); Blomqvist, Lennart [Karolinska University Hospital and Karolinska Institutet, Stockholm (Sweden)

2013-09-15

To develop guidelines describing a standardised approach regarding the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. A consensus meeting of 14 abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) was conducted following the RAND-UCLA Appropriateness Method. Two independent (non-voting) chairs facilitated the meeting. Two hundred and thirty-six items were scored by participants for appropriateness and classified subsequently as appropriate or inappropriate (defined by {>=} 80 % consensus) or uncertain (defined by < 80 % consensus). Items not reaching 80 % consensus were noted. Consensus was reached for 88 % of items: recommendations regarding hardware, patient preparation, imaging sequences, angulation, criteria for MRI assessment and MRI reporting were constructed from these. These expert consensus recommendations can be used as clinical guidelines for primary staging and restaging of rectal cancer using MRI. (orig.)

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…

Validation of the Dutch language version of the Foot and Ankle Outcome Score

NARCIS (Netherlands)

Sierevelt, I.N.; Beimers, L.; van Bergen, C.J.A.; Haverkamp, D.; Terwee, C.B.; Kerkhoffs, G.M.M.J.

2015-01-01

Purpose: The aim of this study was to develop a Dutch language version of the Foot and Ankle Outcome Score (FAOS-DLV) and evaluate its measurement properties according to the definitions of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Methods: After a

Validation of the Dutch language version of the Foot and Ankle Outcome Score

NARCIS (Netherlands)

Sierevelt, I. N.; Beimers, L.; van Bergen, C. J. A.; Haverkamp, D.; Terwee, C. B.; Kerkhoffs, G. M. M. J.

2015-01-01

The aim of this study was to develop a Dutch language version of the Foot and Ankle Outcome Score (FAOS-DLV) and evaluate its measurement properties according to the definitions of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). After a standard

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.

Focal Therapy: Patients, Interventions, and Outcomes—A Report from a Consensus Meeting

Science.gov (United States)

Donaldson, Ian A.; Alonzi, Roberto; Barratt, Dean; Barret, Eric; Berge, Viktor; Bott, Simon; Bottomley, David; Eggener, Scott; Ehdaie, Behfar; Emberton, Mark; Hindley, Richard; Leslie, Tom; Miners, Alec; McCartan, Neil; Moore, Caroline M.; Pinto, Peter; Polascik, Thomas J.; Simmons, Lucy; van der Meulen, Jan; Villers, Arnauld; Willis, Sarah; Ahmed, Hashim U.

2015-01-01

Background Focal therapy as a treatment option for localized prostate cancer (PCa) is an increasingly popular and rapidly evolving field. Objective To gather expert opinion on patient selection, interventions, and meaningful outcome measures for focal therapy in clinical practice and trial design. Design, setting, and participants Fifteen experts in focal therapy followed a modified two-stage RAND/University of California, Los Angeles (UCLA) Appropriateness Methodology process. All participants independently scored 246 statements prior to rescoring at a face-to-face meeting. The meeting occurred in June 2013 at the Royal Society of Medicine, London, supported by the Wellcome Trust and the UK Department of Health. Outcome measurements and statistical analysis Agreement, disagreement, or uncertainty were calculated as the median panel score. Consensus was derived from the interpercentile range adjusted for symmetry level. Results and limitations Of 246 statements, 154 (63%) reached consensus. Items of agreement included the following: patients with intermediate risk and patients with unifocal and multifocal PCa are eligible for focal treatment; magnetic resonance imaging–targeted or template-mapping biopsy should be used to plan treatment; planned treatment margins should be 5 mm from the known tumor; prostate volume or age should not be a primary determinant of eligibility; foci of indolent cancer can be left untreated when treating the dominant index lesion; histologic outcomes should be defined by targeted biopsy at 1 yr; residual disease in the treated area of ≤3 mm of Gleason 3 + 3 did not need further treatment; and focal retreatment rates of ≤20% should be considered clinically acceptable but subsequent whole-gland therapy deemed a failure of focal therapy. All statements are expert opinion and therefore constitute level 5 evidence and may not reflect wider clinical consensus. Conclusions The landscape of PCa treatment is rapidly evolving with new

Consensus statement on the anticipation and prevention of acute postoperative pain: multidisciplinary RADAR approach.

Science.gov (United States)

Vickers, A; Bali, S; Baxter, A; Bruce, G; England, J; Heafield, R; Langford, R; Makin, R; Power, I; Trim, J

2009-10-01

There has been considerable investment in efforts to improve postoperative pain management, including the introduction of acute pain teams. There have also been a number of guidelines published on postoperative pain management and there is widespread agreement on how pain should be practically managed. Despite these advances, there is no apparent improvement in the number of patients experiencing moderately severe or extreme pain after surgery. This highlights significant scope for improvement in acute postoperative pain management. In January 2009, a multidisciplinary UK expert panel met to define and agree a practical framework to encourage implementation of the numerous guidelines and fundamentals of pain management at a local level. The panel recognised that to do this, there was a need to organise the information and guidelines into a simplified, accessible and easy-to-implement system based on their practical clinical experience. Given the volume of literature in this area, the Chair recommended that key international guidelines from professional bodies should be distributed and then reviewed during the meeting to form the basis of the framework. Consensus was reached by unanimous agreement of all ten participants. This report provides a framework for the key themes, including consensus recommendations based upon practical experience agreed during the meeting, with the aim of consolidating the key guidelines to provide a fundamental framework which is simple to teach and implement in all areas. Key priorities that emerged were: Responsibility, Anticipation, Discussion, Assessment and Response. This formed the basis of RADAR, a novel framework to help pain specialists educate the wider care team on understanding and prioritising the management of acute pain. Acute postoperative pain can be more effectively managed if it is prioritised and anticipated by a well-informed care team who are educated with regard to appropriate analgesic options and understand what

e-Bitter: Bitterant Prediction by the Consensus Voting From the Machine-Learning Methods.

Science.gov (United States)

Zheng, Suqing; Jiang, Mengying; Zhao, Chengwei; Zhu, Rui; Hu, Zhicheng; Xu, Yong; Lin, Fu

2018-01-01

In-silico bitterant prediction received the considerable attention due to the expensive and laborious experimental-screening of the bitterant. In this work, we collect the fully experimental dataset containing 707 bitterants and 592 non-bitterants, which is distinct from the fully or partially hypothetical non-bitterant dataset used in the previous works. Based on this experimental dataset, we harness the consensus votes from the multiple machine-learning methods (e.g., deep learning etc.) combined with the molecular fingerprint to build the bitter/bitterless classification models with five-fold cross-validation, which are further inspected by the Y-randomization test and applicability domain analysis. One of the best consensus models affords the accuracy, precision, specificity, sensitivity, F1-score, and Matthews correlation coefficient (MCC) of 0.929, 0.918, 0.898, 0.954, 0.936, and 0.856 respectively on our test set. For the automatic prediction of bitterant, a graphic program "e-Bitter" is developed for the convenience of users via the simple mouse click. To our best knowledge, it is for the first time to adopt the consensus model for the bitterant prediction and develop the first free stand-alone software for the experimental food scientist.

e-Bitter: Bitterant Prediction by the Consensus Voting From the Machine-learning Methods

Science.gov (United States)

Zheng, Suqing; Jiang, Mengying; Zhao, Chengwei; Zhu, Rui; Hu, Zhicheng; Xu, Yong; Lin, Fu

2018-03-01

In-silico bitterant prediction received the considerable attention due to the expensive and laborious experimental-screening of the bitterant. In this work, we collect the fully experimental dataset containing 707 bitterants and 592 non-bitterants, which is distinct from the fully or partially hypothetical non-bitterant dataset used in the previous works. Based on this experimental dataset, we harness the consensus votes from the multiple machine-learning methods (e.g., deep learning etc.) combined with the molecular fingerprint to build the bitter/bitterless classification models with five-fold cross-validation, which are further inspected by the Y-randomization test and applicability domain analysis. One of the best consensus models affords the accuracy, precision, specificity, sensitivity, F1-score, and Matthews correlation coefficient (MCC) of 0.929, 0.918, 0.898, 0.954, 0.936, and 0.856 respectively on our test set. For the automatic prediction of bitterant, a graphic program “e-Bitter” is developed for the convenience of users via the simple mouse click. To our best knowledge, it is for the first time to adopt the consensus model for the bitterant prediction and develop the first free stand-alone software for the experimental food scientist.

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....

A consensus definition and rating scale for minimalist shoes.

Science.gov (United States)

Esculier, Jean-Francois; Dubois, Blaise; Dionne, Clermont E; Leblond, Jean; Roy, Jean-Sébastien

2015-01-01

While minimalist running shoes may have an influence on running biomechanics and on the incidence of overuse injuries, the term "minimalist" is currently used without standardisation. The objectives of this study were to reach a consensus on a standard definition of minimalist running shoes, and to develop and validate a rating scale that could be used to determine the degree of minimalism of running shoes, the Minimalist Index (MI). For this modified Delphi study, 42 experts from 11 countries completed four electronic questionnaires on an optimal definition of minimalist shoes and on elements to include within the MI. Once MI was developed following consensus, 85 participants subjectively ranked randomly assigned footwear models from the most to the least minimalist and rated their degree of minimalism using visual analog scales (VAS), before evaluating the same footwear models using MI. A subsample of thirty participants reassessed the same shoes on another occasion. Construct validity and inter- and intra-rater reliability (intraclass correlation coefficients [ICC]; Gwet's AC1) of MI were evaluated. The following definition of minimalist shoes was agreed upon by 95 % of participants: "Footwear providing minimal interference with the natural movement of the foot due to its high flexibility, low heel to toe drop, weight and stack height, and the absence of motion control and stability devices". Characteristics to be included in MI were weight, flexibility, heel to toe drop, stack height and motion control/stability devices, each subscale carrying equal weighing (20 %) on final score. Total MI score was highly correlated with VAS (r = 0.91). A significant rank effect (p minimalism, and may help to decrease injuries related to footwear transition.

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.

Small renal mass biopsy--how, what and when: report from an international consensus panel.

Science.gov (United States)

Tsivian, Matvey; Rampersaud, Edward N; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J; Shingleton, William B; Aron, Monish; Kim, Charles Y; DeMarzo, Angelo M; Desai, Mihir M; Meler, James D; Donovan, James F; Klingler, Hans Christoph; Sopko, David R; Madden, John F; Marberger, Michael; Ferrandino, Michael N; Polascik, Thomas J

2014-06-01

To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications. © 2013 The Authors. BJU International © 2013 BJU International.

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

Standardized computer-based organized reporting of EEG:SCORE

DEFF Research Database (Denmark)

Beniczky, Sandor; H, Aurlien,; JC, Brøgger,

2013-01-01

process, organized by the European Chapter of the International Federation of Clinical Neurophysiology. The Standardised Computer-based Organised Reporting of EEG (SCORE) software was constructed based on the terms and features of the consensus statement and it was tested in the clinical practice...... in free-text format. The purpose of our endeavor was to create a computer-based system for EEG assessment and reporting, where the physicians would construct the reports by choosing from predefined elements for each relevant EEG feature, as well as the clinical phenomena (for video-EEG recordings....... SCORE can potentially improve the quality of EEG assessment and reporting; it will help incorporate the results of computer-assisted analysis into the report, it will make possible the build-up of a multinational database, and it will help in training young neurophysiologists....

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...

Consensus statement on panic 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; Baldwin, D S; den Boer, J A; Kasper, S; Shear, M K

1998-01-01

To provide primary care clinicians with a better understanding of management issues in panic disorder and guide clinical practice with recommendations for appropriate pharmacotherapy. 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 faculty invited by the chairman also participated: David S. Baldwin, Johan A. den Boer, Siegfried Kasper, and M. Katherine Shear. The consensus statement is based on the 6 review papers that are published in this supplement and on the scientific literature relevant to these issues. There were group meetings held during a 2-day period. On day 1, the group discussed each review paper and the chairman and discussant (Dr. Kasper) identified key issues for further debate. On day 2, the group discussed these key issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chairman and approved by all attendees. The consensus statement provides standard definitions for response and remission and identifies appropriate strategy for the management of panic disorder in a primary care setting. Serotonin selective reuptake inhibitors are recommended as drugs of first choice with a treatment period of 12 to 24 months. Pharmacotherapy should be discontinued slowly over a period of 4 to 6 months.

What's in a Grade? A Professor's Guide to Adjusting Scores on Student Assessments

Science.gov (United States)

Kuhlthau, Kaitlin; Ruscio, John; Luce, Christine; Furey, Matthew

2017-01-01

Grades serve many important purposes, and educators agree it is important to assign them accurately and fairly. Interviews with 100 professors across a broad range of academic disciplines at a mid-sized state college revealed little consensus on whether, when, or how to adjust scores when assigning grades. Their responses informed a review of…

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

Development, appraisal, validation and implementation of a consensus protocol for the assessment of cerebral amyloid angiopathy in post-mortem brain tissue

Science.gov (United States)

Love, Seth; Chalmers, Katy; Ince, Paul; Esiri, Margaret; Attems, Johannes; Jellinger, Kurt; Yamada, Masahito; McCarron, Mark; Minett, Thais; Matthews, Fiona; Greenberg, Steven; Mann, David; Kehoe, Patrick Gavin

2014-01-01

In a collaboration involving 11 groups with research interests in cerebral amyloid angiopathy (CAA), we used a two-stage process to develop and in turn validate a new consensus protocol and scoring scheme for the assessment of CAA and associated vasculopathic abnormalities in post-mortem brain tissue. Stage one used an iterative Delphi-style survey to develop the consensus protocol. The resultant scoring scheme was tested on a series of digital images and paraffin sections that were circulated blind to a number of scorers. The scoring scheme and choice of staining methods were refined by open-forum discussion. The agreed protocol scored parenchymal and meningeal CAA on a 0-3 scale, capillary CAA as present/absent and vasculopathy on 0-2 scale, in the 4 cortical lobes that were scored separately. A further assessment involving three centres was then undertaken. Neuropathologists in three centres (Bristol, Oxford and Sheffield) independently scored sections from 75 cases (25 from each centre) and high inter-rater reliability was demonstrated. Stage two used the results of the three-centre assessment to validate the protocol by investigating previously described associations between APOE genotype (previously determined), and both CAA and vasculopathy. Association of capillary CAA with or without arteriolar CAA with APOE ε4 was confirmed. However APOE ε2 was also found to be a strong risk factor for the development of CAA, not only in AD but also in elderly non-demented controls. Further validation of this protocol and scoring scheme is encouraged, to aid its wider adoption to facilitate collaborative and replication studies of CAA. PMID:24754000

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

Identifying key performance indicators for nursing and midwifery care using a consensus approach.

Science.gov (United States)

McCance, Tanya; Telford, Lorna; Wilson, Julie; Macleod, Olive; Dowd, Audrey

2012-04-01

The aim of this study was to gain consensus on key performance indicators that are appropriate and relevant for nursing and midwifery practice in the current policy context. There is continuing demand to demonstrate effectiveness and efficiency in health and social care and to communicate this at boardroom level. Whilst there is substantial literature on the use of clinical indicators and nursing metrics, there is less evidence relating to indicators that reflect the patient experience. A consensus approach was used to identify relevant key performance indicators. A nominal group technique was used comprising two stages: a workshop involving all grades of nursing and midwifery staff in two HSC trusts in Northern Ireland (n = 50); followed by a regional Consensus Conference (n = 80). During the workshop, potential key performance indicators were identified. This was used as the basis for the Consensus Conference, which involved two rounds of consensus. Analysis was based on aggregated scores that were then ranked. Stage one identified 38 potential indicators and stage two prioritised the eight top-ranked indicators as a core set for nursing and midwifery. The relevance and appropriateness of these indicators were confirmed with nurses and midwives working in a range of settings and from the perspective of service users. The eight indicators identified do not conform to the majority of other nursing metrics generally reported in the literature. Furthermore, they are strategically aligned to work on the patient experience and are reflective of the fundamentals of nursing and midwifery practice, with the focus on person-centred care. Nurses and midwives have a significant contribution to make in determining the extent to which these indicators are achieved in practice. Furthermore, measurement of such indicators provides an opportunity to evidence of the unique impact of nursing/midwifery care on the patient experience. © 2011 Blackwell Publishing Ltd.

Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety.

Science.gov (United States)

Ballenger, James C; Davidson, Jonathan R T; Lecrubier, Yves; Nutt, David J; Marshall, Randall D; Nemeroff, Charles B; Shalev, Arieh Y; Yehuda, Rachel

2004-01-01

To provide an update to the "Consensus Statement on Posttraumatic Stress Disorder From the International Consensus Group on Depression and Anxiety" that was published in a supplement to The Journal of Clinical Psychiatry (2000) by presenting important developments in the field, the latest recommendations for patient care, and suggestions for future research. 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 who were invited by the chair were Randall D. Marshall, Charles B. Nemeroff, Arieh Y. Shalev, and Rachel Yehuda. The consensus statement is based on the 7 review articles in this supplement and the related scientific literature. Group meetings were held over a 2-day period. On day 1, the group discussed topics to be represented by the 7 review articles in this supplement, 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 faculty. There have been advancements in the science and treatment of posttraumatic stress disorder. Attention to this disorder has increased with recent world events; however, continued efforts are needed to improve diagnosis, treatment, and prevention of posttraumatic stress disorder.

Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden.

Science.gov (United States)

Widarsson, Margareta; Engström, Gabriella; Berglund, Anders; Tydén, Tanja; Lundberg, Pranee

2014-12-01

Parental stress can negatively affect the parent-child relationship and reduce the well-being of the whole family. Family disagreement is associated with parental divorce and with psychological problems in children. The aim was to examine perceived parental stress and draw comparisons among mothers and among fathers, in relation to educational level, parental experience, existence of a parental role model and sense of coherence. The aim was also to examine perceived dyadic consensus and its association with perceived parental stress within couples. Questionnaires were completed by 320 mothers and 315 fathers at 1 week and 18 months post-partum. The Swedish Parenthood Stress Questionnaire, the Sense of Coherence Scale and the Dyadic Consensus Subscale were used. Low education, lack of a role model and poor sense of coherence promoted stress in mothers in the subareas social isolation and spouse relationship problems, while lack of a role model and poor sense of coherence promoted stress in fathers in the subarea social isolation. Furthermore, parental experiences promoted stress among mothers in the subarea incompetence while this was not seen among fathers. Mothers perceived a higher level of dyadic consensus than fathers in the items recreational activities, friends, aims and life goals, time spent together, and decisions regarding career and personal development. Household tasks was the only item where fathers perceived a higher level of dyadic consensus than mothers. Additionally, there were associations between perceived parental stress and dyadic consensus in several items and in the total score. To promote parents' health and family stability, health professionals should consider factors affecting stress and stress reactions, and take gender roles into account. © 2013 Nordic College of Caring Science.

Consensus statement on social 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; Bobes, J; Beidel, D C; Ono, Y; Westenberg, H G

1998-01-01

The goal of this consensus statement is to provide primary care clinicians with a better understanding of management issues in social anxiety disorder (social phobia) and guide clinical practice with recommendations for appropriate pharmacotherapy. 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 Julio Bobes, Deborah C. Beidel, Yukata Ono, and Herman G. M. Westenberg. The consensus statement is based on the 7 review papers published in this supplement and on the scientific literature relevant to the issues reviewed in these papers. The group met over a 2-day period. On day 1, the group discussed each review paper, 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 importance of recognizing social anxiety disorder and provides recommendations on how it may be distinguished from other anxiety disorders. It proposes definitions for response and remission and considers appropriate management strategies. Selective serotonin reuptake inhibitors are recommended as first-line therapy, and effective treatment should be continued for at least 12 months. Long-term treatment is indicated if symptoms are unresolved, the patient has a comorbid condition or a history of relapse, or there was an early onset of the disorder.

The scoring of movements in sleep.

Science.gov (United States)

Walters, Arthur S; Lavigne, Gilles; Hening, Wayne; Picchietti, Daniel L; Allen, Richard P; Chokroverty, Sudhansu; Kushida, Clete A; Bliwise, Donald L; Mahowald, Mark W; Schenck, Carlos H; Ancoli-Israel, Sonia

2007-03-15

The International Classification of Sleep Disorders (ICSD-2) has separated sleep-related movement disorders into simple, repetitive movement disorders (such as periodic limb movements in sleep [PLMS], sleep bruxism, and rhythmic movement disorder) and parasomnias (such as REM sleep behavior disorder and disorders of partial arousal, e.g., sleep walking, confusional arousals, night terrors). Many of the parasomnias are characterized by complex behaviors in sleep that appear purposeful, goal directed and voluntary but are outside the conscious awareness of the individual and therefore inappropriate. All of the sleep-related movement disorders described here have specific polysomnographic findings. For the purposes of developing and/or revising specifications and polysomnographic scoring rules, the AASM Scoring Manual Task Force on Movements in Sleep reviewed background literature and executed evidence grading of 81 relevant articles obtained by a literature search of published articles between 1966 and 2004. Subsequent evidence grading identified limited evidence for reliability and/or validity for polysomnographic scoring criteria for periodic limb movements in sleep, REM sleep behavior disorder, and sleep bruxism. Published scoring criteria for rhythmic movement disorder, excessive fragmentary myoclonus, and hypnagogic foot tremor/alternating leg muscle activation were empirical and based on descriptive studies. The literature review disclosed no published evidence defining clinical consequences of excessive fragmentary myoclonus or hypnagogic foot tremor/alternating leg muscle activation. Because of limited or absent evidence for reliability and/or validity, a standardized RAND/UCLA consensus process was employed for recommendation of specific rules for the scoring of sleep-associated movements.

e-Bitter: Bitterant Prediction by the Consensus Voting From the Machine-Learning Methods

Directory of Open Access Journals (Sweden)

Suqing Zheng

2018-03-01

Full Text Available In-silico bitterant prediction received the considerable attention due to the expensive and laborious experimental-screening of the bitterant. In this work, we collect the fully experimental dataset containing 707 bitterants and 592 non-bitterants, which is distinct from the fully or partially hypothetical non-bitterant dataset used in the previous works. Based on this experimental dataset, we harness the consensus votes from the multiple machine-learning methods (e.g., deep learning etc. combined with the molecular fingerprint to build the bitter/bitterless classification models with five-fold cross-validation, which are further inspected by the Y-randomization test and applicability domain analysis. One of the best consensus models affords the accuracy, precision, specificity, sensitivity, F1-score, and Matthews correlation coefficient (MCC of 0.929, 0.918, 0.898, 0.954, 0.936, and 0.856 respectively on our test set. For the automatic prediction of bitterant, a graphic program “e-Bitter” is developed for the convenience of users via the simple mouse click. To our best knowledge, it is for the first time to adopt the consensus model for the bitterant prediction and develop the first free stand-alone software for the experimental food scientist.

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

Myocardium at risk assessed by electrocardiographic scores and cardiovascular magnetic resonance - a MITOCARE substudy

DEFF Research Database (Denmark)

Sejersten, Maria; Fakhri, Yama; Pape, Marianne

2017-01-01

Introduction The myocardium at risk (MaR) represents the quantitative ischemic area destined to myocardial infarction (MI) if no reperfusion therapy is initiated. Different ECG scores for MaR have been developed, but there is no consensus as to which should be preferred. Objective Comparisons...... of ECG scores and Cardiac Magnetic Resonance (CMR) for determining MaR. Methods MaR was determined by 3 different ECG scores, and by CMR in ST-segment elevation MI (STEMI) patients from the MITOCARE cardioprotection trial. The Aldrich score (AL) is based on the number of leads with ST-elevation...... for anterior MI and the sum of ST-segment elevation for inferior MI on the admission ECG. The van Hellemond score (VH) considers both the ischemic and infarcted component of the MaR by adding the AL and the QRS score, which is an estimate of final infarct size. The Hasche score is based on the maximal possible...

AMS 4.0: consensus prediction of post-translational modifications in protein sequences.

Science.gov (United States)

Plewczynski, Dariusz; Basu, Subhadip; Saha, Indrajit

2012-08-01

We present here the 2011 update of the AutoMotif Service (AMS 4.0) that predicts the wide selection of 88 different types of the single amino acid post-translational modifications (PTM) in protein sequences. The selection of experimentally confirmed modifications is acquired from the latest UniProt and Phospho.ELM databases for training. The sequence vicinity of each modified residue is represented using amino acids physico-chemical features encoded using high quality indices (HQI) obtaining by automatic clustering of known indices extracted from AAindex database. For each type of the numerical representation, the method builds the ensemble of Multi-Layer Perceptron (MLP) pattern classifiers, each optimising different objectives during the training (for example the recall, precision or area under the ROC curve (AUC)). The consensus is built using brainstorming technology, which combines multi-objective instances of machine learning algorithm, and the data fusion of different training objects representations, in order to boost the overall prediction accuracy of conserved short sequence motifs. The performance of AMS 4.0 is compared with the accuracy of previous versions, which were constructed using single machine learning methods (artificial neural networks, support vector machine). Our software improves the average AUC score of the earlier version by close to 7 % as calculated on the test datasets of all 88 PTM types. Moreover, for the selected most-difficult sequence motifs types it is able to improve the prediction performance by almost 32 %, when compared with previously used single machine learning methods. Summarising, the brainstorming consensus meta-learning methodology on the average boosts the AUC score up to around 89 %, averaged over all 88 PTM types. Detailed results for single machine learning methods and the consensus methodology are also provided, together with the comparison to previously published methods and state-of-the-art software tools. The

Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK.

Science.gov (United States)

Pressler, Ronit M; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G

2017-08-01

Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

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.

Automated Quantification of the Landing Error Scoring System With a Markerless Motion-Capture System.

Science.gov (United States)

Mauntel, Timothy C; Padua, Darin A; Stanley, Laura E; Frank, Barnett S; DiStefano, Lindsay J; Peck, Karen Y; Cameron, Kenneth L; Marshall, Stephen W

2017-11-01

  The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle.   To determine the reliability of an automated markerless motion-capture system for scoring the LESS.   Cross-sectional study.   United States Military Academy.   A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg).   Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score.   We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons.   A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use

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

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.

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

Delphi consensus of an expert committee in oncogeriatrics regarding comprehensive geriatric assessment in seniors with cancer in Spain.

Science.gov (United States)

Molina-Garrido, Maria-Jose; Guillén-Ponce, Carmen; Blanco, Remei; Saldaña, Juana; Feliú, Jaime; Antonio, Maite; López-Mongil, Rosa; Ramos Cordero, Primitivo; Gironés, Regina

2018-07-01

The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66.7% coincidence in responses and by the stability of said coincidence (changes ≤15% between rounds). The study was conducted between July and December 2016. Of the 17 people invited to participate, 16 agreed. The panel concluded by consensus that the following domains should be included in the CGA:(and the scales to evaluate them): functional (Barthel Index, Lawton-Brody scale, gait speed), cognitive (Pfeiffer questionnaire), nutritional (Mini Nutritional Assessment - MNA), psychological/mood (Yesavage scale), social-familial (Gijon scale), comorbidity (Charlson index), medications, and geriatric syndromes (urinary and/or fecal incontinence, low auditory and/or visual acuity, presence of falls, pressure sores, insomnia, and abuse). Also by consensus, the CGA should be administered to older patients with cancer for whom there is a subsequent therapeutic intent and who scored positive on a previous frailty-screening questionnaire. After 3 rounds, consensus was reached regarding CGA domains to be used in older patients with cancer, the scales to be administered for each of these domains, as well as the timeline to be followed during consultation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Pulmonary Exacerbation Score in Cystlc Fibrosis Patients: Reliability and Validity Testing

OpenAIRE

Keller, F.

2016-01-01

Background: Lung disease in cystic fibrosis (CF) is characterized by recurrent pulmonary exacerbations (PEs), but consensus on diagnostic criteria for PE is lacking. The use of a consistent definition of PE as an outcome measure in CF clinical trials would allow meaningful comparison across centers. The aim of this study was to assess the reliability and validity of a simplified version of the Seattle Pulmonary Exacerbation Score (SPEX). Materials and Methods: A cross-sectional observational ...

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.

A Family of Algorithms for Computing Consensus about Node State from Network Data

Science.gov (United States)

Brush, Eleanor R.; Krakauer, David C.; Flack, Jessica C.

2013-01-01

Biological and social networks are composed of heterogeneous nodes that contribute differentially to network structure and function. A number of algorithms have been developed to measure this variation. These algorithms have proven useful for applications that require assigning scores to individual nodes–from ranking websites to determining critical species in ecosystems–yet the mechanistic basis for why they produce good rankings remains poorly understood. We show that a unifying property of these algorithms is that they quantify consensus in the network about a node's state or capacity to perform a function. The algorithms capture consensus by either taking into account the number of a target node's direct connections, and, when the edges are weighted, the uniformity of its weighted in-degree distribution (breadth), or by measuring net flow into a target node (depth). Using data from communication, social, and biological networks we find that that how an algorithm measures consensus–through breadth or depth– impacts its ability to correctly score nodes. We also observe variation in sensitivity to source biases in interaction/adjacency matrices: errors arising from systematic error at the node level or direct manipulation of network connectivity by nodes. Our results indicate that the breadth algorithms, which are derived from information theory, correctly score nodes (assessed using independent data) and are robust to errors. However, in cases where nodes “form opinions” about other nodes using indirect information, like reputation, depth algorithms, like Eigenvector Centrality, are required. One caveat is that Eigenvector Centrality is not robust to error unless the network is transitive or assortative. In these cases the network structure allows the depth algorithms to effectively capture breadth as well as depth. Finally, we discuss the algorithms' cognitive and computational demands. This is an important consideration in systems in which

Disease scoring systems for oral lichen planus; a critical appraisal

Science.gov (United States)

Wang, Jing

2015-01-01

The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity of both the objective and subjective parameters used in these systems and the lack of acceptance of one of these systems for uniform use, there is a need for an international, authorized consensus meeting on this subject. Because of the natural course of OLP characterized by remissions and exacerbations and also due to the varying distribution pattern and the varying clinical types, e.g. reticular and erosive, the relevance of a DSS based on morphologic parameters is somewhat questionable. Instead, one may consider to only look for a quality of life scoring system adapted for use in OLP patients. Key words:Oral lichen planus, disease scoring system, classification. PMID:25681372

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.

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.

Erratum: Development, appraisal, validation and implementation of a consensus protocol for the assessment of cerebral amyloid angiopathy in post-mortem brain tissue.

Science.gov (United States)

Love, Seth; Chalmers, Katy; Ince, Paul; Esiri, Margaret; Attems, Johannes; Kalaria, Raj; Jellinger, Kurt; Yamada, Masahito; McCarron, Mark; Minett, Thais; Matthews, Fiona; Greenberg, Steven; Mann, David; Kehoe, Patrick Gavin

2015-01-01

In a collaboration involving 11 groups with research interests in cerebral amyloid angiopathy (CAA), we used a two-stage process to develop and in turn validate a new consensus protocol and scoring scheme for the assessment of CAA and associated vasculopathic abnormalities in post-mortem brain tissue. Stage one used an iterative Delphi-style survey to develop the consensus protocol. The resultant scoring scheme was tested on a series of digital images and paraffin sections that were circulated blind to a number of scorers. The scoring scheme and choice of staining methods were refined by open-forum discussion. The agreed protocol scored parenchymal and meningeal CAA on a 0-3 scale, capillary CAA as present/absent and vasculopathy on 0-2 scale, in the 4 cortical lobes that were scored separately. A further assessment involving three centres was then undertaken. Neuropathologists in three centres (Bristol, Oxford and Sheffield) independently scored sections from 75 cases (25 from each centre) and high inter-rater reliability was demonstrated. Stage two used the results of the three-centre assessment to validate the protocol by investigating previously described associations between APOE genotype (previously determined), and both CAA and vasculopathy. Association of capillary CAA with or without arteriolar CAA with APOE ε4 was confirmed. However APOE ε2 was also found to be a strong risk factor for the development of CAA, not only in AD but also in elderly non-demented controls. Further validation of this protocol and scoring scheme is encouraged, to aid its wider adoption to facilitate collaborative and replication studies of CAA.[This corrects the article on p. 19 in vol. 3, PMID: 24754000.].

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.

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…

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.

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...

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

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.

Translation and cultural adaptation of the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS v2.0).

Science.gov (United States)

Santos, Maria Fernanda Oliveira; Barros, Cristina Palmer; Silva, Carlos Henrique Martins da; Paro, Helena Borges Martins da Silva

2017-11-04

To translate and culturally adapt the Pediatric Eosinophilic Esophagitis Symptom Score (version 2.0), a tool used to assess pediatric eosinophilic esophagitis symptoms reported by patients and/or their parents/caregivers. The Pediatric Eosinophilic Esophagitis Symptom Score was translated through the following stages: initial translation, back-translation, and consensus of independent reviewers through the Delphi technique. The pre-final version of the Pediatric Eosinophilic Esophagitis Symptom Score was applied to five 8-to-18-year-old patients and to ten parents of two-to-18-year-old patients from an outpatient pediatric gastroenterology service (pre-test). During the translation process, no translations presenting with difficult consensus in the review process or grammar inconsistencies were observed. During the pre-test, difficulties in comprehension of some unconventional terms, e.g., "náusea", were observed. Adverbs of frequency, such as "quase nunca" were also identified as being of difficult understanding by patients and parents, and the substitution by the term "raramente" was suggested. Such difficulties may be inherent to the pediatric age group. Age 8 years or above should be considered adequate for the self-reporting of symptoms. The study presents the Brazilian version of the Pediatric Eosinophilic Esophagitis Symptom Score, which is adapted to the Brazilian culture. This version may be introduced as a clinical and research tool for the assessment of patients with esophagic disease symptoms. The Pediatric Eosinophilic Esophagitis Symptom Score is a breakthrough in the evaluation of symptoms of pediatric eosinophilic esophagitis, since it reinforces the importance of self-reporting by patients who experience this disease. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Recommendations for the use of new oral anticoagulants (NOACs) after TIA or stroke caused by atrial fibrillation (AF), after a consensus conference among Italian neurologists (the Venice group).

Science.gov (United States)

Toso, Vito

2014-05-01

Vascular neurologists of Veneto and Friuli Venezia Giulia, north-east regions of Italy, have sought an agreement on the two following questions: (A) what prophylactic treatment should we recommend to patients with a stroke ascribed to atrial fibrillation (AF), who were not previously on antithrombotic treatment, to prevent further strokes? (B) What should we do in the event of an ischemic or hemorrhagic stroke associated with AF in patients who were already on antithrombotic treatment? There was a unanimous consensus for preferring the new oral anticoagulants (NOACs) in patients not taking any antithrombotics and in cases treated with antithrombotic drugs (coumadin and/or antiplatelets), due to a lower incidence of intracranial bleeding complications and a noninferiority for recurrent stroke or TIA. Even after intracranial bleeding complications, when it is useful or necessary to continue anticoagulant treatment, the group of experts preferred the NOACs, suggesting, however, to be very cautious in cases with widespread leukoaraiosis or microbleeds, practice frequent monitoring of creatinine clearance (CrCl) and avoid using NOACs when CrCl is <30 mL/min.

Rational consensus under uncertainty: Expert judgment in the EC-USNRC uncertainty study

International Nuclear Information System (INIS)

Cooke, R.; Kraan, B.; Goossens, L.

1999-01-01

Governmental bodies are confronted with the problem of achieving rational consensus in the face of substantial uncertainties. The area of accident consequence management for nuclear power plants affords a good example. Decisions with regard to evacuation, decontamination, and food bans must be taken on the basis of predictions of environmental transport of radioactive material, contamination through the food chain, cancer induction, and the like. These predictions use mathematical models containing scores of uncertain parameters. Decision makers want to take, and want to be perceived to take, these decisions in a rational manner. The question is, how can this be accomplished in the face of large uncertainties? Indeed, the very presence of uncertainty poses a threat to rational consensus. Decision makers will necessarily base their actions on the judgments of experts. The experts, however, will not agree among themselves, as otherwise we would not speak of large uncertainties. Any given expert's viewpoint will be favorable to the interests of some stakeholders, and hostile to the interests of others. If a decision maker bases his/her actions on the views of one single expert, then (s)he is invariably open to charges of partiality toward the interests favored by this viewpoint. An appeal to 'impartial' or 'disinterested' experts will fail for two reasons. First, experts have interests; they have jobs, mortgages and professional reputations. Second, even if expert interests could somehow be quarantined, even then the experts would disagree. Expert disagreement is not explained by diverging interests, and consensus cannot be reached by shielding the decision process from expert interests. If rational consensus requires expert agreement, then rational consensus is simply not possible in the face of uncertainty. If rational consensus under uncertainty is to be achieved, then evidently the views of a diverse set of experts must be taken into account. The question is how

Committee Structure and its Implications for Monetary Policy Decision-making

NARCIS (Netherlands)

J.M. Berk (Jan Marc); B.K. Bierut

2003-01-01

textabstractWe investigate the implications for the setting of interest rates when monetary policy decisions are taken by a committee, in which a subset of members may meet prior to the voting in the committee and therefore has the possibility to reach consensus ex ante to vote unanimously ex post.

