267,796 research outputs found
Decision Support System for Managing and Determining International Class Program
Indonesian higher education today is faced with serious challenges that will threaten the existence of some universities. An increasing international competition will require that universities take a progressive approach to attract enough students to ensure their survival. One way the universities must improve is in the quality of their administration management. While universities in Indonesia do not compare well internationally, steps can be taken to improve the quality. There are potential lessons to be learned from corporate experience in quality control management. Decision-making in the field of academic resource planning involves extensive analysis of many data originating from multiple systems. Academic resource planning management is concerned with management resources in order to effectively support the universityâs educational framework (such as offered degrees, enrolment and retention, resources teaching, course structure and curriculum). We propose a methodology for managing and determining the proposed International class based on many criteria of academic performance in university. The approach has been implemented as a decision support system allowing evaluation of various criteria and scenarios. The system combines two different methods in decision support system: Analytical hierarchy Process (AHP) and linear weightage model, the proposed model uses the AHP pairwise comparisons and the measure scale to generate the weights for the criteria which are much better and guarantee more fairly preference of criteria. Applying the system as decision-support facility for the management has resulted in significant acceleration of planning procedures and implementation, raised the overall effectiveness with respect to the underlying methodology and ultimately enabled more efficient academic administration
Consensus on early detection of disease progression in patients with multiple sclerosis
Consensus; Early detection; Secondary progressive multiple sclerosisConsenso; DetecciĂłn precoz; Esclerosis mĂșltiple progresiva secundariaConsens; DetecciĂł precoç; Esclerosi mĂșltiple progressiva secundĂ riaBackground: Early identification of the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS) can be challenging for clinicians, as diagnostic criteria for SPMS are primarily based on physical disability and a holistic interpretation.
Objective: To establish a consensus on patient monitoring to identify promptly disease progression and the most useful clinical and paraclinical variables for early identification of disease progression in MS.
Methods: A RAND/UCLA Appropriateness Method was used to establish the level of agreement among a panel of 15 medical experts in MS. Eighty-three items were circulated to the experts for confidential rating of the grade of agreement and recommendation. Consensus was defined when â„66% agreement or disagreement was achieved.
Results: Consensus was reached in 72 out of 83 items (86.7%). The items addressed frequency of follow-up visits, definition of progression, identification of clinical, cognitive, and radiological assessments as variables of suspected or confirmed SPMS diagnosis, the need for more accurate assessment tools, and the use of promising molecular and imaging biomarkers to predict disease progression and/or diagnose SPMS.
Conclusion: Consensus achieved on these topics could guide neurologists to identify earlier disease progression and to plan targeted clinical and therapeutic interventions during the earliest stages of SPMS.This work was supported by Novartis. Meetings, data analysis, and medical writing assistance were funded by Novartis. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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Long-term safety of siltuximab in patients with idiopathic multicentric Castleman disease: a prespecified, open-label, extension analysis of two trials.
BACKGROUND:Siltuximab is recommended by international consensus as a first-line treatment for idiopathic multicentric Castleman disease on the basis of durable efficacy and safety data. This study was done to assess the long-term safety and activity of siltuximab over up to 6 years of treatment. METHODS:This study is a prespecified open-label extension analysis of a phase 1 trial (NCT00412321) and a phase 2 trial (NCT01024036), done at 26 hospitals worldwide. Patients in both studies were at least 18 years old with histologically confirmed, symptomatic Castleman disease. This extension study enrolled 60 patients who completed the previous trials without disease progression on siltuximab. Patients received siltuximab infusions of 11 mg/kg every 3 weeks (which could be extended to 6 weeks) for up to 6 years. Descriptive statistics were used to summarise the data. No formal hypothesis testing was performed. The primary endpoint was the safety of siltuximab, assessed at each dosing cycle. The study was registered with ClinicalTrials.gov, number NCT01400503 and with EudraCT, number 2010-022837-27. FINDINGS:Patient enrolment into the phase 1 trial was from June 20, 2005, to Sept 15, 2009, and enrolment into the phase 2 trial was from Feb 9, 2010, to Feb 3, 2012. Patients were enrolled in this long-term extension from April 1, 2011, to Jan 15, 2014. Median follow-up was 6 years (IQR 5·11-7·76). Median treatment duration, from the beginning of the previous trials to the end of the present study, was 5·5 years (IQR 4·26-7·14). Siltuximab was well tolerated; however, adverse events of grade 3 or worse were reported in 36 (60%) of 60 patients with the most common being hypertension (eight [13%]), fatigue (five [8%]), nausea (four [7%]), neutropenia (four [7%]), and vomiting (three [5%]). 25 (42%) patients reported at least one serious adverse event, which most commonly was an infection (eight [13%]). Only two serious adverse events, polycythaemia and urinary retention, were considered related to siltuximab treatment. 18 patients discontinued before study completion, either to receive siltuximab locally (eight) or because of progressive disease (two), adverse events (two), or other reasons (six). No deaths were reported. INTERPRETATION:These results show that siltuximab is well tolerated long term and provides important evidence for the feasibility of the life-long use required by patients with idiopathic multicentric Castleman disease. FUNDING:Janssen R&D and EUSA Pharma
Cognitive architectures as Lakatosian research programmes: two case studies
