Degree Of Certainty Research Articles

Instillation checking using long short‐term memories for ophthalmology patients

AbstractIn this paper, we propose a method of checking the eye lotion instillation for ophthalmology patients. Our method first estimates tilt angles of an eye dropper bottle from acceleration values measured by a triaxial sensor attached to the bottle. It next prepares data each of which is equal to a sequence of standardized tilt values, as data to be presented to a discrimination model. It employs either a long short‐term memory (LSTM for short) or a bidirectional long short‐term memory (B_LSTM for short) to construct the model. Once we present the data to be checked to our model, it produces a certainty degree indicating whether a patient corresponding to the presented data applies eye lotion at the time zone in which a sequence of the tilt values used to prepare the presented data was measured. The final judgement for the instillation depends on thresholding of the certainty degree. It is established, from experimental results using practical data, that adopting B_LSTM‐based models is useful in improving metric values compared to adopting LSTM‐based models, and that our models can cope well with the situation specified by the comparatively long time interval of measuring tilt values while some metric values slightly degrade.

Utility of CBCT and AVD for intraprocedural diagnosis and treatment of lower GI bleeding

BackgroundIntraprocedural Cone Beam CT (CBCT) is assessed to examine if use improves diagnosis and embolization rates of acute lower GI bleed (LGIB) and if automatic vessel detection (AVD) software can identify feeding vessels (FV) for embolization. MethodsPatients with inconclusive DSA findings had CBCT and retrospective analysis with AVD software (Innova 3100, GE Company, USA). Technical success was defined as the ability to detect a lower GIB site while clinical success was defined as successful embolization without evidence of rebleeding or death within 30 days. AVD technical success was defined by the ability to identify the FV on both CTA and CBCT upon independent review by 3 blinded IRs, who also assigned a degree of certainty on a 5-point Likert scale. Results74 patients in total were treated for lower GI bleed of which 34 had indeterminate DSA. Of those, 10 patients received DSA only, of which 1 was super selective. 24 patients with GIB on pre-procedural CTA and inconclusive DSA underwent CBCT. Use of CBCT identified 9 bleeds not seen on DSA and an additional source artery in 1 case representing a 42% change in intraprocedural management as all findings were embolized. When a bleed could not be identified on CBCT, but the FV could be identified on CTA, the same suspected FV could be selected on AVD 62% of the time with an average certainty of 4.0. ConclusionCBCT is useful in the intraprocedural detection of GIB when DSA is indeterminate. Furthermore, AVD software can feasibly be utilized to accurately identify FVs for empiric treatment when intraprocedural imaging is inconclusive. Level of evidenceLevel III, therapeutic study.

СУТНІСНА ХАРАКТЕРИСТИКА УЯВЛЕНЬ ПРО НАНОТЕХНОЛОГІЇ ЗДОБУВАЧІВ ЗАГАЛЬНОЇ СЕРЕДНЬОЇ ОСВІТИ

In the context of the development of physical education, there is a problem of formation of ideas about nanotechnology of students of general secondary education, which requires its thorough research. The methodology of the research includes the analysis of legal documents, psychological and pedagogical literature and scientific research to determine the essential characteristics of the main concepts, such as: «perception», «perception of nanotechnology»,«perception of nanotechnology of students of general secondary education». It was found that representations are divided into two groups depending on the impact on the subject's sense organs and perform signaling, regulatory and tuning functions in its implementation. They begin to function in a problem situation, which can have varying degrees of certainty, helping to predict the consequences of an event, solve complex problems, rationally evaluate circumstances, search for cause-and-effect relationships, and act in an environment with incomplete information. The interpretation of the terms with the prefix «nano-», in particular «nanotechnology», which in the general sense is defined as the influence on matter at the level of individual molecules and atoms, is given. It has been established that nanotechnologies provide an opportunity to create and modify nanomaterials in a controlled manner, as well as to integrate them into fully functioning larger-scale systems. Thus, the main task of nanotechnologies is to obtain nanomaterials with a given structure and properties and their use for a specific purpose. Emphasis is placed on the need for students of general secondary education to realize the role of nanotechnology in science, production and various spheres of human activity, which leads to the activation of imagination as an important cognitive process. The possible ways of forming ideas about nanotechnology among students of general secondary education are highlighted: updating the content of physics regarding the physical properties of nanomaterials and the use of nanodevices; coverage of historical facts that lead to changes in the perception of the physical picture of the world; implementation of a separate course on nanotechnology, etc. Key words: students of general secondary education, nanotechnology, imagination, physical education.