Committee structure and its implications for monetary policy decision-making

NARCIS (Netherlands)

Bierut, B.K.; Berk, J.M.

2003-01-01

We investigate the implications for the setting of interest rates when monetary policy decisions are taken by a committee, in which a subset of membersmay meet prior to the voting in the committee and therefore has the possibility to reach consensus ex ante to vote unanimously ex post. We allow

2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation

Directory of Open Access Journals (Sweden)

Chern-En Chiang, MD, PhD

2017-08-01

Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs, knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS aimed to update the available information, and appointed the Practice Guideline sub-committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub-committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.

Horizon scanning for invasive alien species with the potential to threaten biodiversity in Great Britain.

Science.gov (United States)

Roy, Helen E; Peyton, Jodey; Aldridge, David C; Bantock, Tristan; Blackburn, Tim M; Britton, Robert; Clark, Paul; Cook, Elizabeth; Dehnen-Schmutz, Katharina; Dines, Trevor; Dobson, Michael; Edwards, François; Harrower, Colin; Harvey, Martin C; Minchin, Dan; Noble, David G; Parrott, Dave; Pocock, Michael J O; Preston, Chris D; Roy, Sugoto; Salisbury, Andrew; Schönrogge, Karsten; Sewell, Jack; Shaw, Richard H; Stebbing, Paul; Stewart, Alan J A; Walker, Kevin J

2014-12-01

Invasive alien species (IAS) are considered one of the greatest threats to biodiversity, particularly through their interactions with other drivers of change. Horizon scanning, the systematic examination of future potential threats and opportunities, leading to prioritization of IAS threats is seen as an essential component of IAS management. Our aim was to consider IAS that were likely to impact on native biodiversity but were not yet established in the wild in Great Britain. To achieve this, we developed an approach which coupled consensus methods (which have previously been used for collaboratively identifying priorities in other contexts) with rapid risk assessment. The process involved two distinct phases: Preliminary consultation with experts within five groups (plants, terrestrial invertebrates, freshwater invertebrates, vertebrates and marine species) to derive ranked lists of potential IAS. Consensus-building across expert groups to compile and rank the entire list of potential IAS. Five hundred and ninety-one species not native to Great Britain were considered. Ninety-three of these species were agreed to constitute at least a medium risk (based on score and consensus) with respect to them arriving, establishing and posing a threat to native biodiversity. The quagga mussel, Dreissena rostriformis bugensis, received maximum scores for risk of arrival, establishment and impact; following discussions the unanimous consensus was to rank it in the top position. A further 29 species were considered to constitute a high risk and were grouped according to their ranked risk. The remaining 63 species were considered as medium risk, and included in an unranked long list. The information collated through this novel extension of the consensus method for horizon scanning provides evidence for underpinning and prioritizing management both for the species and, perhaps more importantly, their pathways of arrival. Although our study focused on Great Britain, we suggest

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.

PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee.

Science.gov (United States)

Rillo, Oscar; Riera, Humberto; Acosta, Carlota; Liendo, Verónica; Bolaños, Joyce; Monterola, Ligia; Nieto, Edgar; Arape, Rodolfo; Franco, Luisa M; Vera, Mariflor; Papasidero, Silvia; Espinosa, Rolando; Esquivel, Jorge A; Souto, Renee; Rossi, Cesar; Molina, José F; Salas, José; Ballesteros, Francisco; Radrigan, Francisco; Guibert, Marlene; Reyes, Gil; Chico, Araceli; Camacho, Walter; Urioste, Lorena; Garcia, Abraham; Iraheta, Isa; Gutierrez, Carmen E; Aragón, Raúl; Duarte, Margarita; Gonzalez, Margarita; Castañeda, Oswaldo; Angulo, Juan; Coimbra, Ibsen; Munoz-Louis, Roberto; Saenz, Ricardo; Vallejo, Carlos; Briceño, Julio; Acuña, Ramón P; De León, Anibal; Reginato, Anthony M; Möller, Ingrid; Caballero, Carlo V; Quintero, Maritza

2016-10-01

The objective of this consensus is to update the recommendations for the treatment of hand, hip, and knee osteoarthritis (OA) by agreeing on key propositions relating to the management of hand, hip, and knee OA, by identifying and critically appraising research evidence for the effectiveness of the treatments and by generating recommendations based on a combination of the available evidence and expert opinion of 18 countries of America. Recommendations were developed by a group of 48 specialists of rheumatologists, members of other medical disciplines (orthopedics and physiatrists), and three patients, one for each location of OA. A systematic review of existing articles, meta-analyses, and guidelines for the management of hand, hip, and knee OA published between 2008 and January 2014 was undertaken. The scores for Level of Evidence and Grade of Recommendation were proposed and fully consented within the committee based on The American Heart Association Evidence-Based Scoring System. The level of agreement was established through a variation of Delphi technique. Both "strong" and "conditional" recommendations are given for management of hand, hip, and knee OA and nonpharmacological, pharmacological, and surgical modalities of treatment are presented according to the different levels of agreement. These recommendations are based on the consensus of clinical experts from a wide range of disciplines taking available evidence into account while balancing the benefits and risks of nonpharmacological, pharmacological, and surgical treatment modalities, and incorporating their preferences and values. Different backgrounds in terms of patient education or drug availability in different countries were not evaluated but will be important.

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.

A histopathological score on baseline biopsies from elderly donors predicts outcome 1 year after renal transplantation

DEFF Research Database (Denmark)

Toft, Birgitte G; Federspiel, Birgitte H; Sørensen, Søren S

2012-01-01

wall thickness of arteries and/or arterioles. Nineteen renal baseline biopsies from 15 donors (age: 64 ± 10 years) were included and following consensus the histopathological score was 4.3 ± 2.1 (intraclass correlation coefficient: 0.81; confidence interval: 0.66-0.92). The donor organs were used......Kidneys from elderly deceased patients and otherwise marginal donors may be considered for transplantation and a pretransplantation histopathological score for prediction of postoperative outcome is warranted. In a retrospective design, 29 baseline renal needle biopsies from elderly deceased donors...... Danish donors a histopathological score on baseline renal needle biopsies, with at least ten glomeruli and one artery present, predicts graft function 1 year after transplantation....

Inter-reader agreement of multi-parametric MR imaging for the detection of prostate cancer. Evaluation of a scoring system

International Nuclear Information System (INIS)

Quentin, M.; Roehlen, S.; Klasen, J.; Antoch, G.; Blondin, D.; Arsov, C.; Albers, P.

2012-01-01

Purpose: Functional prostate MR is performed in varying combinations of T2-weighted images with diffusion-weighted imaging (DWI), dynamic contrast-enhanced MRI (DCE-MRI), and spectroscopic imaging (MRSI). Recently, a European consensus meeting proposed the use of a simple 5-point scale for estimating the probability of a lesion being malignant. The aim of the present study was to determine the inter-reader agreement of MR imaging using a scoring system based on the recommendations of the consensus. Materials and Methods: The appearance of 108 predefined lesions in three different MR sequences (T2-weighted images, DWI, and DCE-MRI) in 50 functional prostate MR examinations were retrospectively scored by three blinded radiologists using a 5-point scale for each MR sequence. After scoring T2/DWI and T2/DWI/DCE-MRI, every lesion was graded based on its probability for malignancy. The inter-observer reliability was evaluated using Kappa statistics (Κ). Results: With respect to T2-weighted images, DWI and DCE-MRI Κ was 0.49, 0.97, and 0.77, respectively. Combined scoring of T2-weighted images and DWI demonstrated correct tumor diagnosis (true positive) in 71 - 88 % (depending on reader) of cases (Κ = 0.78). The accuracy was further improved to 88 - 96 % after scoring all three MR sequences including DCE-MRI (Κ = 0.90). Conclusion: The use of a simple 5-point scoring system for T2-weighted images, DWI, and DCE-MRI is feasible in functional prostate MRI and has high inter-observer reliability.

A proposal of group decision making procedure for supporting social consensus making

International Nuclear Information System (INIS)

Shimizu, Yoshiaki

1996-01-01

Being interested in supporting social consensus making, in this paper, we have proposed a group decision making procedure through conflict resolution in the following situation: each group has a different privilege with decision making; the final goal should be evaluated by a few qualitative sub-goals besides quantitative ones. For this purpose, we have developed a step-wise procedure that has been popularly adapted when encountered with complicated and large-scale problem-solving. As well as at the value system design phase, we applied the analytic hierarchy process, AHP to decide weights standing for the privilege at the decision making phase. Then, after rearranging the hierarchy of the sub-goals depending on the nature, we have provided an iterative procedure to derive a final solution from a discrete optimization problem. To reduce the difficulties of multi-objective decision making thereat, we took a scoring method for total evaluation and applied the genetic algorithm as a solution method. Through numerical experiments applied to a planning problem of the radioactive waste management system, we have shown numerically the proposed approach is very promising for social consensus making. (author)

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.

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.

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.

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.

CRISP: Catheterization RISk score for Pediatrics: A Report from the Congenital Cardiac Interventional Study Consortium (CCISC).

Science.gov (United States)

Nykanen, David G; Forbes, Thomas J; Du, Wei; Divekar, Abhay A; Reeves, Jaxk H; Hagler, Donald J; Fagan, Thomas E; Pedra, Carlos A C; Fleming, Gregory A; Khan, Danyal M; Javois, Alexander J; Gruenstein, Daniel H; Qureshi, Shakeel A; Moore, Phillip M; Wax, David H

2016-02-01

We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures. Systematic assessment of risk of SAE in pediatric catheterization can be challenging in view of a wide variation in procedure and patient complexity as well as rapidly evolving technology. A 10 component scoring system was originally developed based on expert consensus and review of the existing literature. Data from an international multi-institutional catheterization registry (CCISC) between 2008 and 2013 were used to validate this scoring system. In addition we used multivariate methods to further refine the original risk score to improve its predictive power of SAE's. Univariate analysis confirmed the strong correlation of each of the 10 components of the original risk score with SAE attributed to a pediatric cardiac catheterization (P pediatric cardiac catheterization procedures. © 2015 Wiley Periodicals, Inc.

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.

Predicting Consensus Structures for RNA Alignments Via Pseudo-Energy Minimization

Directory of Open Access Journals (Sweden)

Junilda Spirollari

2009-01-01

Full Text Available Thermodynamic processes with free energy parameters are often used in algorithms that solve the free energy minimization problem to predict secondary structures of single RNA sequences. While results from these algorithms are promising, an observation is that single sequence-based methods have moderate accuracy and more information is needed to improve on RNA secondary structure prediction, such as covariance scores obtained from multiple sequence alignments. We present in this paper a new approach to predicting the consensus secondary structure of a set of aligned RNA sequences via pseudo-energy minimization. Our tool, called RSpredict, takes into account sequence covariation and employs effective heuristics for accuracy improvement. RSpredict accepts, as input data, a multiple sequence alignment in FASTA or ClustalW format and outputs the consensus secondary structure of the input sequences in both the Vienna style Dot Bracket format and the Connectivity Table format. Our method was compared with some widely used tools including KNetFold, Pfold and RNAalifold. A comprehensive test on different datasets including Rfam sequence alignments and a multiple sequence alignment obtained from our study on the Drosophila X chromosome reveals that RSpredict is competitive with the existing tools on the tested datasets. RSpredict is freely available online as a web server and also as a jar file for download at http:// datalab.njit.edu/biology/RSpredict.

A summary of the recommendations adopted unanimously at the Fourth World Conference on Women (4-15 September 1995).

Science.gov (United States)

1996-01-01

This article presents a summary of the platform of action recommendations adopted unanimously at the Fourth World Conference on Women in 1995. The Platform called for the empowerment of women; the protection of human rights and freedoms throughout the life cycle; and equity at home, at work, and abroad, items that reinforced the Beijing Declaration. This article identifies recommended actions on poverty, education and training, health, domestic violence, armed conflict, economy, decision-making, institutional mechanisms, human rights, mass media, environment, the girl-child, and institutional and financial arrangements. The Platform recommends, for example, action to create macroeconomic policies and development strategies that address the needs of women in poverty. It recommends changes in laws and administrative practices to ensure women's equal rights and access to economic resources. It recommends action to ensure equal access to education throughout the life cycle, to eradicate illiteracy among women, to develop nondiscriminatory education and training, and to allocate sufficient resources for educational reform. It recommends action to increase women's access throughout the life cycle to appropriate, affordable, and quality health care, information, and related services. Action should reduce maternal mortality by at least 50% of 1990 levels by the year 2000, and a further 50% by 2015. Legislation must be adopted to end violence against women in peace and wartime. Action must promote women's economic and human rights and women's equal access to and full participation in power structures and government decision-making.

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

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.

Do Schools Owe a Special Duty of Care to "Special-Needs" Students?

Science.gov (United States)

Fossey, Richard; Russo, Charles J.

2009-01-01

Schools officials owe a duty of care to all the students in their custody. An emerging, but not unanimous, judicial consensus seems to agree that school board officials have a greater legal duty when supervising students with disabilities. A case on this important issue arose in "Jennifer C. v. Los Angeles Unified School District"…

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...

Developing an international scoring system for a consensus-based social cognition measure: MSCEIT-managing emotions.

Science.gov (United States)

Hellemann, G S; Green, M F; Kern, R S; Sitarenios, G; Nuechterlein, K H

2017-10-01

Measures of social cognition are increasingly being applied to psychopathology, including studies of schizophrenia and other psychotic disorders. Tests of social cognition present unique challenges for international adaptations. The Mayer-Salovey-Caruso Emotional Intelligence Test, Managing Emotions Branch (MSCEIT-ME) is a commonly-used social cognition test that involves the evaluation of social scenarios presented in vignettes. This paper presents evaluations of translations of this test in six different languages based on representative samples from the relevant countries. The goal was to identify items from the MSCEIT-ME that show different response patterns across countries using indices of discrepancy and content validity criteria. An international version of the MSCEIT-ME scoring was developed that excludes items that showed undesirable properties across countries. We then confirmed that this new version had better performance (i.e. less discrepancy across regions) in international samples than the version based on the original norms. Additionally, it provides scores that are comparable to ratings based on local norms. This paper shows that it is possible to adapt complex social cognitive tasks so they can provide valid data across different cultural contexts.

The use of early warning scores to recognise and respond to patient deterioration in district nursing.

Science.gov (United States)

Tucker, Guy; Lusher, Adele

2018-02-02

This discussion article focuses on the literature surrounding early warning scoring systems and their use in primary care, specifically within district nursing. Patient deterioration is a global concern, associated with high mortality rates and avoidable deaths. Early recognition and response by nursing and other health care staff has been attributed to early warning scoring systems (EWSS) and tools. However, the use of equivalent tools in the community appears to be lacking. This review concludes that there is no consensus over the use of EWSS in district nursing and culture of practice is varied, rather than standardised.

[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.

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

A consensus for the development of a vector model to assess clinical complexity.

Science.gov (United States)

Corazza, Gino Roberto; Klersy, Catherine; Formagnana, Pietro; Lenti, Marco Vincenzo; Padula, Donatella

2017-12-01

The progressive rise in multimorbidity has made management of complex patients one of the most topical and challenging issues in medicine, both in clinical practice and for healthcare organizations. To make this easier, a score of clinical complexity (CC) would be useful. A vector model to evaluate biological and extra-biological (socio-economic, cultural, behavioural, environmental) domains of CC was proposed a few years ago. However, given that the variables that grade each domain had never been defined, this model has never been used in clinical practice. To overcome these limits, a consensus meeting was organised to grade each domain of CC, and to establish the hierarchy of the domains. A one-day consensus meeting consisting of a multi-professional panel of 25 people was held at our Hospital. In a preliminary phase, the proponents selected seven variables as qualifiers for each of the five above-mentioned domains. In the course of the meeting, the panel voted for five variables considered to be the most representative for each domain. Consensus was established with 2/3 agreement, and all variables were dichotomised. Finally, the various domains were parametrized and ranked within a feasible vector model. A Clinical Complexity Index was set up using the chosen variables. All the domains were graphically represented through a vector model: the biological domain was chosen as the most significant (highest slope), followed by the behavioural and socio-economic domains (intermediate slope), and lastly by the cultural and environmental ones (lowest slope). A feasible and comprehensive tool to evaluate CC in clinical practice is proposed herein.

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.

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...

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

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

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.

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 ...

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...

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).

Limited consensus around ARM information protection practices ...

African Journals Online (AJOL)

An existing enterprise IP SoP was adapted to ARM through literature analysis and produced a draft ARM SoP. The draft ARM SoP was applied in a rote fashion to a small sample of government-operated archives to identify likely areas of consensus and lack of consensus surrounding the various elements of the SoP.

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.

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

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.

75 FR 70074 - Consensus Standards, Light-Sport Aircraft

Science.gov (United States)

2010-11-16

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Consensus Standards, Light-Sport... accepted consensus standards relating to the provisions of the Sport Pilot and Light-Sport Aircraft rule issued July 16, 2004, and effective September 1, 2004. ASTM International Committee F37 on Light Sport...

Expert consensus on the classification of subtype in Budd-Chiari syndrome

Directory of Open Access Journals (Sweden)

Expert committee on Vane Cava Obstruction,Specialized CommitteeofEndovascology,ChineseMedicalDoctorAssociation

2017-07-01

Full Text Available From 2012 to 2015 the Department of Interventional Radiology of the Affiliated Hospital of Xuzhou Medical University undertook the clinical special research subject ”Study on the standardization of interventional diagnosis and treatment of Budd- Chiari syndrome”（No. BL2012021）， a program supported by the Department of Science and Technology of Jiangsu Province. Based on the clinical results of three years research and the scientific summary of the experience from more than 2150 cases accumulated in more than 20 years， the Department of Interventional Radiology of the Affiliated Hospital of Xuzhou Medical University presided over a demonstration meeting about “the standardization of interventional diagnosis and treatment of Budd- Chiari syndrome” on January 14， 2016 in Xuzhou City of Jiangsu Province， China. The scholars from the Expert Committee on Vena Cava Obstruction of Specialized Committee of Endovascology， Chinese Medical Doctor Association， as well as the experts from the related medical fields， including interventional radiology， vascular surgery， pathology and diagnostic imaging， who have been engaged in the study of Budd- Chiari syndrome， attended the meeting， and in the meeting the participants made a full and thorough discussion on the classification and subtypes of Budd - Chiari syndrome. The scholars and experts have unanimously reached a consensus on the subtype definition of Budd- Chiari syndrome: the Budd Chiari syndrome is suggested to be classified into the hepatic vein occlusion subtype， the inferior vena cava occlusion subtype and mixed occlusion subtype， including 10 subtype entities in total. The hepatic vein occlusion subtype includes membranous occlusion of hepatic vein/accessory hepatic vein， segmental occlusion of hepatic vein， extensive occlusion of hepatic vein， and hepatic vein occlusion associated with thrombus formation. The inferior vena cava occlusion subtype

Expert surgical consensus for prenatal counseling using the Delphi method.

Science.gov (United States)

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

2017-11-28

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

Consensus Through Conversation How to Achieve High-Commitment Decisions

CERN Document Server

Dressler, Larry

2006-01-01

Facilitation expert Larry Dressler's Consensus Through Conversation is a guide for the effective facilitation and practice of one of business's most popular - but most widely misunderstood - decision-making models: consensus.

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

Science.gov (United States)

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

2015-09-01

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

H∞ Consensus for Multiagent Systems with Heterogeneous Time-Varying Delays

Directory of Open Access Journals (Sweden)

Beibei Wang

2013-01-01

Full Text Available We apply the linear matrix inequality method to consensus and H∞ consensus problems of the single integrator multiagent system with heterogeneous delays in directed networks. To overcome the difficulty caused by heterogeneous time-varying delays, we rewrite the multiagent system into a partially reduced-order system and an integral system. As a result, a particular Lyapunov function is constructed to derive sufficient conditions for consensus of multiagent systems with fixed (switched topologies. We also apply this method to the H∞ consensus of multiagent systems with disturbances and heterogeneous delays. Numerical examples are given to illustrate the theoretical results.

Combating a two-decade campaign attacking the scientific consensus on climate change

International Nuclear Information System (INIS)

Cook, J.

2013-01-01

New research published this year found that among peer-reviewed climate papers stating a position on anthropogenic global warning, over 97% endorsed the scientific consensus that humans were causing climate change. Meanwhile, the public think there is a 50/50 consensus among climate scientists. The article analyses how such a wide consensus gap has developed. At the beginning there was a misinformation campaign originated from opponents of climate action who rather than propose alternative policy solutions to climate change instead opted to attack the science. A key strategy was (and still is) creating the illusion of ongoing debate by magnifying the voices of a few dissenting scientists. Another common technique is the promotion of 'fake experts', using spokespeople unqualified in climate research. It is not easy to close the consensus gap because public perception of consensus is strongly associated with political ideology: the more conservative you are, the lower the consensus you perceive. Closing the consensus gap is absolutely necessary because when people perceive that scientists agree on an issue, they are more likely to support that issue. An intense information campaign focusing on the 97% consensus might be efficient to topple the fifty/fifty consensus. (A.C.)

Optimizing the pre-referral workup for gastroenterology and hepatology specialty care: consensus using the Delphi method.

Science.gov (United States)

Ho, Chanda K; Boscardin, Christy K; Gleason, Nathaniel; Collado, Don; Terdiman, Jonathan; Terrault, Norah A; Gonzales, Ralph

2016-02-01

Specialty care referrals have doubled in the last decade. Optimization of the pre-referral workup by a primary care doctor can lead to a more efficient first specialty visit with the patient. Guidance regarding pre-referral laboratory testing is a first step towards improving the specialty referral process. Our aim was to establish consensus regarding appropriate pre-referral workup for common gastrointestinal and liver conditions. The Delphi method was used to establish local consensus for recommending certain laboratory tests prior to specialty referral for 13 clinical conditions. Seven conditions from The University of Michigan outpatient referral guidelines were used as a baseline. An expert panel of three PCPs and nine gastroenterologists from three academic hospitals participated in three iterative rounds of electronic surveys. Each panellist ranked each test using a 5-point Likert scale (strongly disagree to strongly agree). Local panellists could recommend additional tests for the initial diagnoses, and also recommended additional diagnoses needing guidelines: iron deficiency anaemia, abdominal pain, irritable bowel syndrome, fatty liver disease, liver mass and cirrhosis. Consensus was defined as ≥70% of experts scoring ≥4 (agree or strongly agree). Applying Delphi methodology to extrapolate externally developed referral guidelines for local implementation resulted in considerable modifications. For some conditions, many tests from the external group were eliminated by the local group (abdominal bloating; iron deficiency anaemia; irritable bowel syndrome). In contrast, for chronic diarrhoea, abnormal liver enzymes and viral hepatitis, all/most original tests were retained with additional tests added. For liver mass, fatty liver disease and cirrhosis, there was high concordance among the panel with few tests added or eliminated. Consideration of externally developed referral guidelines using a consensus-building process leads to significant local

The Importance of Consensus Information in Acceptance of Climate Change (Invited)

Science.gov (United States)

Cook, J.; Lewandowsky, S.

2013-12-01

In recent years, public perception of the scientific consensus on human-caused global warming has been disturbingly low, in contrast to the overwhelming level of agreement among climate scientists and in peer-reviewed research. The misperception is partly cultural, with a significant link between perceived consensus and political ideology, and partly informational with all cultural groups exhibiting the misperception to varying degrees. This universal 'consensus gap' is in large part due to a persistent and focused misinformation campaign casting doubt on the consensus, dating back as early as the 1980s. Opponents of climate action have long recognized that perception of scientific consensus is linked to support for climate policy, a link only acknowledged by social scientists in the last few years. How do we counter the all-too-effective misinformation campaign? Psychological research tells us that a crucial aspect of effective refutations is an alternative narrative. In this case, an important counter-narrative to the consensus story is the strategy to perpetuate the impression of ongoing scientific debate. I will also present recent research into the effect that consensus information has on climate beliefs of Australians and Americans. For both groups, the consensus message significantly increased beliefs about human-caused global warming and outperformed interventions that feature evidence or scientists' expertise. For the Australian sample, consensus information partially neutralised the biasing influence of ideology. However, for Americans, a backfire effect (reduced climate belief) was observed for a small minority holding strong conservative views. A psychological model employing Bayesian Networks indicates that a key element to the backfire effect is conspiratorial thinking, consistent with other research finding a link between rejection of climate science and conspiratorial ideation. Thus when presented to a general audience, consensus information has an

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...

CONSTRUCT VALIDITY AND SCORING METHODS OF THE WORLD HEALTH ORGANIZATION- HEALTH AND WORK PERFORMANCE QUESTIONNAIRE AMONG WORKERS WITH ARTHRITIS AND RHEUMATOLOGICAL CONDITIONS

Science.gov (United States)

AlHeresh, Rawan; LaValley, Michael P.; Coster, Wendy; Keysor, Julie J.

2017-01-01

Objective To evaluate construct validity and scoring methods of the world health organization- health and work performance questionnaire (HPQ) for people with arthritis. Methods Construct validity was examined through hypothesis testing using the recommended guidelines of the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Results The HPQ using the absolute scoring method showed moderate construct validity as 4 of the 7 hypotheses were met. The HPQ using the relative scoring method had weak construct validity as only one of the 7 hypotheses were met. Conclusion The absolute scoring method for the HPQ is superior in construct validity to the relative scoring method in assessing work performance among people with arthritis and related rheumatic conditions; however, more research is needed to further explore other psychometric properties of the HPQ. PMID:28598938

Construct Validity and Scoring Methods of the World Health Organization: Health and Work Performance Questionnaire Among Workers With Arthritis and Rheumatological Conditions.

Science.gov (United States)

AlHeresh, Rawan; LaValley, Michael P; Coster, Wendy; Keysor, Julie J

2017-06-01

To evaluate construct validity and scoring methods of the world health organization-health and work performance questionnaire (HPQ) for people with arthritis. Construct validity was examined through hypothesis testing using the recommended guidelines of the consensus-based standards for the selection of health measurement instruments (COSMIN). The HPQ using the absolute scoring method showed moderate construct validity as four of the seven hypotheses were met. The HPQ using the relative scoring method had weak construct validity as only one of the seven hypotheses were met. The absolute scoring method for the HPQ is superior in construct validity to the relative scoring method in assessing work performance among people with arthritis and related rheumatic conditions; however, more research is needed to further explore other psychometric properties of the HPQ.

Communitarian Consensus: A New Social Philosophy for Good ...

African Journals Online (AJOL)

... and discuss the communitarian consensus as a new social philosophy of development and reconstruction for Africa. The notion of consensus as first canvassed by Kwasi Wiredu, is an important element in traditional African societies. It revolves around the view that African should be able to speak with one voice on issues ...

Convergence speed of consensus problems over undirected scale-free networks

International Nuclear Information System (INIS)

Sun Wei; Dou Li-Hua

2010-01-01

Scale-free networks and consensus behaviour among multiple agents have both attracted much attention. To investigate the consensus speed over scale-free networks is the major topic of the present work. A novel method is developed to construct scale-free networks due to their remarkable power-law degree distributions, while preserving the diversity of network topologies. The time cost or iterations for networks to reach a certain level of consensus is discussed, considering the influence from power-law parameters. They are both demonstrated to be reversed power-law functions of the algebraic connectivity, which is viewed as a measurement on convergence speed of the consensus behaviour. The attempts of tuning power-law parameters may speed up the consensus procedure, but it could also make the network less robust over time delay at the same time. Large scale of simulations are supportive to the conclusions. (general)

Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal

NARCIS (Netherlands)

Schwendicke, F.; Frencken, J.E.; Bjorndal, L.; Maltz, M.; Manton, D.J.; Ricketts, D.; Van Landuyt, K.; Banerjee, A.; Campus, G.; Domejean, S.; Fontana, M.; Leal, S.; Lo, E.; Machiulskiene, V.; Schulte, A.; Splieth, C.; Zandona, A.F.; Innes, N.P.

2016-01-01

The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental

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.

Consensus Making in Requirements Negotiation: the communication perspective

Directory of Open Access Journals (Sweden)

Jenny Price

2005-11-01

Full Text Available When developing an Information System (IS, organizational goals of various stakeholders are commonly in direct conflict. Furthermore, individuals often rank their private objectives well over their management's directions. Recognising and reconciling all these diverse goals, and reaching agreement among the stakeholders, are prerequisite to establishing project cooperation and collaboration. This paper focuses, in particular, on the negotiation and consensus making during requirements elicitation - the earliest stages of the IS development process. As requirements elicitation involves rich communication between project stakeholders, we therefore explore negotiation and consensus making from the communication perspective. The resulting model assists our understanding of the communication factors that influence the consensus process during requirements negotiation.

Involving patients in a multidisciplinary European consensus process and in the development of a 'patient summary of the consensus document for colon and rectal cancer care'.

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Boelens, Petra G; Taylor, Claire; Henning, Geoffrey; Marang-van de Mheen, Perla J; Espin, Eloy; Wiggers, Theo; Gore-Booth, Jola; Moss, Barbara; Valentini, Vincenzo; van de Velde, Cornelis J H

2014-01-01

High-quality cancer care should be accessible for patients and healthcare professionals. Involvement of patients as partners in guideline formation and consensus processes is still rarely found. EURECCA, short for European Registration of Cancer Care, is the platform to improve outcomes of cancer care by reducing variation in the diagnostic and treatment process. EURECCA acknowledges the important role of patients in implementation of consensus information in clinical practice. The aim of this article is to describe the process of involving patients in the consensus process and in developing the patient summary of the consensus for colon and rectal cancer care. The Delphi method for achieving consensus was used. Three online voting rounds and one tele-voting round were offered to an expert panel of oncology professionals and patient representatives. At four different stages, patients and/or patient representatives were involved in the process: (1) during the consensus process, (2) lecturing about the role of the patient, (3) development of the patient summary, and (4) testing the patient summary. Representatives were invited to the voting and commenting rounds of this process and given an equal vote. Although patients were not consulted during the planning stages of this process, patient involvement increased following the panel's discussion of the implementation of the consensus among the patient population. After the consensus meeting, the patient summary was written by patient representatives, oncologists and nurses. A selection of proactive patients reviewed the draft patient summary; responses were positive and several patient-reported outcomes were added. Questionnaires to evaluate the use and implementation of the patient summary in daily practice are currently being developed and tested. Patient consultation will be needed in future planning for selection of topics. The present study may function as a model for future consensus processes to involve patients

Developing consensus-based policy solutions for medicines adherence for Europe: a delphi study

Science.gov (United States)

2012-01-01

Background Non-adherence to prescribed medication is a pervasive problem that can incur serious effects on patients’ health outcomes and well-being, and the availability of resources in healthcare systems. This study aimed to develop practical consensus-based policy solutions to address medicines non-adherence for Europe. Methods A four-round Delphi study was conducted. The Delphi Expert Panel comprised 50 participants from 14 countries and was representative of: patient/carers organisations; healthcare providers and professionals; commissioners and policy makers; academics; and industry representatives. Participants engaged in the study remotely, anonymously and electronically. Participants were invited to respond to open questions about the causes, consequences and solutions to medicines non-adherence. Subsequent rounds refined responses, and sought ratings of the relative importance, and operational and political feasibility of each potential solution to medicines non-adherence. Feedback of individual and group responses was provided to participants after each round. Members of the Delphi Expert Panel and members of the research group participated in a consensus meeting upon completion of the Delphi study to discuss and further refine the proposed policy solutions. Results 43 separate policy solutions to medication non-adherence were agreed by the Panel. 25 policy solutions were prioritised based on composite scores for importance, and operational and political feasibility. Prioritised policy solutions focused on interventions for patients, training for healthcare professionals, and actions to support partnership between patients and healthcare professionals. Few solutions concerned actions by governments, healthcare commissioners, or interventions at the system level. Conclusions Consensus about practical actions necessary to address non-adherence to medicines has been developed for Europe. These actions are also applicable to other regions. Prioritised

Refining the global spatial limits of dengue virus transmission by evidence-based consensus.

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Oliver J Brady

Full Text Available Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.A baseline methodology was used to assess a range of evidence for each country. In regions where dengue status was uncertain, additional evidence types were included to either clarify dengue status or confirm that it is unknown at this time. An algorithm was developed that assesses evidence quality and consistency, giving each country an evidence consensus score. Using this approach, we were able to generate a contemporary global map of national-level dengue status that assigns a relative measure of certainty and identifies gaps in the available evidence.The map produced here provides a list of 128 countries for which there is good evidence of dengue occurrence, including 36 countries that have previously been classified as dengue-free by the World Health Organization and/or the US Centers for Disease Control. It also identifies disease surveillance needs, which we list in full. The disease extents and limits determined here using evidence consensus, marks the beginning of a five-year study to advance the mapping of dengue virus transmission and disease risk. Completion of this first step has allowed us to produce a preliminary estimate of population at risk with an upper bound of 3.97 billion people. This figure will be refined in future work.

Realization of consensus of multi-agent systems with stochastically mixed interactions

Energy Technology Data Exchange (ETDEWEB)

Sun, Yongzheng, E-mail: yzsung@gmail.com; Li, Wang [School of Science, China University of Mining and Technology, Xuzhou 221008 (China); Zhao, Donghua [School of Mathematical Sciences, Fudan University, Shanghai 200433 (China)

2016-07-15

In this paper, we propose a new consensus model in which the interactions among agents stochastically switch between attraction and repulsion. Such a positive-and-negative mechanism is described by the white-noise-based coupling. Analytic criteria for the consensus and non-consensus in terms of the eigenvalues of the noise intensity matrix are derived, which provide a better understanding of the constructive roles of random interactions. Specifically, we discover a positive role of noise coupling that noise can accelerate the emergence of consensus. We find that the converging speed of the multi-agent network depends on the square of the second smallest eigenvalue of its graph Laplacian. The influence of network topologies on the consensus time is also investigated.

Judicial Deference Allows European Consensus to Emerge

DEFF Research Database (Denmark)

Dothan, Shai

2018-01-01

jurisdiction. But the ECHR sometimes defers to countries, even if their policies fall short of the standard accepted by most of the countries in Europe. This deference is accomplished by using the so-called "margin of appreciation" doctrine. Naturally, emerging consensus and margin of appreciation are often......, the paper demonstrates that a correct application of the margin of appreciation doctrine actually helps emerging consensus reach optimal results, by giving countries an incentive to make their policies independently....

Laparoscopic adhesiolysis: consensus conference guidelines.

Science.gov (United States)

Vettoretto, N; Carrara, A; Corradi, A; De Vivo, G; Lazzaro, L; Ricciardelli, L; Agresta, F; Amodio, C; Bergamini, C; Borzellino, G; Catani, M; Cavaliere, D; Cirocchi, R; Gemini, S; Mirabella, A; Palasciano, N; Piazza, D; Piccoli, M; Rigamonti, M; Scatizzi, M; Tamborrino, E; Zago, M

2012-05-01

Laparoscopic adhesiolysis has been demonstrated to be technically feasible in small bowel obstruction and carries advantages in terms of post-surgical course. The increasing dissemination of laparoscopic surgery in the emergency setting and the lack of concrete evidence in the literature have called for a consensus conference to draw recommendations for clinical practice. A literature search was used to outline the evidence, and a consensus conference was held between experts in the field. A survey of international experts added expertise to the debate. A public jury of surgeons discussed and validated the statements, and the entire process was reviewed by three external experts. Recommendations concern the diagnostic evaluation, the timing of the operation, the selection of patients, the induction of the pneumoperitoneum, the removal of the cause of obstructions, the criteria for conversion, the use of adhesion-preventing agents, the need for high-technology dissection instruments and behaviour in the case of misdiagnosed hernia or the need for bowel resection. Evidence of this kind of surgery is scanty because of the absence of randomized controlled trials. Nevertheless laparoscopic skills in emergency are widespread. The recommendations given with the consensus process might be a useful tool in the hands of surgeons. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

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

Food Security: The Elaboration of Contested Claims to a Consensus Frame

Science.gov (United States)

Mooney, Patrick H.; Hunt, Scott A.

