CBR and MBR techniques: review for an application in the emergencies domain

The purpose of this document is to provide an in-depth analysis of current reasoning engine practice and the integration strategies of Case Based Reasoning and Model Based Reasoning that will be used in the design and development of the RIMSAT system. RIMSAT (Remote Intelligent Management Support and Training) is a European Commission funded project designed to: a.. Provide an innovative, 'intelligent', knowledge based solution aimed at improving the quality of critical decisions b.. Enhance the competencies and responsiveness of individuals and organisations involved in highly complex, safety critical incidents - irrespective of their location. In other words, RIMSAT aims to design and implement a decision support system that using Case Base Reasoning as well as Model Base Reasoning technology is applied in the management of emergency situations. This document is part of a deliverable for RIMSAT project, and although it has been done in close contact with the requirements of the project, it provides an overview wide enough for providing a state of the art in integration strategies between CBR and MBR technologies.Postprint (published version

Bridging the gap between methods research and the needs of policy makers: A review of the research priorities of the National Institute for Health and Clinical Excellence

Objectives: The aim of this study was to establish a list of priority topics for methods research to support decision making at the National Institute for Health and Clinical Excellence (NICE). Methods: Potential priorities for methods research topics were identified through a focused literature review, interviews, an email survey, a workshop and a Web-based feedback exercise. Participants were members of the NICE secretariat and its advisory bodies, representatives from academia, industry, and other organizations working closely with NICE. The Web exercise was open to anyone to complete but publicized among the above groups. Results: A list of potential topics was collated. Priorities for further research differed according to the type of respondent and the extent to which they work directly with NICE. Priorities emerging from the group closest to NICE included: methodology for indirect and mixed treatment comparisons; synthesis of qualitative evidence; research relating to the use of quality-adjusted life-years (QALYs) in decision making; methods and empirical research for establishing the cost-effectiveness threshold; and determining how data on the uncertainty of effectiveness and cost-effectiveness data should be taken into account in the decision-making process. Priorities emerging from the broadest group of respondents (through the Web exercise) included: methods for extrapolating beyond evidence observed in trials, methods for capturing benefits not included in the QALY and methods to assess when technologies should be recommended in the context of further evidence gathering. Conclusions: Consideration needs to be given to the needs of those who use the outputs of research for decision making when determining priorities for future methods research.NIHR Medical Research Council

Factors affecting seasonal forecast use in Arizona water management: A case study of the 1997-98 El Niño

The 1997-98 El Niño was exceptional, not only because of its magnitude, but also because of the visibility and use of its forecasts. The 3 to 9 mo advance warning of a wet winter with potential flooding in the US Southwest, easily accessible by water management agencies, was unprecedented. Insights about use of this information in operational water management decision processes were developed through a series of semi-structured in-depth interviews with key personnel from a broad array of agencies responsible for emergency management and water supply, with jurisdictions ranging from urban to rural and local to regional. Interviews investigated where information was acquired, how it was interpreted and how it was incorporated into specific decisions and actions. In addition, technical and institutional barriers to forecast use are explored. Study findings emphasize (1) the need for special handling of tailored forecast products on a regional scale, (2) the need for systematic regional forecast evaluation and (3) the potential for climate information to directly affect water management decisions through integrating climate forecasts into water supply outlooks where appropriate

Some research possibilities in diagnostic radiography

This is tha author's PDF version of an article published in Radiography© 1998. The definitive version is available at www.elsevierhealth.comAlthough scientific method is usually viewed as starting with hypotheses which must then be exposed to experimental test, there are situations where this rigid scenario is inappropriate. Fortunately, the alternatives provide avenues for valuable investigative work in radiographic research. Research questions may be addressed by collecting data from existing sources in a way that not only provides fundamental information about human biology, but may improve the efficacy of radiographic practice while avoiding ethical problems about the use of patients. Among those involved in osteology, it is radiographers who see and store the most bone images. Subsequently, they have access to more osteological information than anyone else. All that remains is for this information to be extracted and put into a more accessible form. Since they are closely involved with the patients from whom their radiographs stem, there are research questions which radiographers are uniquely situated to raise.Supported by a University of Liverpool research development gran