Possibilistic Data Cleaning

Classical data cleaning performs a minimal set of operations on the data to satisfy the given integrity constraints. Often, this minimization is equivalent to vertex cover, for example when tuples can be removed due to the violation of functional dependencies. Classically, the uncertainty of tuples and constraints is ignored. We propose not to view data as dirty but the uncertainty information about data. Since probabilities are often unavailable and their treatment is limited due to correlations in the data, we investigate a qualitative approach to uncertainty. Tuples are assigned degrees of possibility with which they occur, and constraints are assigned degrees of certainty that say to which tuples they apply. Our approach is non-invasive to the data as we lower the possibility degree of tuples as little as possible. The new resulting qualitative version of vertex cover remains NP-hard. We establish an algorithm that is fixed-parameter tractable in the size of the qualitative vertex cover. Experiments with synthetic and real-world data show that our algorithm outperforms the classical algorithm proportionally to the available number of uncertainty degrees. By mining the certainty degrees with which constraints hold, our framework becomes applicable even when uncertainty information is unavailable.

BWC assurance: increasing certainty in BWC compliance

ABSTRACT Following the 2001 end to negotiations on a legally binding protocol, states parties to the 1972 Biological and Toxin Weapons Convention (BWC) developed entrenched positions about the necessity of treaty verification, hindering progress on treaty aims. The study described in this article was designed to facilitate dialogue on verification-related issues outside the context of those positions, using the term “assurance” to represent the degree of certainty that states parties are meeting their treaty obligations. From August 2020 to July 2021, the researchers conducted 36 interviews—16 with state-party delegations and 20 with independent experts, representing 20 countries. They performed mixed-methods analysis on the interviews, including quantitative metrics on qualitative interview content. Interviewees’ views on verification, compliance, and related concepts varied widely. Future efforts by states parties to achieve common understanding on these topics could facilitate concrete progress. While no single mechanism is sufficient to achieve verification or assess compliance, packages of mechanisms could increase assurance. Interviewees expressed general support for implementing assurance mechanisms, even in the absence of a comprehensive, legally binding protocol or verification regime, even among states parties for which that is the primary goal. Avenues to increase assurance among BWC stakeholders merit further discussion in the current intersessional program.

PP115 Analysis Of Previous Joint Clinical Assessment And Potential Transferability To Four European Countries: Case Study And Conceptual Approach

IntroductionThe European Network for Health Technology Assessment (EUnetHTA) has led together, with member states, several joint actions, including Joint Clinical Assessments (JCA), under the form of project-based voluntary cooperation, which outputs and transferability of those projects in other European countries remains somehow limited. In June 2021, the European Council has reached an agreement on the European Health Technology Assessment (HTA) regulation, which is entering into force gradually. Initially limited to oncology products, then extended to orphan/advanced therapy, and after a five to eight-year additional period, it will apply to all centrally approved products. The JCA will consist of a focused scientific analysis on relative effectiveness assessment, including the health condition, technology description, clinical effectiveness, and safety. These analyses will also include information relating to the degree of certainty. We consider that the evidence appraisal might have limitations, and transferability would not be generalizable. We aim to determine the potential drivers and barriers for HTA transferability in EU4, employing the analysis of a case example where JCA was conducted.MethodsEmploying an oncology JCA, we will compare an HTA analysis conducted in EU4 countries (Germany, France, Italy, and Spain). Overview and background information on countries involved in the JCA, and EU4 HTA system will be provided, followed by HTA outcome and main evidence requirements, reimbursement outcome, and pricing agreements.ResultsStudy results supporting HTA outcomes may focus on the population assessed, the comparator considered, and uncertainty management. A conceptual adaptation about the scope of the EU JCA regulation will be discussed, to understand its potential advantages to individual HTAs in Europe and remaining gaps to effectively inform HTA or decision-making process.ConclusionsThe analysis of pricing and reimbursement outcomes can further help understand potential barriers and drivers for JCA transferability and potential areas of evidence generation requirements.