2009-01-01

This article demonstrates Gamson's claim that behind the apparent agreement implied by "consensus frames" lies considerable dissensus. Ironically, the very potency of consensus frames may generate contested claims to the ownership of a social problem. Food security is a potent consensus frame that has generated at least three distinct collective…

30 CFR Appendix I to Subpart M of... - National Consensus Standards

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false National Consensus Standards I Appendix I to... Machinery and Equipment Pt. 56, Subpt. M, App. I Appendix I to Subpart M of Part 56—National Consensus... object protective structures (FOPS) may consult the following national consensus standards, as applicable...

29 CFR Appendix B to Subpart L of... - National Consensus Standards

Science.gov (United States)

2010-07-01

... 29 Labor 5 2010-07-01 2010-07-01 false National Consensus Standards B Appendix B to Subpart L of... Appendix B to Subpart L of Part 1910—National Consensus Standards The following table contains a cross-reference listing of those current national consensus standards which contains information and guidelines...

Genome-wide conserved consensus transcription factor binding motifs are hyper-methylated

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Down Thomas A

2010-09-01

Full Text Available Abstract Background DNA methylation can regulate gene expression by modulating the interaction between DNA and proteins or protein complexes. Conserved consensus motifs exist across the human genome ("predicted transcription factor binding sites": "predicted TFBS" but the large majority of these are proven by chromatin immunoprecipitation and high throughput sequencing (ChIP-seq not to be biological transcription factor binding sites ("empirical TFBS". We hypothesize that DNA methylation at conserved consensus motifs prevents promiscuous or disorderly transcription factor binding. Results Using genome-wide methylation maps of the human heart and sperm, we found that all conserved consensus motifs as well as the subset of those that reside outside CpG islands have an aggregate profile of hyper-methylation. In contrast, empirical TFBS with conserved consensus motifs have a profile of hypo-methylation. 40% of empirical TFBS with conserved consensus motifs resided in CpG islands whereas only 7% of all conserved consensus motifs were in CpG islands. Finally we further identified a minority subset of TF whose profiles are either hypo-methylated or neutral at their respective conserved consensus motifs implicating that these TF may be responsible for establishing or maintaining an un-methylated DNA state, or whose binding is not regulated by DNA methylation. Conclusions Our analysis supports the hypothesis that at least for a subset of TF, empirical binding to conserved consensus motifs genome-wide may be controlled by DNA methylation.

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

Science.gov (United States)

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

2004-05-01

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

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

Treatment of adrenocorticotropin-dependent cushing's syndrome: A consensus statement

NARCIS (Netherlands)

B.M.K. Biller; A. Grossman (Ashley Barry); P.M. Stewart; S. Melmed (Shlomo); X. Bertagna; J. Bertherat (Jerome); M. Buchfelder; A. Colao (Annamaria); A.R.M.M. Hermus (Ad); L.J. Hofland (Leo); A. Klibanski; A. Lacroix; J.R. Lindsay; J. Newell-Price (John); L.K. Nieman; S. Petersenn; N. Sonino; G.K. Stalla (Günter); B. Swearingen; M.L. Vance; J.A.H. Wass (John); M. Boscaro

2008-01-01

textabstractObjective: Our objective was to evaluate the published literature and reach a consensus on the treatment of patients with ACTH-dependent Cushing's syndrome, because there is no recent consensus on the management of this rare disorder. Participants: Thirty-two leading endocrinologists,

Treatment of adrenocorticotropin-dependent Cushing's syndrome: a consensus statement.

NARCIS (Netherlands)

Biller, B.M.; Grossman, A.B.; Stewart, P.M.; Melmed, S.; Bertagna, X.; Bertherat, J.; Buchfelder, M.; Colao, A.; Hermus, A.R.M.M.; Hofland, L.J.; Klibanski, A.; Lacroix, A.; Lindsay, J.R.; Newell-Price, J.; Nieman, L.K.; Petersenn, S.; Sonino, N.; Stalla, G.K.; Swearingen, B.; Vance, M.L.; Wass, J.A.; Boscaro, M.

2008-01-01

OBJECTIVE: Our objective was to evaluate the published literature and reach a consensus on the treatment of patients with ACTH-dependent Cushing's syndrome, because there is no recent consensus on the management of this rare disorder. PARTICIPANTS: Thirty-two leading endocrinologists, clinicians,

Consensus Among International Ethical Guidelines for the Provision of Videoconferencing-Based Mental Health Treatments

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Wakefield, Claire E; McGill, Brittany C; Wilson, Helen L; Patterson, Pandora

2016-01-01

Background Online technologies may reduce barriers to evidence-based mental health care, yet they also create numerous ethical challenges. Recently, numerous professional organizations and expert groups have produced best-practice guidelines to assist mental health professionals in delivering online interventions in an ethically and clinically sound manner. However, there has been little critical examination of these international best-practice guidelines regarding appropriate electronic mental health (e-mental health) service delivery via technologies such as videoconferencing (including Skype), particularly for specific, vulnerable populations. Further, the extent to which concordance exists between these guidelines remains unclear. Synthesizing this literature to provide clear guidance to both mental health professionals and researchers is critical to ensure continued progress in the field of e-mental health. Objective This study aims to review all currently available ethical and best-practice guidelines relating to videoconferencing-delivered mental health treatments in order to ascertain the recommendations for which international consensus could be found. Additionally, this review examines the extent to which each set of guidance addresses several key special populations, including children and young people, and populations living with illness. Methods This systematic review examined guidelines using a two-armed search strategy, examining (1) professional organizations’ published guidance; and (2) MEDLINE, PsycINFO, and EMBASE for the past ten years. In order to determine consensus for best-practice, a recommendation was considered "firm" if 50% or more of the reviewed guidelines endorsed it and "tentative" if recommended by fewer guidelines than these. The professional guidelines were also scored by two raters using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) criteria. Results In the study, 19 guidelines were included, yielding 11

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

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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.

Pediatric psycho-oncology care: standards, guidelines, and consensus reports.

Science.gov (United States)

Wiener, Lori; Viola, Adrienne; Koretski, Julia; Perper, Emily Diana; Patenaude, Andrea Farkas

2015-02-01

The aim of this study was to identify existing guidelines, standards, or consensus-based reports for psychosocial care of children with cancer and their families. Psychosocial standards of care for children with cancer can systematize the approach to care and create a replicable model that can be utilized in pediatric hospitals around the world. Determining gaps in existing standards in pediatric psycho-oncology can guide development of useful evidence-based and consensus-based standards. The MEDLINE and PubMed databases were searched by investigators at two major pediatric oncology centers for existing guidelines, consensus-based reports, or standards for psychosocial care of patients with pediatric cancer and their families published in peer-reviewed journals in English between 1980 and 2013. We located 27 articles about psychosocial care that met inclusion criteria: 5 set forth standards, 19 were guidelines, and 3 were consensus-based reports. None was sufficiently up to date, comprehensive, specific enough, or evidence- or consensus-based to serve as a current standard for psychosocial care for children with cancer and their families. Despite calls by a number of international pediatric oncology and psycho-oncology professional organizations about the urgency of addressing the psychosocial needs of the child with cancer to reduce suffering, there remains a need for development of a widely acceptable, evidence-based and consensus-based, comprehensive standard of care to guide provision of essential psychosocial services to all patients with pediatric cancer. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety

NARCIS (Netherlands)

Ballenger, JC; Lecrubier, Y; Nutt, DJ; Baldwin, DS; den Boer, JA; Kasper, S; Shear, MK

1998-01-01

Objective: To provide primary care clinicians with a better understanding of management issues in panic disorder and guide clinical practice with recommendations for appropriate pharmacotherapy. Participants: The 4 members of the International Consensus Group on Depression and Anxiety were James C.

Male-female differences in Scoliosis Research Society-30 scores in adolescent idiopathic scoliosis.

Science.gov (United States)

Roberts, David W; Savage, Jason W; Schwartz, Daniel G; Carreon, Leah Y; Sucato, Daniel J; Sanders, James O; Richards, Benjamin Stephens; Lenke, Lawrence G; Emans, John B; Parent, Stefan; Sarwark, John F

2011-01-01

Longitudinal cohort study. To compare functional outcomes between male and female patients before and after surgery for adolescent idiopathic scoliosis (AIS). There is no clear consensus in the existing literature with respect to sex differences in functional outcomes in the surgical treatment of AIS. A prospective, consecutive, multicenter database of patients who underwent surgical correction for adolescent idiopathic scoliosis was analyzed retrospectively. All patients completed Scoliosis Research Society-30 (SRS-30) questionnaires before and 2 years after surgery. Patients with previous spine surgery were excluded. Data were collected for sex, age, Risser grade, previous bracing history, maximum preoperative Cobb angle, curve correction at 2 years, and SRS-30 domain scores. Paired sample t tests were used to compare preoperative and postoperative scores within each sex. Independent sample t tests were used to compare scores between sexes. A P value of Self-image/appearance had the greatest relative improvement. Males had better self-image/appearance scores preoperatively, better pain scores at 2 years, and better mental health and total scores both preoperatively and at 2 years. Both males and females were similarly satisfied with surgery. Males treated with surgery for AIS report better preoperative self-image, less postoperative pain, and better mental health than females. These differences may be clinically significant. For both males and females, the most beneficial effect of surgery is improved self-image/appearance. Overall, the benefits of surgery for AIS are similar for both sexes.

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.

New algorithm improves fine structure of the barley consensus SNP map

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Endelman Jeffrey B

2011-08-01

Full Text Available Abstract Background The need to integrate information from multiple linkage maps is a long-standing problem in genetics. One way to visualize the complex ordinal relationships is with a directed graph, where each vertex in the graph is a bin of markers. When there are no ordering conflicts between the linkage maps, the result is a directed acyclic graph, or DAG, which can then be linearized to produce a consensus map. Results New algorithms for the simplification and linearization of consensus graphs have been implemented as a package for the R computing environment called DAGGER. The simplified consensus graphs produced by DAGGER exactly capture the ordinal relationships present in a series of linkage maps. Using either linear or quadratic programming, DAGGER generates a consensus map with minimum error relative to the linkage maps while remaining ordinally consistent with them. Both linearization methods produce consensus maps that are compressed relative to the mean of the linkage maps. After rescaling, however, the consensus maps had higher accuracy (and higher marker density than the individual linkage maps in genetic simulations. When applied to four barley linkage maps genotyped at nearly 3000 SNP markers, DAGGER produced a consensus map with improved fine structure compared to the existing barley consensus SNP map. The root-mean-squared error between the linkage maps and the DAGGER map was 0.82 cM per marker interval compared to 2.28 cM for the existing consensus map. Examination of the barley hardness locus at the 5HS telomere, for which there is a physical map, confirmed that the DAGGER output was more accurate for fine structure analysis. Conclusions The R package DAGGER is an effective, freely available resource for integrating the information from a set of consistent linkage maps.

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.

Development and Reliability of a Preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score.

Science.gov (United States)

Halstead, Jill; Martín-Hervás, Carmen; Hensor, Elizabeth M A; McGonagle, Dennis; Keenan, Anne-Maree; Redmond, Anthony C; Conaghan, Philip G

2017-08-01

Foot osteoarthritis (OA) is very common but underinvestigated musculoskeletal condition and there is little consensus as to common magnetic resonance imaging (MRI) features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. This preliminary semiquantitative score included the hindfoot, midfoot, and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN; 0-3), osteophytes (0-3), joint effusion/synovitis, and bone cysts (present/absent). Erosions and bone marrow lesions (BML) were scored (0-3) and BML were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis (0-3) and midfoot ligament pathology (present/absent) were scored. Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols, and assessed using ICC as an overall score and per anatomical site. Intrareader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.90, osteophytes 0.90, effusion/synovitis 0.46, cysts 0.87), bone features (BML 0.83, erosion 0.66, BML entheses 0.66, BML sub-tendon 0.60) and soft tissue features (tenosynovitis 0.83, ligaments 0.77). Interreader agreement was lower for joint features (JSN 0.43, osteophytes 0.27, effusion/synovitis 0.02, cysts 0.48), bone features (BML 0.68, erosion 0.00, BML entheses 0.34, BML sub-tendon 0.13), and soft tissue features (tenosynovitis 0.35, ligaments 0.33). This preliminary FOAMRIS demonstrated good intrareader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.

Neural mechanisms underlying human consensus decision-making.

Science.gov (United States)

Suzuki, Shinsuke; Adachi, Ryo; Dunne, Simon; Bossaerts, Peter; O'Doherty, John P

2015-04-22

Consensus building in a group is a hallmark of animal societies, yet little is known about its underlying computational and neural mechanisms. Here, we applied a computational framework to behavioral and fMRI data from human participants performing a consensus decision-making task with up to five other participants. We found that participants reached consensus decisions through integrating their own preferences with information about the majority group members' prior choices, as well as inferences about how much each option was stuck to by the other people. These distinct decision variables were separately encoded in distinct brain areas-the ventromedial prefrontal cortex, posterior superior temporal sulcus/temporoparietal junction, and intraparietal sulcus-and were integrated in the dorsal anterior cingulate cortex. Our findings provide support for a theoretical account in which collective decisions are made through integrating multiple types of inference about oneself, others, and environments, processed in distinct brain modules. Copyright © 2015 Elsevier Inc. All rights reserved.

Tradução e adaptação transcultural do instrumento de avaliação do quadril "Harris Hip Score" Translation and cultural adaptation of the Harris Hip Score into portuguese

Directory of Open Access Journals (Sweden)

Rodrigo Pereira Guimarães

2010-01-01

Full Text Available OBJETIVO: O Harris Hip Score é instrumento de avaliação específica, desenvolvido originalmente para avaliar os resultados da artroplastia total de quadril. O objetivo deste estudo foi traduzir e adaptar culturalmente este instrumento para a língua portuguesa. MÉTODO: O método de tradução e adaptação cultural do Harris Hip Score envolveu quatro etapas: 1 - tradução inicial; 2 - retrotradução; 3 - apreciação das versões com elaboração da versão de consenso; 4 - pré-teste comentado com elaboração da versão final. RESULTADOS: A versão de consenso foi aplicada em 30 pacientes com afecção do quadril, sendo verificadas dificuldades no entendimento de algumas expressões, as quais foram substituídas por termos de mais fácil entendimento. Na reaplicação do questionário com a nova versão houve entendimento por 100% dos pacientes no que diz respeito ao sentido semântico, idiomático e contextual. CONCLUSÃO: A versão brasileira do Harris Hip Score permitiu a disponibilização de mais este instrumento para avaliação da qualidade de vida de pacientes com afecções do quadril. Há necessidade de um estudo de avaliação da confiabilidade e validade da versão adaptada culturalmente, a qual já está em desenvolvimento.OBJECTIVE: The Harris Hip Score is a specific evaluation tool, originally developed to assess the results of hip arthroplasty. The objective of this study was to translate and cross-culturally adapt the Harris Hip Score for the Portuguese language. METHOD: The method of translating and culturally adapting the Harris Hip Score involved four steps: 1 - initial translation, 2 - back-translation, 3 - evaluation of the pre-final versions with the development of a consensus version, 4 - commented pre-test with development of the final version. RESULTS: The consensus version was applied to thirty patients with hip disorders. Some difficulties were identified in understanding some expressions, which were replaced

Consensus of Heterogeneous Multiagent Systems with Arbitrarily Bounded Communication Delay

Directory of Open Access Journals (Sweden)

Xue Li

2017-01-01

Full Text Available This paper focuses on the consensus problem of high-order heterogeneous multiagent systems with arbitrarily bounded communication delays. Through the method of nonnegative matrices, we get a sufficient consensus condition for the systems with dynamically changing topology. The results of this paper show, even when there are arbitrarily bounded communication delays in the systems, all agents can reach a consensus no matter whether there are spanning trees for the corresponding communication graphs at any time.

Consensus of second-order multi-agent dynamic systems with quantized data

Energy Technology Data Exchange (ETDEWEB)

Guan, Zhi-Hong, E-mail: zhguan@mail.hust.edu.cn [Department of Control Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074 (China); Meng, Cheng [Department of Control Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074 (China); Liao, Rui-Quan [Petroleum Engineering College,Yangtze University, Jingzhou, 420400 (China); Zhang, Ding-Xue, E-mail: zdx7773@163.com [Petroleum Engineering College,Yangtze University, Jingzhou, 420400 (China)

2012-01-09

The consensus problem of second-order multi-agent systems with quantized link is investigated in this Letter. Some conditions are derived for the quantized consensus of the second-order multi-agent systems by the stability theory. Moreover, a result characterizing the relationship between the eigenvalues of the Laplacians matrix and the quantized consensus is obtained. Examples are given to illustrate the theoretical analysis. -- Highlights: ► A second-order multi-agent model with quantized data is proposed. ► Two sufficient and necessary conditions are obtained. ► The relationship between the eigenvalues of the Laplacians matrix and the quantized consensus is discovered.

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

DEFF Research Database (Denmark)

Roos, Ewa M.; Roos, H P; Lohmander, L S

1998-01-01

There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

End points for validating early warning scores in the context of rapid response systems

DEFF Research Database (Denmark)

Pedersen, N. E.; Oestergaard, D.; Lippert, A.

2016-01-01

with optimal treatment. This could pose a limitation to studies using these end points. We studied current expert opinion on end points for validating tools for the identification of patients in hospital wards at risk of imminent critical illness. METHODS: The Delphi consensus methodology was used. We......INTRODUCTION: When investigating early warning scores and similar physiology-based risk stratification tools, death, cardiac arrest and intensive care unit admission are traditionally used as end points. A large proportion of the patients identified by these end points cannot be saved, even...

Endodontic retreatment decisions: no consensus.

Science.gov (United States)

Aryanpour, S; Van Nieuwenhuysen, J P; D'Hoore, W

2000-05-01

The objectives of the present study were to: (i) evaluate the consensus, if any, amongst dental schools, students and their instructors managing the same clinical cases, all of which involved endodontically treated teeth; and (ii) determine the predominant proposed treatment option. Final year students, endodontic staff members and instructors of 10 European dental schools were surveyed as decision makers. Fourteen different radiographic cases of root canal treated teeth accompanied by a short clinical history were presented to them in a uniform format. For each case the decision makers were requested to: (i) choose only one out of nine treatment alternatives proposed, from 'no treatment' to 'extraction' via 'retreatment' and 'surgery' (ii) assess on two 5-point scales: the difficulty of making a decision, and the technical complexity of the retreatment procedure. The results indicate wide inter- and also intra-school disagreements in the clinical management of root canal treated teeth. Analysis of variance showed that the main source of variation was the 'school effect', explaining 1.8% (NS) to 18.6% (P < 0.0001) of the treatment variations. No other factor explained as much variance. Decision difficulty was moderately correlated to technical complexity (Pearsons' r ranging from 0.19 to 0.35, P < 0.0001). No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the 'school effect'.

Cofactor specificity switch in Shikimate dehydrogenase by rational design and consensus engineering.

Science.gov (United States)

García-Guevara, Fernando; Bravo, Iris; Martínez-Anaya, Claudia; Segovia, Lorenzo

2017-08-01

Consensus engineering has been used to design more stable variants using the most frequent amino acid at each site of a multiple sequence alignment; sometimes consensus engineering modifies function, but efforts have mainly been focused on studying stability. Here we constructed a consensus Rossmann domain for the Shikimate dehydrogenase enzyme; separately we decided to switch the cofactor specificity through rational design in the Escherichia coli Shikimate dehydrogenase enzyme and then analyzed the effect of consensus mutations on top of our design. We found that consensus mutations closest to the 2' adenine moiety increased the activity in our design. Consensus engineering has been shown to result in more stable proteins and our findings suggest it could also be used as a complementary tool for increasing or modifying enzyme activity during design. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Identifying differential miR and gene consensus patterns in peripheral blood of patients with cardiovascular diseases from literature data.

Science.gov (United States)

Šatrauskienė, Agnė; Navickas, Rokas; Laucevičius, Aleksandras; Huber, Heinrich J

2017-06-30

Numerous recent studies suggest the potential of circulating MicroRNAs (miRs) in peripheral blood samples as diagnostic or prognostic markers for coronary artery disease (CAD), acute coronary syndrome (ACS) and heart failure (HF). However, literature often remains inconclusive regarding as to which markers are most indicative for which of the above diseases. This shortcoming is mainly due to the lack of a systematic analyses and absence of information on the functional pathophysiological role of these miRs and their target genes. We here provide an-easy-to-use scoring approach to investigate the likelihood of regulation of several miRs and their target genes from literature by identifying consensus patterns of regulation. We therefore have screened over 1000 articles that study mRNA markers in cardiovascular and metabolic diseases, and devised a scoring algorithm to identify consensus means for miRs and genes regulation across several studies. We then aimed to identify differential markers between CAD, ACS and HF. We first identified miRs (miR-122, -126, -223, -138 and -370) as commonly regulated within a group of metabolic disease, while investigating cardiac-related pathologies (CAD, ACS, HF) revealed a decisive role of miR-1, -499, -208b, and -133a. Looking at differential markers between cardiovascular disease revealed miR-1, miR-208a and miR-133a to distinguish ACS and CAD to HF. Relating differentially expressed miRs to their putative gene targets using MirTarBase, we further identified HCN2/4 and LASP1 as potential markers of CAD and ACS, but not in HF. Likewise, BLC-2 was found oppositely regulated between CAD and HF. Interestingly, while studying overlap in target genes between CAD, ACS and HF only revealed little similarities, mapping these genes to gene ontology terms revealed a surprising similarity between CAD and ACS compared to HF. We conclude that our analysis using gene and miR scores allows the extraction of meaningful markers and the elucidation

Second-Order Consensus for Multiagent Systems With Directed Topologies and Nonlinear Dynamics

NARCIS (Netherlands)

Yu, Wenwu; Chen, Guanrong; Cao, Ming; Kurths, Juergen; Kurths, Jürgen

This paper considers a second-order consensus problem for multiagent systems with nonlinear dynamics and directed topologies where each agent is governed by both position and velocity consensus terms with a time-varying asymptotic velocity. To describe the system's ability for reaching consensus, a

Consensus of satellite cluster flight using an energy-matching optimal control method

Science.gov (United States)

Luo, Jianjun; Zhou, Liang; Zhang, Bo

2017-11-01

This paper presents an optimal control method for consensus of satellite cluster flight under a kind of energy matching condition. Firstly, the relation between energy matching and satellite periodically bounded relative motion is analyzed, and the satellite energy matching principle is applied to configure the initial conditions. Then, period-delayed errors are adopted as state variables to establish the period-delayed errors dynamics models of a single satellite and the cluster. Next a novel satellite cluster feedback control protocol with coupling gain is designed, so that the satellite cluster periodically bounded relative motion consensus problem (period-delayed errors state consensus problem) is transformed to the stability of a set of matrices with the same low dimension. Based on the consensus region theory in the research of multi-agent system consensus issues, the coupling gain can be obtained to satisfy the requirement of consensus region and decouple the satellite cluster information topology and the feedback control gain matrix, which can be determined by Linear quadratic regulator (LQR) optimal method. This method can realize the consensus of satellite cluster period-delayed errors, leading to the consistency of semi-major axes (SMA) and the energy-matching of satellite cluster. Then satellites can emerge the global coordinative cluster behavior. Finally the feasibility and effectiveness of the present energy-matching optimal consensus for satellite cluster flight is verified through numerical simulations.

Prospective validation of a near real-time EHR-integrated automated SOFA score calculator.

Science.gov (United States)

Aakre, Christopher; Franco, Pablo Moreno; Ferreyra, Micaela; Kitson, Jaben; Li, Man; Herasevich, Vitaly

2017-07-01

We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota. We prospectively compared the accuracy of automated versus manual calculation for a sample of patients admitted to the medical intensive care unit at Mayo Clinic Hospitals in Rochester, Minnesota and Jacksonville, Florida. Agreement was calculated with Cohen's kappa statistic. Reason for discrepancy was tabulated during manual review. Random spot check comparisons were performed 134 times on 27 unique patients, and daily SOFA score comparisons were performed for 215 patients over a total of 1206 patient days. Agreement between automatically scored and manually scored SOFA components for both random spot checks (696 pairs, κ=0.89) and daily calculation (5972 pairs, κ=0.89) was high. The most common discrepancies were in the respiratory component (inaccurate fraction of inspired oxygen retrieval; 200/1206) and creatinine (normal creatinine in patients with no urine output on dialysis; 128/1094). 147 patients were at risk of developing sepsis after intensive care unit admission, 10 later developed sepsis confirmed by chart review. All were identified before onset of sepsis with the ΔSOFA≥2 point criterion and 46 patients were false-positives. Near real-time automated SOFA scoring was found to have strong agreement with manual score calculation and may be useful for the detection of sepsis utilizing the new SEPSIS-3 definition. Copyright © 2017 Elsevier B.V. All

Dynamical organization towards consensus in the Axelrod model on complex networks

Science.gov (United States)

Guerra, Beniamino; Poncela, Julia; Gómez-Gardeñes, Jesús; Latora, Vito; Moreno, Yamir

2010-05-01

We analyze the dynamics toward cultural consensus in the Axelrod model on scale-free networks. By looking at the microscopic dynamics of the model, we are able to show how culture traits spread across different cultural features. We compare the diffusion at the level of cultural features to the growth of cultural consensus at the global level, finding important differences between these two processes. In particular, we show that even when most of the cultural features have reached macroscopic consensus, there are still no signals of globalization. Finally, we analyze the topology of consensus clusters both for global culture and at the feature level of representation.

Transatlantic Multispecialty Consensus on Fundamental Endovascular Skills: Results of a Delphi Consensus Study.

Science.gov (United States)

Maertens, H; Aggarwal, R; Macdonald, S; Vermassen, F; Van Herzeele, I

2016-01-01

The aim of this study was to establish a consensus on Fundamental Endovascular Skills (FES) for educational purposes and development of training curricula for endovascular procedures. The term "Fundamental Endovascular Skills" is widely used; however, the current literature does not explicitly describe what skills are included in this concept. Endovascular interventions are performed by several specialties that may have opposing perspectives on these skills. A two round Delphi questionnaire approach was used. Experts from interventional cardiology, interventional radiology, and vascular surgery from the United States and Europe were invited to participate. An electronic questionnaire was generated by endovascular therapists with an appropriate educational background but who would not participate in subsequent rounds. The questionnaire consisted of 50 statements describing knowledge, technical, and behavioral skills during endovascular procedures. Experts received the questionnaires by email. They were asked to rate the importance of each skill on a Likert scale from 1 to 5. A statement was considered fundamental when more than 90% of the experts rated it 4 or 5 out of 5. Twenty-three of 53 experts invited agreed to participate: six interventional radiologists (2 USA, 4 Europe), 10 vascular surgeons (4 USA, 6 Europe), and seven interventional cardiologists (4 USA, 3 Europe). There was a 100% response rate in the first round and 87% in the second round. Results showed excellent consensus among responders (Cronbach's alpha = .95 first round; .93 second round). Ninety percent of all proposed skills were considered fundamental. The most critical skills were determined. A transatlantic multispecialty consensus was achieved about the content of "FES" among interventional radiologists, interventional cardiologists, and vascular surgeons from Europe and the United States. These results can serve as directive principles for developing endovascular training curricula

[Experts consensus of dental esthetic photography].

Science.gov (United States)

2017-05-09

Clinical photography in esthetic dentistry is an essential skill in clinical practice. It is widely applied clinically in multiple fields related to esthetic dentistry. Society of Esthetic Dentistry of Chinese Stomatological Association established a consensus for clinical photography and standards for images in esthetic dentistry in order to standardize domestic dental practitioners' procedure, and meet the demands of diagnosis and design in modern esthetic dentistry. It was also developed to facilitate domestic and international academic communication. Sixteen commonly used images in practice, which are of apparent importance in guiding esthetic analysis, design and implementation, are proposed in the standards. This consensus states the clinical significance of these images and the standard protocol of acquiring them.

The influence of theosophy on Mondrian's neoplastic work

OpenAIRE

Bris Marino, Pablo

2014-01-01

(ENG)The influence of Theosophy in the symbolist painting of Mondrian (1908-1911) has been unanimously recognized. There is not, however, the same consensus with respect to the influence of theosophy in his neoplastic period. There is a relationship between Mondrian’s theoretical writing and his practical work, but no proportionality. Mondrian’s theoretical discourse is not limited to painting and touches on other arts and disciplines (architecture,...

Power, conflict and consensus building in Africa: Ideology revisited ...

African Journals Online (AJOL)

This paper interrogates and rejects the effectiveness of consensus building as a mechanism for conflict resolution in Africa. Drawing from the conflict/consensus theoretical debates of the 1960s, the paper argues that because of the inherent character of power, and considering the nature of the state in Africa which is ...

Communicating and countering misconceptions about the scientific consensus on human-caused global warming

Science.gov (United States)

Cook, J.

2016-12-01

A number of studies have sought to quantify the level of agreement among climate scientists on human-caused global warming. This has included surveys of the scientific community, analyses of public declarations about climate change and analyses of peer-reviewed climate papers. This body of research has found that the level of consensus increases with expertise in climate science, culminating in 97% agreement among publishing climate scientists. Despite this robust finding, there is a significant gap between public perception of scientific consensus and the overwhelming agreement among climate scientists. This "consensus gap" is due in large part to a persistent, focused campaign to manufacture doubt about the scientific consensus by opponents of climate action. This campaign has employed non-expert spokespeople, magnified the small minority of dissenting scientists and exploited the journalistic norm of balance to generate the impression of an equal debate among scientists. Given the importance of perceived consensus as a "gateway belief" influencing a number of climate beliefs and attitudes, it is imperative that climate communicators close the consensus gap. This can be achieved by communicating the 97% consensus and explaining the techniques used to cast doubt on the consensus.

Distributed MPC based consensus for single-integrator multi-agent systems.

Science.gov (United States)

Cheng, Zhaomeng; Fan, Ming-Can; Zhang, Hai-Tao

2015-09-01

This paper addresses model predictive control schemes for consensus in multi-agent systems (MASs) with discrete-time single-integrator dynamics under switching directed interaction graphs. The control horizon is extended to be greater than one which endows the closed-loop system with extra degree of freedom. We derive sufficient conditions on the sampling period and the interaction graph to achieve consensus by using the property of infinite products of stochastic matrices. Consensus can be achieved asymptotically if the sampling period is selected such that the interaction graph among agents has a directed spanning tree jointly. Significantly, if the interaction graph always has a spanning tree, one can select an arbitrary large sampling period to guarantee consensus. Finally, several simulations are conducted to illustrate the effectiveness of the theoretical results. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Helicobacter pylori management in ASEAN: The Bangkok consensus report.

Science.gov (United States)

Mahachai, Varocha; Vilaichone, Ratha-Korn; Pittayanon, Rapat; Rojborwonwitaya, Jarin; Leelakusolvong, Somchai; Maneerattanaporn, Monthira; Chotivitayatarakorn, Peranart; Treeprasertsuk, Sombat; Kositchaiwat, Chomsri; Pisespongsa, Pises; Mairiang, Pisaln; Rani, Aziz; Leow, Alex; Mya, Swe Mon; Lee, Yi-Chia; Vannarath, Sengdao; Rasachak, Bouachanh; Chakravuth, Oung; Aung, Moe Myint; Ang, Tiing-Leong; Sollano, Jose D; Trong Quach, Duc; Sansak, Inchaya; Wiwattanachang, Olarn; Harnsomburana, Piyathida; Syam, Ari Fahrial; Yamaoka, Yoshio; Fock, Kwong-Ming; Goh, Khean-Lee; Sugano, Kentaro; Graham, David

2018-01-01

Helicobacter pylori (H. pylori) infection remains to be the major cause of important upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. H. pylori management in ASEAN: the Bangkok consensus report gathered key opinion leaders for the region to review and evaluate clinical aspects of H. pylori infection and to develop consensus statements, rationales, and grades of recommendation for the management of H. pylori infection in clinical practice in ASEAN countries. This ASEAN Consensus consisted of 34 international experts from 10 ASEAN countries, Japan, Taiwan, and the United States. The meeting mainly focused on four issues: (i) epidemiology and disease association; (ii) diagnostic tests; (iii) management; and (iv) follow-up after eradication. The final results of each workshop were presented for consensus voting by all participants. Statements, rationale, and recommendations were developed from the available current evidence to help clinicians in the diagnosis and treatment of H. pylori and its clinical diseases. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Blockchain Consensus Protocols in the Wild (Keynote Talk)

OpenAIRE

Cachin, Christian; Vukolic, 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...

Detecting community structure using label propagation with consensus weight in complex network

International Nuclear Information System (INIS)

Liang Zong-Wen; Li Jian-Ping; Yang Fan; Petropulu Athina

2014-01-01

Community detection is a fundamental work to analyse the structural and functional properties of complex networks. The label propagation algorithm (LPA) is a near linear time algorithm to find a good community structure. Despite various subsequent advances, an important issue of this algorithm has not yet been properly addressed. Random update orders within the algorithm severely hamper the stability of the identified community structure. In this paper, we executed the basic label propagation algorithm on networks multiple times, to obtain a set of consensus partitions. Based on these consensus partitions, we created a consensus weighted graph. In this consensus weighted graph, the weight value of the edge was the proportion value that the number of node pairs allocated in the same cluster was divided by the total number of partitions. Then, we introduced consensus weight to indicate the direction of label propagation. In label update steps, by computing the mixing value of consensus weight and label frequency, a node adopted the label which has the maximum mixing value instead of the most frequent one. For extending to different networks, we introduced a proportion parameter to adjust the proportion of consensus weight and label frequency in computing mixing value. Finally, we proposed an approach named the label propagation algorithm with consensus weight (LPAcw), and the experimental results showed that the LPAcw could enhance considerably both the stability and the accuracy of community partitions. (interdisciplinary physics and related areas of science and technology)

Second-Order Multiagent Systems with Event-Driven Consensus Control

Directory of Open Access Journals (Sweden)

Jiangping Hu

2013-01-01

Full Text Available Event-driven control scheduling strategies for multiagent systems play a key role in future use of embedded microprocessors of limited resources that gather information and actuate the agent control updates. In this paper, a distributed event-driven consensus problem is considered for a multi-agent system with second-order dynamics. Firstly, two kinds of event-driven control laws are, respectively, designed for both leaderless and leader-follower systems. Then, the input-to-state stability of the closed-loop multi-agent system with the proposed event-driven consensus control is analyzed and the bound of the inter-event times is ensured. Finally, some numerical examples are presented to validate the proposed event-driven consensus control.

A score model for the continuous grading of early allograft dysfunction severity.

Science.gov (United States)

Pareja, Eugenia; Cortes, Miriam; Hervás, David; Mir, José; Valdivieso, Andrés; Castell, José V; Lahoz, Agustín

2015-01-01

Early allograft dysfunction (EAD) dramatically influences graft and patient outcomes. A lack of consensus on an EAD definition hinders comparisons of liver transplant outcomes and management of recipients among and within centers. We sought to develop a model for the quantitative assessment of early allograft function [Model for Early Allograft Function Scoring (MEAF)] after transplantation. A retrospective study including 1026 consecutive liver transplants was performed for MEAF score development. Multivariate data analysis was used to select a small number of postoperative variables that adequately describe EAD. Then, the distribution of these variables was mathematically modeled to assign a score for each actual variable value. A model, based on easily obtainable clinical parameters (ie, alanine aminotransferase, international normalized ratio, and bilirubin) and scoring liver function from 0 to 10, was built. The MEAF score showed a significant association with patient and graft survival at 3-, 6- and 12-month follow-ups. Hepatic steatosis and age for donors; cold/warm ischemia times and postreperfusion syndrome for surgery; and intensive care unit and hospital stays, Model for End-Stage Liver Disease and Child-Pugh scores, body mass index, and fresh frozen plasma transfusions for recipients were factors associated significantly with EAD. The model was satisfactorily validated by its application to an independent set of 200 patients who underwent liver transplantation at a different center. In conclusion, a model for the quantitative assessment of EAD severity has been developed and validated for the first time. The MEAF provides a more accurate graft function assessment than current categorical classifications and may help clinicians to make early enough decisions on retransplantation benefits. Furthermore, the MEAF score is a predictor of recipient and graft survival. The standardization of the criteria used to define EAD may allow reliable comparisons of

False consensus in social context: differential projection and perceived social distance.

Science.gov (United States)

Jones, Paul E

2004-09-01

The study implicates the notion of perceived social distance as an explanation of why ingroup false consensus exceeds outgroup false consensus. Whilst previous demonstrations are best understood from social identity perspectives, the findings reported here suggest that self-group as well as inter-group comparisons can underlie such effects. In particular, perceived social distance was shown to mediate the effect of social categorisation: ingroup false consensus was greater because more social distance was perceived with the outgroup. The findings also extended to non-student samples and generalised across both opinion and ability items. In addition, examining the effect of item type in conjunction with social categorisation seriously challenged the generality of the false consensus effect.

