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espanolLa Odontologia basada en la evidencia permite tomar decisiones clinicas fundamentadas en investigaciones actuales apoyadas en la mejor evidencia disponible, integrando la experiencia clinica con las preferencias y necesidades de los pacientes. Objetivo: el objetivo de este estudio fue determinar el estado inicial de los conocimientos, actitudes, acceso y confianza acerca de los principios de la Evidencia Basada en la Practica de los estudiantes de primer ano de la Facultad de Odontologia de la Universidad Mayor de San Simon. Metodos: estudio descriptivo, prospectivo y transversal que aplico el formulario KACE validado por Hendricson, que consta de 35 items dividido en cuatro areas: Conocimientos, Actitudes, Acceso, Confianza. Resultados: los estudiantes participantes (n=239), presentaron en el Area Conocimiento 62,76 %; registraron respuestas correctas acerca del conocimiento de estudio de casos. Area Actitudes 67,37 % indico estar de acuerdo con la atencion del paciente, basada en evidencia. Area Acceso a la Evidencia 40,17 %, de los estudiantes acceden a libros de texto en busqueda de informacion; Area Confianza en las habilidades de evaluacion critica 45,61% indicaron tener algo de confianza acerca de la adecuacion del tamano de la muestra. Conclusion: de acuerdo a los resultados de este estudio, se debe profundizar la capacitacion de conocimientos acerca de la Odontologia Basada en la Practica. En cuanto a actitudes los resultados muestran el interes de los estudiantes, en el area de acceso existen limitaciones, y acerca del area de confianza en las habilidades de evaluacion critica, los estudiantes registraron un valor regular. EnglishEvidence-based Dentistry allows clinical decisions based on current research supported by the best available evidence, integrating the clinical experience, with the preferences and needs of the patients. Objective: the objective of this article was to determine the initial state of knowledge, attitudes, access, and confidence about the principles of Evidence Based on Practice of first-year students at Dental School at the San Simon University. Methods: descriptive, prospective cross-sectional study that applied the KACE form validated by Hendricson in 2012, consists of 35 items divided into four categories: Knowledge, Attitudes, Access, Confidence. Results: the students who participated (n=239) registered in Knowledge category 62.76% correct answers about case study knowledge. In Attitudes category 67.37 % indicated they agree with the evidence-based patient care. Access to Evidence category 40.17% of the students’ access textbooks in search of information; Confidence category in critical evaluation skill 45.61% indicated having some confidence about the adequacy of the sample size. Conclusion: according to the results, the training of knowledge about Practice Based Dentistry should be deepened. Regarding attitudes, the results indicate student interest; in access to evidence, students registered a fair value in confidence in critical assessment.

Aims To provide a pathophysiological basis for distinguishing metabolic variants of the frailty phenotype in older adults with type 2 diabetes. Methods We have made an in-depth review of the possible mechanisms in diabetes, ageing and frailty that will alter allow us to describe phenotypic changes which might assist in predicting responses to particular glucose-lowering therapy. Results Our review has enable us to describe with some confidence a sarcopenic obese phenotype and an anorexic malnourished phenotype. Conclusions By identifying these two phenotypes we can predict which would be most responsive to certain classes of therapy and where therapies may be ill-advised. This represents the first novel approach in this area. Further work is being planned to develop this hypothesis. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••.

If parents have used donated gametes, it is a personal choice whether they disclose to their children. For those that do, there is, however, little advice on how to tell their children. The Donor Conception Network (DCN) has made a series of books to help parents disclose. This study evaluated parents’ experience of using these books. An online survey with both quantitative and qualitative questions was used. The DCN membership and social media were used to publicize the survey, and 108 responses were analysed. At the time of conception, the parents’ family types were mainly mother and father (56.5%) and solo mothers (36.1%). The method of conception was mainly donor spermatozoa (55.6%) followed by donor egg (38.0%), double donation (8.3%) and one case of surrogacy. Most parents had read the book to their children before 2 years of age (76.9%). Before reading the books, some of the parents had some confidence in telling (43.5%) or were very confident in telling (30.6%). After reading the books, 60.2% reported having much more confidence in telling. Most parents felt their children had no understanding (76.8%) or only some understanding (22.3%) of donor conception before reading the books. After reading the books most parents felt their children’s understanding had increased (71.3%). Most parents felt that reading the books had given them more confidence in using donor conception language (90.7%). The use of books to tell children about their conception may be a useful resource for parents wishing to be open with their children.