Non-alcoholic fatty liver disease screening in type 2 diabetes mellitus: A cost-effectiveness and price threshold analysis

The cost-effectiveness of screening asymptomatic non-alcoholic fatty liver disease (NAFLD) patients remains debatable, with current studies assuming lifelong benefits of NAFLD screening while neglecting cardiovascular outcomes. This study aims to assess the cost-effectiveness of NAFLD screening among type 2 diabetes mellitus (T2DM) patients, and to establish a price threshold for NAFLD treatment, when it becomes available. A Markov model was constructed comparing 4 screening strategies (versus no screening) to identify NAFLD with advanced fibrosis among T2DM patients: fibrosis-4 (FIB-4), vibration-controlled transient elastography (VCTE), FIB-4 and VCTE (simultaneous), and FIB-4 and VCTE (sequential). Sensitivity analyses and price threshold analyses were performed to assess parameter uncertainties in the results. VCTE was the most cost-effective NAFLD screening strategy (USD24,727/quality-adjusted life year [QALY]), followed by FIB-4 (USD36,800/QALY), when compared to no screening. Probabilistic sensitivity analysis revealed a higher degree of certainty for VCTE as a cost-effective strategy compared to FIB-4 (90.7% versus 73.2%). The duration of expected screening benefit is the most influential variable based on incremental cost-effectiveness ratio tornado analysis. The minimum duration of screening benefit for NAFLD screening to be cost-effective was at least 2.6 years. The annual cost of NAFLD treatment should be less than USD751 for NAFLD screening to be cost-effective. Both VCTE and FIB-4 are cost-effective NAFLD screening strategies among T2DM patients in Singapore. However, given the lack of access to VCTE at primacy care and potential budget constraints, FIB-4 can also be considered for NAFLD screening among T2DM patients in Singapore.

Student Learning Motivation as Effort to Improve Learning Outcomes of Aqidah Akhlak in MIN 7 Southeast Aceh

The problem of decreasing learning outcomes is a question mark for teachers, parents and the school. For this reason, it is necessary to have strong motivation so that students continue to be able to improve learning outcomes in accordance with predetermined standard results. This research uses qualitative data analysis with field study techniques, documentation and interviews. At the data analysis stage using data reduction, data presentation, drawing conclusions. To determine the validity of the data, the criteria used are the degree of trust (credibility), transferability (transferability), dependability (dependability), and certainty). The results of the study indicate that there is a need for effectiveness in the learning process so that learning is right on target according to the curriculum that should be, there is self-evaluation carried out on students, teachers and parents and culture to provide motivation for students in each lesson.

Immunomodulators in Mechanically Ventilated Patients With COVID-19: Lessons Learned From Underpowered Trials.

Immunomodulators in Mechanically Ventilated Patients With COVID-19: Lessons Learned From Underpowered Trials.

Assessment of Dysgranulopoiesis By Optical Cytology Compared to Distribution of Monocyte Subsets By Flow Cytometry in Peripheral Blood for Predicting the Diagnosis of CMML