Myocardial perfusion imaging and coronary calcium scoring with a two-slice SPECT/CT system: can the attenuation map be calculated from the calcium scoring CT scan?

Energy Technology Data Exchange (ETDEWEB)

Wenning, Christian; Rahbar, Kambiz; Schober, Otmar; Stegger, Lars [University of Muenster, Department of Nuclear Medicine, Muenster (Germany); Vrachimis, Alexis; Schaefers, Michael [University of Muenster, Department of Nuclear Medicine, Muenster (Germany); University of Muenster, European Institute for Molecular Imaging, Muenster (Germany)

2013-07-15

Coronary artery calcium scoring can complement myocardial perfusion imaging (MPI). The purpose of this study was to evaluate the feasibility and accuracy of using the CalciumScore-CT derived from a combined SPECT/CT device also for SPECT attenuation correction (AC). The study group comprised 99 patients who underwent both post-stress and rest MPI using a two-slice SPECT/CT system. For AC, one of the two scans was accompanied by a CalciumScore-CT scan (CalciumScore-CTAC) and the other by a conventional spiral CT (AttenCorr-CT) scan (AttenCorr-CTAC). In 48 patients the CalciumScore-CT scan was acquired with the post-stress scan and the AttenCorr-CT scan with the rest scan, and in 51 patients the order was reversed. The accuracy of the images based on AC was determined qualitatively by consensus reading with respect to the clinical diagnoses as well as quantitatively by comparing the perfusion summed stress scores (SSS) and the summed rest scores (SRS) between attenuation-corrected and uncorrected images. In comparison to the uncorrected images CalciumScore-CTAC led to regional inaccuracies in 14 of 51 of studies (27.5 %) versus 12 of 48 studies (25 %) with AttenCorr-CTAC for the stress studies and in 5 of 48 (10 %) versus 1 of 51 (2 %) for the rest studies, respectively. This led to intermediate and definite changes in the final diagnosis (ischaemia and/or scarring) in 12 % of the studies (12 of 99) and in 7 % of the studies (7 of 99) with CalciumScore-CTAC and in 9 % of the studies (9 of 99) and 4 % of the studies (4 of 99) with AttenCorr-CTAC. Differences in SSS and SRS with respect to the uncorrected images were greater for the CalciumScore-CTAC images than for the AttenCorr-CTAC images ({Delta}SSS 4.5 {+-} 5.6 and 2.1 {+-} 4.4, p = 0.023; {Delta}SRS 4.2 {+-} 4.9 and 1.6 {+-} 3.2, p = 0.004, respectively). Using the same CT scan for calcium scoring and SPECT AC is feasible. Image interpretation must, however, include uncorrected images since CT-based AC relatively

Learning gene regulatory networks from gene expression data using weighted consensus

KAUST Repository

Fujii, Chisato; Kuwahara, Hiroyuki; Yu, Ge; Guo, Lili; Gao, Xin

2016-01-01

An accurate determination of the network structure of gene regulatory systems from high-throughput gene expression data is an essential yet challenging step in studying how the expression of endogenous genes is controlled through a complex interaction of gene products and DNA. While numerous methods have been proposed to infer the structure of gene regulatory networks, none of them seem to work consistently over different data sets with high accuracy. A recent study to compare gene network inference methods showed that an average-ranking-based consensus method consistently performs well under various settings. Here, we propose a linear programming-based consensus method for the inference of gene regulatory networks. Unlike the average-ranking-based one, which treats the contribution of each individual method equally, our new consensus method assigns a weight to each method based on its credibility. As a case study, we applied the proposed consensus method on synthetic and real microarray data sets, and compared its performance to that of the average-ranking-based consensus and individual inference methods. Our results show that our weighted consensus method achieves superior performance over the unweighted one, suggesting that assigning weights to different individual methods rather than giving them equal weights improves the accuracy. © 2016 Elsevier B.V.

Learning gene regulatory networks from gene expression data using weighted consensus

KAUST Repository

Fujii, Chisato

2016-08-25

An accurate determination of the network structure of gene regulatory systems from high-throughput gene expression data is an essential yet challenging step in studying how the expression of endogenous genes is controlled through a complex interaction of gene products and DNA. While numerous methods have been proposed to infer the structure of gene regulatory networks, none of them seem to work consistently over different data sets with high accuracy. A recent study to compare gene network inference methods showed that an average-ranking-based consensus method consistently performs well under various settings. Here, we propose a linear programming-based consensus method for the inference of gene regulatory networks. Unlike the average-ranking-based one, which treats the contribution of each individual method equally, our new consensus method assigns a weight to each method based on its credibility. As a case study, we applied the proposed consensus method on synthetic and real microarray data sets, and compared its performance to that of the average-ranking-based consensus and individual inference methods. Our results show that our weighted consensus method achieves superior performance over the unweighted one, suggesting that assigning weights to different individual methods rather than giving them equal weights improves the accuracy. © 2016 Elsevier B.V.

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.

Sampled-Data Consensus of Linear Multi-agent Systems With Packet Losses.

Science.gov (United States)

Zhang, Wenbing; Tang, Yang; Huang, Tingwen; Kurths, Jurgen

In this paper, the consensus problem is studied for a class of multi-agent systems with sampled data and packet losses, where random and deterministic packet losses are considered, respectively. For random packet losses, a Bernoulli-distributed white sequence is used to describe packet dropouts among agents in a stochastic way. For deterministic packet losses, a switched system with stable and unstable subsystems is employed to model packet dropouts in a deterministic way. The purpose of this paper is to derive consensus criteria, such that linear multi-agent systems with sampled-data and packet losses can reach consensus. By means of the Lyapunov function approach and the decomposition method, the design problem of a distributed controller is solved in terms of convex optimization. The interplay among the allowable bound of the sampling interval, the probability of random packet losses, and the rate of deterministic packet losses are explicitly derived to characterize consensus conditions. The obtained criteria are closely related to the maximum eigenvalue of the Laplacian matrix versus the second minimum eigenvalue of the Laplacian matrix, which reveals the intrinsic effect of communication topologies on consensus performance. Finally, simulations are given to show the effectiveness of the proposed results.In this paper, the consensus problem is studied for a class of multi-agent systems with sampled data and packet losses, where random and deterministic packet losses are considered, respectively. For random packet losses, a Bernoulli-distributed white sequence is used to describe packet dropouts among agents in a stochastic way. For deterministic packet losses, a switched system with stable and unstable subsystems is employed to model packet dropouts in a deterministic way. The purpose of this paper is to derive consensus criteria, such that linear multi-agent systems with sampled-data and packet losses can reach consensus. By means of the Lyapunov function

Consensus standard requirements and guidance

International Nuclear Information System (INIS)

Putman, V.L.

1995-01-01

This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

Establishing research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus.

Science.gov (United States)

Turner, Grace M; Backman, Ruth; McMullan, Christel; Mathers, Jonathan; Marshall, Tom; Calvert, Melanie

2018-01-01

that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Background Clinical management after transient ischaemic attack (TIA) and minor stroke focuses on stroke prevention. However, evidence demonstrates that many patients experience ongoing residual impairments. Residual impairments post-TIA and minor stroke may affect patients' quality of life and return to work or social activities. Research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of TIA and minor stroke are unknown. Methods Our objective was to establish the top shared research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus. A one-day priority setting consensus meeting took place with representatives from different stakeholder groups in October 2016 (Birmingham, UK). Nominal group technique was used to establish research priorities. This involved three stages: (i) gathering research priorities from individual stakeholders; (ii) interim prioritisation in three subgroups; and (iii) final priority setting. Results The priority setting consensus meeting was attended by 11 stakeholders. The individual stakeholders identified 34 different research priorities. During the interim prioritisation exercise, the three subgroups generated 24 unique research priorities which were discussed as a whole group. Following the final consensus discussion, 11 shared research priorities were unanimously agreed.The 11 research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members

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.

Weighted voting-based consensus clustering for chemical structure databases

Science.gov (United States)

Saeed, Faisal; Ahmed, Ali; Shamsir, Mohd Shahir; Salim, Naomie

2014-06-01

The cluster-based compound selection is used in the lead identification process of drug discovery and design. Many clustering methods have been used for chemical databases, but there is no clustering method that can obtain the best results under all circumstances. However, little attention has been focused on the use of combination methods for chemical structure clustering, which is known as consensus clustering. Recently, consensus clustering has been used in many areas including bioinformatics, machine learning and information theory. This process can improve the robustness, stability, consistency and novelty of clustering. For chemical databases, different consensus clustering methods have been used including the co-association matrix-based, graph-based, hypergraph-based and voting-based methods. In this paper, a weighted cumulative voting-based aggregation algorithm (W-CVAA) was developed. The MDL Drug Data Report (MDDR) benchmark chemical dataset was used in the experiments and represented by the AlogP and ECPF_4 descriptors. The results from the clustering methods were evaluated by the ability of the clustering to separate biologically active molecules in each cluster from inactive ones using different criteria, and the effectiveness of the consensus clustering was compared to that of Ward's method, which is the current standard clustering method in chemoinformatics. This study indicated that weighted voting-based consensus clustering can overcome the limitations of the existing voting-based methods and improve the effectiveness of combining multiple clusterings of chemical structures.

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016.

Science.gov (United States)

Bossé, D; Ng, T; Ahmad, C; Alfakeeh, A; Alruzug, I; Biagi, J; Brierley, J; Chaudhury, P; Cleary, S; Colwell, B; Cripps, C; Dawson, L A; Dorreen, M; Ferland, E; Galiatsatos, P; Girard, S; Gray, S; Halwani, F; Kopek, N; Mahmud, A; Martel, G; Robillard, L; Samson, B; Seal, M; Siddiqui, J; Sideris, L; Snow, S; Thirwell, M; Vickers, M; Goodwin, R; Goel, R; Hsu, T; Tsvetkova, E; Ward, B; Asmis, T

2016-12-01

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents.

ESMO consensus conference on malignant lymphoma

DEFF Research Database (Denmark)

Ladetto, M; Buske, C; Hutchings, M

2016-01-01

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...... to their potentially high prognostic value, at least in some lymphoma entities, implementation of interim PET, COO and MRD was highly recommended in the context of clinical trials. All expert panel members approved this final article....

Consensus on Exercise Reporting Template (CERT)

DEFF Research Database (Denmark)

Slade, Susan C; Dionne, Clermont E; Underwood, Martin

2016-01-01

the reporting of exercise programs in all evaluative study designs and contains 7 categories: materials, provider, delivery, location, dosage, tailoring, and compliance. The CERT will encourage transparency, improve trial interpretation and replication, and facilitate implementation of effective exercise......BACKGROUND: Exercise interventions are often incompletely described in reports of clinical trials, hampering evaluation of results and replication and implementation into practice. OBJECTIVE: The aim of this study was to develop a standardized method for reporting exercise programs in clinical...... trials: the Consensus on Exercise Reporting Template (CERT). DESIGN AND METHODS: Using the EQUATOR Network's methodological framework, 137 exercise experts were invited to participate in a Delphi consensus study. A list of 41 items was identified from a meta-epidemiologic study of 73 systematic reviews...

Towards a New Democracy: Consensus Through Quantum Parliament

OpenAIRE

Aerts, Diederik

2005-01-01

We compare different actual forms of democracy and analyse in which way they are variations of a 'natural consensus decision process'. We analyse how 'consensus decision followed by majority voting' is open to 'false play' by the majority, and investigate how other types of false play appear in alternative types of democratic decision procedures. We introduce the combined notion of 'quantum parliament' and 'quantum decision procedure', and prove it to be the only one, when applied after conse...

Voting experiments: Bandwagon voting or false-consensus effect?

OpenAIRE

Ivo Bischoff; Henrik Egbert

2008-01-01

In an experiment designed to test for expressive voting, Tyran (JPubEc 2004) found a strong positive correlation between the participants' approval for a proposal to donate money for charity and their expected approval rate for fellow voters. This phenomenon can be due to bandwagon voting or a false consensus effect. The social science literature reports both effects for voting decisions. Replicating Tyran's experiment and adding new treatments, we provide evidence for a false consensus effec...

Deriving consensus rankings via multicriteria decision making methodology

OpenAIRE

Amy Poh Ai Ling; Mohamad Nasir Saludin; Masao Mukaidono

2012-01-01

Purpose - This paper seeks to take a cautionary stance to the impact of the marketing mix on customer satisfaction, via a case study deriving consensus rankings for benchmarking on selected retail stores in Malaysia. Design/methodology/approach - The ELECTRE I model is used in deriving consensus rankings via multicriteria decision making method for benchmarking base on the marketing mix model 4P's. Descriptive analysis is used to analyze best practice among the four marketing tactics. Finding...

The importance of assessing and communicating scientific consensus

Science.gov (United States)

Maibach, Edward W.; van der Linden, Sander L.

2016-09-01

The spread of influential misinformation, such as conspiracy theories about the existence of a secret, large-scale atmospheric spraying program (SLAP), is contributing to the politicization of science. In an important recent study, Shearer et al (2016 Environ. Res. Lett. 11 084011) employ a novel methodology to quantify the expert consensus of popular SLAP assertions. The authors find that 99% (76/77) of surveyed experts have not encountered any evidence that would support the existence of such a program. Here we argue that this finding is important because a growing body of research has shown that the public’s perception of expert consensus on key societal issues acts an important ‘gateway’ to science acceptance. Furthermore, communicating normative agreement among experts, such as the strong scientific consensus against the existence of a SLAP, can help limit the spread of misinformation and promote more effective public decision-making about science and society.

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.

Constructing post-surgical discharge instructions through a Delphi consensus methodology.

Science.gov (United States)

Scott, Aaron R; Sanderson, Cody J; Rush, Augustus J; Alore, Elizabeth A; Naik, Aanand D; Berger, David H; Suliburk, James W

2018-05-01

Patient education materials are a crucial part of physician-patient communication. We hypothesize that available discharge instructions are difficult to read and fail to address necessary topics. Our objective is to evaluate readability and content of surgical discharge instructions using thyroidectomy to develop standardized discharge materials. Thyroidectomy discharge materials were analyzed for readability and assessed for content. Fifteen endocrine surgeons participated in a modified Delphi consensus panel to select necessary topics. Using readability best practices, we created standardized discharge instructions which included all selected topics. The panel evaluated 40 topics, selected 23, deemed 4 inappropriate, consolidated 5, and did not reach consensus on 8 topics after 4 rounds. The evaluated instructions' reading levels ranged from grade 6.5 to 13.2; none contained all consensus topics. Current post surgical thyroidectomy discharge instructions are more difficult to read than recommended by literacy standards and omit consensus warning signs of major complications. Our easy-to-read discharge instructions cover pertinent topics and may enhance patient education. Delphi methodology is useful for developing post-surgical instructions. Patient education materials need appropriate readability levels and content. We recommend the Delphi method to select content using consensus expert opinion whenever higher level data is lacking. Copyright © 2017 Elsevier B.V. All rights reserved.

Stem cell research ethics: consensus statement on emerging issues.

Science.gov (United States)

Caulfield, Timothy; Ogbogu, Ubaka; Nelson, Erin; Einsiedel, Edna; Knoppers, Bartha; McDonald, Michael; Brunger, Fern; Downey, Robin; Fernando, Kanchana; Galipeau, Jacques; Geransar, Rose; Griener, Glenn; Grenier, Glenn; Hyun, Insoo; Isasi, Rosario; Kardel, Melanie; Knowles, Lori; Kucic, Terrence; Lotjonen, Salla; Lyall, Drew; Magnus, David; Mathews, Debra J H; Nisbet, Matthew; Nisker, Jeffrey; Pare, Guillaume; Pattinson, Shaun; Pullman, Daryl; Rudnicki, Michael; Williams-Jones, Bryn; Zimmerman, Susan

2007-10-01

This article is a consensus statement by an international interdisciplinary group of academic experts and Canadian policy-makers on emerging ethical, legal and social issues in human embryonic stem cells (hESC) research in Canada. The process of researching consensus included consultations with key stakeholders in hESC research (regulations, stem cell researchers, and research ethics experts), preparation and distribution of background papers, and an international workshop held in Montreal in February 2007 to discuss the papers and debate recommendations. The recommendations provided in the consensus statement focus on issues of immediate relevance to Canadian policy-makers, including informed consent to hESC research, the use of fresh embryos in research, management of conflicts of interest, and the relevance of public opinion research to policy-making.

Dynamical Consensus Algorithm for Second-Order Multi-Agent Systems Subjected to Communication Delay

International Nuclear Information System (INIS)

Liu Chenglin; Liu Fei

2013-01-01

To solve the dynamical consensus problem of second-order multi-agent systems with communication delay, delay-dependent compensations are added into the normal asynchronously-coupled consensus algorithm so as to make the agents achieve a dynamical consensus. Based on frequency-domain analysis, sufficient conditions are gained for second-order multi-agent systems with communication delay under leaderless and leader-following consensus algorithms respectively. Simulation illustrates the correctness of the results. (interdisciplinary physics and related areas of science and technology)

Populism vs. elitism: social consensus and social status as bases of attitude certainty.

Science.gov (United States)

Prislin, Radmila; Shaffer, Emily; Crowder, Marisa

2012-01-01

This study examined the effects of social consensus and social status on attitude certainty that is conceptualized multi-dimensionally as perceived clarity and correctness of one's attitude. In a mock opinion exchange about a social issue, participants were either supported (high consensus) or opposed (low consensus) by most of the confederates. They were informed that their opinion (high status) or their opponents' opinion (low status) had the alleged psychological significance indicative of future success. Post-experimental attitude clarity was significantly greater when attitudinal position was associated with high rather than low status. Attitude correctness was interactively affected by social status and social consensus. Supporting the compensatory effect hypothesis, attitude correctness was comparable across the levels of social consensus as long as they were associated with high status, and across the levels of social status as long as they were associated with high social consensus.

Effects of heterogeneous convergence rate on consensus in opinion dynamics

Science.gov (United States)

Huang, Changwei; Dai, Qionglin; Han, Wenchen; Feng, Yuee; Cheng, Hongyan; Li, Haihong

2018-06-01

The Deffuant model has attracted much attention in the study of opinion dynamics. Here, we propose a modified version by introducing into the model a heterogeneous convergence rate which is dependent on the opinion difference between interacting agents and a tunable parameter κ. We study the effects of heterogeneous convergence rate on consensus by investigating the probability of complete consensus, the size of the largest opinion cluster, the number of opinion clusters, and the relaxation time. We find that the decrease of the convergence rate is favorable to decreasing the confidence threshold for the population to always reach complete consensus, and there exists optimal κ resulting in the minimal bounded confidence threshold. Moreover, we find that there exists a window before the threshold of confidence in which complete consensus may be reached with a nonzero probability when κ is not too large. We also find that, within a certain confidence range, decreasing the convergence rate will reduce the relaxation time, which is somewhat counterintuitive.

Consensus positive position feedback control for vibration attenuation of smart structures

Science.gov (United States)

Omidi, Ehsan; Nima Mahmoodi, S.

2015-04-01

This paper presents a new network-based approach for active vibration control in smart structures. In this approach, a network with known topology connects collocated actuator/sensor elements of the smart structure to one another. Each of these actuators/sensors, i.e., agent or node, is enhanced by a separate multi-mode positive position feedback (PPF) controller. The decentralized PPF controlled agents collaborate with each other in the designed network, under a certain consensus dynamics. The consensus constraint forces neighboring agents to cooperate with each other such that the disagreement between the time-domain actuation of the agents is driven to zero. The controller output of each agent is calculated using state-space variables; hence, optimal state estimators are designed first for the proposed observer-based consensus PPF control. The consensus controller is numerically investigated for a flexible smart structure, i.e., a thin aluminum beam that is clamped at its both ends. Results demonstrate that the consensus law successfully imposes synchronization between the independently controlled agents, as the disagreements between the decentralized PPF controller variables converge to zero in a short time. The new consensus PPF controller brings extra robustness to vibration suppression in smart structures, where malfunctions of an agent can be compensated for by referencing the neighboring agents’ performance. This is demonstrated in the results by comparing the new controller with former centralized PPF approach.

Consensus over peri-implantaire infecties

NARCIS (Netherlands)

van Winkelhoff, A J

2010-01-01

In 2008, in a workshop of the European Federation on Periodontology, a consensus was reached concerning oral peri-implant infections on the basis of the state of the art in the relevant sciences. Important conclusions were that peri-implant mucositis occurs in 80% of subjects with oral implants, and

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 correlation between the astro consensus panel definition of biochemical failure and clinical outcome for patients with prostate cancer treated with external beam irradiation

International Nuclear Information System (INIS)

Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Matter, Richard C.; Martinez, Alvaro A.

1997-01-01

Purpose: The ASTRO Consensus Panel on PSA After Radiation Therapy recently recommended a definition of biochemical failure (BF) following treatment of prostate cancer with radiation therapy. We reviewed our institution's experience treating patients with external beam irradiation (RT) to determine if the Consensus Panel definition correlates with clinical distant metastases free survival (DMFS), disease free survival (DFS), cause specific survival (CSS), and local control (LC) rates for a large group of patients from the PSA era. Methods And Materials: Between 1/1/87 and 12/31/92, 653 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. Of these patients, 568 had a minimum follow-up of 2 years and constitute the study population. The median pre-treatment PSA and Gleason score was 11 ng/ml and 6, respectively. The median dose to the prostate using megavoltage RT was 66.6 Gy (range: 60-70.4 Gy) using a four field or arc technique. No patient received hormonal therapy either prior to, during, or after radiotherapy unless local or distant failure was documented. Pre-treatment and post-treatment serum PSA levels were recorded. Biochemical failure was defined as three consecutive increases in post-treatment PSA after achieving a nadir. Biochemical failure was recorded as the time midway between the nadir and first increase in PSA. Five year actuarial rates of DMFS, DFS, CSS, and LC were calculated for patients who were biochemically controlled (BC) versus those who failed biochemically. Results: Median follow-up was 56 months (range: 24-118 months). The overall 5 year actuarial rates of DMFS, DFS, CSS, and LC were significantly better in patients who were biochemically controlled versus those who were not (p< 0.001). The median time to DM within the BF group was 21 months (range: 2-112 months). When stratifying by pre-treatment PSA, Gleason score, and T stage, these

The relationship between IQ and performance on the MATRICS consensus cognitive battery

Directory of Open Access Journals (Sweden)

Christine Mohn

2014-06-01

Full Text Available The associations between IQ and individual tests of neurocognitive function are well studied. However, there is a lack of information as to how IQ relates to performance on neuropsychological test batteries as a whole and in the same individuals. In this study, 250 healthy participants aged 20-69 years were tested with the Wechsler Abbreviated Scale of Intelligence (WASI and the MATRICS Consensus Cognitive Battery (MCCB. In correlation analyses, IQ was significantly related to all MCCB scores, except the Social Cognition domain. Hierarchical regression analyses including gender, age, and education confirmed this association. For overall cognitive function, 50% of the variance was explained by IQ and demographic characteristics. For the domains Speed of Processing, Working Memory, Visual and Verbal Learning, IQ explained a larger proportion of the variance than the demographic factors did. The implication is that these domains may provide information of a person’s intelligence level.

Bipartite consensus for multi-agent systems with antagonistic interactions and communication delays

Science.gov (United States)

Guo, Xing; Lu, Jianquan; Alsaedi, Ahmed; Alsaadi, Fuad E.

2018-04-01

This paper studies the consensus problems over signed digraphs with arbitrary finite communication delays. For the considered system, the information flow is directed and only locally delayed information can be used for each node. We derive that bipartite consensus of this system can be realized when the associated signed digraph is strongly connected. Furthermore, for structurally balanced networks, this paper studies the pinning partite consensus for the considered system. we design a pinning scheme to pin any one agent in the signed network, and obtain that the network achieves pinning bipartite consensus with any initial conditions. Finally, two examples are provided to demonstrate the effectiveness of our main results.

Psychometric characteristics of the MATRICS Consensus Cognitive Battery in a large pooled cohort of stable schizophrenia patients.

Science.gov (United States)

Georgiades, Anastasia; Davis, Vicki G; Atkins, Alexandra S; Khan, Anzalee; Walker, Trina W; Loebel, Antony; Haig, George; Hilt, Dana C; Dunayevich, Eduardo; Umbricht, Daniel; Sand, Michael; Keefe, Richard S E

2017-12-01

The MATRICS Consensus Cognitive Battery (MCCB) was developed to assess cognitive treatment effects in schizophrenia clinical trials, and is considered the FDA gold standard outcome measure for that purpose. The aim of the present study was to establish pre-treatment psychometric characteristics of the MCCB in a large pooled sample. The dataset included 2616 stable schizophrenia patients enrolled in 15 different clinical trials between 2007 and 2016 within the United States (94%) and Canada (6%). The MCCB was administered twice prior to the initiation of treatment in 1908 patients. Test-retest reliability and practice effects of the cognitive composite score, the neurocognitive composite score, which excludes the domain Social Cognition, and the subtests/domains were examined using Intra-Class Correlations (ICC) and Cohen's d. Simulated regression models explored which domains explained the greatest portion of variance in composite scores. Test-retest reliability was high (ICC=0.88) for both composite scores. Practice effects were small for the cognitive (d=0.15) and neurocognitive (d=0.17) composites. Simulated bootstrap regression analyses revealed that 3 of the 7 domains explained 86% of the variance for both composite scores. The domains that entered most frequently in the top 3 positions of the regression models were Speed of Processing, Working Memory, and Visual Learning. Findings provide definitive psychometric characteristics and a benchmark comparison for clinical trials using the MCCB. The test-retest reliability of the MCCB composite scores is considered excellent and the learning effects are small, fulfilling two of the key criteria for outcome measures in cognition clinical trials. Copyright © 2017 Elsevier B.V. All rights reserved.

Consensus achievement of leadership, organisational and individual factors that influence safety climate: Implications for nursing management.

Science.gov (United States)

Fischer, Shelly A; Jones, Jacqueline; Verran, Joyce A

2018-01-01

To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety. © 2017 John Wiley & Sons Ltd.

Robust consensus algorithm for multi-agent systems with exogenous disturbances under convergence conditions

Science.gov (United States)

Jiang, Yulian; Liu, Jianchang; Tan, Shubin; Ming, Pingsong

2014-09-01

In this paper, a robust consensus algorithm is developed and sufficient conditions for convergence to consensus are proposed for a multi-agent system (MAS) with exogenous disturbances subject to partial information. By utilizing H∞ robust control, differential game theory and a design-based approach, the consensus problem of the MAS with exogenous bounded interference is resolved and the disturbances are restrained, simultaneously. Attention is focused on designing an H∞ robust controller (the robust consensus algorithm) based on minimisation of our proposed rational and individual cost functions according to goals of the MAS. Furthermore, sufficient conditions for convergence of the robust consensus algorithm are given. An example is employed to demonstrate that our results are effective and more capable to restrain exogenous disturbances than the existing literature.

Overlapping community detection using weighted consensus ...

Indian Academy of Sciences (India)

2016-09-21

Sep 21, 2016 ... Complex networks; overlapping community; consensus clustering. PACS Nos 89.75 ... networks, a person may be in several social groups like family, friends ..... the social interactions between individuals in a karate club in an.

What is a good result after clubfoot treatment? A Delphi-based consensus on success by regional clubfoot trainers from across Africa.

Directory of Open Access Journals (Sweden)

Tracey Smythe

Full Text Available Congenital talipes equino-varus (CTEV, also known as clubfoot, is one of the most common congenital musculoskeletal malformations. Despite this, considerable variation exists in the measurement of deformity correction and outcome evaluation. This study aims to determine the criteria for successful clubfoot correction using the Ponseti technique in low resource settings through Africa.Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an 'acceptable or good clubfoot correction' at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC. From the original 22 criteria, ten criteria with a mean score >7 and SD 9 and SD<1.5.The consensus definition of a successfully treated clubfoot includes: (1 a plantigrade foot, (2 the ability to wear a normal shoe, (3 no pain, and (4 the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97.The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.

Statistical Inference for Cultural Consensus Theory

Science.gov (United States)

2014-02-24

Social Network Conference XXXII , Redondo Beach, California, March 2012. Agrawal, K. (Presenter), and Batchelder, W. H. Cultural Consensus Theory...Aggregating Complete Signed Graphs Under a Balance Constraint -- Part 2. International Sunbelt Social Network Conference XXXII , Redondo Beach

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

A note on the consensus finding problem in communication networks with switching topologies

KAUST Repository

Haskovec, Jan

2014-05-07

In this note, we discuss the problem of consensus finding in communication networks of agents with dynamically switching topologies. In particular, we consider the case of directed networks with unbalanced matrices of communication rates. We formulate sufficient conditions for consensus finding in terms of strong connectivity of the underlying directed graphs and prove that, given these conditions, consensus is found asymptotically. Moreover, we show that this consensus is an emergent property of the system, being encoded in its dynamics and not just an invariant of its initial configuration. © 2014 © 2014 Taylor & Francis.

Consensus problem in directed networks of multi-agents via nonlinear protocols

International Nuclear Information System (INIS)

Liu Xiwei; Chen Tianping; Lu Wenlian

2009-01-01

In this Letter, the consensus problem via distributed nonlinear protocols for directed networks is investigated. Its dynamical behaviors are described by ordinary differential equations (ODEs). Based on graph theory, matrix theory and the Lyapunov direct method, some sufficient conditions of nonlinear protocols guaranteeing asymptotical or exponential consensus are presented and rigorously proved. The main contribution of this work is that for nonlinearly coupled networks, we generalize the results for undirected networks to directed networks. Consensus under pinning control technique is also developed here. Simulations are also given to show the validity of the theories.

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

Diagnosis and treatments of Prader-Willi syndrome: a review of current consensuses

Directory of Open Access Journals (Sweden)

2014-05-01

Full Text Available We analyzed international consensuses of experts and clinical recommendations on diagnosis and treatment of Prader-Willi syndrome (PWS: PWS consensus diagnostic criteria (1993; US PWS Association (PWSA-USA consensus statements on evaluating of breathing abnormalities (2007, osteoporosis (2008, growth hormone treatment in PWS (2000 and 2009; Endocrine society clinical practice guideline on Prevention and treatment of pediatric obesity (2008; the Second Expert Meeting of the Comprehensive Care of Patients with PWS Consensus published as Recommendations for the diagnosis and management of PWS (2008. Historical analysis and comparison of recommendations are presented in this review article. Absence of Russian clinical practice guidelines on PWS patients management makes necessary the detailed study of listed documents.

Non-consensus Opinion Models on Complex Networks

Science.gov (United States)

Li, Qian; Braunstein, Lidia A.; Wang, Huijuan; Shao, Jia; Stanley, H. Eugene; Havlin, Shlomo

2013-04-01

Social dynamic opinion models have been widely studied to understand how interactions among individuals cause opinions to evolve. Most opinion models that utilize spin interaction models usually produce a consensus steady state in which only one opinion exists. Because in reality different opinions usually coexist, we focus on non-consensus opinion models in which above a certain threshold two opinions coexist in a stable relationship. We revisit and extend the non-consensus opinion (NCO) model introduced by Shao et al. (Phys. Rev. Lett. 103:01870, 2009). The NCO model in random networks displays a second order phase transition that belongs to regular mean field percolation and is characterized by the appearance (above a certain threshold) of a large spanning cluster of the minority opinion. We generalize the NCO model by adding a weight factor W to each individual's original opinion when determining their future opinion (NCO W model). We find that as W increases the minority opinion holders tend to form stable clusters with a smaller initial minority fraction than in the NCO model. We also revisit another non-consensus opinion model based on the NCO model, the inflexible contrarian opinion (ICO) model (Li et al. in Phys. Rev. E 84:066101, 2011), which introduces inflexible contrarians to model the competition between two opinions in a steady state. Inflexible contrarians are individuals that never change their original opinion but may influence the opinions of others. To place the inflexible contrarians in the ICO model we use two different strategies, random placement and one in which high-degree nodes are targeted. The inflexible contrarians effectively decrease the size of the largest rival-opinion cluster in both strategies, but the effect is more pronounced under the targeted method. All of the above models have previously been explored in terms of a single network, but human communities are usually interconnected, not isolated. Because opinions propagate not

RENZI SCORE FOR OBSTRUCTED DEFECATION SYNDROME - VALIDATION OF THE PORTUGUESE VERSION ACCORDING TO THE COSMIN CHECKLIST.

Science.gov (United States)

Caetano, Ana Celia; Dias, Sara; Santa-Cruz, André; Rolanda, Carla

2018-01-01

Recently, the Obstructed Defecation Syndrome score (ODS score) was developed and validated by Renzi to assess clinical staging and to allow evaluation and comparison of the efficacy of treatment of this disorder. Our goal is to validate the Portuguese version of Renzi ODS score, according to the Consensus based Standards for the selection of the Health Measurement Instruments (COSMIN) checklist. Following guidelines for cross-cultural validity, Renzi ODS score was translated into the Portuguese language. Then, a group of patients and healthy controls were invited to fill in the Renzi ODS score at baseline, after 2 weeks and 3 months, respectively. We assessed internal consistency, reliability and measurement error, content and construct validity, responsiveness and interpretability. A total of 113 individuals (77 patients; 36 healthy controls) completed the questionnaire. Seventy and 30 patients repeated the Renzi ODS score after 2 weeks and 3 months respectively. Factor analysis confirmed the unidimensionality of the scale. Cronbach's α coefficient of 0.77 supported item's homogeneity. Weighted quadratic kappa of 0.89 established test-retest reliability. The smallest detectable change at the individual level was 2.66 and at the group level was 0.30. Renzi ODS score and the total (-0.32) and physical (-0.43) SF-36 scores correlated negatively. Patient and control's groups significantly differed (11 points). The change score of Renzi ODS score between baseline and 3 months correlated negatively with the clinical evolution (-0.86). ROC analysis showed minimal important change of 2.00 with AUC 0.97. Neither floor nor ceiling effects were observed. This work validated the Portuguese version of Renzi ODS score. We can now use this reliable, responsive, and interpretable (at the group level) tool to evaluate Portuguese ODS patients.

Consensus in averager-copier-voter networks of moving dynamical agents

Science.gov (United States)

Shang, Yilun

2017-02-01

This paper deals with a hybrid opinion dynamics comprising averager, copier, and voter agents, which ramble as random walkers on a spatial network. Agents exchange information following some deterministic and stochastic protocols if they reside at the same site in the same time. Based on stochastic stability of Markov chains, sufficient conditions guaranteeing consensus in the sense of almost sure convergence have been obtained. The ultimate consensus state is identified in the form of an ergodicity result. Simulation studies are performed to validate the effectiveness and availability of our theoretical results. The existence/non-existence of voters and the proportion of them are unveiled to play key roles during the consensus-reaching process.

Consensus among Economists--An Update

Science.gov (United States)

Fuller, Dan; Geide-Stevenson, Doris

2014-01-01

In this article, the authors explore consensus among economists on specific propositions based on a fall 2011 survey of American Economic Association members. Results are based on 568 responses and provide evidence of changes in opinion over time by including propositions from earlier studies in 2000 (Fuller and Geide-Stevenson 2003) and 1992…

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

NARCIS (Netherlands)

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

2016-01-01

There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management

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

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

Building consensus in the community

International Nuclear Information System (INIS)

Bishop, J.

1994-01-01

The importance for the development of UK renewable energy projects of building consensus in the community is discussed. After outlining the benefits of such an approach, some of the likely concerns and questions from a developer's viewpoint are explored. The key principles of good practice are considered and an example from a wind project examined. (UK)

Consensus on the guidelines for the dietary management of classical galactosemia.

