115 research outputs found

    On-Line Student Modeling for Coached Problem Solving Using Bayesian Networks

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    This paper describes the student modeling component of ANDES, an Intelligent Tutoring System for Newtonian physics. ANDES' student model uses a Bayesian network to do long-term knowledge assessment, plan recognition and prediction of students' actions during problem solving. The network is updated in real time, using an approximate anytime algorithm based on stochastic sampling, as a student solves problems with ANDES.The information in the student model is used by ANDES' Help system to tailor its support when the student reaches impasses in the problem solving process. In this paper, we describe the knowledge structures represented in the student model and discuss the implementation of the Bayesian network assessor. We also present a preliminary evaluation of the time performance of stochastic sampling algorithms to update the network

    Modeling Of Laser Ablation And Fragmentation Of Human Calculi

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    The large-scale radiation-hydrodynamics computer code LASNEX, has been used to model experimental results in the laser ablation and fragmentation of renal and biliary calculi. Recent experiments have demonstrated laser ablation and fragmentation of human calculi in vitro and in vivo. In the interaction, laser light incident upon the calculus is of sufficient intensity to produce a plasma (a hot ionized gas). The physical picture which emerges is as follows. The plasma couples to acoustic and shear waves which then propagate through the dense stone material, causing spall and fracture by reflection from material discontinuities or boundaries. Experiments have thus far yielded data on the interaction against which models can be tested. Data on the following have been published: (1) light emission, (2) absorption and emission spectra, (3) fragmentation efficiency, (4) cavitation bubble dynamics and (5) mass removal. We have performed one dimensional simulations of the laser-matter interaction to elucidate the important physical mechanisms. We find that good quantitative fits between simulation and experiment are obtained for visible light emission, electron temperature, electron density, plasma pressure and cavitation bubble growth. With regard to mass removal, experiment and simulation are consistent with each other and give an excellent estimate of the ablation threshold. The modeling indicates that a very small ablation layer at the surface of the calculus is responsible for significant mass loss by fragmentation within the bulk of the calculus. With such quantitative fits in hand, we believe this type of modeling can now be applied to the study of other procedures involving plasma formation of interest to the medical community. 25 refs., 7 figs

    OVERTURE: A worldwide, prospective, observational study of disease characteristics in patients with ADPKD

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    Introduction The course of autosomal dominant polycystic kidney disease (ADPKD) varies greatly among affected individuals, necessitating natural history studies to characterize the determinants and effects of disease progression. Therefore, we conducted an observational, longitudinal study (OVERTURE; NCT01430494) of patients with ADPKD. Methods This prospective study enrolled a large international population (N = 3409) encompassing a broad spectrum of ages (12–78 years), chronic kidney disease (CKD) stages (G1–G5), and Mayo imaging classifications (1A–1E). Outcomes included kidney function, complications, quality of life, health care resource utilization, and work productivity. Results Most subjects (84.4%) completed ≥12 months of follow-up. Consistent with earlier findings, each additional l/m of height-adjusted total kidney volume (htTKV) on magnetic resonance imaging (MRI) was associated with worse outcomes, including lower estimated glomerular filtration rate (eGFR) (regression coefficient 17.02, 95% confidence interval [CI] 15.94–18.11) and greater likelihood of hypertension (odds ratio [OR] 1.25, 95% CI 1.17–1.34), kidney pain (OR 1.22, 95% CI 1.11–1.33), and hematuria (OR 1.35, 95% CI 1.21–1.51). Greater baseline htTKV was also associated with worse patient-reported health-related quality of life (e.g., ADPKD Impact Scale physical score, regression coefficient 1.02, 95% CI 0.65–1.39), decreased work productivity (e.g., work days missed, regression coefficient 0.55, 95% CI 0.18–0.92), and increased health care resource utilization (e.g., hospitalizations, OR 1.48, 95% CI 1.33–1.64) during follow-up. Conclusion Although limited by a maximum 3-year duration of follow-up, this observational study characterized the burden of ADPKD in a broad population and indicated the predictive value of kidney volume for outcomes other than kidney function
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