Introduction The diagnosis of chronic myelomonocytic leukemia (CMML) according to the WHO 2017 requires the presence of absolute (≥ 1x109/L) and relative (≥ 10%) monocytosis. Optical cytology represents the basis for its diagnosis and is essential to evaluate dysmyelopoiesis and to identify promonocytes and blasts. Although dysplasia is not a specific finding, its presence along with a persistent monocytosis is highly suggestive of CMML. In this sense, dysgranulopoiesis is an almost constant finding in CMML. The study of monocyte subsets distribution in peripheral blood (PB) by multiparametric flow cytometry (MFC) has proven to be a very useful tool, since the presence of >94% of classical phenotype monocytes (MO1) allows to predict the diagnosis of CMML with a sensitivity and specificity greater than 90% (Selimoglu-Buet et al. Blood 2015). The aim of this study was to evaluate the predictive capacity of morphological evaluation of PB smears for the diagnosis of CMML in a series of patients with absolute and relative monocytosis. Additionally, these results were compared with the analysis of monocyte subsets distribution in PB by MFC. Methods 162 patients with absolute and relative monocytosis were studied. 114 PB smears were available for morphological assessment and 160 MFC analysis of monocyte subsets distribution. The final diagnosis for these patients was: CMML (n=76), Phi negative chronic myeloproliferative neoplasia (MPN) (n=9) and reactive monocytosis (n=77). Genomic information (cytogenetics and NGS) was available in 66 CMML and all of MPN. After anonymizing PB smears, a cytological assessment was performed without additional clinical or analytical data (eg.: age, blood counts, biochemistry). This way we tried to compare the predictive capacity for the diagnosis of CMML of both techniques without the influence of additional data other that the known absolute and relative monocytosis. The cytological evaluation of PB smears consisted fundamentally of a qualitative evaluation of dysgranulopoiesis: nuclear hyposegmentation, chromatin hypercondensation and/or cytoplasmic hypo-degranulation. The sensitivity, specificity, Youden index, positive predictive value (PPV) and negative predictive value (NPV) of both techniques were analyzed. The Youden index allows to evaluate the balance between sensitivity and specificity ([sensitivity + specificity] -100). The capacity for diagnostic prediction of CMML for both techniques was assessed using the C-index. Finally, Cohen's Kappa index was used to evaluate the concordance between both techniques. Results Table 1 shows the results of sensitivity, specificity, Youden index, PPV, NPV and C-index of both techniques. The Kappa index showed a very good degree of agreement (K=0.715; p<0.001) between both techniques. Conclusions The presence of >94% MO1 had a better balance between sensitivity and specificity than the assessment of dysgranulopoiesis in PB. It also had a high sensitivity, demonstrating that it can be very useful screening tool. Despite this, the specificity and PPV of the assessment of dysgranulopoiesis were higher than those of the MFC, demonstrating that the identification of morphological dysplasia would allow the diagnosis of CMML to be predicted with a higher degree of certainty in the initial workup of absolute and relative monocytosis. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

LA MODALIDAD EPISTÉMICA EN ELE: RETOS EN LA DESCRIPCIÓN DE LA SEMÁNTICA DE VARIAS UNIDADES EN MATERIALES DIDÁCTICOS. EPISTEMIC MODALITY IN SFL: CHALLENGES IN THE DESCRIPTION OF THE SEMANTICS OF SOME UNITS IN A CORPUS OF DIDACTIC MATERIALS

Spanish possesses a vast array of items that codify the speaker’s degree of certainty or doubt (i.e., epistemic modality), such as quizá, igual, seguramente or sin duda. Little attention has been devoted to them in the field of Spanish as a Foreign Language, especially regarding their semantics. The aim of this article is to show that some of the semantic descriptions of such items reveal inconsistencies in a variety of didactic sources, and this might hinder students from mastering them. We focus on three case studies involving (a) where certain items are allocated in the epistemic scale, (b) how a group of similar expressions is treated, and (c) how the semantics of an adverb is described vis-à-vis its cognates in other languages.

A journey with no roadmap—The need for validated criteria of the MS prodrome

Background: A growing body of compelling evidence has emerged to validate a set of signs and symptoms that indicates the onset of disease before more typical signs and symptoms present to fulfill a diagnosis of MS. On 24 June 2021, a group of international researchers, patient advocates, and Society representatives led by Professors Helen Tremlett (University of British Columbia) and Ruth Ann Marrie (University of Manitoba) convened virtually for a workshop. Objective: Identify key gaps in knowledge, opportunities, and research priorities regarding the prodromal stage of MS. Methods: The group developed a new framework for MS that includes the stage of early signs and symptoms of MS—and outlined a roadmap to guide future research, with the “goal of preventing the progression to onset of typical symptoms of MS in those who present during the prodromal stage of MS”. Results: If high-risk individuals in the early stages of MS can be identified with a high degree of certainty, there is an opportunity to intervene and minimize the risk of progressing to typical MS symptoms and a diagnosis of MS. Conclusion: Standardized criteria must be developed, validated, and point of intervention found to better recognize, better diagnose, and better treat MS.

What are fundamentalist beliefs?