Science.gov (United States)

Kerckhove, Kristel Vande; Diels, Marianne; Vanhaesebrouck, Sigrid; Luyten, Karin; Pyck, Nancy; De Meyer, An; Van Driessche, Marleen; Robert, Martine; Corthouts, Karen; Caris, Ariane; Duchateau, Emilie; Dassy, Martine; Bihet, Genevieve

2015-02-01

Worldwide there is scientific discussion about the dietary management of galactosemia. The dietary management is very different in several countries among Europe, the US and Canada. The main points of discussion are related to the fact that i) despite a strict diet some patients still have poor outcomes; ii) there is lack of scientific knowledge about the role of endogenous production of galactose on disease evolution, with or without diet. The aim of the current work was the creation of a Belgian consensus on dietary guidelines for the management of galactosemia. A step-wise approach was used to achieve a consensus, including: a workshop, a Delphi round, discussion groups and a round table of different Belgian experts. The consensus is an agreement between strict guidelines (strict limitation of fruits, vegetables and soybean products/French guidelines) and the more liberal guidelines (comparable with a diet free of lactose/guidelines of UK and the Netherlands). The consensus document consists of different modules, including the medical context, the theoretical background of dietary guidelines and the age-specific practical dietary guidelines. A Belgian consensus on the guidelines for the dietary management of classical galactosemia was developed despite the uncertainties of the efficacy and practical application of these guidelines. The final consensus is based on scientific knowledge and practical agreement among experts. In the future, regular revision of the guidelines is recommended and a uniform European guideline is desirable. Copyright © 2014 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

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.)

Recurrence of Dupuytren's contracture: A consensus-based definition.

Directory of Open Access Journals (Sweden)

Hester J Kan

Full Text Available One of the major determinants of Dupyutren disease (DD treatment efficacy is recurrence of the contracture. Unfortunately, lack of agreement in the literature on what constitutes recurrence makes it nearly impossible to compare the multiple treatments alternatives available today. The aim of this study is to bring an unbiased pool of experts to agree upon what would be considered a recurrence of DD after treatment; and from that consensus establish a much-needed definition for DD recurrence.To reach an expert consensus on the definition of recurrence we used the Delphi method and invited 43 Dupuytren's research and treatment experts from 10 countries to participate by answering a series of questionnaire rounds. After each round the answers were analyzed and the experts received a feedback report with another questionnaire round to further hone in of the definition. We defined consensus when at least 70% of the experts agreed on a topic.Twenty-one experts agreed to participate in this study. After four consensus rounds, we agreed that DD recurrence should be defined as "more than 20 degrees of contracture recurrence in any treated joint at one year post-treatment compared to six weeks post-treatment". In addition, "recurrence should be reported individually for every treated joint" and afterwards measurements should be repeated and reported yearly.This study provides the most comprehensive to date definition of what should be considered recurrence of DD. These standardized criteria should allow us to better evaluate the many treatment alternatives.

Towards a consensus about the role of empathy in interpersonal understanding

DEFF Research Database (Denmark)

Michael, John Andrew

2014-01-01

about how to conceptualize empathy, and then analyze the potential contribution of empathy to interpersonal understanding. However, it is not at all clear that such a consensus will soon be forthcoming, given that different people have fundamentally conflicting intuitions about the concept of empathy....... Thus, instead of trying to resolve this controversy, I will try to show that a fair amount of consensus is within reach about how empathy can be a source of interpersonal understanding even in the absence of a consensus about how to conceptualize empathy. As we shall see, the main controversy concerns...

Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

Science.gov (United States)

Gatot, D.; Mardia, A. I.

2018-03-01

Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

Consensus formation in science modeled by aggregated bibliographic coupling

DEFF Research Database (Denmark)

Nicolaisen, Jeppe; Frandsen, Tove Faber

2012-01-01

as their unit of analysis. To produce a more fine grained citation analysis one needs to study consensusformation on an even more detailed level – i.e. the scientific document or article. To do so, we have developed a new technique that measures consensus by aggregatedbibliographiccouplings (ABC) between...... documents. The advantages of the ABC-technique are demonstrated in a study of two selected disciplines in which the levels of consensus are measured using the propopsed technique....

Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative.

Science.gov (United States)

Penciner, Rick; Woods, Robert A; McEwen, Jill; Lee, Richard; Langhan, Trevor; Bandiera, Glen

2013-01-01

There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators. We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided. This study established a national consensus defining the core competencies for EM clerkship in Canada.

Distributed Data-aggregation Consensus for Sensor Networks: Relaxation of Consensus Concept and Convergence Property

Science.gov (United States)

2014-08-01

consensus algorithm called randomized gossip is more suitable [7, 8]. In asynchronous randomized gossip algorithms, pairs of neighboring nodes exchange...messages and perform updates in an asynchronous and unattended manner, and they also 1 The class of broadcast gossip algorithms [9, 10, 11, 12] are...dynamics [2] and asynchronous pairwise randomized gossip [7, 8], broadcast gossip algorithms do not require that nodes know the identities of their

Link-Prediction Enhanced Consensus Clustering for Complex Networks (Open Access)

Science.gov (United States)

2016-05-20

RESEARCH ARTICLE Link-Prediction Enhanced Consensus Clustering for Complex Networks Matthew Burgess1*, Eytan Adar1,2, Michael Cafarella1 1Computer...consensus clustering algorithm to enhance community detection on incomplete networks. Our framework utilizes existing community detection algorithms that...types of complex networks exhibit community structure: groups of highly connected nodes. Communities or clusters often reflect nodes that share similar

Consensus of best current management: the starting point for clinical quality assessment

International Nuclear Information System (INIS)

Hanks, G.E.; Kramer, S.

1984-01-01

Consensus of best current management developed by a rational and deliberative process can provide the basis for clinical quality assessment. When it is possible to arrive at consensus in a specific disease, this consensus should detail appropriate pretreatment evaluation and the details of the treatment. Committees of experts for each specific disease site can formulate the consensus and must document their decision based on information from the current world literature. The authors have observed that individuals formulating consensus of best current management do not strictly follow their own criteria, and that compliance in various strata of practice throughout the United States shows a greater deviation from consensus than anticipated and indeed this deviation crosses all types of practice. The authors have observed quite different outcomes for two groups of patients with Hodgkin's disease treated with the same processes (i.e., mantle field technology and adequate radiation dose, etc.). They were unable to identify the reason for an increased failure rate in one group of these patients until they looked at each individual mantle port film from the two groups of patients. They identified that one facility was not including the Hodgkin's disease in the treatment portal due to poor technical performance. This program of process verification may be important in evaluating quality for any disease site

24 CFR 3288.305 - Consultation with the Manufactured Housing Consensus Committee.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Consultation with the Manufactured Housing Consensus Committee. 3288.305 Section 3288.305 Housing and Urban Development Regulations Relating... Housing Consensus Committee. HUD will seek input from the MHCC when revising the HUD Manufactured Home...

testing a consensus conference method by discussing

African Journals Online (AJOL)

hi-tech

2000-10-10

Oct 10, 2000 ... Objectives: To test the recommended consensus conference methods in Tanzania by discussing the management ... “wrong”, based on recommendations advocated in western ..... future scenarios sponsored the conference.

2016 updated MASCC/ESMO consensus recommendations

DEFF Research Database (Denmark)

Roila, Fausto; Warr, David; Hesketh, Paul J

2017-01-01

PURPOSE: An update of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy published after the last MASCC/ESMO antiemetic consensus conference in 2009 has been carried out. METHODS: A systematic literature search using PubMed from Janua...

Consensus of Discrete Multiagent System with Various Time Delays and Environmental Disturbances

Directory of Open Access Journals (Sweden)

Zheping Yan

2014-12-01

Full Text Available In this paper, the consensus problem of discrete multiagent systems with time varying sampling periods is studied. Firstly, with thorough analysis of various delays among agents, the control input of each agent is designed with consideration of sending delay and receiving delay. With construction of discrete dynamics of state error vector, it is proved by applying Halanay inequality that consensus of the system can be reached. Further, the definition of bounded consensus is proposed in the situation where environmental disturbances exist. In order to handle this problem, the Halanay inequality is extended into a more general one with boundedness property. Based on the new Halanay inequality obtained, the boundedness of consensus error is guaranteed. At last, simulation examples are presented to demonstrate the theoretical conclusions.

Use of Convexity in Ostomy Care: Results of an International Consensus Meeting.

Science.gov (United States)

Hoeflok, Jo; Salvadalena, Ginger; Pridham, Sue; Droste, Werner; McNichol, Laurie; Gray, Mikel

Ostomy skin barriers that incorporate a convexity feature have been available in the marketplace for decades, but limited resources are available to guide clinicians in selection and use of convex products. Given the widespread use of convexity, and the need to provide practical guidelines for appropriate use of pouching systems with convex features, an international consensus panel was convened to provide consensus-based guidance for this aspect of ostomy practice. Panelists were provided with a summary of relevant literature in advance of the meeting; these articles were used to generate and reach consensus on 26 statements during a 1-day meeting. Consensus was achieved when 80% of panelists agreed on a statement using an anonymous electronic response system. The 26 statements provide guidance for convex product characteristics, patient assessment, convexity use, and outcomes.

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...

Monitoring vital signs: development of a modified early warning scoring (MEWS system for general wards in a developing country.

Directory of Open Access Journals (Sweden)

Una Kyriacos

Full Text Available OBJECTIVE: The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa. METHODS: Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart. PARTICIPANTS: One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12 were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round. RESULTS: Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries. CONCLUSIONS: A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration.

Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

Science.gov (United States)

Kim, Hee Yeon; Jang, Jeong Won

2015-01-01

Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for end-stage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research. PMID:26167066

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.

Time for a neonatal-specific consensus definition for sepsis.

Science.gov (United States)

Wynn, James L; Wong, Hector R; Shanley, Thomas P; Bizzarro, Matthew J; Saiman, Lisa; Polin, Richard A

2014-07-01

To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. The review focused primarily on pediatric literature relevant to the topic of interest. Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.

You never compare alone: How social consensus and comparative context affect self-evaluation

Directory of Open Access Journals (Sweden)

Grabowski Adam

2014-06-01

Full Text Available Three studies address the role of social consensus on evaluative standards in different comparative contexts. Previous research has documented that self-categorisation at the individual or group level changes social comparison effects in terms of assimilation and contrast. With regard to self-ratings of physical attractiveness, the present studies show that people who focus on group membership can benefit from including outstanding others in their reference group, whereas people who focus on their individual attributes run the risk of self-devaluation. It is argued that high consensus strengthens the association between evaluative standards and group membership and renders the inclusion of outstanding others more likely. Study 3 shows that the need to protect self-esteem moderates the influence of perceived consensus. Stressing the individual self led participants who received negative feedback to exclude outstanding others when consensus was low. Stressing the social self, however, led participants to include outstanding others when consensus was high.

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.

Interdisciplinary consensus document for the treatment of fibromyalgia.

Science.gov (United States)

de Miquel, C Alegre; Campayo, J García; Flórez, M Tomás; Arguelles, J M Gómez; Tarrio, E Blanco; Montoya, M Gobbo; Martin, Á Pérez; Salio, A Martínez; Fuentes, J Vidal; Alberch, E Altarriba; de la Cámara, A Gómez

2010-01-01

Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.Objective. To develop a consensus on the treatment of fibromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry,rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes,having specific symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.Methods. The different clinical classifications proposed in fibromyalgia and the scientific evidence of the treatments used in this disease were reviewed. For the selection of the classification used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.Conclusion. The classification of Giesecke of fibromyalgia into 3 subgroups seems to have the greatest scientific evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fibromyalgia. However, in addition, for each subgroup, there are a series of specific pharmacological and psychological-type recommendations and those of modification of the environment, which will make it possible to have a personalized approach to the patient with fibromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).

A Delphi consensus panel on nutritional therapy in chronic kidney disease.

Science.gov (United States)

Bellizzi, Vincenzo; Bianchi, Stefano; Bolasco, Piergiorgio; Brunori, Giuliano; Cupisti, Adamasco; Gambaro, Giovanni; Gesualdo, Loreto; Polito, Pasquale; Santoro, Domenico; Santoro, Antonio

2016-10-01

The conservative management of chronic kidney disease (CKD) includes nutritional therapy (NT) with the aim to reduce the intake of proteins, phosphorus, organic acids, sodium, and potassium, while ensuring adequate caloric intake. While there is evidence that NT may help to prevent and control metabolic alterations in CKD, the criteria for implementing a low-protein regimen in CKD are still debated. There is no final consensus on the composition of the diet, nor indications for specific patient settings or different stages of CKD. Also when and how to start dietary manipulation of different nutrients in CKD is not well defined. A group of Italian nephrologists participated, under the auspices of the Italian Society of Nephrology, in a Delphi exercise to explore the consensus on some open questions regarding the nutritional treatment in CKD in Italy, generating a consensus opinion for 23 statements on: (1) general principles of NT; (2) indications for and initiation of NT; (3) role of protein-free products; (4) NT safety; (5) integrated management of NT. This Delphi exercise shows that there is broad consensus regarding NT in CKD across a wide range of management areas. These clinician-led consensus statements provide a framework for appropriate guidance on NT in patients with CKD, and are intended as a guide in decision-making whenever possible.

Taiwan consensus of pharmacological treatment for bipolar disorder

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Ya-Mei Bai

2013-10-01

Full Text Available Bipolar disorder is an important psychiatric disorder with different disease phases. The pharmacological treatment is complicated, and is updated frequently as new research evidence emerges. For the purpose of international collaboration, research, and education, the Taiwan consensus of pharmacological treatment for bipolar disorders was initiated by the Taiwanese Society of Biological Psychiatry and Neuropsychopharmacology (TSBPN – the Bipolar Chapter, which was established in August 2010 and approved as a member of International Society of Bipolar Disorder. TSBPN is the country member of the World Federation of Societies of Biological Psychiatry (WFSBP. The development of the Taiwan consensus for bipolar disorder was mainly based on the template of WFSBP Guidelines, with references to other international guidelines including the Canadian Network for Mood and Anxiety Treatments, and British Association for Psychopharmacology. We have also added Taiwanese experts’ experience, Taiwan national health insurance data, and the indications for the pharmacological treatment of bipolar disorder given by the Taiwan Department of Health, to emphasize the balance between efficacy and safety, and to make this consensus a concise, empirical, and important reference for clinical psychiatric practice.

Learning Gene Regulatory Networks Computationally from Gene Expression Data Using Weighted Consensus

KAUST Repository

Fujii, Chisato

2015-01-01

the performance of the consensus. The linear programming- based consensus method is evaluated and it had the best performance on in silico and Saccharomyces cerevisiae networks, and the second best on the Escherichia coli network outperformed by Inferelator

Leader-follower consensus and synchronization in numerosity-constrained networks with dynamic leadership.

Science.gov (United States)

Roy, Subhradeep; Abaid, Nicole

2016-11-01

In this work, we study leader-follower consensus and synchronization protocols over a stochastically switching network. The agents representing the followers can communicate with any other agent, whereas the agents serving as leaders are restricted to interact only with the other leaders. The model incorporates the phenomenon of numerosity, which limits the perceptual capacity of the agents while allowing for shuffling with whom each individual interacts at each time step. We derive closed form expressions for necessary and sufficient conditions for consensus, the rate of convergence to consensus, and conditions for stochastic synchronization in terms of the asymptotic convergence factor. We provide simulation results to validate the theoretical findings and to illustrate the dependence of this factor on system parameters. The closed form results enable us to study the factors affecting the feasibility of consensus. We show that agents' traits can be chosen for an engineered system to maximize the convergence speed and that protocol speed is enhanced as the proportion of the leaders increases in certain cases. These results may find application in the design and control of an engineered leader-follower system, where consensus or synchronization at the fastest possible rate is desired.

Leader-follower consensus and synchronization in numerosity-constrained networks with dynamic leadership

Science.gov (United States)

Roy, Subhradeep; Abaid, Nicole

2016-11-01

In this work, we study leader-follower consensus and synchronization protocols over a stochastically switching network. The agents representing the followers can communicate with any other agent, whereas the agents serving as leaders are restricted to interact only with the other leaders. The model incorporates the phenomenon of numerosity, which limits the perceptual capacity of the agents while allowing for shuffling with whom each individual interacts at each time step. We derive closed form expressions for necessary and sufficient conditions for consensus, the rate of convergence to consensus, and conditions for stochastic synchronization in terms of the asymptotic convergence factor. We provide simulation results to validate the theoretical findings and to illustrate the dependence of this factor on system parameters. The closed form results enable us to study the factors affecting the feasibility of consensus. We show that agents' traits can be chosen for an engineered system to maximize the convergence speed and that protocol speed is enhanced as the proportion of the leaders increases in certain cases. These results may find application in the design and control of an engineered leader-follower system, where consensus or synchronization at the fastest possible rate is desired.

A consensus view on liquidity risk

NARCIS (Netherlands)

Acharya, V.; Krishnamurthy, A.; Perotti, E.

2011-01-01

Liquidity risk - which was at the heart of the September 2008 financial meltdown and explains regulatory concerns about a Greek default today - remains an open issue in financial regulatory reform. This column presents a consensus view of several leading academics on what more needs to be done to

Quantifying the consensus on anthropogenic global warming in the scientific literature

International Nuclear Information System (INIS)

Cook, John; Nuccitelli, Dana; Winkler, Bärbel; Painting, Rob; Skuce, Andrew; Green, Sarah A; Richardson, Mark; Way, Robert; Jacobs, Peter

2013-01-01

We analyze the evolution of the scientific consensus on anthropogenic global warming (AGW) in the peer-reviewed scientific literature, examining 11 944 climate abstracts from 1991–2011 matching the topics ‘global climate change’ or ‘global warming’. We find that 66.4% of abstracts expressed no position on AGW, 32.6% endorsed AGW, 0.7% rejected AGW and 0.3% were uncertain about the cause of global warming. Among abstracts expressing a position on AGW, 97.1% endorsed the consensus position that humans are causing global warming. In a second phase of this study, we invited authors to rate their own papers. Compared to abstract ratings, a smaller percentage of self-rated papers expressed no position on AGW (35.5%). Among self-rated papers expressing a position on AGW, 97.2% endorsed the consensus. For both abstract ratings and authors’ self-ratings, the percentage of endorsements among papers expressing a position on AGW marginally increased over time. Our analysis indicates that the number of papers rejecting the consensus on AGW is a vanishingly small proportion of the published research. (letter)

The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System.

Science.gov (United States)

Epstein, Jonathan I; Egevad, Lars; Amin, Mahul B; Delahunt, Brett; Srigley, John R; Humphrey, Peter A

2016-02-01

In November, 2014, 65 prostate cancer pathology experts, along with 17 clinicians including urologists, radiation oncologists, and medical oncologists from 19 different countries gathered in a consensus conference to update the grading of prostate cancer, last revised in 2005. The major conclusions were: (1) Cribriform glands should be assigned a Gleason pattern 4, regardless of morphology; (2) Glomeruloid glands should be assigned a Gleason pattern 4, regardless of morphology; (3) Grading of mucinous carcinoma of the prostate should be based on its underlying growth pattern rather than grading them all as pattern 4; and (4) Intraductal carcinoma of the prostate without invasive carcinoma should not be assigned a Gleason grade and a comment as to its invariable association with aggressive prostate cancer should be made. Regarding morphologies of Gleason patterns, there was clear consensus on: (1) Gleason pattern 4 includes cribriform, fused, and poorly formed glands; (2) The term hypernephromatoid cancer should not be used; (3) For a diagnosis of Gleason pattern 4, it needs to be seen at 10x lens magnification; (4) Occasional/seemingly poorly formed or fused glands between well-formed glands is insufficient for a diagnosis of pattern 4; (5) In cases with borderline morphology between Gleason pattern 3 and pattern 4 and crush artifacts, the lower grade should be favored; (6) Branched glands are allowed in Gleason pattern 3; (7) Small solid cylinders represent Gleason pattern 5; (8) Solid medium to large nests with rosette-like spaces should be considered to represent Gleason pattern 5; and (9) Presence of unequivocal comedonecrosis, even if focal is indicative of Gleason pattern 5. It was recognized by both pathologists and clinicians that despite the above changes, there were deficiencies with the Gleason system. The Gleason grading system ranges from 2 to 10, yet 6 is the lowest score currently assigned. When patients are told that they have a Gleason score 6 out

Kinome profiling of Arabidopsis using arrays of kinase consensus substrates

Directory of Open Access Journals (Sweden)

Pieterse Corné MJ

2007-02-01

Full Text Available Abstract Background Kinome profiling aims at the parallel analysis of kinase activities in a cell. Novel developed arrays containing consensus substrates for kinases are used to assess those kinase activities. The arrays described in this paper were already used to determine kinase activities in mammalian systems, but since substrates from many organisms are present we decided to test these arrays for the determination of kinase activities in the model plant species Arabidopsis thaliana. Results Kinome profiling using Arabidopsis cell extracts resulted in the labelling of many consensus peptides by kinases from the plant, indicating the usefulness of this kinome profiling tool for plants. Method development showed that fresh and frozen plant material could be used to make cell lysates containing active kinases. Dilution of the plant extract increased the signal to noise ratio and non-radioactive ATP enhances full development of spot intensities. Upon infection of Arabidopsis with an avirulent strain of the bacterial pathogen Pseudomonas syringae pv. tomato, we could detect differential kinase activities by measuring phosphorylation of consensus peptides. Conclusion We show that kinome profiling on arrays with consensus substrates can be used to monitor kinase activities in plants. In a case study we show that upon infection with avirulent P. syringae differential kinase activities can be found. The PepChip can for example be used to purify (unknown kinases that play a role in P. syringae infection. This paper shows that kinome profiling using arrays of consensus peptides is a valuable new tool to study signal-transduction in plants. It complements the available methods for genomics and proteomics research.

Consensus Algorithms for Networks of Systems with Second- and Higher-Order Dynamics

Science.gov (United States)

Fruhnert, Michael

This thesis considers homogeneous networks of linear systems. We consider linear feedback controllers and require that the directed graph associated with the network contains a spanning tree and systems are stabilizable. We show that, in continuous-time, consensus with a guaranteed rate of convergence can always be achieved using linear state feedback. For networks of continuous-time second-order systems, we provide a new and simple derivation of the conditions for a second-order polynomials with complex coefficients to be Hurwitz. We apply this result to obtain necessary and sufficient conditions to achieve consensus with networks whose graph Laplacian matrix may have complex eigenvalues. Based on the conditions found, methods to compute feedback gains are proposed. We show that gains can be chosen such that consensus is achieved robustly over a variety of communication structures and system dynamics. We also consider the use of static output feedback. For networks of discrete-time second-order systems, we provide a new and simple derivation of the conditions for a second-order polynomials with complex coefficients to be Schur. We apply this result to obtain necessary and sufficient conditions to achieve consensus with networks whose graph Laplacian matrix may have complex eigenvalues. We show that consensus can always be achieved for marginally stable systems and discretized systems. Simple conditions for consensus achieving controllers are obtained when the Laplacian eigenvalues are all real. For networks of continuous-time time-variant higher-order systems, we show that uniform consensus can always be achieved if systems are quadratically stabilizable. In this case, we provide a simple condition to obtain a linear feedback control. For networks of discrete-time higher-order systems, we show that constant gains can be chosen such that consensus is achieved for a variety of network topologies. First, we develop simple results for networks of time

Metastatic non-small-cell lung cancer: consensus on pathology and molecular tests, first-line, second-line, and third-line therapy: 1st ESMO Consensus Conference in Lung Cancer; Lugano 2010

DEFF Research Database (Denmark)

Felip, E; Gridelli, C; Baas, P

2011-01-01

the conference, the expert panel prepared clinically relevant questions concerning five areas: early and locally advanced non-small-cell lung cancer (NSCLC), first-line metastatic NSCLC, second-/third-line NSCLC, NSCLC pathology and molecular testing, and small-cell lung cancer to be addressed through discussion......The 1st ESMO Consensus Conference on lung cancer was held in Lugano, Switzerland on 21 and 22 May 2010 with the participation of a multidisciplinary panel of leading professionals in pathology and molecular diagnostics, medical oncology, surgical oncology and radiation oncology. Before...... at the Consensus Conference. All relevant scientific literature for each question was reviewed in advance. During the Consensus Conference, the panel developed recommendations for each specific question. The consensus agreement on three of these areas: NSCLC pathology and molecular testing, the treatment of first-line...

Adult Asthma Consensus Guidelines Update 2003

Directory of Open Access Journals (Sweden)

Catherine Lemière

2004-01-01

Full Text Available BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.

Analysis of Four Scoring Systems for the Prognosis of Patients with Metastasis of the Vertebral Column.

Science.gov (United States)

Pollner, Péter; Horváth, Anna; Mezei, Tamás; Banczerowski, Péter; Czigléczki, Gábor

2018-04-01

Metastatic spinal diseases are common health problems and there is no consensus on the appropriate treatment of metastases in several conditions. Using clinical measures (e.g., survival time and functional status), prognosis prediction systems advise on the appropriate interventions. The aim of this article is to assess and compare 4 widely used scoring systems (revised Tokuhashi, Tomita, van der Linden, and modified Bauer scores) on a single-center cohort. A retrospective study was designed of 329 patients who were subjected to surgery because of metastatic spinal diseases. Subpopulations according to the classifications of the 4 scoring systems were identified. The overall survival was calculated with the Kaplan-Meier formula. The difference between the survival curves of subpopulations was analyzed with log-rank tests. The consistency rates for the 4 scoring systems are calculated as well. The follow-up period was 8 years. The median survival time was 222 days. The overall survival of prognostic categories in 3 scoring systems was significantly different from each other, but we found no differences between the categories of the van der Linden system. In this cohort, the revised Tokuhashi system gave the best approximation for survival, with a mean predictive capability 60.5%. The evaluation of 4 standard scoring systems showed that 3 were self-consistent, although none of systems was able to predict the survival in our cohort. Based on the predictive capability, the revised Tokuhashi system may provide the best predictions with careful examination of individual cases. Copyright © 2018 Elsevier Inc. All rights reserved.

Consensus Analysis of Second-Order Multiagent Systems with General Topology and Time Delay

Directory of Open Access Journals (Sweden)

Bo Liu

2013-01-01

Full Text Available This paper addresses the consensus of second-order multiagent systems with general topology and time delay based on the nearest neighbor rule. By using the Laplace transform technique, it is proved that the second-order multi-agent system in the presence of time-delay can reach consensus if the network topology contains a globally reachable node and time delay is bounded. The bound of time-delay only depends on eigenvalues of the Laplacian matrix of the system. The main contribution of this paper is that the accurate state of the consensus center and the upper bound of the communication delay to make the agents reach consensus are given. Some numerical simulations are given to illustrate the theoretical results.

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

DEFF Research Database (Denmark)

Krege, Susanne; Beyer, Jörg; Souchon, Rainer

2007-01-01

OBJECTIVES: The first consensus report that had been presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of ...

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

DEFF Research Database (Denmark)

Krege, Susanne; Beyer, Jörg; Souchon, Rainer

2007-01-01

OBJECTIVES: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the A...

Expert consensus v. evidence-based approaches in the revision of the DSM.

Science.gov (United States)

Kendler, K S; Solomon, M

2016-08-01

The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions - which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process - should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.

Reaching Consensus on Essential Biomedical Science Learning Objectives in a Dental Curriculum.

Science.gov (United States)

Best, Leandra; Walton, Joanne N; Walker, Judith; von Bergmann, HsingChi

2016-04-01

This article describes how the University of British Columbia Faculty of Dentistry reached consensus on essential basic biomedical science objectives for DMD students and applied the information to the renewal of its DMD curriculum. The Delphi Method was used to build consensus among dental faculty members and students regarding the relevance of over 1,500 existing biomedical science objectives. Volunteer panels of at least three faculty members (a basic scientist, a general dentist, and a dental specialist) and a fourth-year dental student were formed for each of 13 biomedical courses in the first two years of the program. Panel members worked independently and anonymously, rating each course objective as "need to know," "nice to know," "irrelevant," or "don't know." Panel members were advised after each round which objectives had not yet achieved a 75% consensus and were asked to reconsider their ratings. After a maximum of three rounds to reach consensus, a second group of faculty experts reviewed and refined the results to establish the biomedical science objectives for the renewed curriculum. There was consensus on 46% of the learning objectives after round one, 80% after round two, and 95% after round three. The second expert group addressed any remaining objectives as part of its review process. Only 47% of previous biomedical science course objectives were judged to be essential or "need to know" for the general dentist. The consensus reached by participants in the Delphi Method panels and a second group of faculty experts led to a streamlined, better integrated DMD curriculum to prepare graduates for future practice.

Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience.

Science.gov (United States)

Yu, Songfeng; Takasu, Naoki; Watanabe, Toshihiro; Fukumoto, Tsuyoshi; Okazaki, Shinji; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

2017-08-01

The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF. The positive predictive values of HRS and WF were 66.7% and 35.7% for branch duct IPMN and 80% and 38.1% for main duct IPMN, respectively. Univariate analysis indicated that all the factors in HRS and WF had statistical significance. Whereas multivariate analysis revealed only enhanced solid component (odds ratio [OR], 50.01; P = 0.008), presence of mural nodule (OR, 73.83; P < 0.001) and lymphadenopathy (OR, 20.85; P = 0.03) were independent predictors. Scoring HRS and WF by different numbers of positive factors resulted in improved predictive value. The area under the curve of HRS score was significantly lower than that of WF or HRS + WF score (0.680 vs 0.900 or 0.902, respectively; P < 0.001). As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

To Create a Consensus on Malnutrition Diagnostic Criteria.

Science.gov (United States)

Cederholm, Tommy; Jensen, Gordon L

2017-03-01

During the European Society for Clinical Nutrition and Metabolism (ESPEN) Congress in Copenhagen, Denmark (September 2016), representatives of the 4 largest global parenteral and enteral nutrition (PEN) societies from Europe (ESPEN), the United States (American Society for Parenteral and Enteral Nutrition [ASPEN]), Asia (Parenteral and Enteral Nutrition Society of Asia [PENSA]), and Latin America (Latin American Federation of Parenteral and Enteral Nutrition [FELANPE]) and from national PEN societies around the world met to continue the conversation on how to diagnose malnutrition that started during the Clinical Nutrition Week, Austin, Texas (February 2016). Current thinking on diagnostic approaches was shared; ESPEN suggested a grading approach that could encompass various types of signs, symptoms, and etiologies to support diagnosis. ASPEN emphasized where the parties agree; that is, that the 3 major published approaches (ESPEN, ASPEN-Academy of Nutrition and Dietetics, and Subjective Global Assessment [SGA]) all propose weight loss as a key indicator for malnutrition. FELANPE suggested that the anticipated consensus approach needs to prioritize a diagnostic method that is available for everybody since resources differ globally. PENSA highlighted that body mass index varies by ethnicity/race and that sarcopenia/muscle mass evaluation is important for the diagnosis of malnutrition. A Core Working Committee of the Global Leadership Initiative on Malnutrition has been established (comprising 2 representatives each from the 4 largest PEN societies) that will lead consensus development in collaboration with a larger working group with broad global representation, using e-mail, telephone conferences, and face-to-face meetings during the upcoming ASPEN and ESPEN congresses. Transparency and external input will be sought. Objectives include (1) consensus development around evidence-based criteria for broad application, (2) promotion of global dissemination of the

Improving consensus contact prediction via server correlation reduction.

Science.gov (United States)

Gao, Xin; Bu, Dongbo; Xu, Jinbo; Li, Ming

2009-05-06

Protein inter-residue contacts play a crucial role in the determination and prediction of protein structures. Previous studies on contact prediction indicate that although template-based consensus methods outperform sequence-based methods on targets with typical templates, such consensus methods perform poorly on new fold targets. However, we find out that even for new fold targets, the models generated by threading programs can contain many true contacts. The challenge is how to identify them. In this paper, we develop an integer linear programming model for consensus contact prediction. In contrast to the simple majority voting method assuming that all the individual servers are equally important and independent, the newly developed method evaluates their correlation by using maximum likelihood estimation and extracts independent latent servers from them by using principal component analysis. An integer linear programming method is then applied to assign a weight to each latent server to maximize the difference between true contacts and false ones. The proposed method is tested on the CASP7 data set. If the top L/5 predicted contacts are evaluated where L is the protein size, the average accuracy is 73%, which is much higher than that of any previously reported study. Moreover, if only the 15 new fold CASP7 targets are considered, our method achieves an average accuracy of 37%, which is much better than that of the majority voting method, SVM-LOMETS, SVM-SEQ, and SAM-T06. These methods demonstrate an average accuracy of 13.0%, 10.8%, 25.8% and 21.2%, respectively. Reducing server correlation and optimally combining independent latent servers show a significant improvement over the traditional consensus methods. This approach can hopefully provide a powerful tool for protein structure refinement and prediction use.

Improving consensus contact prediction via server correlation reduction

Directory of Open Access Journals (Sweden)

Xu Jinbo

2009-05-01

Full Text Available Abstract Background Protein inter-residue contacts play a crucial role in the determination and prediction of protein structures. Previous studies on contact prediction indicate that although template-based consensus methods outperform sequence-based methods on targets with typical templates, such consensus methods perform poorly on new fold targets. However, we find out that even for new fold targets, the models generated by threading programs can contain many true contacts. The challenge is how to identify them. Results In this paper, we develop an integer linear programming model for consensus contact prediction. In contrast to the simple majority voting method assuming that all the individual servers are equally important and independent, the newly developed method evaluates their correlation by using maximum likelihood estimation and extracts independent latent servers from them by using principal component analysis. An integer linear programming method is then applied to assign a weight to each latent server to maximize the difference between true contacts and false ones. The proposed method is tested on the CASP7 data set. If the top L/5 predicted contacts are evaluated where L is the protein size, the average accuracy is 73%, which is much higher than that of any previously reported study. Moreover, if only the 15 new fold CASP7 targets are considered, our method achieves an average accuracy of 37%, which is much better than that of the majority voting method, SVM-LOMETS, SVM-SEQ, and SAM-T06. These methods demonstrate an average accuracy of 13.0%, 10.8%, 25.8% and 21.2%, respectively. Conclusion Reducing server correlation and optimally combining independent latent servers show a significant improvement over the traditional consensus methods. This approach can hopefully provide a powerful tool for protein structure refinement and prediction use.

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.

Priority target conditions for algorithms for monitoring children's growth: Interdisciplinary consensus.

Directory of Open Access Journals (Sweden)

Pauline Scherdel

Full Text Available Growth monitoring of apparently healthy children aims at early detection of serious conditions through the use of both clinical expertise and algorithms that define abnormal growth. Optimization of growth monitoring requires standardization of the definition of abnormal growth, and the selection of the priority target conditions is a prerequisite of such standardization.To obtain a consensus about the priority target conditions for algorithms monitoring children's growth.We applied a formal consensus method with a modified version of the RAND/UCLA method, based on three phases (preparatory, literature review, and rating, with the participation of expert advisory groups from the relevant professional medical societies (ranging from primary care providers to hospital subspecialists as well as parent associations. We asked experts in the pilot (n = 11, reading (n = 8 and rating (n = 60 groups to complete the list of diagnostic classification of the European Society for Paediatric Endocrinology and then to select the conditions meeting the four predefined criteria of an ideal type of priority target condition.Strong agreement was obtained for the 8 conditions selected by the experts among the 133 possible: celiac disease, Crohn disease, craniopharyngioma, juvenile nephronophthisis, Turner syndrome, growth hormone deficiency with pituitary stalk interruption syndrome, infantile cystinosis, and hypothalamic-optochiasmatic astrocytoma (in decreasing order of agreement.This national consensus can be used to evaluate the algorithms currently suggested for growth monitoring. The method used for this national consensus could be re-used to obtain an international consensus.

A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints

Directory of Open Access Journals (Sweden)

Fábio Henrique de Gobbi Porto

2013-09-01

Full Text Available It is not easy to differentiate patients with mild cognitive impairment (MCI from subjective memory complainers (SMC. Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE and the Brief Cognitive Battery (BCB. We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR, and also a phonemic fluency test of letter P fluency (LPF. A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC, the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively. Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29; LDR: 56%, 62% and 0.62 (cut off <3; LPF: 71%, 71% and 0.71 (cut off <14; delayed recall of BCB: 56%, 82% and 0.68 (cut off <9. The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.

Using a Delphi process to establish consensus on emergency medicine clerkship competencies.

Science.gov (United States)

Penciner, Rick; Langhan, Trevor; Lee, Richard; McEwen, Jill; Woods, Robert A; Bandiera, Glen

2011-01-01

Currently, there is no consensus on the core competencies required for emergency medicine (EM) clerkships in Canada. Existing EM curricula have been developed through informal consensus or local efforts. The Delphi process has been used extensively as a means for establishing consensus. The purpose of this project was to define core competencies for EM clerkships in Canada, to validate a Delphi process in the context of national curriculum development, and to demonstrate the adoption of the CanMEDS physician competency paradigm in the undergraduate medical education realm. Using a modified Delphi process, we developed a consensus amongst a panel of expert emergency physicians from across Canada utilizing the CanMEDS 2005 Physician Competency Framework. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). This study demonstrated that a modified Delphi process can result in a strong consensus around a realistic number of core competencies for EM clerkships. We propose that such a method could be used by other medical specialties and health professions to develop rotation-specific core competencies.

