Degree Of Certainty Research Articles

Development and evaluation of a blended learning training programme for pharmacy technicians’ continuing education

ObjectivesThe role of the pharmacy technician (PT) has expanded in recent years, requiring new competencies, better communications skills and high-level knowledge about drugs. The objective of this study is to...

Investigation of directional discrimination in the nociceptive system using temperature-controlled laser stimuli.

Cutaneous laser stimulation has commonly been employed to investigate the thermal properties of the nociceptive system. The aim of this study was to investigate how a temperature-controlled laser system improves the assessment of directional discrimination in the nociceptive system. In total, twenty healthy volunteers participated in this study. To determine the directional discrimination threshold (stimulation length 50% correct, expressed in mm), thermal stimuli were delivered using a diode laser and the laser beam was perpendicularly displaced across the skin to give a linear stimulation in four different directions (distal, proximal, lateral and medial) and displacement lengths (3 for lateral-medial and 5 for distal-proximal). Two temperature control modes were used in the stimulation system, open-loop and closed-loop control. The subjects had to report the perceived stimulus direction, the degree of certainty regarding the perceived direction and the intensity of the perceived stimulus (0-10 numerical rating scale, 3: pain threshold). During closed-loop control, the orientation of stimuli was discriminated significantly more accurately than during open-loop control. During closed-loop control, the directional discrimination threshold was 31.9 and 26.1 mm for distal-proximal and lateral-medial directed stimuli, respectively. A numerical rating scale was significantly higher for the lateral/medial directions. Moreover, the variability of the discrimination threshold is reduced in the closed-loop control system. The findings show that discrimination ability is better in the lateral-medial directions compared to the distal-proximal directions. This study indicates that using a system enabling closed-loop temperature control, allows more robust probing of the temporo-spatial mechanisms in the nociceptive system. This study shows that a newly developed temperature-controlled laser stimulation system enhances the possibilities to investigate the nociceptive temporo-spatial integration, as shown by a less variable directional discrimination threshold. The results also show that different orthogonal directions are discriminated differently. This new method allows a better investigation of the combined temporal and spatial mechanisms in the nociceptive system.

Using Decomposed Error for Reproducing Implicit Understanding of Algorithms.

Reproducibility is important for having confidence in evolutionary machine learning algorithms. Although the focus of reproducibility is usually to recreate an aggregate prediction error score using fixed random seeds, this is not sufficient. Firstly, multiple runs of an algorithm, without a fixed random seed, should ideally return statistically equivalent results. Secondly, it should be confirmed whether the expected behaviour of an algorithm matches its actual behaviour, in terms of how an algorithm targets a reduction in prediction error. Confirming the behaviour of an algorithm is not possible when using a total error aggregate score. Using an error decomposition framework as a methodology for improving the reproducibility of results in evolutionary computation addresses both of these factors. By estimating decomposed error using multiple runs of an algorithm and multiple training sets, the framework provides a greater degree of certainty about the prediction error. Also, decomposing error into bias, variance due to the algorithm (internal variance), and variance due to the training data (external variance) more fully characterises evolutionary algorithms. This allows the behaviour of an algorithm to be confirmed. Applying the framework to a number of evolutionary algorithms shows that their expected behaviour can be different to their actual behaviour. Identifying a behaviour mismatch is important in terms of understanding how to further refine an algorithm as well as how to effectively apply an algorithm to a problem.

THE TWO LETTERS W.H. IN THE DEDICATION TO W. SHAKESPEARE’S SONNETS AND THE CUMULATIVE EFFECT OF DIRECT AND CIRCUMSTANTIAL EVIDENCE IN SHAKESPEAROLOGY