ABSTRACT Fundamentalist beliefs are often discussed in relation to extremist, radical, or fanaticist beliefs, or terrorist ideology, as well as in relation to terrorism, radicalization, and violent extremism. Besides, the notion is frequently defined and operationalized, for example in the field of psychology. Despite the frequent recurrence of the notion in the literature, no clear and agreed-upon definition exists. Elements and characteristics that are commonly thought of as constituting fundamentalist beliefs are intellectual vices such as closed-mindedness or dogmatism, certain group dynamics and affections, a high degree of certainty in holding these beliefs, and fundamentalist content. Drawing on, among other things, recent developments in (social) epistemology, these alleged elements are critically reviewed. Based on this review, we develop what we call the Content-Reaction-Affect account of fundamentalist belief. This account, it is argued, is not only accurate, precise, fair, and clear, but also theoretically and practically fruitful.

Travel Time Reliability Analysis in Three Different Routes in Baghdad City

Travel time reliability is defined as the degree of certainty and predictability of travel time on a transportation system. Reliable transportation systems provide some guarantees to reach a particular destination within a reasonable time in harmony with the expected time. In this study data collection process on the specified paths was carried out through the test vehicle equipped with GPS (moving vehicle technology) device. The Statistical Package program(SPSS) was used to analyse the total travel time of each link on the three selected routes and the estimated speeds based on GPS field data collected during 50 running trials in the south and north directions during morning and evening hours. The results of buffer time indexes for three routes are presented for each route from Bayaa to Bab Almuadam to illustrate changing structure of the reliability during the peak period. Extra delays with regard to free flow travel time are observed on route 1, 2, and 3 in terms of 95% percentile travel time about 52, 38, and 41%, respectively.

Russian Meddling in U.S. Elections: How News of Disinformation’s Impact Can Affect Trust in Electoral Outcomes and Satisfaction with Democracy

ABSTRACT Russia’s Internet Research Agency (R-IRA) has been a key focus of disinformation research due to its attempts to use social media to influence the outcome of the 2016 United States presidential election. However, questions remain about the extent to which news coverage of the R-IRA’s efforts may have shaped public perceptions of U.S. democracy. To assess its impact, we ran an experiment involving U.S. social media users (N = 916). We tested whether reading news reports about the R-IRA’s activities heightened perceptions that the R-IRA influenced the public’s vote choices, and whether this influence in turn reduced confidence in the outcomes of the 2016 and 2020 elections and broader satisfaction with democracy. Specifically, we tested if these indirect effects differ depending on whether the R-IRA activity was presented via news frames conveying certainty or uncertainty about the R-IRA’s impact on the U.S. public’s behavior. While the news frames did not significantly influence perceptions that the R-IRA had influenced the U.S. public in general, the degree of certainty with which they described the effects of the R-IRA differently affected perceptions that Republicans and Democrats had been influenced. This, in turn, influenced participants’ confidence in elections and satisfaction with democracy.

Introduction

Introduction

Tackling Human Trafficking in Governments Supply Chains: Legal Certainty and Effectiveness Issues Under the Australian Commonwealth Procurement Rules Model

International organisations emphasise how Governments around the world must use the public procurement process to aid a global drive to eliminate human trafficking in their supply chains. In this significant and original contribution, the authors examine a leading procurement model, the Australian Commonwealth Procurement Rules (CPR), for the purpose of examining whether the CPR model satisfies the necessary standards of Legal Certainty and Effectiveness for addressing the risk of trafficking occurring in public sector supply chains. The research generates new insights for countries seeking to tackle trafficking via public procurement systems and identifies pitfalls for countries to avoid if seeking to emulate the Australia CPR model, making appropriate reference to US and UK models where appropriate. The authors demonstrate how key elements of the CPR model fail to provide for the required degree of Legal Certainty and Effectiveness to tackle trafficking. System failure is demonstrated by analysis of the CPR, showing either how key CPR provisions fail to satisfy these 2 key tests, or because there is a complete absence of appropriate provisions to comprehensively deal with the risk of trafficking in public sector supply chains. This article should serve not only as a guide to countries yet to address human rights considerations in their public procurement supply chains, but also as a blueprint for countries around the world seeking to re-evaluate whether existingprovisions in their domestic procurement frameworks are fit to tackle the global scourge of trafficking in public supply chains.

COVID-19 and female fertility: the flaws of Italian Law 40/2004 on assisted procreation in pandemic times.

