A framework for group decision-making: Including cognitive and affective aspects in a MCDA method for alternatives rejection

© Springer International Publishing AG, part of Springer Nature 2019. With the evolution of the organizations and technology, Group Decision Support Systems have changed to support decision-makers that cannot be together at the same place and time to make a decision. However, these systems must now be able to support the interaction between decision-makers and provide all the relevant information at the most adequate times. Failing to do so may compromise the success and the acceptance of the system. In this work it is proposed a framework for group decision using a Multiple Criteria Decision Analysis method capable of identify inconsistent assessments done by the decision-maker and identify alternatives that should be rejected by the group of decision-makers. The proposed framework allows to present more relevant information throughout the decision-making process and this way guide decision-makers in the achievement of more consensual and satisfactory decisions.INCT-EN - Instituto Nacional de Ciência e Tecnologia para Excitotoxicidade e Neuroproteção(ANI|P2020 21958

Broadening Risk Factor or Disease Definition as a Driver for Overdiagnosis: A Narrative Review

Medical overuse-defined as the provision of health services for which potential harms exceed potential benefits-constitutes a paradigm of low-value care and is seen as a threat to the quality of care. Value in healthcare implies a precise definition of disease. However, defining a disease may not be straightforward since clinical data do not show discrete boundaries, calling for some clinical judgment. And, if in time a redefinition of disease is needed, it is important to recognize that it can induce overdiagnosis, the identification of medical conditions that would, otherwise, never cause any significant symptoms or lead to clinical harm. A classic example is the impact of recommendations from professional societies in the late 1990s, lowering the threshold for abnormal total cholesterol from 240 mg/dl to 200 mg/dl. Due to these changes in risk factor definition, literally overnight there were 42 million new cases eligible for treatment in the United States. The same happened with hypertension-using either the 2019 NICE guidelines or the 2018 ESC/ECC guidelines criteria for arterial hypertension, the proportion of people overdiagnosed with hypertension was calculated to be between 14% and 33%. In this review, we will start by discussing resource overuse. We then present the basis for disease definition and its conceptual problems. Finally, we will discuss the impact of changing risk factor/disease definitions in the prevalence of disease and its consequences in overdiagnosis and overtreatment (a problem particularly relevant when definitions are widened to include earlier or milder disease).info:eu-repo/semantics/publishedVersio

Broadening Risk Factor or Disease Definition as a Driver for Overdiagnosis: A Narrative Review

Medical overuse-defined as the provision of health services for which potential harms exceed potential benefits-constitutes a paradigm of low-value care and is seen as a threat to the quality of care. Value in healthcare implies a precise definition of disease. However, defining a disease may not be straightforward since clinical data do not show discrete boundaries, calling for some clinical judgment. And, if in time a redefinition of disease is needed, it is important to recognize that it can induce overdiagnosis, the identification of medical conditions that would, otherwise, never cause any significant symptoms or lead to clinical harm. A classic example is the impact of recommendations from professional societies in the late 1990s, lowering the threshold for abnormal total cholesterol from 240 mg/dl to 200 mg/dl. Due to these changes in risk factor definition, literally overnight there were 42 million new cases eligible for treatment in the United States. The same happened with hypertension-using either the 2019 NICE guidelines or the 2018 ESC/ECC guidelines criteria for arterial hypertension, the proportion of people overdiagnosed with hypertension was calculated to be between 14% and 33%. In this review, we will start by discussing resource overuse. We then present the basis for disease definition and its conceptual problems. Finally, we will discuss the impact of changing risk factor/disease definitions in the prevalence of disease and its consequences in overdiagnosis and overtreatment (a problem particularly relevant when definitions are widened to include earlier or milder disease).info:eu-repo/semantics/publishedVersio

Soluble human Suppression of Tumorigenicity 2 is associated with endoscopic activity in patients with moderate-to-severe ulcerative colitis treated with golimumab

Suppressor of Tumorigenicity 2 (ST2) is an IL33 receptor detected in the mucosa and serum of ulcerative colitis (UC) patients. We evaluated soluble ST2 (sST2) as a surrogate biomarker of disease outcome and therapeutic response, in moderate-to-severe UC patients treated with golimumab.Agência financiadora Merck Sharp and Dohme, Lda, Portugal MK8259-22info:eu-repo/semantics/publishedVersio

Phylogeny, molecular dating and zoogeographic history of the titi monkeys (Callicebus, Pitheciidae) of eastern Brazil