Analyzing and Interpreting Neural Networks for NLP: A Report on the First BlackboxNLP Workshop

The EMNLP 2018 workshop BlackboxNLP was dedicated to resources and techniques specifically developed for analyzing and understanding the inner-workings and representations acquired by neural models of language. Approaches included: systematic manipulation of input to neural networks and investigating the impact on their performance, testing whether interpretable knowledge can be decoded from intermediate representations acquired by neural networks, proposing modifications to neural network architectures to make their knowledge state or generated output more explainable, and examining the performance of networks on simplified or formal languages. Here we review a number of representative studies in each category

A Process Modelling Framework Based on Point Interval Temporal Logic with an Application to Modelling Patient Flows

This thesis considers an application of a temporal theory to describe and model the patient journey in the hospital accident and emergency (A&E) department. The aim is to introduce a generic but dynamic method applied to any setting, including healthcare. Constructing a consistent process model can be instrumental in streamlining healthcare issues. Current process modelling techniques used in healthcare such as flowcharts, unified modelling language activity diagram (UML AD), and business process modelling notation (BPMN) are intuitive and imprecise. They cannot fully capture the complexities of the types of activities and the full extent of temporal constraints to an extent where one could reason about the flows. Formal approaches such as Petri have also been reviewed to investigate their applicability to the healthcare domain to model processes. Additionally, to schedule patient flows, current modelling standards do not offer any formal mechanism, so healthcare relies on critical path method (CPM) and program evaluation review technique (PERT), that also have limitations, i.e. finish-start barrier. It is imperative to specify the temporal constraints between the start and/or end of a process, e.g., the beginning of a process A precedes the start (or end) of a process B. However, these approaches failed to provide us with a mechanism for handling these temporal situations. If provided, a formal representation can assist in effective knowledge representation and quality enhancement concerning a process. Also, it would help in uncovering complexities of a system and assist in modelling it in a consistent way which is not possible with the existing modelling techniques. The above issues are addressed in this thesis by proposing a framework that would provide a knowledge base to model patient flows for accurate representation based on point interval temporal logic (PITL) that treats point and interval as primitives. These objects would constitute the knowledge base for the formal description of a system. With the aid of the inference mechanism of the temporal theory presented here, exhaustive temporal constraints derived from the proposed axiomatic system’ components serves as a knowledge base. The proposed methodological framework would adopt a model-theoretic approach in which a theory is developed and considered as a model while the corresponding instance is considered as its application. Using this approach would assist in identifying core components of the system and their precise operation representing a real-life domain deemed suitable to the process modelling issues specified in this thesis. Thus, I have evaluated the modelling standards for their most-used terminologies and constructs to identify their key components. It will also assist in the generalisation of the critical terms (of process modelling standards) based on their ontology. A set of generalised terms proposed would serve as an enumeration of the theory and subsume the core modelling elements of the process modelling standards. The catalogue presents a knowledge base for the business and healthcare domains, and its components are formally defined (semantics). Furthermore, a resolution theorem-proof is used to show the structural features of the theory (model) to establish it is sound and complete. After establishing that the theory is sound and complete, the next step is to provide the instantiation of the theory. This is achieved by mapping the core components of the theory to their corresponding instances. Additionally, a formal graphical tool termed as point graph (PG) is used to visualise the cases of the proposed axiomatic system. PG facilitates in modelling, and scheduling patient flows and enables analysing existing models for possible inaccuracies and inconsistencies supported by a reasoning mechanism based on PITL. Following that, a transformation is developed to map the core modelling components of the standards into the extended PG (PG*) based on the semantics presented by the axiomatic system. A real-life case (from the King’s College hospital accident and emergency (A&E) department’s trauma patient pathway) is considered to validate the framework. It is divided into three patient flows to depict the journey of a patient with significant trauma, arriving at A&E, undergoing a procedure and subsequently discharged. Their staff relied upon the UML-AD and BPMN to model the patient flows. An evaluation of their representation is presented to show the shortfalls of the modelling standards to model patient flows. The last step is to model these patient flows using the developed approach, which is supported by enhanced reasoning and scheduling