SARS-CoV-2 has infected over 614 million people worldwide, killing more than 6.5 million. COVID-19 impact on fertility may have far-reaching ramifications, considering that only in Italy, over 20 million people have been infected, many more considering unconfirmed cases. The authors aimed to outline the repercussions of COVID-19 on female reproductive capabilities, through an analysis of underlying mechanisms and dynamics liable to cause long-term COVID-19 complications and sequelae, including direct virus-induced tissue damage. The entry receptor for SARS-CoV-2, Angiotensin-converting enzyme 2 (ACE2) can be found in several tissues and organs within the human body, including ovaries, oocytes and placenta. In order to assess the fertility-damaging potential of the disease, it is necessary to clarify highly complex mechanisms such as the ovarian renin-angiotensin system (OVRAS) affecting ovarian physiology and dysfunction. COVID-19 and its potential to undermine the fertility prospects of millions cannot be underestimated. It is therefore essential for lawmakers to solve inconsistencies such as those in Italy's Law 40/2004, which has been all but dismantled by Constitutional Court and European Court of Human Rights rulings, and cannot therefore offer a sufficient degree of certainty and reliability. When crafting novel, updated standards, norms and regulations to govern access to medically-assisted procreation, national leaders need to take into account the grave threat to fertility in a country such as Italy, which already has one of the world's lowest birth rates, posed by COVID-19 in light of currently available research findings outlining its impact on reproductive capacity.

Development of a mathematical model to predict the health impact and duration of SARS-CoV-2 outbreaks on board cargo vessels

The Coronavirus Disease (COVID-19) pandemic has brought significant impact onto the maritime activities worldwide, including disruption to global trade and supply chains. The ability to predict the evolution and duration of a COVID-19 outbreak on cargo vessels would inform a more nuanced response to the event and provide a more precise return-to-trade date. This paper presents the SEIQ(H)R (Susceptibility–Exposed–Infected–Quarantine–(Hospitalisation)–Removed/Recovered) model, which is the first deterministic mathematical model developed and fit-tested to describe the transmission dynamics of COVID-19 on board cargo vessels of up to 60 crew members. Due to specific living and working circumstances on board cargo vessels, instead of utilising the reproduction number, we consider the highest fraction of crew members who share the same nationality to quantify the transmissibility of the disease. The performance of the model is verified using case studies based on data collected during COVID-19 outbreaks on three cargo vessels in Western Australia during 2020. The simulations show that the model can forecast the time taken for the transmission dynamics on each vessel to reach their equilibriums, providing informed predictions on the evolution of the outbreak, including hospitalisation rates and duration. The model demonstrates that (a) all crew members are susceptible to infection; (b) their roles on board are a determining factor in the evolution of the outbreak; and (c) an unmitigated outbreak could affect the entire crew and continue on for many weeks. The ability to model the evolution of an outbreak, in both duration and severity, is essential to predict outcomes and to plan for the best response strategy. At the same time, it offers a higher degree of certainty regarding the return to trade, which is of significant importance to multiple stakeholders.

Santri Character Development (Primary Age Children) Through the Tahfidzul Qur'an Program

This study aims to describe efforts to develop the character of elementary-aged students through the tahfidz al-Qur'an program at the Tahfidzul Qur'an Al Fawwaz Foundation in Medan. This study uses a qualitative approach with a descriptive study method. Collecting data sources through interviews, observations, and documentation. Sources of data or informants are the foundation, parents of students and students from the foundation. While checking the validity of the data is done through the degree of trust (credibility), transferability, dependability, and certainty (confirmability). The results of this study conclude that: first, the implementation of character building in the tahfidz Al-Qur'an program is guided by the vision and mission of the Tahfidzul Qur'an Al-Fawwaz Foundation, while the implementation process goes through three stages, namely the tahsin activity program (reading improvement), tasmi' (memorization deposit), and muraja'ah (repeating rote) activities. As for the strategy, and evaluation through three approaches, namely teacher example, habituation, and tahfiz. Second, aspects of character building in the Al-Qur'an tahfidz program at the Al-Fawwaz Tahfidzul Qur'an Foundation, among others; religious aspects, discipline, willingness, hard work, and responsibility. Third, the successful implementation of character education in the Tahfidz Al-Qur'an program at the Tahfidzul Qur'an Al-Fawwaz Foundation, namely, First: the embedded values of religious character, discipline, high will, hard work, and responsibility of students. Second: the students' memorization achievement continues to increase.