The titi monkeys belong to a genus of New World primates endemic to South America, which were recently reclassified in three genera (Cheracebus, Plecturocebus and Callicebus). The genus Callicebus, which currently includes five species, is endemic to eastern Brazil, occurring in the Caatinga, Savanna, and Atlantic Forest biomes. In the present study, we investigated the validity of these species and inferred their phylogenetic relationships, divergence times, and biogeographic patterns based on the molecular analysis of a concatenated sequence of 11 mitochondrial and nuclear DNA markers, derived from 13 specimens. We ran Maximum Likelihood (ML) and Bayesian Inference (BI) analyses, and estimated genetic distances, divergence times. Ancestral areas were estimated on BioGeoBears. Our results suggest that at about twelve million years ago, the ancestor of all titi monkeys inhabited a wide area that extended from the Amazon forest to the South of the Atlantic forest. A first vicariant event originated Cheracebus in the West of the Amazon and the ancestor of Callicebus and Plectorocebus which, later were separated by a second one. The diversification of Callicebus occurred during the Plio-Pleistocene (beginning at 5 Ma) probably influenced by climatic fluctuations and geological events. Therefore, the results of the present work confirmed the existence of five species that currently inhabit forested areas under increasing threat from human activities. Thus, a reliable diagnosis of the taxonomic status of species living in endangered environments is extremely important for the development of conservation measures

Guidelines for the Management of Center-Involving Diabetic Macular Edema: Treatment Options and Patient Monitorization

Diabetic macular edema (DME) is the main cause of visual impairment associated with diabetic retinopathy (DR) and macular laser, during approximately three decades, and was the single treatment option. More recently, intravitreous injections of anti-angiogenics and corticosteroids modified the treatment paradigm associated with significant vision improvements. Nevertheless, not all patients respond satisfactorily to anti-VEGF or corticosteroid injections, so an adequate treatment choice and a prompt switch in therapeutic class is recommended. Several algorithms and guidelines have been proposed for treating center involving DME to improve patients' vision and quality of life. However, in Portugal, such guidelines are lacking. The present review aimed to provide guidelines for the treatment options and patient monitorization in the management of center-involving DME. We recommend anti-vascular endothelial growth factor (VEGF) as first-line therapy after a clinical evaluation accompanied by a rigorous metabolic control. Depending on the response obtained after 3-6 monthly intravitreal injections we suggest switching outside the class in case of a non-responder, maintaining the anti-VEGF-therapy in responders to anti-angiogenics. The treatment regimen for Dexamethasone intravitreal implant (DEXii) should be pro-re-nata with bi-monthly or quarterly monitoring visits (with a scheduled visit at 6-8 weeks after DEXii for intraocular pressure control). If a patient does not respond to DEXii, switch again to anti-VEGF therapy, combine therapies, or re-evaluate patients diagnose. There is a resilient need to understand the disease, its treatments, regimens available, and convenience for all involved to propose an adequate algorithm for the treatment of diabetic retinopathy (DR) and DME in an individualized regimen. Further understanding of the contributing factors to the development and progression of DR should bring new drug discoveries for more effective and better-tolerated treatments.info:eu-repo/semantics/publishedVersio

Quantitative nanoscale vortex-imaging using a cryogenic quantum magnetometer

Microscopic studies of superconductors and their vortices play a pivotal role in our understanding of the mechanisms underlying superconductivity. Local measurements of penetration depths or magnetic stray-fields enable access to fundamental aspects of superconductors such as nanoscale variations of superfluid densities or the symmetry of their order parameter. However, experimental tools, which offer quantitative, nanoscale magnetometry and operate over the large range of temperature and magnetic fields relevant to address many outstanding questions in superconductivity, are still missing. Here, we demonstrate quantitative, nanoscale magnetic imaging of Pearl vortices in the cuprate superconductor YBCO, using a scanning quantum sensor in form of a single Nitrogen-Vacancy (NV) electronic spin in diamond. The sensor-to-sample distance of ~10nm we achieve allows us to observe striking deviations from the prevalent monopole approximation in our vortex stray-field images, while we find excellent quantitative agreement with Pearl's analytic model. Our experiments yield a non-invasive and unambiguous determination of the system's local London penetration depth, and are readily extended to higher temperatures and magnetic fields. These results demonstrate the potential of quantitative quantum sensors in benchmarking microscopic models of complex electronic systems and open the door for further exploration of strongly correlated electron physics using scanning NV magnetometry.Comment: Main text (5 pages, 4 figures) plus supplementary material (5 pages, 6 figures). Comments welcome. Further information under http://www.quantum-sensing.c