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder:systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder

Diagnosis and the management constituency of small-scale fisheries

Diagnosis and adaptive management can help improve the ability of small-scale fisheries (SSF) in the developing world to better cope with and adapt to both external drivers and internal sources of uncertainty. This paper presents a framework for diagnosis and adaptive management and discusses ways of implementing the first two phases of learning: diagnosis and mobilising an appropriate management constituency. The discussion addresses key issues and suggests suitable approaches and tools as well as numerous sources of further information. Diagnosis of a SSF defines the system to be managed, outlines the scope of the management problem in terms of threats and opportunities, and aims to construct realistic and desired future projections for the fishery. These steps can clarify objectives and lead to development of indicators necessary for adaptive management. Before management, however, it is important to mobilize a management constituency to enact change. Ways of identifying stakeholders and understanding both enabling and obstructive interactions and management structures are outlined. These preliminary learning phases for adaptive SSF management are expected to work best if legitimised by collaborative discussion among fishery stakeholders drawing on multiple knowledge systems and participatory approaches to assessment. (PDF contains 33 pages

Complexity stage model of the medical device development based on economic evaluation-MedDee

The development of a new product is essential for the progress and success of any company. The medical device market is very specific, which is challenging. Therefore, this paper assesses an economic model for medical device evaluation using the economic, health, technology regulatory, and present market knowledge to enable the cost-time conception for any applicant. The purpose of this study is to propose a comprehensive stage model of the medical device development to subsequently describe the financial expenditure of the entire development process. The identification of critical steps was based on the literature review, and analysis, and a comparison of the available medical device development stages and directives. Furthermore, a preliminary assessment of the medical device development steps and procedures on the basis of the interviews was performed. Six interviews were conducted with an average duration of one hour, focusing on areas: relevance and level of detail of the medical device development stages, involvement of economic methods, and applicability of the proposed model. Subsequently, the improvement and modification of the medical device investment process, based on respondents' responses, were conducted. The authors have proposed the complexity model MedDee-Medical Devices Development by Economic Evaluation. This model is comprised of six phases: initiation, concept, design, production, final verification, and market disposition in which the economic methods are incorporated.Web of Science125art. no. 175

Automatic determination of fault effects on aircraft functionality

The problem of determining the behavior of physical systems subsequent to the occurrence of malfunctions is discussed. It is established that while it was reasonable to assume that the most important fault behavior modes of primitive components and simple subsystems could be known and predicted, interactions within composite systems reached levels of complexity that precluded the use of traditional rule-based expert system techniques. Reasoning from first principles, i.e., on the basis of causal models of the physical system, was required. The first question that arises is, of course, how the causal information required for such reasoning should be represented. The bond graphs presented here occupy a position intermediate between qualitative and quantitative models, allowing the automatic derivation of Kuipers-like qualitative constraint models as well as state equations. Their most salient feature, however, is that entities corresponding to components and interactions in the physical system are explicitly represented in the bond graph model, thus permitting systematic model updates to reflect malfunctions. Researchers show how this is done, as well as presenting a number of techniques for obtaining qualitative information from the state equations derivable from bond graph models. One insight is the fact that one of the most important advantages of the bond graph ontology is the highly systematic approach to model construction it imposes on the modeler, who is forced to classify the relevant physical entities into a small number of categories, and to look for two highly specific types of interactions among them. The systematic nature of bond graph model construction facilitates the process to the point where the guidelines are sufficiently specific to be followed by modelers who are not domain experts. As a result, models of a given system constructed by different modelers will have extensive similarities. Researchers conclude by pointing out that the ease of updating bond graph models to reflect malfunctions is a manifestation of the systematic nature of bond graph construction, and the regularity of the relationship between bond graph models and physical reality