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.

Bruxism defined and graded: an international consensus.

Science.gov (United States)

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 bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains. © 2012 Blackwell Publishing Ltd.

Leader-Following Consensus Stability of Discrete-Time Linear Multiagent Systems with Observer-Based Protocols

Directory of Open Access Journals (Sweden)

Bingbing Xu

2013-01-01

Full Text Available We consider the leader-following consensus problem of discrete-time multiagent systems on a directed communication topology. Two types of distributed observer-based consensus protocols are considered to solve such a problem. The observers involved in the proposed protocols include full-order observer and reduced-order observer, which are used to reconstruct the state variables. Two algorithms are provided to construct the consensus protocols, which are based on the modified discrete-time algebraic Riccati equation and Sylvester equation. In light of graph and matrix theory, some consensus conditions are established. Finally, a numerical example is provided to illustrate the obtained result.

Review of Consensus Standard Spectra for Flat Plate and Concentrating Photovoltaic Performance

Energy Technology Data Exchange (ETDEWEB)

Myers, D.

2011-09-01

Consensus standard reference terrestrial solar spectra are used to establish nameplate ratings for photovoltaic device performance at standard reporting conditions. This report describes reference solar spectra developed in the United States and international consensus standards community which are widely accepted as of this writing (June 2011).

24 CFR 3286.15 - Consultation with the Manufactured Housing Consensus Committee (MHCC).

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Consultation with the Manufactured Housing Consensus Committee (MHCC). 3286.15 Section 3286.15 Housing and Urban Development Regulations... Consensus Committee (MHCC). The Secretary will seek input from the MHCC when revising the installation...

Cultural Consensus Theory: Aggregating Continuous Responses in a Finite Interval

Science.gov (United States)

Batchelder, William H.; Strashny, Alex; Romney, A. Kimball

Cultural consensus theory (CCT) consists of cognitive models for aggregating responses of "informants" to test items about some domain of their shared cultural knowledge. This paper develops a CCT model for items requiring bounded numerical responses, e.g. probability estimates, confidence judgments, or similarity judgments. The model assumes that each item generates a latent random representation in each informant, with mean equal to the consensus answer and variance depending jointly on the informant and the location of the consensus answer. The manifest responses may reflect biases of the informants. Markov Chain Monte Carlo (MCMC) methods were used to estimate the model, and simulation studies validated the approach. The model was applied to an existing cross-cultural dataset involving native Japanese and English speakers judging the similarity of emotion terms. The results sharpened earlier studies that showed that both cultures appear to have very similar cognitive representations of emotion terms.

Consensus and stratification in the affective meaning of human sociality.

Science.gov (United States)

Ambrasat, Jens; von Scheve, Christian; Conrad, Markus; Schauenburg, Gesche; Schröder, Tobias

2014-06-03

We investigate intrasocietal consensus and variation in affective meanings of concepts related to authority and community, two elementary forms of human sociality. Survey participants (n = 2,849) from different socioeconomic status (SES) groups in German society provided ratings of 909 social concepts along three basic dimensions of affective meaning. Results show widespread consensus on these meanings within society and demonstrate that a meaningful structure of socially shared knowledge emerges from organizing concepts according to their affective similarity. The consensus finding is further qualified by evidence for subtle systematic variation along SES differences. In relation to affectively neutral words, high-status individuals evaluate intimacy-related and socially desirable concepts as less positive and powerful than middle- or low-status individuals, while perceiving antisocial concepts as relatively more threatening. This systematic variation across SES groups suggests that the affective meaning of sociality is to some degree a function of social stratification.

A new fast method for inferring multiple consensus trees using k-medoids.

Science.gov (United States)

Tahiri, Nadia; Willems, Matthieu; Makarenkov, Vladimir

2018-04-05

Gene trees carry important information about specific evolutionary patterns which characterize the evolution of the corresponding gene families. However, a reliable species consensus tree cannot be inferred from a multiple sequence alignment of a single gene family or from the concatenation of alignments corresponding to gene families having different evolutionary histories. These evolutionary histories can be quite different due to horizontal transfer events or to ancient gene duplications which cause the emergence of paralogs within a genome. Many methods have been proposed to infer a single consensus tree from a collection of gene trees. Still, the application of these tree merging methods can lead to the loss of specific evolutionary patterns which characterize some gene families or some groups of gene families. Thus, the problem of inferring multiple consensus trees from a given set of gene trees becomes relevant. We describe a new fast method for inferring multiple consensus trees from a given set of phylogenetic trees (i.e. additive trees or X-trees) defined on the same set of species (i.e. objects or taxa). The traditional consensus approach yields a single consensus tree. We use the popular k-medoids partitioning algorithm to divide a given set of trees into several clusters of trees. We propose novel versions of the well-known Silhouette and Caliński-Harabasz cluster validity indices that are adapted for tree clustering with k-medoids. The efficiency of the new method was assessed using both synthetic and real data, such as a well-known phylogenetic dataset consisting of 47 gene trees inferred for 14 archaeal organisms. The method described here allows inference of multiple consensus trees from a given set of gene trees. It can be used to identify groups of gene trees having similar intragroup and different intergroup evolutionary histories. The main advantage of our method is that it is much faster than the existing tree clustering approaches, while

Development of Consensus Treatment Plans for Juvenile Localized Scleroderma

Science.gov (United States)

Li, Suzanne C.; Torok, Kathryn S.; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T.; Rabinovich, C. Egla; Laxer, Ronald M.; Higgins, Gloria C.; Ferguson, Polly J.; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M.; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A.; Ilowite, Norman T.; Fuhlbrigge, Robert C

2013-01-01

Objective To develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile localized scleroderma (jLS). Background jLS is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies have been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment of have made it difficult to compare approaches and identify optimal therapy. Methods A core group of pediatric rheumatologists, dermatologists and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for jLS using consensus methods/nominal group techniques. Recommendations were validated in two face-to-face conferences with a larger group of practitioners with expertise in jLS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the U.S and Canada. Results Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (67% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with jLS. Conclusions Using consensus methodology, we have developed standardized treatment plans and assessment methods for jLS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of jLS. PMID:22505322

Prostate cancer: ESMO Consensus Conference Guidelines 2012

NARCIS (Netherlands)

Horwich, A.; Hugosson, J.; de Reijke, T.; Wiegel, T.; Fizazi, K.; Kataja, V.; Parker, Chris; Bellmunt, Joaquim; Berthold, Dominik; Bill-Axelson, Anna; Carlsson, Sigrid; Daugaard, Gedske; de Meerleer, Gert; Dearnaley, David; Fizazi, Karim; Fonteyne, Valérie; Gillessen, Silke; Heinrich, Daniel; Horwich, Alan; Hugosson, Jonas; Kataja, Vesa; Kwiatkowski, Maciej; Nilsson, Sten; Padhani, Anwar; Papandreou, Christos; Roobol, Monique; Sella, Avishay; Valdagni, Riccardo; van der Kwast, Theo; Verhagen, Paul; Wiegel, Thomas

2013-01-01

The first ESMO Consensus Conference on prostate cancer was held in Zurich, Switzerland, on 17-19 November 2011, with the participation of a multidisciplinary panel of leading professionals including experts in methodological aspects. Before the conference, the expert panel prepared clinically

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.

Science.gov (United States)

Griffin, D R; Dickenson, E J; O'Donnell, J; Agricola, R; Awan, T; Beck, M; Clohisy, J C; Dijkstra, H P; Falvey, E; Gimpel, M; Hinman, R S; Hölmich, P; Kassarjian, A; Martin, H D; Martin, R; Mather, R C; Philippon, M J; Reiman, M P; Takla, A; Thorborg, K; Walker, S; Weir, A; Bennell, K L

2016-10-01

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.Author note The Warwick Agreement on femoroacetabular impingement syndrome has been endorsed by the following 25 clinical societies: American Medical Society for Sports Medicine (AMSSM), Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM), Australasian College of Sports and Exercise Physicians (ACSEP), Austian Sports Physiotherapists, British Association of Sports and Exercise

On the importance of having an identity or, is consensus really universal?

NARCIS (Netherlands)

Buhrman, H.; Panconesi, A.; Silvestri, R.; Vitanyi, P.

2006-01-01

We show that Naming - the existence of distinct IDs known to all - is a hidden, but necessary, assumption of Herlihy's universality result for Consensus. We then show in a very precise sense that Naming is harder than Consensus and bring to the surface some relevant differences existing between

The ''Article Act'' - a substitute for the miscarried energy consensus?

International Nuclear Information System (INIS)

Knott, G.

1994-01-01

A prerequisite for arriving at a long-term energy policy is that all political parties come to an energy consensus. This paper reviews the chronology of the energy consensus negatiations, their failure, and the consequent energy-political rerouting which is to be realised by an act securing hard coal a share in electricity generation and amending the Atomic Energy Act (termed 'Article Act'). The Article Act is an attempt at a binding definition of central issues of the energy consensus talks even in the absence of an all-party agreement. It is particularly noteworthy that the bill makes mention of both coal and nuclear energy, reviving this link-up between the two energy sources already decined lost. The German electricity industry considers the provisions on atomic energy law contained in the Article Act insufficient for securing already existing power plants an untroubled future and for providing the investment climate needed by the manufacturing industry. To the electricity industry the main problems lie in the execution deficits at the Laender level, but these are not affected by the Article Act. It is concluded that an all-party consensus on an answerable nuclear energy utilisation will have to be found by 1995 at the latest in order to give the manufacturing industry the go-alread for continuing research and provide electricity producers with a sound basis for investment decisions. (orig./HSCH) [de

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

Trust, values and false consensus

OpenAIRE

Butler, Jeffrey V.; Giuliano, Paola; Guiso, Luigi

2012-01-01

Trust beliefs are heterogeneous across individuals and, at the same time, persistent across generations. We investigate one mechanism yielding these dual patterns: false consensus. In the context of a trust game experiment, we show that individuals extrapolate from their own type when forming trust beliefs about the same pool of potential partners – i.e., more (less) trustworthy individuals form more optimistic (pessimistic) trust beliefs - and that this tendency continues to color trust beli...

Dual-energy CT workflow: multi-institutional consensus on standardization of abdominopelvic MDCT protocols.

Science.gov (United States)

Patel, Bhavik N; Alexander, Lauren; Allen, Brian; Berland, Lincoln; Borhani, Amir; Mileto, Achille; Moreno, Courtney; Morgan, Desiree; Sahani, Dushyant; Shuman, William; Tamm, Eric; Tublin, Mitchell; Yeh, Benjamin; Marin, Daniele

2017-03-01

To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used. Consensus was considered with a score of ≥2.5. Survey results were discussed over three separate live webinar sessions. 5/9 (56%) institutions exclude large patients from DECT. 2 (40%) use weight, 2 (40%) use transverse dimension, and 1 (20%) uses both. 7/9 (78%) use 50 keV for low and 70 keV for medium monochromatic reconstructed images. DECT is indicated for dual liver [agreement score (AS) 3.78; utilization score (US) 3.22] and dual pancreas in the arterial phase (AS 3.78; US 3.11), mesenteric ischemia/gastrointestinal bleeding in both the arterial and venous phases (AS 2.89; US 2.79), RCC exams in the arterial phase (AS 3.33; US 2.78), and CT urography in the nephrographic phase (AS 3.11; US 2.89). DECT for renal stone and certain single-phase exams is indicated (AS 3.00). DECT is indicated during the arterial phase for multiphasic abdominal exams, nephrographic phase for CTU, and for certain single-phase and renal stone exams.

An Emergency Department Validation of the SEP-3 Sepsis and Septic Shock Definitions and Comparison With 1992 Consensus Definitions.

Science.gov (United States)

Henning, Daniel J; Puskarich, Michael A; Self, Wesley H; Howell, Michael D; Donnino, Michael W; Yealy, Donald M; Jones, Alan E; Shapiro, Nathan I

2017-10-01

The Third International Consensus Definitions Task Force (SEP-3) proposed revised criteria defining sepsis and septic shock. We seek to evaluate the performance of the SEP-3 definitions for prediction of inhospital mortality in an emergency department (ED) population and compare the performance of the SEP-3 definitions to that of the previous definitions. This was a secondary analysis of 3 prospectively collected, observational cohorts of infected ED subjects aged 18 years or older. The primary outcome was all-cause inhospital mortality. In accordance with the SEP-3 definitions, we calculated test characteristics of sepsis (quick Sequential Organ Failure Assessment [qSOFA] score ≥2) and septic shock (vasopressor dependence plus lactate level >2.0 mmol/L) for mortality and compared them to the original 1992 consensus definitions. We identified 7,754 ED patients with suspected infection overall; 117 had no documented mental status evaluation, leaving 7,637 patients included in the analysis. The mortality rate for the overall population was 4.4% (95% confidence interval [CI] 3.9% to 4.9%). The mortality rate for patients with qSOFA score greater than or equal to 2 was 14.2% (95% CI 12.2% to 16.2%), with a sensitivity of 52% (95% CI 46% to 57%) and specificity of 86% (95% CI 85% to 87%) to predict mortality. The original systemic inflammatory response syndrome-based 1992 consensus sepsis definition had a 6.8% (95% CI 6.0% to 7.7%) mortality rate, sensitivity of 83% (95% CI 79% to 87%), and specificity of 50% (95% CI 49% to 51%). The SEP-3 septic shock mortality was 23% (95% CI 16% to 30%), with a sensitivity of 12% (95% CI 11% to 13%) and specificity of 98.4% (95% CI 98.1% to 98.7%). The original 1992 septic shock definition had a 22% (95% CI 17% to 27%) mortality rate, sensitivity of 23% (95% CI 18% to 28%), and specificity of 96.6% (95% CI 96.2% to 97.0%). Both the new SEP-3 and original sepsis definitions stratify ED patients at risk for mortality, albeit with

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)....

Bladder tumor markers beyond cytology: International Consensus Panel on bladder tumor markers.

NARCIS (Netherlands)

Lokeshwar, V.B.; Habuchi, T.; Grossman, H.B.; Murphy, W.M.; Hautmann, S.H.; Hemstreet, G.P.; Bono, A.V.; Getzenberg, R.H.; Goebell, P.; Schmitz-Drager, B.J.; Schalken, J.A.; Fradet, Y.; Marberger, M.; Messing, E.; Droller, M.J.

2005-01-01

This is the first of 2 articles that summarize the findings of the International Consensus Panel on cytology and bladder tumor markers. The objectives of our panel were to reach a consensus on the areas where markers are needed, to define the attributes of an ideal tumor marker, and to identify

Non-fragile consensus algorithms for a network of diffusion PDEs with boundary local interaction

Science.gov (United States)

Xiong, Jun; Li, Junmin

2017-07-01

In this study, non-fragile consensus algorithm is proposed to solve the average consensus problem of a network of diffusion PDEs, modelled by boundary controlled heat equations. The problem deals with the case where the Neumann-type boundary controllers are corrupted by additive persistent disturbances. To achieve consensus between agents, a linear local interaction rule addressing this requirement is given. The proposed local interaction rules are analysed by applying a Lyapunov-based approach. The multiplicative and additive non-fragile feedback control algorithms are designed and sufficient conditions for the consensus of the multi-agent systems are presented in terms of linear matrix inequalities, respectively. Simulation results are presented to support the effectiveness of the proposed algorithms.

Identifying patients and clinical scenarios for use of long-acting injectable antipsychotics – expert consensus survey part 1

Directory of Open Access Journals (Sweden)

Sajatovic M

2018-06-01

Full Text Available Martha Sajatovic,1,2 Ruth Ross,3 Susan N Legacy,4 Christoph U Correll,5,6 John M Kane,5,6 Faith DiBiasi,7 Heather Fitzgerald,8 Matthew Byerly9 1Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; 2Departments of Psychiatry and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Ross Editorial, Port Townsend, WA, USA; 4US Medical Affairs Neuroscience, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA; 5Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA; 6Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, USA; 7Scientific Communications, Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD, USA; 8Medical Affairs, Lundbeck LLC, Deerfield, IL, USA; 9Cell Biology and Neuroscience, Center for Mental Health Research and Recovery, Montana State University, Bozeman, MT, USA Objective: To assess expert consensus on barriers and facilitators for long-acting injectable antipsychotic (LAI use and provide clinical recommendations on issues where clinical evidence is lacking, including identifying appropriate clinical situations for LAI use. Methods: A 50-question survey comprising 916 response options was distributed to 42 research experts and high prescribers with extensive LAI experience. Respondents rated options on relative appropriateness/importance using a 9-point scale. Consensus was determined using chi-square test of score distributions. Mean (standard deviation ratings were calculated. Responses to 29 questions (577 options relating to appropriate patients and clinical scenarios for LAI use are reported. Results: Recommendations aligned with research on risk factors for nonadherence and poor outcomes for patients with schizophrenia/schizoaffective or bipolar disorder. Findings suggested, contrary to general practice patterns, that LAI use may be appropriate earlier in

Using consensus building to improve utility regulation

International Nuclear Information System (INIS)

Raab, J.

1994-01-01

The utility industry and its regulatory environment are at a crossroads. Utilities, intervenors and even public utility commissions are no longer able to initiate and sustain changes unilaterally. Traditional approaches to regulation are often contentious and costly, producing results that are not perceived as legitimate or practical. Consensus building and alternative dispute resolution have the potential to help utilities, intervenors and regulators resolve a host of regulatory issues. This book traces the decline of consensus in utility regulation and delineates current controversies. It presents the theory and practice of alternative dispute resolution in utility regulation and offers a framework for evaluating the successes and failures of attempts to employ these processes. Four regulatory cases are analyzed in detail: the Pilgrim nuclear power plant outage settlement, the use of DSM collaboratives, the New Jersey resource bidding policy and the formation of integrated resource management rules in Massachusetts

Distributed Position-Based Consensus of Second-Order Multiagent Systems With Continuous/Intermittent Communication.

Science.gov (United States)

Song, Qiang; Liu, Fang; Wen, Guanghui; Cao, Jinde; Yang, Xinsong

2017-04-24

This paper considers the position-based consensus in a network of agents with double-integrator dynamics and directed topology. Two types of distributed observer algorithms are proposed to solve the consensus problem by utilizing continuous and intermittent position measurements, respectively, where each observer does not interact with any other observers. For the case of continuous communication between network agents, some convergence conditions are derived for reaching consensus in the network with a single constant delay or multiple time-varying delays on the basis of the eigenvalue analysis and the descriptor method. When the network agents can only obtain intermittent position data from local neighbors at discrete time instants, the consensus in the network without time delay or with nonuniform delays is investigated by using the Wirtinger's inequality and the delayed-input approach. Numerical examples are given to illustrate the theoretical analysis.

Interpreting the results of the Semmes-Weinstein monofilament test: accounting for false-positive answers in the international consensus on the diabetic foot protocol by a new model.

Science.gov (United States)

Slater, Robert A; Koren, Shlomit; Ramot, Yoram; Buchs, Andreas; Rapoport, Micha J

2014-01-01

The Semmes-Weinstein monofilament is the most widely used test to diagnose the loss of protective sensation. The commonly used protocol of the International Consensus on the Diabetic Foot includes a 'sham' application that allows for false-positive answers. We sought to study the heretofore unexamined significance of false-positive answers. Forty-five patients with diabetes and a history of pedal ulceration (Group I) and 81 patients with diabetes but no history of ulceration (Group II) were studied. The three original sites of the International Consensus on the Diabetic Foot at the hallux, 1st metatarsal and 5th metatarsal areas were used. At each location, the test was performed three times: 2 actual and 1 "sham" applications. Scores were graded from 0 to 3 based upon correct responses. Determination of loss of protective sensation was performed with and without calculating a false-positive answer as a minus 1 score. False-positive responses were found in a significant percentage of patients with and without history of ulceration. Introducing false-positive results as minus 1 into the test outcome significantly increased the number of patients diagnosed with loss of protective sensation in both groups. False-positive answers can significantly affect Semmes-Weinstein monofilament test results and the diagnosis of LOPS. A model that accounts for false-positive answers is offered. Copyright © 2013 John Wiley & Sons, Ltd.

Fault-Tolerant Consensus of Multi-Agent System With Distributed Adaptive Protocol.

Science.gov (United States)

Chen, Shun; Ho, Daniel W C; Li, Lulu; Liu, Ming

2015-10-01

In this paper, fault-tolerant consensus in multi-agent system using distributed adaptive protocol is investigated. Firstly, distributed adaptive online updating strategies for some parameters are proposed based on local information of the network structure. Then, under the online updating parameters, a distributed adaptive protocol is developed to compensate the fault effects and the uncertainty effects in the leaderless multi-agent system. Based on the local state information of neighboring agents, a distributed updating protocol gain is developed which leads to a fully distributed continuous adaptive fault-tolerant consensus protocol design for the leaderless multi-agent system. Furthermore, a distributed fault-tolerant leader-follower consensus protocol for multi-agent system is constructed by the proposed adaptive method. Finally, a simulation example is given to illustrate the effectiveness of the theoretical analysis.

D-score: a search engine independent MD-score.

Science.gov (United States)

Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

2013-03-01

While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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.

IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations

Directory of Open Access Journals (Sweden)

Yutskovskaya Y

2015-06-01

Full Text Available Yana Yutskovskaya,1 Elena Gubanova,2 Irina Khrustaleva,3 Vasiliy Atamanov,4 Anastasiya Saybel,5 Elena Parsagashvili,6 Irina Dmitrieva,7 Elena Sanchez,8 Natalia Lapatina,9 Tatiana Korolkova,10 Alena Saromytskaya,11 Elena Goltsova,12 Elmira Satardinova13 1Department of Dermatovenereology and Cosmetology, Pacific State Medical University, Vladivostock, 2Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, 3Department of Plastic Surgery, IP Pavlov Medical State University, St Petersburg, 4Department of Reconstructive and Plastic Surgery, SN Fedorova, Federal State Institution, Novosibirsk, 5Clinic Ideal, Laser Technologies Center, Moscow, 6Aestima-clinic, 7Clinic “Academy”, St Petersburg, 8Eklan Medical Center of Cosmetological Correction, 9Clinic of Aesthetic Medicine and Plastic Surgery, Moscow, 10Department of Cosmetology, II Mechnikov North-Western State Medical University, St Petersburg, 11Plastic Surgery Clinic, Center of Aesthetic Medicine and Beauty Cosmetology, 12“Neo-Clinic,” Tyumen, 13Botulinum Toxin Therapy Department, Diagnostic Center of the Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia Background: Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians. Methods: Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013, and Moscow, Russia (March 2014

Perceptions of a fluid consensus: uniqueness bias, false consensus, false polarization, and pluralistic ignorance in a water conservation crisis.

Science.gov (United States)

Monin, Benoît; Norton, Michael I

2003-05-01

A 5-day field study (N = 415) during and right after a shower ban demonstrated multifaceted social projection and the tendency to draw personality inferences from simple behavior in a time of drastic consensus change. Bathers thought showering was more prevalent than did non-bathers (false consensus) and respondents consistently underestimated the prevalence of the desirable and common behavior--be it not showering during the shower ban or showering after the ban (uniqueness bias). Participants thought that bathers and non-bathers during the ban differed greatly in their general concern for the community, but self-reports demonstrated that this gap was illusory (false polarization). Finally, bathers thought other bathers cared less than they did, whereas non-bathers thought other non-bathers cared more than they did (pluralistic ignorance). The study captures the many biases at work in social perception in a time of social change.

Consensus stability testing protocols for organic photovoltaic materials and devices

DEFF Research Database (Denmark)

Reese, Matthew O.; Gevorgyan, Suren; Jørgensen, Mikkel

2011-01-01

Procedures for testing organic solar cell devices and modules with respect to stability and operational lifetime are described. The descriptions represent a consensus of the discussion and conclusions reached during the first 3 years of the international summit on OPV stability (ISOS). The proced......Procedures for testing organic solar cell devices and modules with respect to stability and operational lifetime are described. The descriptions represent a consensus of the discussion and conclusions reached during the first 3 years of the international summit on OPV stability (ISOS...

Acute pancreatitis: reflections through the history of the Atlanta Consensus

OpenAIRE

Torres López, Ana María; Hoyos Duque, Sergio Iván

2014-01-01

Acute pancreatitis is an inflammatory process with systemic and local repercussions. Most cases are mild with low mortality rate, but 20% of the patients have severe pancreatitis with a mortality rate up to 30%. Through the years the medical community has tried to reach consensus about this disease in order to better understand, classify and treat it. The most important of these has been known as the Atlanta Consensus 1992, in use for many years. However, it has been recently the subject of v...

Use of expert consensus to improve atherogenic dyslipidemia management.

Science.gov (United States)

Millán Núñez-Cortés, Jesús; Pedro-Botet, Juan; Brea-Hernando, Ángel; Díaz-Rodríguez, Ángel; González-Santos, Pedro; Hernández-Mijares, Antonio; Mantilla-Morató, Teresa; Pintó-Sala, Xavier; Simó, Rafael

2014-01-01

Although atherogenic dyslipidemia is a recognized cardiovascular risk factor, it is often underassessed and thus undertreated and poorly controlled in clinical practice. The objective of this study was to reach a multidisciplinary consensus for the establishment of a set of clinical recommendations on atherogenic dyslipidemia to optimize its prevention, early detection, diagnostic evaluation, therapeutic approach, and follow-up. After a review of the scientific evidence, a scientific committee formulated 87 recommendations related to atherogenic dyslipidemia, which were grouped into 5 subject areas: general concepts (10 items), impact and epidemiology (4 items), cardiovascular risk (32 items), detection and diagnosis (19 items), and treatment (22 items). A 2-round modified Delphi method was conducted to compare the opinions of a panel of 65 specialists in cardiology (23%), endocrinology (24.6%), family medicine (27.7%), and internal medicine (24.6%) on these issues. After the first round, the panel reached consensus on 65 of the 87 items discussed, and agreed on 76 items by the end of the second round. Insufficient consensus was reached on 3 items related to the detection and diagnosis of atherogenic dyslipidemia and 3 items related to the therapeutic goals to be achieved in these patients. The external assessment conducted by experts on atherogenic dyslipidemia showed a high level of professional agreement with the proposed clinical recommendations. These recommendations represent a useful tool for improving the clinical management of patients with atherogenic dyslipidemia. A detailed analysis of the current scientific evidence is required for those statements that eluded consensus. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Towards consensus in operational definitions in functional capacity evaluation: a Delphi Survey.

Science.gov (United States)

Soer, Remko; van der Schans, Cees P; Groothoff, Johan W; Geertzen, Jan H B; Reneman, Michiel F

2008-12-01

The problem of inconsistent terminology in functional capacity evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. A Delphi Survey with FCE experts was conducted which consisted of three rounds of questioning, using semi and full structured questions. The expert group was formed from international experts in FCE. Experts were selected if they met any of the following criteria: at least one international publication as first author and one as co-author in the field of FCE; or an individual who had developed an FCE that was subject of investigation in at least one publication in international literature. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of FCE, for which two potential eligible definitions remained. Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.

Coping with nuclear power risks: a national strategy

International Nuclear Information System (INIS)

Starr, C.

1983-01-01

The question of risk policy for nuclear power plants must be addressed in the framework of a total social benefit and cost perspective that is not fully defined, and which may always lack a unanimous consensus in our pluralistic and politically varying society. This report emphasizes those aspects that may be important to a final balance, particularly where the social values involved are culturally self-evident. To illustrate those social values, this paper begins with a global view and proceeds to the individual nuclear plant

Assessment and management of agitation in psychiatry: Expert consensus.

Science.gov (United States)

Garriga, Marina; Pacchiarotti, Isabella; Kasper, Siegfried; Zeller, Scott L; Allen, Michael H; Vázquez, Gustavo; Baldaçara, Leonardo; San, Luis; McAllister-Williams, R Hamish; Fountoulakis, Konstantinos N; Courtet, Philippe; Naber, Dieter; Chan, Esther W; Fagiolini, Andrea; Möller, Hans Jürgen; Grunze, Heinz; Llorca, Pierre Michel; Jaffe, Richard L; Yatham, Lakshmi N; Hidalgo-Mazzei, Diego; Passamar, Marc; Messer, Thomas; Bernardo, Miquel; Vieta, Eduard

2016-01-01

Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions. An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items. Out of 2175 papers assessing psychomotor agitation, 124 were included in the review. Each component was assigned a level of evidence. Integrating the evidence and the experience of the task force members, a consensus was reached on 22 statements on this topic. Recommendations on the assessment of agitation emphasise the importance of identifying any possible medical cause. For its management, experts agreed in considering verbal de-escalation and environmental modification techniques as first choice, considering physical restraint as a last resort strategy. Regarding pharmacological treatment, the "ideal" medication should calm without over-sedate. Generally, oral or inhaled formulations should be preferred over i.m. routes in mildly agitated patients. Intravenous treatments should be avoided.

Delayed Consensus Problem for Single and Double Integrator Systems

Directory of Open Access Journals (Sweden)

Martín Velasco-Villa

2015-01-01

Full Text Available This work deals with the analysis of the consensus problem for networks of agents constituted by single and double integrator systems. It is assumed that the communication among agents is affected by a constant time-delay. Previous and numerous analysis of the problem shows that the maximum communication time-delay that can be introduced to the network without affecting the consensus of the group of the agents depends on the considered topology. In this work, a control scheme that is based on the estimation of future states of the agents and that allows increasing the magnitude of a possible time-delay affecting the communication channels is proposed. How the proposed delay compensation strategy is independent of the network topology in the sense that the maximum allowable time-delay that could be supported by the network depends on a design parameter and not on the maximum eigenvalue of the corresponding Laplacian matrix is shown. It is formally proven that, under the proposed prediction scheme, the consensus of the group can be achieved by improving the maximum time-delay bounds previously reported in the literature. Numerical simulations show the effectiveness of the proposed solution.

False consensus effect for attitudes related to body shape in normal weight women concerned with body shape.

Science.gov (United States)

Muller, S L; Williamson, D A; Martin, C K

2002-06-01

This study investigated the presence of the False Consensus Effect (FCE) with body and shape-related attitudes in 30 normal weight women who scored high or low on a measure of concern with body shape. The participants were asked to rate depressive, positive, neutral, and body shape self-statements for relevance to self and to others. They also estimated the percentage of individuals that would agree with each attitudinal statement. Women with high body shape concerns rated themselves and others as significantly more likely to agree with the statements expressing such concerns than those with low concerns. They also believed that a significantly higher percentage of others would favor those attitudes. This pattern of findings is supportive of the presence of a FCE in normal weight women preoccupied with body shape and size.

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

Extension of the lod score: the mod score.

Science.gov (United States)

Clerget-Darpoux, F

2001-01-01

In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it

Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers—Evidence- and Opinion-Based Review and Consensus Recommendations

Science.gov (United States)

Liew, Steven; Sundaram, Hema; De Boulle, Koenraad L.; Goodman, Greg J.; Monheit, Gary; Wu, Yan; Trindade de Almeida, Ada R.; Swift, Arthur; Vieira Braz, André

2016-01-01

Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management. Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers. Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment. Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise. PMID:27219265

Fitness voter model: Damped oscillations and anomalous consensus.

Science.gov (United States)

Woolcock, Anthony; Connaughton, Colm; Merali, Yasmin; Vazquez, Federico

2017-09-01

We study the dynamics of opinion formation in a heterogeneous voter model on a complete graph, in which each agent is endowed with an integer fitness parameter k≥0, in addition to its + or - opinion state. The evolution of the distribution of k-values and the opinion dynamics are coupled together, so as to allow the system to dynamically develop heterogeneity and memory in a simple way. When two agents with different opinions interact, their k-values are compared, and with probability p the agent with the lower value adopts the opinion of the one with the higher value, while with probability 1-p the opposite happens. The agent that keeps its opinion (winning agent) increments its k-value by one. We study the dynamics of the system in the entire 0≤p≤1 range and compare with the case p=1/2, in which opinions are decoupled from the k-values and the dynamics is equivalent to that of the standard voter model. When 0≤psystem approaches exponentially fast to the consensus state of the initial majority opinion. The mean consensus time τ appears to grow logarithmically with the number of agents N, and it is greatly decreased relative to the linear behavior τ∼N found in the standard voter model. When 1/2system initially relaxes to a state with an even coexistence of opinions, but eventually reaches consensus by finite-size fluctuations. The approach to the coexistence state is monotonic for 1/2oscillations around the coexistence value. The final approach to coexistence is approximately a power law t^{-b(p)} in both regimes, where the exponent b increases with p. Also, τ increases respect to the standard voter model, although it still scales linearly with N. The p=1 case is special, with a relaxation to coexistence that scales as t^{-2.73} and a consensus time that scales as τ∼N^{β}, with β≃1.45.

Integrated consensus genetic and physical maps of flax (Linum usitatissimum L.).

Science.gov (United States)

Cloutier, Sylvie; Ragupathy, Raja; Miranda, Evelyn; Radovanovic, Natasa; Reimer, Elsa; Walichnowski, Andrzej; Ward, Kerry; Rowland, Gordon; Duguid, Scott; Banik, Mitali

2012-12-01

Three linkage maps of flax (Linum usitatissimum L.) were constructed from populations CDC Bethune/Macbeth, E1747/Viking and SP2047/UGG5-5 containing between 385 and 469 mapped markers each. The first consensus map of flax was constructed incorporating 770 markers based on 371 shared markers including 114 that were shared by all three populations and 257 shared between any two populations. The 15 linkage group map corresponds to the haploid number of chromosomes of this species. The marker order of the consensus map was largely collinear in all three individual maps but a few local inversions and marker rearrangements spanning short intervals were observed. Segregation distortion was present in all linkage groups which contained 1-52 markers displaying non-Mendelian segregation. The total length of the consensus genetic map is 1,551 cM with a mean marker density of 2.0 cM. A total of 670 markers were anchored to 204 of the 416 fingerprinted contigs of the physical map corresponding to ~274 Mb or 74 % of the estimated flax genome size of 370 Mb. This high resolution consensus map will be a resource for comparative genomics, genome organization, evolution studies and anchoring of the whole genome shotgun sequence.

The Italian Consensus Conference on Pain in Neurorehabilitation: rationale and methodology

Directory of Open Access Journals (Sweden)

Tamburin S

2016-05-01

Full Text Available Stefano Tamburin,1 Stefano Paolucci,2 Francesca Magrinelli,1 Massimo Musicco,2,3 Giorgio Sandrini4,5 On behalf of the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN 1Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, 2Santa Lucia Foundation, IRCCS, Rome, 3Institute of Biomedical Technologies (IBT National Research Council of Italy (CNR, Segrate, Milan, 4C. Mondino National Institute of Neurology Foundation, IRCCS, 5Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy Abstract: Pain is very common in the neurorehabilitation setting, where it may not only represent a target for treatment but can also negatively influence rehabilitation procedures directly or through the side effects of painkillers. To date, there are neither guidelines nor consensus on how to assess and treat pain in neurorehabilitation. Because of the very scanty pieces of evidence on this topic, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN was promoted under the auspices of different scientific societies. This article illustrates the rationale, methodology, and topics of the ICCPN. The recommendations of the ICCPN will offer some information on how to deal with pain in neurorehabilitation and may represent the starting point for further studies.Keywords: assessment, consensus conference, neurology, pain, rehabilitation, treatment

Distributed Leader-Following Finite-Time Consensus Control for Linear Multiagent Systems under Switching Topology

Science.gov (United States)

Xu, Xiaole; Chen, Shengyong

2014-01-01

This paper investigates the finite-time consensus problem of leader-following multiagent systems. The dynamical models for all following agents and the leader are assumed the same general form of linear system, and the interconnection topology among the agents is assumed to be switching and undirected. We mostly consider the continuous-time case. By assuming that the states of neighbouring agents are known to each agent, a sufficient condition is established for finite-time consensus via a neighbor-based state feedback protocol. While the states of neighbouring agents cannot be available and only the outputs of neighbouring agents can be accessed, the distributed observer-based consensus protocol is proposed for each following agent. A sufficient condition is provided in terms of linear matrix inequalities to design the observer-based consensus protocol, which makes the multiagent systems achieve finite-time consensus under switching topologies. Then, we discuss the counterparts for discrete-time case. Finally, we provide an illustrative example to show the effectiveness of the design approach. PMID:24883367

Evaluating the 2008 consensus conference on genetically modified foods in Taiwan.