Event Monitoring System to Classify Unexpected Events for Production Planning

[EN] Production planning prepares companies to a future production scenario. The decision process followed to obtain the production plan considers real data and estimated data of this future scenario. However, these plans can be affected by unexpected events that alter the planned scenario and in consequence, the production planning. This is especially critical when the production planning is ongoing. Thus providing information about these events can be critical to reconsider the production planning. We herein propose an event monitoring system to identify events and to classify them into different impact levels. The information obtained from this system helps to build a risk matrix, which determines the significance of the risk from the impact level and the likelihood. A prototype has been built following this proposal.This research has been carried out in the framework of the project GV/2014/010 funded by the Generalitat Valenciana (Identificacion de la informacion proporcionada por los nuevos sistemas de deteccion accesibles mediante internet en el ambito de las "sensing enterprises" para la mejora de la toma de decisiones en la planificacion de la produccion).Boza, A.; Alarcón Valero, F.; Alemany Díaz, MDM.; Cuenca, L. (2017). Event Monitoring System to Classify Unexpected Events for Production Planning. Lecture Notes in Business Information Processing. 291:140-154. https://doi.org/10.1007/978-3-319-62386-3_7S140154291Barták, R.: On the boundary of planning and scheduling: a study (1999)Buzacott, J.A., Corsten, H., Gössinger, R., Schneider, H.M.: Production Planning and Control: Basics and Concepts. Oldenbourg Wissenschaftsverlag, München (2012)Özdamar, L., Bozyel, M.A., Birbil, S.I.: A hierarchical decision support system for production planning (with case study). Eur. J. Oper. Res. 104(3), 403–422 (1998)Van Wezel, W., Van Donk, D.P., Gaalman, G.: The planning flexibility bottleneck in food processing industries. J. Oper. Manag. 24(3), 287–300 (2006)Shamsuzzoha, A.H., Rintala, S., Cunha, P.F., Ferreira, P.S., Kankaanpää, T., Maia Carneiro, L.: Event monitoring and management process in a non-hierarchical business network. In: Intelligent Non-hierarchical Manufacturing Networks, pp. 349–374. Wiley, Hoboken (2013)Sacala, I.S., Moisescu, M.A., Repta, D.: Towards the development of the future internet based enterprise in the context of cyber-physical systems. In: 19th International Conference on Control Systems and Computer Science, CSCS 2013, pp. 405–412 (2013)Chen, K.C.: Decision support system for tourism development: system dynamics approach. J. Comput. Inf. Syst. 45(1), 104–112 (2004)Boza, A., Alemany, M.M.E., Vicens, E., Cuenca, L.: Event management in decision-making processes with decision support systems. In: 5th International Conference on Computers Communications and Control (2014)Liao, S.-H.: Expert system methodologies and applications–a decade review from 1995 to 2004. Expert Syst. Appl. 28(1), 93–103 (2005)ISO: 73: 2009: Risk management vocabulary. International Organization for Standardization (2009)Chan, F.T.S., Au, K.C., Chan, P.L.Y.: A decision support system for production scheduling in an ion plating cell. Expert Syst. Appl. 30(4), 727–738 (2006)Weinstein, L., Chung, C.-H.: Integrating maintenance and production decisions in a hierarchical production planning environment. Comput. Oper. Res. 26(10–11), 1059–1074 (1999)Poon, T.C., Choy, K.L., Chan, F.T.S., Lau, H.C.W.: A real-time production operations decision support system for solving stochastic production material demand problems. Expert Syst. 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Gold nanorods induce early embryonic developmental delay and lethality in zebrafish (Danio rerio)

Due to their unique electronic and optical features, gold nanoparticles (AuNP) have received a great deal of attention for application in different fields such as catalysis, electronics, and biomedicine. The large-volume manufacturing predicted for future decades and the inevitable release of these substances into the environment necessitated an assessment of potential adverse human and ecological risks due to exposure to AuNP. Accordingly, this study aimed to examine the acute and developmental toxicity attributed to a commercial suspension of Au nanorods stabilized with cetyltrimethylammonium bromide (CTAB-AuNR) using early embryonic stages of zebrafish (Danio rerio), a well-established model in ecotoxicology. Zebrafish embryos were exposed to CTAB-AuNR (0–150 µg/L) to determine for developmental assessment until 96 hr post fertilization (hpf) and lethality. Uptake of CTAB-AuNR by embryos and nanoparticles potential to induce DNA damage was also measured at 48 and 96 hpf. Analysis of the concentration-response curves with cumulative mortality at 96 hpf revealed a median lethal concentration (LC50,96h) of 110.2 μg/L. At sublethal concentrations, CTAB-AuNR suspensions were found to produce developmental abnormalities such as tail deformities, pericardial edema, decreased body length, and delayed eye, head, and tail elongation development. Further, less than 1% of the initial concentration of CTAB-AuNR present in the exposure media was internalized by zebrafish embryos prior to (48 hpf) and after hatching (96 hpf). In addition, no marked DNA damage was detected in embryos after exposure to CTAB-AuNR. Overall, CTAB-AuNR suspensions produced lethal and sublethal effects on zebrafish embryos with possible repercussions in fitness of adult stages. However, these results foresee a low risk for fish since the observed effects occurred at concentrations above the levels expected to find in the aquatic environment.This work was supported by FEDER funds through the program COMPETE—Programa Operacional Factores de Competitividade,” and by the Portuguese Foundation for Science and Technology (FCT), within the CESAM’s strategic program (UID/AMB/50017/2013), the research project Synchrony (PTDC/AAG-MAA/2140/2012). This research was also partially supported by FCT and the European Regional Development Fund (ERDF), in the framework of the program PT2020 and of ERA-NET SIINN through project NanoToxClass (ERA-SIINN/0001/2013). The materials characterization performed was also developed in the scope of the project CICECO—Aveiro Institute of Materials, POCI-01-0145-FEDER-007679 (Ref. FCT UID/CTM/50011/2013), financed by national funds through the FCT/MEC and when applicable co-financed by FEDER under the PT2020 Partnership Agreement, and also the project MAGICOAT (PTDC/CTM-BIO/2170/2014). JT thanks FCT for the research grant IF/00347/2013