Cognitive architectures - task-general theories of the structure and function of the complete cognitive system - are sometimes argued to be more akin to frameworks or belief systems than scientific theories. The argument stems from the apparent non-falsifiability of existing cognitive architectures. Newell was aware of this criticism and argued that architectures should be viewed not as theories subject to Popperian falsification, but rather as Lakatosian research programs based on cumulative growth. Newell's argument is undermined because he failed to demonstrate that the development of Soar, his own candidate architecture, adhered to Lakatosian principles. This paper presents detailed case studies of the development of two cognitive architectures, Soar and ACT-R, from a Lakatosian perspective. It is demonstrated that both are broadly Lakatosian, but that in both cases there have been theoretical progressions that, according to Lakatosian criteria, are pseudo-scientific. Thus, Newell's defense of Soar as a scientific rather than pseudo-scientific theory is not supported in practice. The ACT series of architectures has fewer pseudo-scientific progressions than Soar, but it too is vulnerable to accusations of pseudo-science. From this analysis, it is argued that successive versions of theories of the human cognitive architecture must explicitly address five questions to maintain scientific credibility
System optimization by multiobjective genetic algorithms and analysis of the coupling between variables, constraints and objectives
This paper presents a methodology based on Multiobjective Genetic Algorithms (MOGAâs) for the design of electrical engineering systems. MOGAâs allow to optimize multiple heterogeneous criteria in complex systems, but also simplify couplings and sensitivity analysis by determining the evolution of design variables along the Pareto-optimal front. A rather simplified case study dealing with the optimal dimensioning of an inverter â permanent magnet motor â reducer â load association is carried out to demonstrate the interest of the approach
The role of falsification in the development of cognitive architectures: insights from a Lakatosian analysis
It has been suggested that the enterprise of developing mechanistic theories of the human cognitive architecture is flawed because the theories produced are not directly falsifiable. Newell attempted to sidestep this criticism by arguing for a Lakatosian model of scientific progress in which cognitive architectures should be understood as theories that develop over time. However, Newellâs own candidate cognitive architecture adhered only loosely to Lakatosian principles. This paper reconsiders the role of falsification and the potential utility of Lakatosian principles in the development of cognitive architectures. It is argued that a lack of direct falsifiability need not undermine the scientific development of a cognitive architecture if broadly Lakatosian principles are adopted. Moreover, it is demonstrated that the Lakatosian concepts of positive and negative heuristics for theory development and of general heuristic power offer methods for guiding the development of an architecture and for evaluating the contribution and potential of an architectureâs research program
Automated, high accuracy classification of Parkinsonian disorders: a pattern recognition approach
Progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and idiopathic Parkinsonâs disease (IPD) can be clinically indistinguishable, especially in the early stages, despite distinct patterns of molecular pathology. Structural neuroimaging holds promise for providing objective biomarkers for discriminating these diseases at the single subject level but all studies to date have reported incomplete separation of disease groups. In this study, we employed multi-class pattern recognition to assess the value of anatomical patterns derived from a widely available structural neuroimaging sequence for automated classification of these disorders. To achieve this, 17 patients with PSP, 14 with IPD and 19 with MSA were scanned using structural MRI along with 19 healthy controls (HCs). An advanced probabilistic pattern recognition approach was employed to evaluate the diagnostic value of several pre-defined anatomical patterns for discriminating the disorders, including: (i) a subcortical motor network; (ii) each of its component regions and (iii) the whole brain. All disease groups could be discriminated simultaneously with high accuracy using the subcortical motor network. The region providing the most accurate predictions overall was the midbrain/brainstem, which discriminated all disease groups from one another and from HCs. The subcortical network also produced more accurate predictions than the whole brain and all of its constituent regions. PSP was accurately predicted from the midbrain/brainstem, cerebellum and all basal ganglia compartments; MSA from the midbrain/brainstem and cerebellum and IPD from the midbrain/brainstem only. This study demonstrates that automated analysis of structural MRI can accurately predict diagnosis in individual patients with Parkinsonian disorders, and identifies distinct patterns of regional atrophy particularly useful for this process
Exercise and progressive supranuclear palsy : the need for explicit exercise reporting
Background
Progressive Supranuclear Palsy (PSP) is the most frequent form of atypical Parkinsonism. Although there is preliminary evidence for the benefits of gait rehabilitation, balance training and oculomotor exercises in PSP, the quality of reporting of exercise therapies appears mixed. The current investigation aims to evaluate the comprehensiveness of reporting of exercise and physical activity interventions in the PSP literature.
Methods
Two independent reviewers used the Consensus on Exercise Reporting Template (CERT) to extract all exercise intervention data from 11 studies included in a systematic review. CERT items covered: âwhatâ (materials), âwhoâ (instructor qualifications), âhowâ (delivery), âwhereâ (location), âwhenâ, âhow muchâ (dosage), âtailoringâ (what, how), and âhow wellâ (fidelity) exercise delivery complied with the protocol. Each exercise item was scored â1â (adequately reported) or â0â (not adequately reported or unclear). The CERT score was calculated, as well as the percentage of studies that reported each CERT item.
Results
The CERT scores ranged from 3 to 12 out of 19. No PSP studies adequately described exercise elements that would allow exact replication of the interventions. Well-described items included exercise equipment, exercise settings, exercise therapy scheduling, frequency and duration. Poorly described items included decision rules for exercise progression, instructor qualifications, exercise adherence, motivation strategies, safety and adverse events associated with exercise therapies.
Discussion
The results revealed variability in the reporting of physical therapies for people living with PSP. Future exercise trials need to more comprehensively describe equipment, instructor qualifications, exercise and physical activity type, dosage, setting, individual tailoring of exercises, supervision, adherence, motivation strategies, progression decisions, safety and adverse events.
Conclusion
Although beneficial for people living with PSP, exercise and physical therapy interventions have been inadequately reported. It is recommended that evidence-based reporting templates be utilised to comprehensively document therapeutic exercise design, delivery and evaluation
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