William Shakespeare’s works had been written more than 4 centuries ago; since then scholars had enough time to subject his texts and the facts of his biography to the interpretations which are so numerous and so diversified that many Shakespearologists have come to believe that it is simply impossible to give indisputable answers to quite a number of highly significant questions. To these unsolvable problems one might attribute the identification of the addressee of Shakespeare’s sonnets and of Mr W.H. who is mentioned in the dedication to these poetic texts. Syntactically the text of the dedication may be interpreted either as one sentence with “Mr W.H.” acting in the capacity of an indirect object or as a subject in the first of the two independent clauses. The choice of either of these two variants of reading (in the article the second variant is accepted as the only possible one) influences the direction of the further discussion of the sonnets. The article is aimed at showing that through studying the literary texts by Shakespeare and his contemporaries and through closely analyzing the relevant direct and circumstantial evidence one may arrive at the inherently sound and noncontroversial interpretations of Shakespeare’s life and work. When applied to Shakespeare’s sonnets, such an approach allows one 1) to corroborate certain theories concerning the time when most of the sonnets were created and 2) to prove that the addressee of the sonnets and Mr W.H. were two different people who may be identified with a fair degree of certainty.

Level evaluation of concrete dam fractures based on game theory combination weighting-normal cloud model

Hazard evaluation of concrete dam fractures is vital for safe operations. The width (S1), length (S2), and depth (S3) of fractures are adopted as the assessment index, and the game theory combination weighting-normal cloud model is introduced. The normal cloud model of certain dam fractures is subsequently established. The weight coefficients of each index are calculated using game theory combination weighting, and the certainty degree of each index is determined using the cloud model. Finally, the hazard levels of the concrete dam fractures are judged. The proposed model solves the fuzziness and randomness of different indexes; the conclusions demonstrate that the model is feasible for the hazard assessment of concrete dam fractures, and its accuracy is very high; therefore, a new approach can be provided for future hazard-level assessments of concrete dam fractures.

Maimon as a Baconian: natural histories, induction and the ladder of certainty

ABSTRACT In this article, I address an uncharted topic in the scholarship on Salomon Maimon – the great influence that Bacon's philosophy had on Maimon. I suggest that by considering Maimon as a Baconian, we achieve a better understanding of Maimon's work, especially in three respects: (i) his use of natural histories to achieve philosophical insights, (ii) the employment of induction to find new propositions and establish known ones as certain but not as objectively necessary and (iii) a probabilistic view of science, wherein we acknowledge that we can achieve higher degrees of certainty attributed to propositions but are unable to show that empirical propositions are objectively necessary. It is in this context that I propose to use the term ‘ladder of certainty’ and discuss how it is connected to Maimon's skeptical stance.

The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study.

Several criteria exist to diagnose pulmonary aspergillosis with varying degrees of certainty in specific populations, including oncohaematological patients (EORTC/MSG), ICU patients (mAspICU) and COVID-19 patients (ECMM). At the beginning of the pandemic, however, the diagnosis of COVID-19-Associated Pulmonary Aspergillosis (CAPA) could not be performed easily, and the decision to treat (DTT) was empirical. In this cross-sectional retrospective study including patients with SARS-CoV-2 infection and suspicion of CAPA, we studied the concordance between the DTT and the three diagnostic criteria using Cohen's coefficient, and then we identified the factors associated with the DTT and corrected them by treatment to study the influence of the diagnostic criteria on survival. We showed good concordance of the DTT and mAspICU and ECMM criteria, with "compatible signs", "positive culture" and "positive galactomannan" influencing the DTT. Treatment also showed a positive effect on survival once corrected for a putative, possible or probable diagnosis of CAPA using mAspICU and ECMM criteria. We conclude that EORTC/MSGERC are not considered applicable in clinical practice due to the lack of inclusion of signs and symptoms and do not lead to improved survival. mAspICU and ECMM criteria showed a good degree of agreement with the DTT and a positive correlation with patient recovery.

The Influence of Comminution and Posterior Ligamentous Complex Integrity on Treatment Decision Making in Thoracolumbar Burst Fractures Without Neurologic Deficit?