Science.gov (United States)

Fan, Mei-Fang

2015-07-01

Genetically modified foods have become one of the most popular topics for deliberative exercises involving ordinary citizens worldwide. This paper examines the Taiwanese consensus conference on GM foods held in June 2008, and the implications and limitations of the public deliberations. The consensus conference facilitated multiparty dialogues and enhanced citizens' knowledge, and affected their attitudes. This study demonstrates the ways contextual factors have influenced the outcome of the citizens' deliberative practices, including the government's conventional technocratic decision-making style, the strong influence of the U.S. government, the political and technological culture, the government's framing of economic development concerns, and a lack of pressure from civil society to compel the government to formally respond to their concerns. The consensus conference had a limited effect on policy decision-making, and seemed to serve as a socio-political experiment. © The Author(s) 2013.

Maastricht consensus-5: analytical review of statements

Directory of Open Access Journals (Sweden)

Yu.M. Stepanov

2017-02-01

Full Text Available This article analyzes the statements of Maastricht consensus-5 on H. pylori infection studying. There was shown the changes in approaches to diagnostics and treatment of H. pylori infection in previous Maastricht consensuses. H. pylori associated gastritis was considered to be an infection disease. There was also analyzed the relation between this infection and gatroduodenal pathology including functional dyspepsia, NSAID-gastropathy and others. The paper deals with up-to-date approaches to diagnostics of H. pylori infection with determination of the most optimal diagnostic method in different situations. The approaches to antihelicobacter therapy were analyzed. The special attention was paid to dependence of modern therapeutic schemes of helicobacteriosis therapy on H. pylori resistance to key antibiotics. There was confirmed the importance of H. pylori eradication for prevention of precancerous changes in the stomach. The increased interest of researchers to non-helicobacter flora in the stomach was shown. There was regarded an important role of probiotics in antihelicobacter therapy.

Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II).

Science.gov (United States)

Peck-Radosavljevic, Markus; Angermayr, Bernhard; Datz, Christian; Ferlitsch, Arnulf; Ferlitsch, Monika; Fuhrmann, Valentin; Häfner, Michael; Kramer, Ludwig; Maieron, Andreas; Payer, Berit; Reiberger, Thomas; Stauber, Rudolf; Steininger, Rudolf; Trauner, Michael; Thurnher, Siegfried; Ulbrich, Gregor; Vogel, Wolfgang; Zoller, Heinz; Graziadei, Ivo

2013-04-01

In November 2004, the Austrian Society of Gastroenterology and Hepatology (ÖGGH) held for the first time a consensus meeting on the definitions and treatment of portal hypertension and its complications in the Billroth-Haus in Vienna, Austria (Billroth I-Meeting). This meeting was preceded by a meeting of international experts on portal hypertension with some of the proponents of the Baveno consensus conferences (http://www.oeggh.at/videos.asp). The consensus itself is based on the Baveno III consensus with regard to portal hypertensive bleeding and the suggestions of the International Ascites Club regarding the treatment of ascites. Those statements were modified by new knowledge derived from the recent literature and also by the current practice of medicine as agreed upon by the participants of the consensus meeting. In October 2011, the ÖGGH organized the second consensus meeting on portal hypertension and its complications in Vienna (Billroth II-Meeting). The Billroth II-Guidelines on the definitions and treatment of portal hypertension and its complications take into account the developments of the last 7 years, including the Baveno-V update and several key publications.

Engineering large-scale agent-based systems with consensus

Science.gov (United States)

Bokma, A.; Slade, A.; Kerridge, S.; Johnson, K.

1994-01-01

The paper presents the consensus method for the development of large-scale agent-based systems. Systems can be developed as networks of knowledge based agents (KBA) which engage in a collaborative problem solving effort. The method provides a comprehensive and integrated approach to the development of this type of system. This includes a systematic analysis of user requirements as well as a structured approach to generating a system design which exhibits the desired functionality. There is a direct correspondence between system requirements and design components. The benefits of this approach are that requirements are traceable into design components and code thus facilitating verification. The use of the consensus method with two major test applications showed it to be successful and also provided valuable insight into problems typically associated with the development of large systems.

Risk communication strategies : achieving a multidisciplinary consensus; La communication des risques : un consensus multidisciplinaire

Energy Technology Data Exchange (ETDEWEB)

Robert, B.; Cloutier, I. [Ecole Polytechnique, Montreal, PQ (Canada). Dept. de Mathematiques et de Genie Industriel; Sabourin, J.P. [Ville de Quebec, Quebec, PQ (Canada)

2006-07-01

Risk management related to floods and dam failures requires input from a variety of stakeholders from both the private and the public sector. This paper provided details of a risk management communication strategy based on a consequence approach that established work sequence modes to achieve a multidisciplinary consensus of opinion. The communication of risk was considered as a bilateral exchange of information between concerned parties, who were divided into 2 spheres: (1) a public sphere which included interest groups, government agencies, individuals and the media; and (2) a technical sphere comprised of industry members, scientific experts, and government agencies. Divided between the 2 spheres, government agencies play a distinct role in both the communication and understanding of risk. In Quebec, municipal agencies are required to identify risk and develop plans that ensure public safety. Risk management plans developed by industry members are a valuable source of information for municipal authorities, who can identify vulnerabilities in their own risk communication strategies. In addition, members of the public play an important role in eliciting further risk communications to improve areas of vulnerability. Interest groups can demand further analyses from impartial sources on sensitive issues. Conflicting results offer a plurality of opinions that must be considered to obtain a consensus in risk assessment, which is the ultimate aim of all risk analyses and communications strategies. It was concluded that risk communication strategies benefit from the engagement of a variety of often conflicting views. 8 refs., 3 figs.

Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East.

Science.gov (United States)

Al Sayed, Nasreen; Al Waili, Khalid; Alawadi, Fatheya; Al-Ghamdi, Saeed; Al Mahmeed, Wael; Al-Nouri, Fahad; Al Rukhaimi, Mona; Al-Rasadi, Khalid; Awan, Zuhier; Farghaly, Mohamed; Hassanein, Mohamed; Sabbour, Hani; Zubaid, Mohammad; Barter, Philip

2016-12-15

Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations. The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Dialogic Consensus In Clinical Decision-Making.

Science.gov (United States)

Walker, Paul; Lovat, Terry

2016-12-01

This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.

Consensus and Cognitivism in Habermas's Discourse | Moellendorf ...

African Journals Online (AJOL)

Habermas asserts that his discourse ethics rests on two main commitments: 1) Moral judgements have cognitive content analogous to truth value; and 2) moral justification requires real- life discourse. Habermas elaborates on the second claim by making actual consensus a necessary condition of normative validity. I argue ...

Expert consensus document

DEFF Research Database (Denmark)

Boehm, Ulrich; Bouloux, Pierre-Marc; Dattani, Mehul T

2015-01-01

Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different...... migration of GnRH-synthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some...... of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ∼10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus...

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

International veterinary epilepsy task force consensus proposal : diagnostic approach to epilepsy in dogs

NARCIS (Netherlands)

De Risio, Luisa; Bhatti, Sofie; Muñana, Karen; Penderis, Jacques; Stein, Veronika; Tipold, Andrea; Berendt, Mette; Farqhuar, Robyn; Fischer, Andrea; Long, Sam; Mandigers, Paul J J; Matiasek, Kaspar; Packer, Rowena M A; Pakozdy, Akos; Patterson, Ned; Platt, Simon; Podell, Michael; Potschka, Heidrun; Batlle, Martí Pumarola; Rusbridge, Clare; Volk, Holger A

2015-01-01

This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient

Analyses of integrated aircraft cabin contaminant monitoring network based on Kalman consensus filter.

Science.gov (United States)

Wang, Rui; Li, Yanxiao; Sun, Hui; Chen, Zengqiang

2017-11-01

The modern civil aircrafts use air ventilation pressurized cabins subject to the limited space. In order to monitor multiple contaminants and overcome the hypersensitivity of the single sensor, the paper constructs an output correction integrated sensor configuration using sensors with different measurement theories after comparing to other two different configurations. This proposed configuration works as a node in the contaminant distributed wireless sensor monitoring network. The corresponding measurement error models of integrated sensors are also proposed by using the Kalman consensus filter to estimate states and conduct data fusion in order to regulate the single sensor measurement results. The paper develops the sufficient proof of the Kalman consensus filter stability when considering the system and the observation noises and compares the mean estimation and the mean consensus errors between Kalman consensus filter and local Kalman filter. The numerical example analyses show the effectiveness of the algorithm. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Robust Adaptive Sliding Mode Consensus of Multiagent Systems with Perturbed Communications and Actuators

Directory of Open Access Journals (Sweden)

Xiao-Zheng Jin

2013-01-01

Full Text Available This paper deals with the asymptotic consensus problem for a class of multiagent systems with time-varying additive actuator faults and perturbed communications. The L2 performance of systems is also considered in the consensus controller designs. The upper and lower bounds of faults and perturbations in actuators and communications and controller gains are assumed to be unknown but can be estimated by designing some indirect adaptive laws. Based on the information from the adaptive estimation mechanism, the distributed robust adaptive sliding mode controllers are constructed to automatically compensate for the effects of faults and perturbations and to achieve any given level of L2 gain attenuation from external disturbance to consensus errors. Through Lyapunov functions and adaptive schemes, the asymptotic consensus of resulting adaptive multiagent system can be achieved with a specified performance criterion in the presence of perturbed communications and actuators. The effectiveness of the proposed design is illustrated via a decoupled longitudinal model of F-18 aircraft.

IAEA Director General welcomes NPT consensus

International Nuclear Information System (INIS)

2000-01-01

The document informs that the Director General of the IAEA welcomed the adoption with consensus by the Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons of the final document on the review and operation of the Treaty, and that he was pleased by the vote of confidence shown in the IAEA and its role in the implementation of the Treaty

The Zhongshan Score

Science.gov (United States)

Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

2015-01-01

Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

Re-Scoring the Game’s Score

DEFF Research Database (Denmark)

Gasselseder, Hans-Peter

2014-01-01

This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self-report questionnai......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self......-temporal alignment in the resulting emotional congruency of nondiegetic music. Whereas imaginary aspects of immersive presence are systemically affected by the presentation of dynamic music, sensory spatial aspects show higher sensitivity towards the arousal potential of the music score. It is argued...

[GEITDAH consensus on conduct disorders in children and adolescents].

Science.gov (United States)

Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco

2015-08-16

In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.

Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools.

Science.gov (United States)

King, Daniel L; Haagsma, Maria C; Delfabbro, Paul H; Gradisar, Michael; Griffiths, Mark D

2013-04-01

Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Repigmentation in vitiligo: position paper of the Vitiligo Global Issues Consensus Conference.

Science.gov (United States)

Gan, Emily Y; Eleftheriadou, Viktoria; Esmat, Samia; Hamzavi, Iltefat; Passeron, Thierry; Böhm, Markus; Anbar, Tag; Goh, Boon Kee; Lan, Cheng-Che E; Lui, Harvey; Ramam, M; Raboobee, Noufal; Katayama, Ichiro; Suzuki, Tamio; Parsad, Davinder; Seth, Vaneeta; Lim, Henry W; van Geel, Nanja; Mulekar, Sanjeev; Harris, John; Wittal, Richard; Benzekri, Laila; Gauthier, Yvon; Kumarasinghe, Prasad; Thng, Steven T G; Silva de Castro, Caio Cesar; Abdallah, Marwa; Vrijman, Charlotte; Bekkenk, Marcel; Seneschal, Julien; Pandya, Amit G; Ezzedine, Khaled; Picardo, Mauro; Taïeb, Alain

2017-01-01

The Vitiligo Global Issues Consensus Conference (VGICC), through an international e-Delphi consensus, concluded that 'repigmentation' and 'maintenance of gained repigmentation' are essential core outcome measures in future vitiligo trials. This VGICC position paper addresses these core topics in two sections and includes an atlas depicting vitiligo repigmentation patterns and color match. The first section delineates mechanisms and characteristics of vitiligo repigmentation, and the second section summarizes the outcomes of international meeting discussions and two e-surveys on vitiligo repigmentation, which had been carried out over 3 yr. Treatment is defined as successful if repigmentation exceeds 80% and at least 80% of the gained repigmentation is maintained for over 6 months. No agreement was found on the best outcome measure for assessing target or global repigmentation, therefore highlighting the limitations of e-surveys in addressing clinical measurements. Until there is a clear consensus, existing tools should be selected according to the specific needs of each study. A workshop will be conducted to address the remaining issues so as to achieve a consensus. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

College Math Assessment: SAT Scores vs. College Math Placement Scores

Science.gov (United States)

Foley-Peres, Kathleen; Poirier, Dawn

2008-01-01

Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

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.

Lack of international consensus in low-risk drinking guidelines.

Science.gov (United States)

Furtwaengler, Nina A F F; de Visser, Richard O

2013-01-01

To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Consensus, Polarization, and Alignment in the Economics Profession

Directory of Open Access Journals (Sweden)

Tod S. Van Gunten

2016-12-01

Full Text Available Scholars interested in the political influence of the economics profession debate whether the discipline is unified by policy consensus or divided among competing schools or factions. We address this question by reanalyzing a unique recent survey of elite economists. We present a theoretical framework based on a formal sociological approach to the structure of belief systems and propose alignment, rather than consensus or polarization, as a model for the structure of belief in the economics profession. Moreover, we argue that social clustering in a heterogeneous network topology is a better model for disciplinary social structure than discrete factionalization. Results show that there is a robust latent ideological dimension related to economists’ departmental affiliations and political partisanship. Furthermore, we show that economists closer to one another in informal social networks also share more similar ideologies.

Consensus QSAR model for identifying novel H5N1 inhibitors.

Science.gov (United States)

Sharma, Nitin; Yap, Chun Wei

2012-08-01

Due to the importance of neuraminidase in the pathogenesis of influenza virus infection, it has been regarded as the most important drug target for the treatment of influenza. Resistance to currently available drugs and new findings related to structure of the protein requires novel neuraminidase 1 (N1) inhibitors. In this study, a consensus QSAR model with defined applicability domain (AD) was developed using published N1 inhibitors. The consensus model was validated using an external validation set. The model achieved high sensitivity, specificity, and overall accuracy along with low false positive rate (FPR) and false discovery rate (FDR). The performance of model on the external validation set and training set were comparable, thus it was unlikely to be overfitted. The low FPR and low FDR will increase its accuracy in screening large chemical libraries. Screening of ZINC library resulted in 64,772 compounds as probable N1 inhibitors, while 173,674 compounds were defined to be outside the AD of the consensus model. The advantage of the current model is that it was developed using a large and diverse dataset and has a defined AD which prevents its use on compounds that it is not capable of predicting. The consensus model developed in this study is made available via the free software, PaDEL-DDPredictor.

Acute pancreatitis: reflections through the history of the Atlanta Consensus

Directory of Open Access Journals (Sweden)

Torres López, Ana María

2014-10-01

Full Text Available Acute pancreatitis is an inflammatory process with systemic and local repercussions. Most cases are mild with low mortality rate, but 20% of the patients have severe pancreatitis with a mortality rate up to 30%. Through the years the medical community has tried to reach consensus about this disease in order to better understand, classify and treat it. The most important of these has been known as the Atlanta Consensus 1992, in use for many years. However, it has been recently the subject of various proposals for changes and updates, which are discussed in this review article.

Health Promoting Schools: Consensus, Strategies, and Potential

Science.gov (United States)

Macnab, Andrew J.; Gagnon, Faith A.; Stewart, Donald

2014-01-01

Purpose: The purpose of this paper is to summarize a consensus statement generated on the current challenges, strategies, and potential of health promoting schools (HPS) at a 2011 colloquium at the Stellenbosch Institute for Advanced Study where 40 people from five continents came together to share their global and regional experience surrounding…

Independent Directors

DEFF Research Database (Denmark)

Ringe, Wolf-Georg

2013-01-01

This paper re-evaluates the corporate governance concept of ‘board independence’ against the disappointing experiences during the 2007-08 financial crisis. Independent or outside directors had long been seen as an essential tool to improve the monitoring role of the board. Yet the crisis revealed...... that they did not prevent firms' excessive risk taking; further, these directors sometimes showed serious deficits in understanding the business they were supposed to control, and remained passive in addressing structural problems. A closer look reveals that under the surface of seemingly unanimous consensus...

Building a model based on scientific consensus for Life Cycle Impact Assessment of chemicals:

DEFF Research Database (Denmark)

Hauschild, Michael Zwicky; Huijbregts, Mark; Jolliet, Olivier

2008-01-01

Achieving consensus among scientists is often a challenge - particularly in model development. In this article we describe a recent scientific consensus-building process for Life Cycle Impact Assessment (LCIA) models applied to chemical emissions - including the strategy, execution, and results...

On Federated and Proof Of Validation Based Consensus Algorithms In Blockchain

Science.gov (United States)

Ambili, K. N.; Sindhu, M.; Sethumadhavan, M.

2017-08-01

Almost all real world activities have been digitized and there are various client server architecture based systems in place to handle them. These are all based on trust on third parties. There is an active attempt to successfully implement blockchain based systems which ensures that the IT systems are immutable, double spending is avoided and cryptographic strength is provided to them. A successful implementation of blockchain as backbone of existing information technology systems is bound to eliminate various types of fraud and ensure quicker delivery of the item on trade. To adapt IT systems to blockchain architecture, an efficient consensus algorithm need to be designed. Blockchain based on proof of work first came up as the backbone of cryptocurrency. After this, several other methods with variety of interesting features have come up. In this paper, we conduct a survey on existing attempts to achieve consensus in block chain. A federated consensus method and a proof of validation method are being compared.

New ICRP recommendations 2005: without full consensus?

International Nuclear Information System (INIS)

Novakovic, M.

2005-01-01

Ionising radiation is viewed as one of the most studied of all known carcinogens. Over the last 50 years Recommendations of International Commission for Radiological Protection (ICRP) have been changed regularly every 10 years. At the beginning these changes were significant, sometimes even radical, according to quick acquiring of new scientific evidence on physical, biological and health effects of radiation. In order to handle each new situation evolution of the radiation protection system has been extended and new portions have been added (the ubiquitous exposure of public to radon gas and its progeny, and the need to develop an appropriate response to emergency situations, increasing social desire to participate in decision making processes, concern for the protection of non-human species and environment), that resulted in a system that is increasingly complicated. Over the last few years very broad discussions of major radiation protection concepts have been encouraged by the ICRP in order to achieve consensus on a more operational and coherent system of radiation protection elaborated in a transparent fashion, and presented in readily understandable terms. This process for the first time involves a broad spectrum of stake holders in these discussions. It is further assumed that these debates will eventually result in consensus on the basis for the next round of ICRP general recommendations, probably in the 2005. While now it is certain that the consensus is not yet reached within the international community and the discussion of these issues will continue for some time the new recommendations should be seen as a consolidation of recommendations from 1990 to give a single unified set that can be simply and coherently expressed. The paper presents essential issues of the outcome of the Commission discussions and improvement of the current system of radiation protection.(author)

Construction of barley consensus map showing chromosomal ...

African Journals Online (AJOL)

GRACE

2006-02-02

Feb 2, 2006 ... the purpose of this consensus map (containing QTL) is to provide a tool for scientists to accurately locate molecular markers to ... community with powerful tools for comparative genomics. (Gai et al., 2000; Mekhdov et al., ...... and controlled by almost the same loci (Marquez et al.,. 2000). In the present study ...

Consensus among Economics Teachers from Transition Economies

Science.gov (United States)

Leet, Don R.; Lang, Nancy A.

2010-01-01

The authors analyze the economic opinions of teachers and economists from the former Soviet Union who participated in economic education programs sponsored by the U.S. Department of Education under the auspices of the National Council on Economic Education from 1995-2001. They sought to determine the level of consensus on economic topics among the…

Histologic scoring indices for evaluation of disease activity in Crohn's disease.

Science.gov (United States)

Novak, Gregor; Parker, Claire E; Pai, Rish K; MacDonald, John K; Feagan, Brian G; Sandborn, William J; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

2017-07-21

Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and operating characteristics of available histologic disease activity indices in Crohn's disease. Electronic searches of MEDLINE, EMBASE, PubMed, and the Cochrane Library (CENTRAL) databases from inception to 20 July 2016 were supplemented by manual reviews of bibliographies and abstracts submitted to major gastroenterology meetings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organisation). Any study design (e.g. randomised controlled trial, cohort study, case series) that evaluated a histologic disease activity index in patients with Crohn's disease was considered for inclusion. Study participants included adult patients (> 16 years), diagnosed with Crohn's disease using conventional clinical, radiographic or endoscopic criteria. Two authors independently reviewed the titles and abstracts of the studies identified from the literature search. The full text of potentially relevant citations were reviewed for inclusion and the study investigators were contacted as needed for clarification. Any disagreements regarding study eligibility were resolved by discussion and consensus with a third author.Two authors independently extracted and recorded data using a standard form. The following data were recorded from each eligible study: number of patients enrolled; number of patients per treatment arm; patient characteristics: age and gender distribution; description of histologic disease activity index utilized; and outcomes such as content validity, construct validity, criterion validity, responsiveness, intra-rater reliability, inter-rater reliability, and feasibility. Sixteen reports of 14 studies describing 14 different numerical

Identification of Phytochemicals Targeting c-Met Kinase Domain using Consensus Docking and Molecular Dynamics Simulation Studies.

Science.gov (United States)

Aliebrahimi, Shima; Montasser Kouhsari, Shideh; Ostad, Seyed Nasser; Arab, Seyed Shahriar; Karami, Leila

2018-06-01

c-Met receptor tyrosine kinase is a proto-oncogene whose aberrant activation is attributed to a lower rate of survival in most cancers. Natural product-derived inhibitors known as "fourth generation inhibitors" constitute more than 60% of anticancer drugs. Furthermore, consensus docking approach has recently been introduced to augment docking accuracy and reduce false positives during a virtual screening. In order to obtain novel small-molecule Met inhibitors, consensus docking approach was performed using Autodock Vina and Autodock 4.2 to virtual screen Naturally Occurring Plant-based Anti-cancer Compound-Activity-Target database against active and inactive conformation of c-Met kinase domain structure. Two hit molecules that were in line with drug-likeness criteria, desired docking score, and binding pose were subjected to molecular dynamics simulations to elucidate intermolecular contacts in protein-ligand complexes. Analysis of molecular dynamics simulations and molecular mechanics Poisson-Boltzmann surface area studies showed that ZINC08234189 is a plausible inhibitor for the active state of c-Met, whereas ZINC03871891 may be more effective toward active c-Met kinase domain compared to the inactive form due to higher binding energy. Our analysis showed that both the hit molecules formed hydrogen bonds with key residues of the hinge region (P1158, M1160) in the active form, which is a hallmark of kinase domain inhibitors. Considering the pivotal role of HGF/c-Met signaling in carcinogenesis, our results propose ZINC08234189 and ZINC03871891 as the therapeutic options to surmount Met-dependent cancers.

Exploring a Source of Uneven Score Equity across the Test Score Range

Science.gov (United States)

Huggins-Manley, Anne Corinne; Qiu, Yuxi; Penfield, Randall D.

2018-01-01

Score equity assessment (SEA) refers to an examination of population invariance of equating across two or more subpopulations of test examinees. Previous SEA studies have shown that score equity may be present for examinees scoring at particular test score ranges but absent for examinees scoring at other score ranges. No studies to date have…

[Chinese expert consensus on the diagnosis and treatment of hypertension in the elderly(2017)].

Science.gov (United States)

2017-11-01

China has stepped into an aging society. Hypertension is an independent risk factor of cardio-cerebrovascular diseases and related to mortality and disability of the elderly. Compared to middle-aged and young patients with similar blood pressure elevation, the risks of cardiovascular and cerebrovascular events significantly increase in the elderly. Since the Chinese expert consensus on the diagnosis and treatment of hypertension in the elderly(2008, 2011 version) were published, many guidelines have been accordingly updated, which further improved the prevention and control strategy of hypertension. In this article, Chinese expert consensus on the diagnosis and treatment of hypertension in the elderly(2017) is revised as to facilitate the prevention and treatment of hypertension in Chinese elderly. The consensus is composed of eight parts, including definition, epidemiology, characteristics, evidence, treatment objectives and measurements of elderly hypertension. The purpose of the consensus is to provide guidance for management of elderly hypertensive patients.

Team Cooperation in a Network of Multi-Vehicle Unmanned Systems Synthesis of Consensus Algorithms

CERN Document Server

Semsar-Kazerooni, Elham

2013-01-01

Team Cooperation in a Network of Multi-Vehicle Unmanned Systems develops a framework for modeling and control of a network of multi-agent unmanned systems in a cooperative manner and with consideration of non-ideal and practical considerations. The main focus of this book is the development of “synthesis-based” algorithms rather than on conventional “analysis-based” approaches to the team cooperation, specifically the team consensus problems. The authors provide a set of modified “design-based” consensus algorithms whose optimality is verified through introduction of performance indices. This book also: Provides synthesis-based methodology for team cooperation Introduces a consensus-protocol optimized performance index  Offers comparisons for use of proper indices in measuring team performance Analyzes and predicts  performance of  previously designed consensus algorithms Analyses and predicts team behavior in the presence of non-ideal considerations such as actuator anomalies and faults as wel...

Stabilizing IkappaBalpha by "consensus" design.

Science.gov (United States)

Ferreiro, Diego U; Cervantes, Carla F; Truhlar, Stephanie M E; Cho, Samuel S; Wolynes, Peter G; Komives, Elizabeth A

2007-01-26

IkappaBalpha is the major regulator of transcription factor NF-kappaB function. The ankyrin repeat region of IkappaBalpha mediates specific interactions with NF-kappaB dimers, but ankyrin repeats 1, 5 and 6 display a highly dynamic character when not in complex with NF-kappaB. Using chemical denaturation, we show here that IkappaBalpha displays two folding transitions: a non-cooperative conversion under weak perturbation, and a major cooperative folding phase upon stronger insult. Taking advantage of a native Trp residue in ankyrin repeat (AR) 6 and engineered Trp residues in AR2, AR4 and AR5, we show that the cooperative transition involves AR2 and AR3, while the non-cooperative transition involves AR5 and AR6. The major structural transition can be affected by single amino acid substitutions converging to the "consensus" ankyrin repeat sequence, increasing the native state stability significantly. We further characterized the structural and dynamic properties of the native state ensemble of IkappaBalpha and the stabilized mutants by H/(2)H exchange mass spectrometry and NMR. The solution experiments were complemented with molecular dynamics simulations to elucidate the microscopic origins of the stabilizing effect of the consensus substitutions, which can be traced to the fast conformational dynamics of the folded ensemble.

Attributions, false consensus and valence: two field studies

NARCIS (Netherlands)

van der Pligt, J.

1984-01-01

Two studies, with 1,056 Ss, investigated attitudes, knowledge, and behavior with regard to several environmental issues. Findings demonstrate that observers tend to perceive a false consensus with respect to the relative commonness of their own behavioral choices. This phenomenon was replicated

Updating OSHA standards based on national consensus standards. Direct final rule.

Science.gov (United States)

2007-12-14

In this direct final rule, the Agency is removing several references to consensus standards that have requirements that duplicate, or are comparable to, other OSHA rules; this action includes correcting a paragraph citation in one of these OSHA rules. The Agency also is removing a reference to American Welding Society standard A3.0-1969 ("Terms and Definitions") in its general-industry welding standards. This rulemaking is a continuation of OSHA's ongoing effort to update references to consensus and industry standards used throughout its rules.

Evidence-based consensus on opportunistic infections in inflammatory bowel disease (republication

Directory of Open Access Journals (Sweden)

2018-04-01

Full Text Available Inflammatory bowel disease (IBD patients are a high-risk population for opportunistic infections. The IBD group of the Chinese Society of Gastroenterology of the Chinese Medical Association organized an expert group to discuss and develop this consensus opinion. This consensus opinion referenced clinical study results from China and other countries to provide guidance for clinical practices. Eight major topics, including cytomegalovirus infection, Epstein-Barr virus infection, viral hepatitis, bacterial infection, Mycobacterium tuberculosis infection, fungal infection, parasitic infection, and vaccines were introduced in this article.

[Neuroendocrine dysfunction and brain damage. A consensus statement].

Science.gov (United States)

Leal-Cerro, Alfonso; Rincón, María Dolores; Domingo, Manel Puig

2009-01-01

This consensus statement aims to enhance awareness of the incidence and risks of hypopituitarism in patients with traumatic brain injury (TBI) and/or brain hemorrhages among physicians treating patients with brain damage. The importance of this problem is related not only to the frequency of TBI but also to its prevalence in younger populations. The consequences of TBI are characterized by a series of symptoms that depend on the type of sequels related to neuroendocrine dysfunction. The signs and symptoms of hypopituitarism are often confused with those of other sequels of TBI. Consequently, patients with posttraumatic hypopituitarism may receive suboptimal rehabilitation unless the underlying hormone deficiency is identified and treated. This consensus is based on the recommendation supported by expert opinion that patients with a TBI and/or brain hemorrhage should undergo endocrine evaluation in order to assess pituitary function and, if deficiency is detected, should receive hormone replacement therapy.

Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project

NARCIS (Netherlands)

Zondervan, P. J.; Wagstaff, P. G. K.; Desai, M. M.; de Bruin, D. M.; Fraga, A. F.; Hadaschik, B. A.; Köllermann, J.; Liehr, U. B.; Pahernik, S. A.; Schlemmer, H. P.; Wendler, J. J.; Algaba, F.; de la Rosette, J. J. M. C. H.; Laguna Pes, M. P.

2016-01-01

To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research. Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among

[First SIBEN clinical consensus: diagnostic and therapeutic approach to patent ductus arteriosus in premature newborns].

Science.gov (United States)

Golombek, S G; Sola, A; Baquero, H; Borbonet, D; Cabañas, F; Fajardo, C; Goldsmit, G; Lemus, L; Miura, E; Pellicer, A; Pérez, J M; Rogido, M; Zambosco, G; van Overmeire, B

2008-11-01

To report the process and results of the first neonatal clinical consensus of the Ibero-American region. Two recognized experts in the field (Clyman and Van Overmeire) and 45 neonatologists from 23 countries were invited for active participation and collaboration. We developed 46 questions of clinical-physiological relevance in all aspects of patent ductus arteriosus (PDA). Guidelines for consensus process, literature search and future preparation of educational material and authorship were developed, reviewed and agreed by all. Participants from different countries were distributed in groups, and assigned to interact and work together to answer 3-5 questions, reviewing all global literature and local factors. Answers and summaries were received, collated and reviewed by 2 coordinators and the 2 experts. Participants and experts met in Granada, Spain for 4.5 h (lectures by experts, presentations by groups, discussion, all literature available). 31 neonatologists from 16 countries agreed to participate. Presentations by each group and general discussion were used to develop a consensus regarding: general management, availability of drugs (indomethacin vs. ibuprofen), costs, indications for echo/surgery, etc. Many steps were learnt by all present in a collaborative forum. This first consensus group of Ibero-American neonatologists SIBEN led to active and collaborative participation of neonatologists of 16 countries, improved education of all participants and ended with consensus development on clinical approaches to PDA. Furthermore, it provides recommendations for clinical care reached by consensus. Additionally, it will serve as a useful foundation for future SIBEN Consensus on other topics and it could become valuable as a model to decrease disparity in care and improve outcomes in this and other regions.

The correlation between the ASTRO consensus panel definition of biochemical failure and clinical outcome for patients with prostate cancer treated with external beam irradiation

International Nuclear Information System (INIS)

Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Martinez, Alvaro A.

1998-01-01

Purpose: We reviewed our institution's experience treating patients with external beam irradiation (RT) to determine if the ASTRO Consensus Panel definition of biochemical failure (BF) following radiation therapy correlates with clinical distant metastases free survival (DMFS), disease-free survival (DFS), cause-specific survival (CSS), and local control (LC). Methods and Materials: Between 1/1/87 and 12/31/92, 568 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital (median total dose 66.6 Gy; range: 60-70.4 Gy). Biochemical failure was defined as three consecutive increases in post-treatment prostate specific antigen (PSA) after achieving a nadir. Biochemical failure was recorded as the time midway between the nadir and the first rising PSA. Five-year actuarial rates of clinical DMFS, DFS, CSS, and LC were calculated for patients who were biochemically controlled (BC) versus those who failed biochemically. Median follow-up was 56 months (range: 24-118 months). Results: Five-year actuarial rates of DMFS, DFS, CSS, and LC were significantly greater in patients who were biochemically controlled versus those who were not (p < 0.001). In patients who were BC, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 99%, 99%, 98%, and 99% respectively. For patients who failed biochemically, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 74%, 64%, 89%, and 86% respectively. When stratifying by pretreatment PSA, Gleason score, and T stage these differences remained significant for DMFS, DFS, and CSS. The Cox proportional hazards model demonstrated that BC was the single most important predictor of clinical outcome for DMFS, DFS, CSS, and LC. Pretreatment PSA and Gleason score were also independent predictors of outcome for DMFS and DFS. Conclusions: The ASTRO Consensus Panel definition of BF following radiation therapy correlates well with clinical DMFS, DFS

L{sup 1} group consensus of multi-agent systems with switching topologies and stochastic inputs

Energy Technology Data Exchange (ETDEWEB)

Shang, Yilun, E-mail: shylmath@hotmail.com [Institute for Cyber Security, University of Texas at San Antonio, TX 78249 (United States); SUTD-MIT International Design Center, Singapore University of Technology and Design, Singapore 138682 (Singapore)

2013-10-01

Understanding how interacting subsystems of an overall system lead to cluster/group consensus is a key issue in the investigation of multi-agent systems. In this Letter, we study the L{sup 1} group consensus problem of discrete-time multi-agent systems with external stochastic inputs. Based on ergodicity theory and matrix analysis, L{sup 1} group consensus criteria are obtained for multi-agent systems with switching topologies. Some numerical examples are provided to illustrate the effectiveness and feasibility of the theoretical results.

Learning Gene Regulatory Networks Computationally from Gene Expression Data Using Weighted Consensus

KAUST Repository

Fujii, Chisato

2015-04-16

Gene regulatory networks analyze the relationships between genes allowing us to un- derstand the gene regulatory interactions in systems biology. Gene expression data from the microarray experiments is used to obtain the gene regulatory networks. How- ever, the microarray data is discrete, noisy and non-linear which makes learning the networks a challenging problem and existing gene network inference methods do not give consistent results. Current state-of-the-art study uses the average-ranking-based consensus method to combine and average the ranked predictions from individual methods. However each individual method has an equal contribution to the consen- sus prediction. We have developed a linear programming-based consensus approach which uses learned weights from linear programming among individual methods such that the methods have di↵erent weights depending on their performance. Our result reveals that assigning di↵erent weights to individual methods rather than giving them equal weights improves the performance of the consensus. The linear programming- based consensus method is evaluated and it had the best performance on in silico and Saccharomyces cerevisiae networks, and the second best on the Escherichia coli network outperformed by Inferelator Pipeline method which gives inconsistent results across a wide range of microarray data sets.

Distributed Optimal Consensus Control for Multiagent Systems With Input Delay.

Science.gov (United States)

Zhang, Huaipin; Yue, Dong; Zhao, Wei; Hu, Songlin; Dou, Chunxia; Huaipin Zhang; Dong Yue; Wei Zhao; Songlin Hu; Chunxia Dou; Hu, Songlin; Zhang, Huaipin; Dou, Chunxia; Yue, Dong; Zhao, Wei

2018-06-01

This paper addresses the problem of distributed optimal consensus control for a continuous-time heterogeneous linear multiagent system subject to time varying input delays. First, by discretization and model transformation, the continuous-time input-delayed system is converted into a discrete-time delay-free system. Two delicate performance index functions are defined for these two systems. It is shown that the performance index functions are equivalent and the optimal consensus control problem of the input-delayed system can be cast into that of the delay-free system. Second, by virtue of the Hamilton-Jacobi-Bellman (HJB) equations, an optimal control policy for each agent is designed based on the delay-free system and a novel value iteration algorithm is proposed to learn the solutions to the HJB equations online. The proposed adaptive dynamic programming algorithm is implemented on the basis of a critic-action neural network (NN) structure. Third, it is proved that local consensus errors of the two systems and weight estimation errors of the critic-action NNs are uniformly ultimately bounded while the approximated control policies converge to their target values. Finally, two simulation examples are presented to illustrate the effectiveness of the developed method.

The use of ovarian reserve markers in IVF clinical practice: a national consensus.

