Military Operations Research Society (MORS) Oral History Project Interview of Dr. Jacqueline R. Henningsen, FS

Interviews with Dr. Jacqueline R. Henningsen, FS, took place on February 7, 2006, February 10, 2006, March 1, 2006, May 12, 2006, and September 10, 2016. Mr. Jim Bexfield, FS, Bexfield et al. Military Operations Research Society (MORS) Oral History Project Interview of Dr. Jacqueline R. Henningsen, FS Colonel Roxann Oyler, Mr. Roy Reiss, FS, and Dr. Bob Sheldon, FS, interviewers

Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases:A Systematic Review and Meta-Analysis

To assess safety and outcome of radiofrequency ablation (RFA) and microwave ablation (MWA) as compared to systemic chemotherapy and partial hepatectomy (PH) in the treatment of colorectal liver metastases (CRLM). MEDLINE, Embase and the Cochrane Library were searched. Randomized trials and comparative observational studies with multivariate analysis and/or matching were included. Guidelines from National Guideline Clearinghouse and Guidelines International Network were assessed using the AGREE II instrument. The search revealed 3530 records; 328 were selected for full-text review; 48 were included: 8 systematic reviews, 2 randomized studies, 26 comparative observational studies, 2 guideline-articles and 10 case series; in addition 13 guidelines were evaluated. Literature to assess the effectiveness of ablation was limited. RFA + systemic chemotherapy was superior to chemotherapy alone. PH was superior to RFA alone but not to RFA + PH or to MWA. Compared to PH, RFA showed fewer complications, MWA did not. Outcomes were subject to residual confounding since ablation was only employed for unresectable disease. The results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone. Further randomized comparisons of ablation to current-day chemotherapy alone should therefore be considered unethical. Hence, the highest achievable level of evidence for unresectable CRLM seems reached. The apparent selection bias from previous studies and the superior safety profile mandate the setup of randomized controlled trials comparing ablation to surgery

A CONCEPTUAL FRAMEWORK FOR DISTRIBUTED EXPERT SYSTEM USE IN TIME SENSITIVE HIERARCHICAL CONTROL

There are many problems faced by decision makers involved in complex, time sensitive hierarchical control systems. These may include maintaining knowledge of the functional status of the system components, forecasting the impact of past and future events, transferring information to a distant or poorly connected location, changing the requirements for an operation according to resources available, or creating a independent course of action when system connectivity falls. These problems are transdisciplinary in nature, so decision makers in a variety of organizations face them. This research develops a framework for the use of distributed expert systems in support of time sensitive hierarchical control systems. Attention is focused on determining ways to enhance the likelihood that a system will remain functional during a crisis in which one or more of the system nodes fail. Options in the use of distributed expert systems for this purpose are developed following investigation of related research in the areas of cooperative and distributed systems. A prototype under development of a generic system model called DES (distributed expert systems) is described. DES is a trimular form of support structure, where a trimule is defined to be a combination of a human decision agent, a component system model and an expert system. This concept is an extension of the domular theory of Tenney and Sandell (1981)