Preselected Order Research Articles

A Theory of Best Choice Selection through Objective Arguments Grounded in Linear Response Theory Concepts

In this study, we propose how to use objective arguments grounded in statistical mechanics concepts in order to obtain a single number, obtained after aggregation, which would allow for the ranking of “agents”, “opinions”, etc., all defined in a very broad sense. We aim toward any process which should a priori demand or lead to some consensus in order to attain the presumably best choice among many possibilities. In order to specify the framework, we discuss previous attempts, recalling trivial means of scores—weighted or not—Condorcet paradox, TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), etc. We demonstrate, through geometrical arguments on a toy example and with four criteria, that the pre-selected order of criteria in previous attempts makes a difference in the final result. However, it might be unjustified. Thus, we base our “best choice theory” on the linear response theory in statistical physics: we indicate that one should be calculating correlations functions between all possible choice evaluations, thereby avoiding an arbitrarily ordered set of criteria. We justify the point through an example with six possible criteria. Applications in many fields are suggested. Furthermore, two toy models, serving as practical examples and illustrative arguments are discussed.

PO37 Presentation Time: 4:45 PM: Standardizing an Inpatient Order Set for Patients Undergoing Inpatient Brachytherapy for Gynecologic Oncology Patients

<h3>Purpose</h3> Brachytherapy, also known as internal radiation therapy, is often use for treatment of cervical, uterine and vaginal cancers using intracavitary (e.g. tandem and ring), interstitial (e.g. Syed), or hybrid (e.g. intracavitary applicators with interstitial needles) applicators. Currently, there is little consensus or formal society guidance on management of patients receiving brachytherapy in an inpatient setting. We performed a pre- and post-implementation study of an order set created as a qualitive improvement initiative to standardize admission orders for all patients admitted to the gynecologic oncology service for brachytherapy. <h3>Materials Methods</h3> We reviewed electronic medical records of all patients at a single urban, academic institution who received brachytherapy associated with an overnight stay 6 months prior to and after implementation of the order set, (pre-order set period: 8/2020-1/2021, post-order set period: 2/2021-7/2021). The order set had pre-selected orders to facilitate ease and uniformity with admission orders. Compliance of order set use was assessed in the following categories: ancillary and nursing orders (head of bed elevation, speech and swallow evaluation), medications (pain, anti-diarrheal), laboratory examination, and venous thromboembolism prophylaxis. This project was undertaken as a Quality Improvement Initiative and as such was not formally reviewed by Institutional Review Board. <h3>Results</h3> Thirty patients received brachytherapy associated with an overnight stay for a gynecologic malignancy during the evaluation period with 18 (60%) patients in the pre-order set period and 12 (40%) in the post-order set period. Mean age of the patients was 56 years. Patients demographics were 53% (n=16) white, 37% (n=11) black, and 6% (n=2) identified as other race. Cancer diagnoses were 67% (n=20) cervical, 20% (n=6) vaginal, 10% (n=3) uterine - cuff recurrence, and 3% (n=1) vulvar. Orders for head of bed elevation no higher than 15 degrees increased from 89% (n=16) in the pre-order set period to 100% (n=12) in the post-order set period. Speech and swallow evaluation by speech language pathologists increased from 39% (n=11) in the pre-order set period to 75% (n=9). In the post-order set period, 97% of patients had baseline admission labs ordered, 97% of patients had all recommended medications ordered and 100% of patients had an order for venous thromboembolism prophylaxis. 29% (n=5) of patients in the pre-order set group had a safety event, while 8% (n=1) in the post-order set group had a safety event. <h3>Conclusions</h3> While there are no current society-level recommendations for management of brachytherapy patients associated with an overnight stay, utilization of an order set enhances compliance to core elements of quality overnight admission. Further investigation is needed to see if such order sets improve patient safety, satisfaction, and efficiency over a longer study period.

Approximate model for analyzing band structures of single-ring hollow-core anti-resonant fibers.