A prospective study. to evaluate the impact of vertebral body comminution and Posterior Ligamentous Complex (PLC) integrity on the treatment recommendations of thoracolumbar fractures among an expert panel of 22 spine surgeons. A review of 183 prospectively collected thoracolumbar burst fracture computed tomography (CT) scans by an expert panel of 22 trauma spine surgeons to assess vertebral body comminution and PLC integrity. This study is a sub-study of a prospective observational study of thoracolumbar burst fractures (Spine TL A3/A4). Each expert was asked to grade the degree of comminution and certainty about the PLC disruption from 0 to 100, with 0 representing the intact vertebral body or intact PLC and 100 representing complete comminution or complete PLC disruption, respectively. ≥45% comminution had a 74% chance of having surgery recommended, while <25% comminution had an 86.3% chance of non-surgical treatment. A comminution from 25 to 45% had a 57% chance of non-surgical management. ≥55% PLC injury certainity had a 97% chance of having surgery, and ≥45-55% PLC injury certainty had a 65%. <20% PLC injury had a 64% chance of having non-operative treatment. A 20 to 45% PLC injury certainity had a 56% chance of non-surgical management. There was fair inter-rater agreement on the degree of comminution (ICC .57 [95% CI 0.52-.63]) and the PLC integrity (ICC .42 [95% CI 0.37-.48]). The study concludes that vetebral comminution and PLC integrity are major dterminant in decision making of thoracolumbar fractures without neurological deficit. However, more objective, reliable, and accurate methods of assessment of these variables are warranted.

Using Equipoise to Determine the Radiographic Characteristics Leading to Agreement on Best Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficits.

Retrospective analysis of prospectively collected data. Our goal was to assess radiographic characteristics associated with agreement and disagreement in treatment recommendation in thoracolumbar (TL) burst fractures. A panel of 22 AO Spine Knowledge Forum Trauma experts reviewed 183 cases and were asked to: (1) classify the fracture; (2) assess degree of certainty of PLC disruption; (3) assess degree of comminution; and (4) make a treatment recommendation. Equipoise threshold used was 77% (77:23 distribution of uncertainty or 17 vs 5 experts). Two groups were created: consensus vs equipoise. Of the 183 cases reviewed, the experts reached full consensus in only 8 cases (4.4%). Eighty-one cases (44.3%) were included in the agreement group and 102 cases (55.7%) in the equipoise group. A3/A4 fractures were more common in the equipoise group (92.0% vs 83.7%, P < .001). The agreement group had higher degree of certainty of PLC disruption [35.8% (SD 34.2) vs 27.6 (SD 27.3), P < .001] and more common use of the M1 modifier (44.3% vs 38.3%, P < .001). Overall, the degree of comminution was slightly higher in the equipoise group [47.8 (SD 20.5) vs 45.7 (SD 23.4), P < .001]. The agreement group had a higher degree of certainty of PLC injury and more common use of M1 modifier (more type B fractures). The equipoise group had more A3/A4 type fractures. Future studies are required to identify the role of comminution in decision making as degree of comminution was slightly higher in the equipoise group.

Clinical and virological problems of sudden exanthema in children

The problem of sudden exanthema/children’s roseola, an infection caused by HHV 6, is very relevant in our country. Domestic and foreign experts are actively studying the structure of the virus, the features of clinical forms and course options, methods for diagnosing infection, co-infection with other herpes viruses. It has been established that the immediate environment plays a leading role in the spread of infection. A review of recent data on sudden exanthema makes it clear why healthcare professionals retain such an unusual name for herpesvirus type 6 infection. The underdiagnosis of this disease in our country is associated with a lack of knowledge and alertness on the part of doctors and medical personnel. Although modern clinical and laboratory criteria for diagnosing HHV-6 infection make it possible to quite convincingly diagnose the disease with a fairly high degree of certainty. If desired. The advantage is the use of a technique for detecting virus DNA in plasma and other body media, in combination with serological research methods. The article presents modern recommendations for the treatment and prevention of sudden exanthema

Predictive Algorithm for Surgery Recommendation in Thoracolumbar Burst Fractures Without Neurological Deficits.