Science.gov (United States)

La Marca, Antonio; Ferraretti, Anna Pia; Palermo, Roberto; Ubaldi, Filippo M

2016-01-01

Ovarian reserve markers have been documented to perform very well in the clinical practice. While this is widely recognized, still now there is no consensus on how to use new biomarkers in the clinical practice. This study was conducted among Italian IVF centres using the Delphi technique, a validated consensus-building process. Briefly three consecutive questionnaires were developed for clinicians in charge of IVF centres. In the first rounds, participants were asked to rate the importance of a list of statements regarding the categorization of ovarian response and the diagnostic role of biomarkers. In round 3, participants were asked to rate their agreement and consensus on the list of statements derived from the first two rounds. There were 120 respondents. Consensus was achieved for many points: (a) poor ovarian response is predicted on the basis of the following: AMH  3 ng/ml or AFC > 14; (c) day 3 FSH measurement should always be associated to estradiol; (d) AMH can be measured on a random basis; (e) the measurement of the AFC with the 2D technology may be considered adequate and (f) the AFC should be measured in the early follicular phase and consists in the total number of 2-9 mm follicles in both the ovaries. The present study suggests that extensive consensus on the importance and use of new ovarian reserve markers to improve IVF safety and performance is already present among clinicians.

Consensus for linear multi-agent system with intermittent information transmissions using the time-scale theory

Science.gov (United States)

Taousser, Fatima; Defoort, Michael; Djemai, Mohamed

2016-01-01

This paper investigates the consensus problem for linear multi-agent system with fixed communication topology in the presence of intermittent communication using the time-scale theory. Since each agent can only obtain relative local information intermittently, the proposed consensus algorithm is based on a discontinuous local interaction rule. The interaction among agents happens at a disjoint set of continuous-time intervals. The closed-loop multi-agent system can be represented using mixed linear continuous-time and linear discrete-time models due to intermittent information transmissions. The time-scale theory provides a powerful tool to combine continuous-time and discrete-time cases and study the consensus protocol under a unified framework. Using this theory, some conditions are derived to achieve exponential consensus under intermittent information transmissions. Simulations are performed to validate the theoretical results.

The functional neuroanatomy of bipolar disorder: a consensus model

Science.gov (United States)

Strakowski, Stephen M; Adler, Caleb M; Almeida, Jorge; Altshuler, Lori L; Blumberg, Hilary P; Chang, Kiki D; DelBello, Melissa P; Frangou, Sophia; McIntosh, Andrew; Phillips, Mary L; Sussman, Jessika E; Townsend, Jennifer D

2013-01-01

Objectives Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants’ work as well as that of others. Methods Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data. Results Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human brain. Namely, disruption in early development (e.g., white matter connectivity, prefrontal pruning) within brain networks that modulate emotional behavior leads to decreased connectivity among ventral prefrontal networks and limbic brain regions, especially amygdala. This developmental failure to establish healthy ventral prefrontal–limbic modulation underlies the onset of mania and ultimately, with progressive changes throughout these networks over time and with affective episodes, a bipolar course of illness. Conclusions This model provides a potential substrate to guide future investigations and areas needing additional focus are identified. PMID:22631617

Yes, But...Creating a Consensus for Educational Change.

Science.gov (United States)

Hampel, Robert L.

1991-01-01

Maintains that the division of opinions in a staff can determine an educational innovation's success or failure. Teacher empowerment can help forge widespread agreement and consensus for the innovation. These principles are exemplified by the Sizer initiative in the Delaware schools, which is described. (BB)

78 FR 35085 - Consensus Standards, Light-Sport Aircraft

Science.gov (United States)

2013-06-11

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Consensus Standards, Light-Sport... to the provisions of the Sport Pilot and Light-Sport Aircraft rule issued July 16, 2004, and effective September 1, 2004. ASTM International Committee F37 on Light Sport Aircraft developed the new and...

77 FR 24251 - Consensus Standards, Light-Sport Aircraft

Science.gov (United States)

2012-04-23

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Consensus Standards, Light-Sport... relating to the provisions of the Sport Pilot and Light-Sport Aircraft rule issued July 16, 2004, and effective September 1, 2004. ASTM International Committee F37 on Light Sport Aircraft developed the new and...

Consensus of Fractional-Order Multiagent Systems with Double Integrator under Switching Topologies

Directory of Open Access Journals (Sweden)

Shiyun Shen

2017-01-01

Full Text Available Due to the complexity of the practical environments, many systems can only be described with the fractional-order dynamics. In this paper, the consensus of fractional-order multiagent systems with double integrator under switching topologies is investigated. By applying Mittag-Leffler function, Laplace transform, and dwell time technique, a sufficient condition on consensus is obtained. Finally, a numerical simulation is presented to illustrate the effectiveness of the theoretical result.

Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results

Energy Technology Data Exchange (ETDEWEB)

Inci, Ercan, E-mail: ercan_inci@mynet.com [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Turhan, Ahmet Nuray; Ayguen, Ersan [Department of Surgery, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul (Turkey)

2011-11-15

Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 {+-} 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.

Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results

International Nuclear Information System (INIS)

Inci, Ercan; Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan; Turhan, Ahmet Nuray; Ayguen, Ersan

2011-01-01

Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 ± 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.

Distributed Consensus Tracking for Second-Order Nonlinear Multiagent Systems with a Specified Reference State

Directory of Open Access Journals (Sweden)

Guoguang Wen

2014-01-01

Full Text Available This paper mainly addresses the distributed consensus tracking problem for second-order nonlinear multiagent systems with a specified reference trajectory. The dynamics of each follower consists of two terms: nonlinear inherent dynamics and a simple communication protocol relying only on the position and velocity information of its neighbors. The consensus reference is taken as a virtual leader, whose output is only its position and velocity information that is available to only a subset of a group of followers. To achieve consensus tracking, a class of nonsmooth control protocols is proposed which reply on the relative information among the neighboring agents. Then some corresponding sufficient conditions are derived. It is shown that if the communication graph associated with the virtual leader and followers is connected at each time instant, the consensus can be achieved at least globally exponentially with the proposed protocol. Rigorous proofs are given by using graph theory, matrix theory, and Lyapunov theory. Finally, numerical examples are presented to illustrate the theoretical analysis.

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores.

Science.gov (United States)

Schoenberg, Mike R; Rum, Ruba S

2017-11-01

Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause of medical errors; nevertheless, there remains a lack of consistency in how neuropsychological scores are communicated. A major limitation in the communication of neuropsychological results is the inconsistent use of qualitative descriptors for standardized test scores and the use of vague terminology. PubMed search from 1 Jan 2007 to 1 Aug 2016 to identify guidelines or consensus statements for the description and reporting of qualitative terms to communicate neuropsychological test scores was conducted. The review found the use of confusing and overlapping terms to describe various ranges of percentile standardized test scores. In response, we propose a simplified set of qualitative descriptors for normalized test scores (Q-Simple) as a means to reduce errors in communicating test results. The Q-Simple qualitative terms are: 'very superior', 'superior', 'high average', 'average', 'low average', 'borderline' and 'abnormal/impaired'. A case example illustrates the proposed Q-Simple qualitative classification system to communicate neuropsychological results for neurosurgical planning. The Q-Simple qualitative descriptor system is aimed as a means to improve and standardize communication of standardized neuropsychological test scores. Research are needed to further evaluate neuropsychological communication errors. Conveying the clinical implications of neuropsychological results in a manner that minimizes risk for communication errors is a quintessential component of evidence-based practice. Copyright © 2017 Elsevier B.V. All rights reserved.

An evaluation of automatic coronary artery calcium scoring methods with cardiac CT using the orCaScore framework.

Science.gov (United States)

Wolterink, Jelmer M; Leiner, Tim; de Vos, Bob D; Coatrieux, Jean-Louis; Kelm, B Michael; Kondo, Satoshi; Salgado, Rodrigo A; Shahzad, Rahil; Shu, Huazhong; Snoeren, Miranda; Takx, Richard A P; van Vliet, Lucas J; van Walsum, Theo; Willems, Tineke P; Yang, Guanyu; Zheng, Yefeng; Viergever, Max A; Išgum, Ivana

2016-05-01

The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular disease (CVD) events. In clinical practice, CAC is manually identified and automatically quantified in cardiac CT using commercially available software. This is a tedious and time-consuming process in large-scale studies. Therefore, a number of automatic methods that require no interaction and semiautomatic methods that require very limited interaction for the identification of CAC in cardiac CT have been proposed. Thus far, a comparison of their performance has been lacking. The objective of this study was to perform an independent evaluation of (semi)automatic methods for CAC scoring in cardiac CT using a publicly available standardized framework. Cardiac CT exams of 72 patients distributed over four CVD risk categories were provided for (semi)automatic CAC scoring. Each exam consisted of a noncontrast-enhanced calcium scoring CT (CSCT) and a corresponding coronary CT angiography (CCTA) scan. The exams were acquired in four different hospitals using state-of-the-art equipment from four major CT scanner vendors. The data were divided into 32 training exams and 40 test exams. A reference standard for CAC in CSCT was defined by consensus of two experts following a clinical protocol. The framework organizers evaluated the performance of (semi)automatic methods on test CSCT scans, per lesion, artery, and patient. Five (semi)automatic methods were evaluated. Four methods used both CSCT and CCTA to identify CAC, and one method used only CSCT. The evaluated methods correctly detected between 52% and 94% of CAC lesions with positive predictive values between 65% and 96%. Lesions in distal coronary arteries were most commonly missed and aortic calcifications close to the coronary ostia were the most common false positive errors. The majority (between 88% and 98%) of correctly identified CAC lesions were assigned to the correct artery. Linearly weighted Cohen's kappa

Distributed event-triggered consensus tracking of second-order multi-agent systems with a virtual leader

International Nuclear Information System (INIS)

Cao Jie; Wu Zhi-Hai; Peng Li

2016-01-01

This paper investigates the consensus tracking problems of second-order multi-agent systems with a virtual leader via event-triggered control. A novel distributed event-triggered transmission scheme is proposed, which is intermittently examined at constant sampling instants. Only partial neighbor information and local measurements are required for event detection. Then the corresponding event-triggered consensus tracking protocol is presented to guarantee second-order multi-agent systems to achieve consensus tracking. Numerical simulations are given to illustrate the effectiveness of the proposed strategy. (paper)

Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases

Energy Technology Data Exchange (ETDEWEB)

Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Hoskin, Peter [Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Mitera, Gunita; Zeng Liang [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Lutz, Stephen [Department of Radiation Oncology, Blanchard Valley Regional Cancer Center, Findlay, OH (United States); Roos, Daniel [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia (Australia); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Linden, Yvette van der [Radiotherapeutic Institute Friesland, Leeuwarden (Netherlands); Hartsell, William [Department of Radiation Oncology, Advocate Good Samaritan Cancer Center, Downers Grove, IL (United States); Kumar, Eshwar [Department of Oncology, Atlantic Health Sciences Cancer Centre, Saint John Regional Hospital, Saint John, NB (Canada)

2012-04-01

Purpose: To update the international consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases by surveying international experts regarding previous uncertainties within the 2002 consensus, changes that may be necessary based on practice pattern changes and research findings since that time. Methods and Materials: A two-phase survey was used to determine revisions and new additions to the 2002 consensus. A total of 49 experts from the American Society for Radiation Oncology, the European Society for Therapeutic Radiology and Oncology, the Faculty of Radiation Oncology of the Royal Australian and New Zealand College of Radiologists, and the Canadian Association of Radiation Oncology who are directly involved in the care of patients with bone metastases participated in this survey. Results: Consensus was established in areas involving response definitions, eligibility criteria for future trials, reirradiation, changes in systemic therapy, radiation techniques, parameters at follow-up, and timing of assessments. Conclusion: An outline for trials in bone metastases was updated based on survey and consensus. Investigators leading trials in bone metastases are encouraged to adopt the revised guideline to promote consistent reporting. Areas for future research were identified. It is intended for the consensus to be re-examined in the future on a regular basis.

Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases

International Nuclear Information System (INIS)

Chow, Edward; Hoskin, Peter; Mitera, Gunita; Zeng Liang; Lutz, Stephen; Roos, Daniel; Hahn, Carol; Linden, Yvette van der; Hartsell, William; Kumar, Eshwar

2012-01-01

Purpose: To update the international consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases by surveying international experts regarding previous uncertainties within the 2002 consensus, changes that may be necessary based on practice pattern changes and research findings since that time. Methods and Materials: A two-phase survey was used to determine revisions and new additions to the 2002 consensus. A total of 49 experts from the American Society for Radiation Oncology, the European Society for Therapeutic Radiology and Oncology, the Faculty of Radiation Oncology of the Royal Australian and New Zealand College of Radiologists, and the Canadian Association of Radiation Oncology who are directly involved in the care of patients with bone metastases participated in this survey. Results: Consensus was established in areas involving response definitions, eligibility criteria for future trials, reirradiation, changes in systemic therapy, radiation techniques, parameters at follow-up, and timing of assessments. Conclusion: An outline for trials in bone metastases was updated based on survey and consensus. Investigators leading trials in bone metastases are encouraged to adopt the revised guideline to promote consistent reporting. Areas for future research were identified. It is intended for the consensus to be re-examined in the future on a regular basis.

A Computerized Demonstration of the False Consensus Effect.

Science.gov (United States)

Clement, Russell W.; And Others

1997-01-01

Replicates a classic psychology laboratory experiment where students either endorsed or refuted personal statements and estimated how other people would respond. Students always overestimated an affirmative response on the statements they endorsed, thus illustrating the false consensus effect. Includes a list of the statements and statistical…

A consensus linkage map of the chicken genome

NARCIS (Netherlands)

Groenen, M.A.M.; Cheng, H.H.; Bumstead, N.; Benkel, B.; Briles, E.; Burt, D.W.; Burke, T.; Dodgson, J.; Hillel, J.; Lamont, S.; Ponce, de F.A.; Soller, M.

2000-01-01

A consensus linkage map has been developed in the chicken that combines all of the genotyping data from the three available chicken mapping populations. Genotyping data were contributed by the laboratories that have been using the East Lansing and Compton reference populations and from the Animal

A branch point consensus from Arabidopsis found by non-circular analysis allows for better prediction of acceptor sites

DEFF Research Database (Denmark)

Tolstrup, Niels; Rouzé, Pierre; Brunak, Søren

1997-01-01

Little knowledge exists about branch points in plants; it has even been claimed that plant introns lack conserved branch point sequences similar to those found in vertebrate introns. A putative branch point consensus sequence for Arabidopsis thaliana resembling the well known metazoan consensus s...... in the recognition of true acceptor sites; the false positive rate being reduced by a factor of 2. We take this as an indication that the consensus found here is the genuine one and that the branch point does play a role in the proper recognition of the acceptor site in plants.......Little knowledge exists about branch points in plants; it has even been claimed that plant introns lack conserved branch point sequences similar to those found in vertebrate introns. A putative branch point consensus sequence for Arabidopsis thaliana resembling the well known metazoan consensus...... sequence has been proposed, but this is based on search of sequences similar to those in yeast and metazoa. Here we present a novel consensus sequence found by a non-circular approach. A hidden Markov model with a fixed A nucleotide was trained on sequences upstream of the acceptor site. The consensus...

Overlapping consensus versus discourse in climate change policy: The case of Norway's Sovereign Wealth Fund

International Nuclear Information System (INIS)

Nilsen, Heidi Rapp

2010-01-01

This paper is motivated by the mismatch between emission of greenhouse gases and effective mitigation policies. Science now calls for every tool to be considered in order for radical changes to mitigate the situation more effectively. This paper considers Norway's huge Sovereign Wealth Fund which, although withdrawing investment from firms causing severe environmental damage, does not categorize climate change as 'severe environmental damage'. The main reason is a basis of overlapping consensus, which also hinders argumentation for this practice. Overlapping consensus is part of the broader theory 'Justice as Fairness' as conceived by John Rawls. The consensus is with regard to having a socially just system. The word 'overlapping' refers to people having different reasons for supporting the system. However using overlapping consensus for investment-strategies represents an extension beyond its original intention, and moreover, removes mitigating climate change from the agenda. Removing the basis of overlapping consensus opens up scope for value-based discourse conceived by Habermas' communicative action and discourse ethics. The immense severity of climate change demands value-based and substantial arguments from powerful sovereign wealth funds, to consider the acceptability of their practice.

On a Consensus Measure in a Group Multi-Criteria Decision Making Problem.

OpenAIRE

Michele Fedrizzi

2010-01-01

A method for consensus measuring in a group decision problem is presented for the multiple criteria case. The decision process is supposed to be carried out according to Saaty's Analytic Hierarchy Process, and hence using pairwise comparison among the alternatives. Using a suitable distance between the experts' judgements, a scale transformation is proposed which allows a fuzzy interpretation of the problem and the definition of a consensus measure by means of fuzzy tools as linguistic quanti...

Consensus statement from the Health of the Health Professional Conference, November 2011.

Science.gov (United States)

Hawken, Susan J; Huggard, Peter; Alley, Patrick; Clark, Angela; Moir, Fiona

2012-04-20

This article presents a consensus statement that arose from the views of participants that attended the multidisciplinary conference "The Health of the Health Professional", in Auckland in November 2011. A healthy workforce is the key to improving the health of all New Zealanders. Yet health practitioners' health is of concern, and despite the evidence of real problems little has been done to constructively and systematically address these issues. This consensus statement provides some potential ways to move forward.

On Consensus of Star-Composed Networks with an Application of Laplacian Spectrum

Directory of Open Access Journals (Sweden)

Da Huang

2017-01-01

Full Text Available In this paper, we mainly study the performance of star-composed networks which can achieve consensus. Specifically, we investigate the convergence speed and robustness of the consensus of the networks, which can be measured by the smallest nonzero eigenvalue λ2 of the Laplacian matrix and the H2 norm of the graph, respectively. In particular, we introduce the notion of the corona of two graphs to construct star-composed networks and apply the Laplacian spectrum to discuss the convergence speed and robustness for the communication network. Finally, the performances of the star-composed networks have been compared, and we find that the network in which the centers construct a balanced complete bipartite graph has the most advantages of performance. Our research would provide a new insight into the combination between the field of consensus study and the theory of graph spectra.

The effect of zealots on the rate of consensus achievement in complex networks

Science.gov (United States)

Kashisaz, Hadi; Hosseini, S. Samira; Darooneh, Amir H.

2014-05-01

In this study, we investigate the role of zealots on the result of voting process on both scale-free and Watts-Strogatz networks. We observe that inflexible individuals are very effective in consensus achievement and also in the rate of ordering process in complex networks. Zealots make the magnetization of the system to vary exponentially with time. We obtain that on SF networks, increasing the zealots' population, Z, exponentially increases the rate of consensus achievement. The time needed for the system to reach a desired magnetization, shows a power-law dependence on Z. As well, we obtain that the decay time of the order parameter shows a power-law dependence on Z. We also investigate the role of zealots' degree on the rate of ordering process and finally, we analyze the effect of network's randomness on the efficiency of zealots. Moving from a regular to a random network, the re-wiring probability P increases. We show that with increasing P, the efficiency of zealots for reducing the consensus achievement time increases. The rate of consensus is compared with the rate of ordering for different re-wiring probabilities of WS networks.

Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds® Consensus Exercises

DEFF Research Database (Denmark)

de Lautour, Hugh; Taylor, William J; Adebajo, Ade

2016-01-01

OBJECTIVES: The aim of this study was to establish consensus for potential remission criteria for use in clinical trials of gout. METHODS: Experts (n=88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were...... months (51%) and one year (49%). In the discrete choice experiment, there was a preference towards 12 months as a timeframe for remission. CONCLUSION: These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises...

Consensus strategy in genes prioritization and combined bioinformatics analysis for preeclampsia pathogenesis.

Science.gov (United States)

Tejera, Eduardo; Cruz-Monteagudo, Maykel; Burgos, Germán; Sánchez, María-Eugenia; Sánchez-Rodríguez, Aminael; Pérez-Castillo, Yunierkis; Borges, Fernanda; Cordeiro, Maria Natália Dias Soeiro; Paz-Y-Miño, César; Rebelo, Irene

2017-08-08

Preeclampsia is a multifactorial disease with unknown pathogenesis. Even when recent studies explored this disease using several bioinformatics tools, the main objective was not directed to pathogenesis. Additionally, consensus prioritization was proved to be highly efficient in the recognition of genes-disease association. However, not information is available about the consensus ability to early recognize genes directly involved in pathogenesis. Therefore our aim in this study is to apply several theoretical approaches to explore preeclampsia; specifically those genes directly involved in the pathogenesis. We firstly evaluated the consensus between 12 prioritization strategies to early recognize pathogenic genes related to preeclampsia. A communality analysis in the protein-protein interaction network of previously selected genes was done including further enrichment analysis. The enrichment analysis includes metabolic pathways as well as gene ontology. Microarray data was also collected and used in order to confirm our results or as a strategy to weight the previously enriched pathways. The consensus prioritized gene list was rationally filtered to 476 genes using several criteria. The communality analysis showed an enrichment of communities connected with VEGF-signaling pathway. This pathway is also enriched considering the microarray data. Our result point to VEGF, FLT1 and KDR as relevant pathogenic genes, as well as those connected with NO metabolism. Our results revealed that consensus strategy improve the detection and initial enrichment of pathogenic genes, at least in preeclampsia condition. Moreover the combination of the first percent of the prioritized genes with protein-protein interaction network followed by communality analysis reduces the gene space. This approach actually identifies well known genes related with pathogenesis. However, genes like HSP90, PAK2, CD247 and others included in the first 1% of the prioritized list need to be further

Consolidated principles for screening based on a systematic review and consensus process.

Science.gov (United States)

Dobrow, Mark J; Hagens, Victoria; Chafe, Roger; Sullivan, Terrence; Rabeneck, Linda

2018-04-09

In 1968, Wilson and Jungner published 10 principles of screening that often represent the de facto starting point for screening decisions today; 50 years on, are these principles still the right ones? Our objectives were to review published work that presents principles for population-based screening decisions since Wilson and Jungner's seminal publication, and to conduct a Delphi consensus process to assess the review results. We conducted a systematic review and modified Delphi consensus process. We searched multiple databases for articles published in English in 1968 or later that were intended to guide population-based screening decisions, described development and modification of principles, and presented principles as a set or list. Identified sets were compared for basic characteristics (e.g., number, categorization), a citation analysis was conducted, and principles were iteratively synthesized and consolidated into categories to assess evolution. Participants in the consensus process assessed the level of agreement with the importance and interpretability of the consolidated screening principles. We identified 41 sets and 367 unique principles. Each unique principle was coded to 12 consolidated decision principles that were further categorized as disease/condition, test/intervention or program/system principles. Program or system issues were the focus of 3 of Wilson and Jungner's 10 principles, but comprised almost half of all unique principles identified in the review. The 12 consolidated principles were assessed through 2 rounds of the consensus process, leading to specific refinements to improve their relevance and interpretability. No gaps or missing principles were identified. Wilson and Jungner's principles are remarkably enduring, but increasingly reflect a truncated version of contemporary thinking on screening that does not fully capture subsequent focus on program or system principles. Ultimately, this review and consensus process provides a

Consolidated principles for screening based on a systematic review and consensus process

Science.gov (United States)

Hagens, Victoria; Chafe, Roger; Sullivan, Terrence; Rabeneck, Linda

2018-01-01

BACKGROUND: In 1968, Wilson and Jungner published 10 principles of screening that often represent the de facto starting point for screening decisions today; 50 years on, are these principles still the right ones? Our objectives were to review published work that presents principles for population-based screening decisions since Wilson and Jungner’s seminal publication, and to conduct a Delphi consensus process to assess the review results. METHODS: We conducted a systematic review and modified Delphi consensus process. We searched multiple databases for articles published in English in 1968 or later that were intended to guide population-based screening decisions, described development and modification of principles, and presented principles as a set or list. Identified sets were compared for basic characteristics (e.g., number, categorization), a citation analysis was conducted, and principles were iteratively synthesized and consolidated into categories to assess evolution. Participants in the consensus process assessed the level of agreement with the importance and interpretability of the consolidated screening principles. RESULTS: We identified 41 sets and 367 unique principles. Each unique principle was coded to 12 consolidated decision principles that were further categorized as disease/condition, test/intervention or program/system principles. Program or system issues were the focus of 3 of Wilson and Jungner’s 10 principles, but comprised almost half of all unique principles identified in the review. The 12 consolidated principles were assessed through 2 rounds of the consensus process, leading to specific refinements to improve their relevance and interpretability. No gaps or missing principles were identified. INTERPRETATION: Wilson and Jungner’s principles are remarkably enduring, but increasingly reflect a truncated version of contemporary thinking on screening that does not fully capture subsequent focus on program or system principles

Highly preserved consensus gene modules in human papilloma virus 16 positive cervical cancer and head and neck cancers.

Science.gov (United States)

Zhang, Xianglan; Cha, In-Ho; Kim, Ki-Yeol

2017-12-26

In this study, we investigated the consensus gene modules in head and neck cancer (HNC) and cervical cancer (CC). We used a publicly available gene expression dataset, GSE6791, which included 42 HNC, 14 normal head and neck, 20 CC and 8 normal cervical tissue samples. To exclude bias because of different human papilloma virus (HPV) types, we analyzed HPV16-positive samples only. We identified 3824 genes common to HNC and CC samples. Among these, 977 genes showed high connectivity and were used to construct consensus modules. We demonstrated eight consensus gene modules for HNC and CC using the dissimilarity measure and average linkage hierarchical clustering methods. These consensus modules included genes with significant biological functions, including ATP binding and extracellular exosome. Eigengen network analysis revealed the consensus modules were highly preserved with high connectivity. These findings demonstrate that HPV16-positive head and neck and cervical cancers share highly preserved consensus gene modules with common potentially therapeutic targets.

Consensus shaping and safe space public participation processes

Energy Technology Data Exchange (ETDEWEB)

Andersson, Kjell [Karita Research AB, Taeaby (Sweden)

2015-07-01

map public participation - consultation, consensus shaping processes and safe space. In contrast to consensus shaping processes, in the safe space approach there is no intention to develop solutions together between the implementer and other stakeholders. In comparison with the ladder, the basic approaches offer advantages for the mapping of public participation processes: If you strive for consensus or ''only'' clarity and awareness is a crucial question to be answered before a process is launched as it determines which stakeholders can join and which goals are feasible to reach. It is easier to use in assigning properties to a process, as it more straight-forward to understand if a process is consensus shaping or a safe space than where it is on the ladder. It clarifies better the links between the participation processes and the actual political and/or legal decision-making process. A consensus shaping process should produce real advice (or even decisions) but a safe space is limited to improving the decision making base with enhanced clarity.

Consensus shaping and safe space public participation processes

International Nuclear Information System (INIS)

Andersson, Kjell

2015-01-01

map public participation - consultation, consensus shaping processes and safe space. In contrast to consensus shaping processes, in the safe space approach there is no intention to develop solutions together between the implementer and other stakeholders. In comparison with the ladder, the basic approaches offer advantages for the mapping of public participation processes: If you strive for consensus or ''only'' clarity and awareness is a crucial question to be answered before a process is launched as it determines which stakeholders can join and which goals are feasible to reach. It is easier to use in assigning properties to a process, as it more straight-forward to understand if a process is consensus shaping or a safe space than where it is on the ladder. It clarifies better the links between the participation processes and the actual political and/or legal decision-making process. A consensus shaping process should produce real advice (or even decisions) but a safe space is limited to improving the decision making base with enhanced clarity.

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

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.

A Novel Scoring Metrics for Quality Assurance of Ocean Color Observations

Science.gov (United States)

Wei, J.; Lee, Z.

2016-02-01

Interpretation of the ocean bio-optical properties from ocean color observations depends on the quality of the ocean color data, specifically the spectrum of remote sensing reflectance (Rrs). The in situ and remotely measured Rrs spectra are inevitably subject to errors induced by instrument calibration, sea-surface correction and atmospheric correction, and other environmental factors. Great efforts have been devoted to the ocean color calibration and validation. Yet, there exist no objective and consensus criteria for assessment of the ocean color data quality. In this study, the gap is filled by developing a novel metrics for such data quality assurance and quality control (QA/QC). This new QA metrics is not intended to discard "suspicious" Rrs spectra from available datasets. Rather, it takes into account the Rrs spectral shapes and amplitudes as a whole and grades each Rrs spectrum. This scoring system is developed based on a large ensemble of in situ hyperspectral remote sensing reflectance data measured from various aquatic environments and processed with robust procedures. This system is further tested with the NASA bio-Optical Marine Algorithm Data set (NOMAD), with results indicating significant improvements in the estimation of bio-optical properties when Rrs spectra marked with higher quality assurance are used. This scoring system is further verified with simulated data and satellite ocean color data in various regions, and we envision higher quality ocean color products with the implementation of such a quality screening system.

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...

Implants and/or teeth: consensus statements and recommendations

DEFF Research Database (Denmark)

Gotfredsen, K; Carlsson, G E; Jokstad, A

2008-01-01

In August 23-25, 2007, the Scandinavian Society for Prosthetic Dentistry in collaboration with the Danish Society of Oral Implantology arranged a consensus conference on the topic 'Implants and/or teeth'. It was preceded by a workshop in which eight focused questions were raised and answered in e...

WebScore: An Effective Page Scoring Approach for Uncertain Web Social Networks

Directory of Open Access Journals (Sweden)

Shaojie Qiao

2011-10-01

Full Text Available To effectively score pages with uncertainty in web social networks, we first proposed a new concept called transition probability matrix and formally defined the uncertainty in web social networks. Second, we proposed a hybrid page scoring algorithm, called WebScore, based on the PageRank algorithm and three centrality measures including degree, betweenness, and closeness. Particularly,WebScore takes into a full consideration of the uncertainty of web social networks by computing the transition probability from one page to another. The basic idea ofWebScore is to: (1 integrate uncertainty into PageRank in order to accurately rank pages, and (2 apply the centrality measures to calculate the importance of pages in web social networks. In order to verify the performance of WebScore, we developed a web social network analysis system which can partition web pages into distinct groups and score them in an effective fashion. Finally, we conducted extensive experiments on real data and the results show that WebScore is effective at scoring uncertain pages with less time deficiency than PageRank and centrality measures based page scoring algorithms.

Eliciting Public Attitudes Regarding Bioremediation Cleanup Technologies: Lessons Learned from a Consensus Workshop in Idaho

Energy Technology Data Exchange (ETDEWEB)

Denise Lach, Principle Investigator; Stephanie Sanford, Co-P.I.

2003-03-01

During the summer of 2002, we developed and implemented a ''consensus workshop'' with Idaho citizens to elicit their concerns and issues regarding the use of bioremediation as a cleanup technology for radioactive nuclides and heavy metals at Department of Energy (DOE) sites. The consensus workshop is a derivation of a technology assessment method designed to ensure dialogue between experts and lay people. It has its origins in the United States in the form of ''consensus development conferences'' used by the National Institutes of Health (NIH) to elicit professional knowledge and concerns about new medical treatments. Over the last 25 years, NIH has conducted over 100 consensus development conferences. (Jorgensen 1995). The consensus conference is grounded in the idea that technology assessment and policy needs to be socially negotiated among many different stakeholders and groups rather than narrowly defined by a group of experts. To successfully implement new technology, the public requires access to information that addresses a full complement of issues including understanding the organization proposing the technology. The consensus conference method creates an informed dialogue, making technology understandable to the general public and sets it within perspectives and priorities that may differ radically from those of the expert community. While specific outcomes differ depending on the overall context of a conference, one expected outcome is that citizen panel members develop greater knowledge of the technology during the conference process and, sometimes, the entire panel experiences a change in attitude toward the technology and/or the organization proposing its use (Kluver 1995). The purpose of this research project was to explore the efficacy of the consensus conference model as a way to elicit the input of the general public about bioremediation of radionuclides and heavy metals at Department of Energy sites

Eliciting Public Attitudes Regarding Bioremediation Cleanup Technologies: Lessons Learned from a Consensus Workshop in Idaho

International Nuclear Information System (INIS)

Denise Lach, Principle Investigator; Stephanie Sanford, Co-P.I.

2003-01-01

During the summer of 2002, we developed and implemented a ''consensus workshop'' with Idaho citizens to elicit their concerns and issues regarding the use of bioremediation as a cleanup technology for radioactive nuclides and heavy metals at Department of Energy (DOE) sites. The consensus workshop is a derivation of a technology assessment method designed to ensure dialogue between experts and lay people. It has its origins in the United States in the form of ''consensus development conferences'' used by the National Institutes of Health (NIH) to elicit professional knowledge and concerns about new medical treatments. Over the last 25 years, NIH has conducted over 100 consensus development conferences. (Jorgensen 1995). The consensus conference is grounded in the idea that technology assessment and policy needs to be socially negotiated among many different stakeholders and groups rather than narrowly defined by a group of experts. To successfully implement new technology, the public requires access to information that addresses a full complement of issues including understanding the organization proposing the technology. The consensus conference method creates an informed dialogue, making technology understandable to the general public and sets it within perspectives and priorities that may differ radically from those of the expert community. While specific outcomes differ depending on the overall context of a conference, one expected outcome is that citizen panel members develop greater knowledge of the technology during the conference process and, sometimes, the entire panel experiences a change in attitude toward the technology and/or the organization proposing its use (Kluver 1995). The purpose of this research project was to explore the efficacy of the consensus conference model as a way to elicit the input of the general public about bioremediation of radionuclides and heavy metals at Department of Energy sites. Objectives of the research included: (1

Highlights of the international consensus statement on major depressive disorder.

Science.gov (United States)

Nutt, David J

2011-06-01

The International Consensus Group on Depression gathered to outline a universal treatment algorithm for depression with the purpose of merging the evidence base and standards of clinical practice from various countries, including the United States, Europe, the Middle East, China, and Japan. This brief summary includes the following recommendations made by the consensus group: periodically screen all patients for depression, use measurement-based tools and full psychiatric assessments to complete differential diagnoses, refer patients to psychiatric specialists when appropriate, establish a therapeutic alliance with patients and their families, begin treatment with an antidepressant for moderate or severe depression, treat patients to remission, and continually monitor patients' symptomatic improvement. © Copyright 2011 Physicians Postgraduate Press, Inc.

Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study

Science.gov (United States)

Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

2018-01-01

Background The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. Objective We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. Methods We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. Results In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. Conclusions This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. PMID:29699970

Opinion dynamics of learning agents: does seeking consensus lead to disagreement?

International Nuclear Information System (INIS)

Vicente, Renato; Martins, André C R; Caticha, Nestor

2009-01-01

We study opinion dynamics in a population of interacting adaptive agents voting on a set of issues represented by vectors. We consider agents who can classify issues into one of two categories and can arrive at their opinions using an adaptive algorithm. Adaptation comes from learning and the information for the learning process comes from interacting with other neighboring agents and trying to change the internal state in order to concur with their opinions. The change in the internal state is driven by the information contained in the issue and in the opinion of the other agent. We present results in a simple yet rich context where each agent uses a Boolean perceptron to state their opinion. If the update occurs with information asynchronously exchanged among pairs of agents, then the typical case, if the number of issues is kept small, is the evolution into a society torn by the emergence of factions with extreme opposite beliefs. This occurs even when seeking consensus with agents with opposite opinions. If the number of issues is large, the dynamics becomes trapped, the society does not evolve into factions and a distribution of moderate opinions is observed. The synchronous case is technically simpler and is studied by formulating the problem in terms of differential equations that describe the evolution of order parameters that measure the consensus between pairs of agents. We show that for a large number of issues and unidirectional information flow, global consensus is a fixed point; however, the approach to this consensus is glassy for large societies

Opinion dynamics of learning agents: does seeking consensus lead to disagreement?

Science.gov (United States)

Vicente, Renato; Martins, André C. R.; Caticha, Nestor

2009-03-01

We study opinion dynamics in a population of interacting adaptive agents voting on a set of issues represented by vectors. We consider agents who can classify issues into one of two categories and can arrive at their opinions using an adaptive algorithm. Adaptation comes from learning and the information for the learning process comes from interacting with other neighboring agents and trying to change the internal state in order to concur with their opinions. The change in the internal state is driven by the information contained in the issue and in the opinion of the other agent. We present results in a simple yet rich context where each agent uses a Boolean perceptron to state their opinion. If the update occurs with information asynchronously exchanged among pairs of agents, then the typical case, if the number of issues is kept small, is the evolution into a society torn by the emergence of factions with extreme opposite beliefs. This occurs even when seeking consensus with agents with opposite opinions. If the number of issues is large, the dynamics becomes trapped, the society does not evolve into factions and a distribution of moderate opinions is observed. The synchronous case is technically simpler and is studied by formulating the problem in terms of differential equations that describe the evolution of order parameters that measure the consensus between pairs of agents. We show that for a large number of issues and unidirectional information flow, global consensus is a fixed point; however, the approach to this consensus is glassy for large societies.