Precise knowledge of modal behavior is of essential importance for understanding light guidance, particularly in hollow-core fibers. Here we present a semi-analytical model that allows determination of bands formed in revolver-type anti-resonant hollow-core fibers. The approach is independent of the actual arrangement of the anti-resonant elements, does not enforce artificial lattice arrangements and allows determination of the effective indices of modes of preselected order. The simulations show two classes of modes: (i) low-order modes exhibiting effective indices with moderate slopes and (ii) a high number of high-order modes with very strong effective index dispersion, forming a quasi-continuum of modes. It is shown that the mode density scales with the square of the normalized frequency, being to some extent similar to the behavior of multimode fibers.

Improving the Performance of Anthropometry Measurements in the Pediatric Intensive Care Unit.

Obtaining anthropometry measurements in critically ill children is challenging. Our objective was to improve the process of obtaining anthropometry measurements in the pediatric intensive care unit (PICU; even if previously obtained) using a dedicated PICU nutrition support team (NST). PICU staff were trained to perform anthropometry measurements through online education, skills training, and just-in-time bedside teaching by the PICU NST. Equipment was upgraded and standardized throughout the PICU along with implementation of preselected orders in the electronic medical record. Data were collected before and immediately after intervention and at monthly intervals from 12 to 36 months to test sustainability of practice change. PICU staff were surveyed on barriers to anthropometry measurements at 36 months after initial intervention. Compared with baseline, the intervention resulted in more patients with orders for weight, stature, and head circumference (all P < 0.001) at PICU admission. Correspondingly, more patients had measurements of weight (P = 0.04), stature (P = 0.01), and head circumference (P = 0.009) at PICU admission. For long-stay patients (>7 days), compliance improved with measurements of serial weights (P = 0.002), stature (P < 0.001), and head circumference (P = 0.02). Between 12 and 36 months after the intervention, there was a noticeable trend to increases in weight measurements at PICU admission, and to a lesser extent, of stature and head circumference. Competing clinical priorities were a key barrier to anthropometry measurements. Performance of anthropometry measurements in the PICU can be improved by a dedicated PICU NST; however, sustaining these improvements is challenging due to competing clinical priorities.

Development of a Pictorial Fruit and Vegetable Preference Scale for Preschoolers

There is a plethora of research providing evidence that the preferences for fruits and vegetables (FV) of children at an early age are an indicator of what their eating habits will be like as adults. Although there have been studies to assess food preferences of preschool children, they often assessed the factors influencing these preferences and decision‐making. In addition, the method of determining these preferences more often than not involved tasting food and/or questionnaires. This research involves the usage of scaled pictorial images to determine the FV preferences of 3–5 year old preschool children. The children will be shown high‐quality, color images of a combination of 10 vegetables and 10 fruits in a random, preselected order. A 5‐point star scale is used to indicate preference. The 5 stars, increasing in size from left to right with the smallest star equaling 1 point and the biggest star equaling 5 points, is placed on the image cards and the children are asked to rate their preference for the particular foods by pointing to the appropriate star. This study will provide baseline data for further development and aid in determining the feasibility of using a 5 point pictorial scale to indicate FV knowledge among 3–5 year old preschool children.

Order tracking using the Vold–Kalman tracking filter

The Vold–Kalman filter allows for the high-performance simultaneous tracking of orders in systems with multiple independent axles. The interactions associated with close and crossing orders give rise to beating and complex psychoacoustic phenomena. With this new filter and using multiple tachometer references, waveforms as well as amplitude and phase may be extracted without the beating interactions. The Vold–Kalman filter provides several filter shapes for optimum resolution and stopband suppression. Orders extracted as waveforms have no phase bias, and may hence be used in synthesis and tailoring. The input to Vold–Kalman filtering is time history data. The class of algorithms based on Kalman filters shows no data between preselected orders, but has fine resolution, and is independent of slew rates. The calculation speed may be an issue if a large number of orders is to be extracted. This paper shows an example of the various steps of order tracking using the Vold–Kalman method applied on a simple single-shaft motor. Filter shapes are discussed and an example of decoupling of orders from a multishaft system is demonstrated. The Vold–Kalman filter is implemented in PULSE, the Brüel &amp; Kjær Multianalysis System.

Nucleoprotein-based nanoscale assembly.