Predictive algorithm via decision tree. Artificial intelligence (AI) remain an emerging field and have not previously been used to guide therapeutic decision making in thoracolumbar burst fractures. Building such models may reduce the variability in treatment recommendations. The goal of this study was to build a mathematical prediction rule based upon radiographic variables to guide treatment decisions. Twenty-two surgeons from the AO Knowledge Forum Trauma reviewed 183 cases from the Spine TL A3/A4 prospective study (classification, degree of certainty of posterior ligamentous complex (PLC) injury, use of M1 modifier, degree of comminution, treatment recommendation). Reviewers' regions were classified as Europe, North/South America and Asia. Classification and regression trees were used to create models that would predict the treatment recommendation based upon radiographic variables. We applied the decision tree model which accounts for the possibility of non-normal distributions of data. Cross-validation technique as used to validate the multivariable analyses. The accuracy of the model was excellent at 82.4%. Variables included in the algorithm were certainty of PLC injury (%), degree of comminution (%), the use of M1 modifier and geographical regions. The algorithm showed that if a patient has a certainty of PLC injury over 57.5%, then there is a 97.0% chance of receiving surgery. If certainty of PLC injury was low and comminution was above 37.5%, a patient had 74.2% chance of receiving surgery in Europe and Asia vs 22.7% chance in North/South America. Throughout the algorithm, the use of the M1 modifier increased the probability of receiving surgery by 21.4% on average. This study presents a predictive analytic algorithm to guide decision-making in the treatment of thoracolumbar burst fractures without neurological deficits. PLC injury assessment over 57.5% was highly predictive of receiving surgery (97.0%). A high degree of comminution resulted in a higher chance of receiving surgery in Europe or Asia vs North/South America. Future studies could include clinical and other variables to enhance predictive ability or use machine learning for outcomes prediction in thoracolumbar burst fractures.

Classification of Diagnostic Certainty in Radiology Reports with Deep Learning.

A radiology report is prepared for communicating clinical information about observed abnormal structures and clinically important findings with referring clinicians. However, such observations and findings are often accompanied by ambiguous expressions, which can prevent clinicians from accurately interpreting the content of reports. To systematically assess the degree of diagnostic certainty for each observation and finding in a report, we defined an ordinal scale comprising five classes: definite, likely, may represent, unlikely, and denial. Furthermore, we applied a deep learning classification model to determine its applicability to in-house radiology reports. We trained and evaluated the model using 540 in-house chest computed tomography reports. The deep learning model achieved a micro F1-score of 97.61%, which indicated that our ordinal scale was suitable for measuring the diagnostic certainty of observations and findings in a report.

Manner, result, and intention: implications for event typology from a cognitive account of verb semantics based on fulfilment types

Abstract Verb semantics has been widely approached as a dichotomy of manner and result. However, from a cognitive perspective, manner and result are often linked by intention, as captured by the ‘fulfilment type’ property formulated in the Realisation event domain in Talmy’s event integration theory. The four ‘fulfilment types’ (intrinsic-, moot-, implied-, and attained-fulfilment) indicate different degrees of result certainty in verbs. This study investigates whether manner/result complementarity is cognitively less dichotomous and more nuanced, as the four fulfilment types in verbs could indicate more than two mental representations of verbs. Through two psycholinguistic experiments, we examine whether fulfilment types influence the cognitive salience of manner and result in novel verb meaning interpretation (Experiment 1) and the semantic relatedness between English verbs with different fulfilment types (Experiment 2). Our results demonstrate that manner and result in the mental lexicon act less like a dichotomy but more like a cline. This blur between manner and result verb statuses has consequences for a language’s typological stance in the Realisation domain and implications for how Talmyan event research should be extended beyond well-studied Motion.

Lux Adjuster Controller for Solitary Ocular Comfort

This paper presents a precise lighting controller which can concurrently adjust and display the real-time illuminance of a working platform for solitary ocular comfort. It gives the user the provision to select the right amount of lux for a particular task by knowing illumination as endorsed by IES, which is supposed to receive on the desired working plane or area. The above mentioned controller provides a high degree of certainty for delivering energy savings without compromising ocular comfort. Besides, it can be considered as one of the rationales for the Demand-Side Management lighting technique. This idea is accomplished by integrating a microcontroller prototyping platform with three separate modules namely the controlling module, sensing &amp; displaying module, and power supply module. Appropriate codes for the microcontroller were written, compiled, and uploaded by verifying through simulation. Finally, hardware implementation was done successfully and energy-saving prospects were analyzed.

Evaluation and ranking of fuzzy sets under equivalence fuzzy relations as [formula omitted]certainty and [formula omitted]possibility

In this paper, we deal with a finite collection of fuzzy sets that are used to represent a given linguistic variable in real-world problems. These fuzzy sets are usually represented as fuzzy singletons, fuzzy numbers, or fuzzy G-numbers. In many cases, there are significant interactions between elements of a given set, so it is useful to evaluate and rank elements while taking the degree of interactions into consideration. To find the degree of interaction, we develop a fuzzy equivalence relation based on a similarity function and a triangular norm operator. The compositions of the (max -(T-norm)) and (min -(S-norm)) cause the membership function to change from the minimum values (certainty version) to the maximum values (possibility version). These concepts are also useful for improving fuzzy data mining, rough fuzzy set theory, etc. Furthermore, two indices, α and β, are introduced to determine the degree of certainty (α-certainty) and degree of possibility (β-possibility). Examples are provided to compare the proposed method with the existing method. After comparing the experimental results, it can be concluded that the proposed approach is satisfactory for many situations. Finally, we apply the proposed methodology to evaluate the results of a hospital efficiency study conducted for the Office of Inspector General(OIG)-Eastern Virginia Department of Health and Human Services.

Fuzzy logic in association rule mining: limited effectiveness analysis

ABSTRACT This paper presents a comparative effectiveness analysis of fuzzy and non-fuzzy association rule mining (ARM). The corresponding motivation is the lack of relevant papers devoted to the effectiveness comparison between fuzzy and non-fuzzy ARM. The current research applies the results of fuzzy/non-fuzzy ARM to associative classification and uses the classification accuracy of the corresponding classifiers as the effectiveness measure. The research demonstrates that basic effectiveness comparison between fuzzy and non-fuzzy ARM does not necessarily speak in favour of fuzzy ARM. However, then the research demonstrates that fuzzy ARM has a distinctive ability to handle data inconsistencies, which results in the ability of corresponding fuzzy classifiers to not only provide class predictions but also indicate their certainty in the provided output. The research reveals some distinct correlation between classification accuracy and the degree of certainty in fuzzy associative classification: the greater certainty nearly always results in the better classification accuracy. This ability of fuzzy associative classifiers to indicate their certainty in the performed classification and the corresponding ability of fuzzy ARM to handle data inconsistencies are not applicable in non-fuzzy associative classifiers and ARM. Therefore, these abilities are used in the paper to substantiate the relevance of applying fuzzy logic in ARM.

Dynamic three-way multi-criteria decision making with basic uncertain linguistic information: A case study in product ranking

The concept of basic uncertain linguistic information (BULI) is proposed as an extension of basic uncertain information to enhance the measurement of data quality in decision-making processes by allowing for more flexible utilization of degrees of certainty. This paper seeks to investigate a new model of dynamic three-way decisions and develop an integrated framework for BULI-based multi-criteria decision-making using decision-theoretic rough sets (DTRSs). Firstly, we present the BULI-input dynamic ELECTRE-I method, which is capable of establishing an outranking relation. Then, a novel model of BULI decision-theoretic rough sets (BULIDTRSs) is proposed. The BULI similarity measure is employed to accurately estimate the conditional probability. Following this, we propose four potential approaches for combining loss functions by introducing the BULI ordered weighted averaging operator, which incorporates the consideration of decision risk. The derivation of the three-way decision rules is based on the comparison of BULI and the application of operational laws. In addition, the resolution of various issues such as the determination of criteria weights, identification of ideal solutions, and conversion of ratings to BULI is achieved through the development of a multi-criteria keyword frequency statistical method and a user credibility model. Subsequently, the algorithm for the dynamic three-way multi-criteria decision-making method, aimed at resolving product ranking issues, is presented. Eventually, we elaborate on the utilization of the proposed methodology through the illustration of a case study involving the ranking of passenger cars.

Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis

BackgroundFamily planning (FP) interventions have improved the use of modern contraceptives, yet a high unmet need for contraception still exists in South Asia. This systematic review of existing research was conducted to identify effective FP interventions that led to an increase in the uptake of modern methods of contraception in South Asia.MethodsFive electronic databases were searched for relevant studies published between January 1st, 2000 and May 4, 2023. Experimental studies that reported data on the impact of FP interventions on modern contraceptive use among women of reproductive age (15–49 years) in the South Asian region were included. A random-effects Inverse Variance weighted model was employed to pool the adjusted odds ratio (OR) on modern contraceptive use and unmet need for contraception. In addition, we computed subgroup meta-estimates based on intervention type and the urban-rural divide.ResultsAmong 643 studies identified, 21 met the inclusion criteria. The overall pooled odds ratio for modern contraceptive use was significantly higher (OR 1.51; 95% CI 1.35–1.70; heterogeneity; I2 = 81%) for FP interventions with a significant reduction in unmet need for contraception (OR 0.86; 95% CI 0.78–0.94, I2 = 50%). The subgroup analysis revealed demand-generation (OR 1.61; 95% CI 1.32–1.96), health system integrated (OR 1.53; 95% CI 1.07–2.20), and franchised FP clinic interventions (OR 1.32; 95% CI 1.21–1.44) had promoted the modern contraceptive uptake. Further, FP interventions implemented in urban settings showed a higher increase in modern contraceptive use (OR 1.73; 95% CI 1.44–2.07) compared to rural settings (OR 1.46; 95% CI 1.28–1.66). Given the considerable heterogeneity observed across studies and the low degree of certainty indicated by the GRADE summary for the primary outcome, caution is advised when interpreting the results.ConclusionThe review collated experimentally evaluated FP interventions that increased modern contraception use and reduced the unmet need in South Asia. The demand generation interventions were the most effective in increasing the uptake of modern contraceptive methods. Furthermore, the urban environment provides a conducive environment for interventions to improve contraceptive usage. However, further studies should assess which aspects were most effective on attitudes towards contraception, selection of more effective methods, and contraceptive behaviors.

BEVA primary care clinical guidelines: Equine parasite control.

There is a lack of consensus on how best to balance our need to minimise the risk of parasite-associated disease in the individual horse, with the need to limit the use of anthelmintics in the population to preserve their efficacy through delaying further development of resistance. To develop evidence-based guidelines utilising a modified GRADE framework. A panel of veterinary scientists with relevant expertise and experience was convened. Relevant research questions were identified and developed with associated search terms being defined. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Literature searches were performed utilising CAB abstracts and PubMed. Where there was insufficient evidence to answer the research question the panel developed practical guidance based on their collective knowledge and experience. Search results are presented, and recommendation or practical guidance were made in response to 37 clinically relevant questions relating to the use of anthelmintics in horses. There was insufficient evidence to answer many of the questions with any degree of certainty and practical guidance frequently had to be based upon extrapolation of relevant information and the panel members' collective experience and opinions. Equine parasite control practices and current recommendations have a weak evidence base. These guidelines highlight changes in equine parasite control that should be considered to reduce the threat of parasite-associated disease and delay the development of further anthelmintic resistance.

The color of history in contemporary Iranian art: intertextuality and its envisioned heterotopia

ABSTRACT The desire to reference, interpret, assign value, reconstruct, and envision the past is a critical matter within any culture – especially when expressed in the arts, which always supersede the procrustean limits of linguistic constructs and transcend the iterability inherent in the semantic postulations. The shadowy references in the arts have always illuminated, after scrutiny and in-depth examinations, the contemporaneous cultural sensibilities and emotional conditions that may be harbingers of novel beliefs and perspectives. In fact, one may say with some degree of certainty that history as is selectively constituted and reflected in the arts may well portend the future course of a people. This article is an attempt to examine the intersubjective, subliminal, and conscious portrayals of history, whether as metaphors or metonyms, in contemporary Iranian art. In this essay the contemplation of history conveys a preference for the arbitrary, random, and often fantastic constructs of the past that view history as ‘his’ or ‘her-story’. This ‘Critical-Creative’ approach plays a dominant role in undermining all metaphysical absolutes and Truth-centered ideas, be they religious, political, or philosophical. The outcome of these perspectives and aesthetic perceptions may well presage new social and political structures in the future of Iran.