A system for addressing in the construction of macromolecular assemblies can be based on the biospecificity of DNA (cytosine-5) methyltransferases and the capacity of these enzymes to form abortive covalent complexes at targeted 5-fluorocytosine residues in DNA. Using this system, macromolecular assemblies have been created using two representative methyltransferases: M-HhaI and M x MspI. When 5-fluorocytosine (F) is placed at the targeted cytosine in each recognition sequence in a synthetic oligodeoxynucleotide (GFGC for M x HhaI or FCGG for M x MspI), we show that the first recognition sequence becomes an address for M x HhaI, while the second sequence becomes an address for M x MspI. A chimeric enzyme containing a dodecapeptide antigen linked to the C terminus of M-HhaI retained its recognition specificity. That specificity served to address the linked peptide to the GFGC recognition site in DNA. With this assembly system components can be placed in a preselected order on the DNA helix. Axial spacing for adjacent addresses can be guided by the observed kinetic footprint of each methyltransferase. Axial rotation of the addressable protein can be guided by the screw axis of the DNA helix. The system has significant potential in the general construction of macromolecular assemblies. We anticipate that these assemblies will be useful in the construction of regular protein arrays for structural analysis, in the construction of protein-DNA systems as models of chromatin and the synaptonemal complex, and in the construction of macromolecular devices.

Computerized mass fragmentography and peak matching.

The minicomputer calculates and sets the required accelerating voltages by means of a 16 bit d.a.c. for maximum 8 masses within a 30% mass range. These, together with the t.i.c., are displayed in real time on a television screen and recorded on magnetic tape with a dynamic range of 1:32 000. Automatic fine adjustment of the mass focus and compensation for drifts in the magnetic field are some of the features in the mass fragmentographic package, which also allows data to be displayed, analysed, edited and plotted. Quantitative analyses can be handled entirely by the system if it is provided with the weight ratios of the compound to be determined and the standards to construct the standard curve. A table of the concentration per ml sample at the various times and/or a semi-log plot may be obtained by providing the amount of the standard added to the sample (e.g. blood), the extracted sample volume and the time at which the sample was drawn. Mass determinations of isolated or non-isolated compounds (nanogram amounts) can be performed within a few minutes with a precision usually better than 5 ppm employing a single focusing instrument at a resolution of 600–700. A maximum of seven unknown masses within a 30% range can be specified and determined simultaneously or in a preselected order. The shortest sweep time of the ion beam is 300 ms. The peak shapes can be analysed by displaying the data stored on magnetic tape on the television monitor.

Consideration of power for some two sample tests with censoring based on a given order statistic

SUMMARY This paper deals with some properties of three nonparametric tests which can be used for detecting a difference in location of two populations wlhen samples are censored on the occurrence of a given order statistic. The null distributions of the test statistics are presented together with some tables of critical values. Exact expressions are obtained for the powers of the tests under exponential and rectangular alternatives. Finally, the expected durations of the tests are compared. A number of tests which permit early termination of an experiment have been proposed for detecting a difference in the location of two populations. These tests have important applications in life-testing situations where testing time may be costly. The criterion for termination may be a preselected period of time from the start of the experiment or the occurrence of a given order statistic in one of the samples or the two samples combined. In this paper we consider three nonparametric tests which may be used to provide a one-sided test for difference in location of two populations. The common feature of the tests is that the experiment is terminated on or before the occurrence of a preselected order statistic in one of the samples. We first consider the distributions of the test statistics under the null hypothesis that the two samples have been drawn randomly from populations with identical cumulative distribution functions. Some tables of critical values are presented. Expressions are given for the test powers under the alternative of a translation in an exponential distribution and for changes in the location and scale parameters of a rectangular distribution. Finally some results are given for the expected durations of the tests.

Maximum likelihood estimation of rational transfer function parameters

The problem of estimating unknown transfer function parameters from finite input-output records which have been disturbed by additive Gaussian noise with unknown correlation is considered. A rational sampled-data model of preselected order is assumed appropriate, and following the work of Klein, Åström and Bohlin, and Mayne, the likelihood function is generated from the data by numerical filtering. The maximum likelihood criterion leads to nonlinear regression equations for the unknown parameters, which are solved by damped Gauss-Newton iteration. Some computational experiments are described.