Design of appropriate interaction and human–machine interfaces for the handover of control between vehicle automation and human driver is critical to the success of automated vehicles. Problems in this interfacing between the vehicle and driver have led, in some cases, to collisions and fatalities. In this project, Operator Event Sequence Diagrams (OESDs) were used to design the handover activities to and from vehicle automation. Previous work undertaken in driving simulators has shown that the OESDs can be used to anticipate the likely activities of drivers during the handover of vehicle control. Three such studies showed that there was a strong correlation between the activities drivers represented in OESDs and those observed from videos of drivers in the handover process, in driving simulators. For the current study, OESDs were constructed during the design of the interaction and interfaces for the handover of control to and from vehicle automation. Videos of drivers during the handover were taken on motorways in the UK and compared with the predictions from the OESDs. As before, there were strong correlations between those activities anticipated in the OESDs and those observed during the handover of vehicle control from automation to the human driver. This means that OESDs can be used with some confidence as part of the vehicle automation design process, although validity generalisation remains an important goal for future research.

Previous studies of the Huckel-London-Pople-McWeeny (HLPM) ring-currents and bond-currents associated with the neutral and the dianionic altans, and iterated altans, of corannulene and coronene, are here extended to the hexaanions of (altan)n-corannulene and (altan)n-coronene, with n = 1, 2, and 3. The magnetic properties of some of these species were originally studied by Monaco and Zanasi using the ipso-centric approach, which is ab initio in nature. The "topological" HLPM method, by contrast, constitutes a parameter-free, quasi graph-theoretical model requiring knowledge only of the molecular graph of the conjugated system being considered and the areas assumed for its constituent rings. The HLPM calculations are partially presented by means of a novel illustrative device that we call "difference diagrams". One aim of this work is to compare predictions of this very rudimentary HLPM formalism with those of the much more sophisticated ipso-centric ab initio approach when they are both applied to the calculation of ring-current properties in this family of neutral and anionic (especially, hexaanionic) conjugated systems. For those altans and iterated altans for which ab initio calculations are available for comparison, encouraging qualitative, and even quantitative, agreement is found between the predictions of the ab initio and HLPM approaches. Other structures for which HLPM calculations are reported here but which have not yet been studied by ab initio means are offered with some confidence for possible subsequent evaluation using the ipso-centric (or any other ab initio) formalism.

Objective To evaluate the effect of practice duration on accuracy, retention, and confidence when learning how to tie basic surgical knots. Study design Prospective study. Sample population Fifteen first-year veterinary students. Methods Students were randomly assigned to a 2-week practice (TWP) or an 8-week practice (EWP) to learn how to tie surgeon's, strangle, and miller's knots. Students' knot-tying accuracy and confidence were evaluated immediately after training, at an intermediate time point (2-6 weeks postpractice), and at 12 weeks postpractice. Results Students who had been trained during an extended period tied the strangle knot correctly more often at all assessments (P = .025). The ability of students trained for 2 weeks to tie the strangle knot correctly decreased over time (P = .028). These students lost some confidence (P = .03) and repositioned suture more frequently (P = .03) while constructing the strangle knot at the final time point compared with students trained for 8 weeks. Students who completed TWP felt more confident at placing surgeon's knots than friction knots at the final assessment period (P = .0164 miller's knot, P = .0056 strangle knot), whereas confidence did not differ between knot types for students who completed EWP. All students felt less confident with their knot-tying skills at 12 weeks postpractice. Conclusion Training for 8 weeks rather than for 2 weeks resulted in superior knot tying skills. Students' confidence decreased 12 weeks after training. Clinical significance Prolonged distributed practice is recommended to train students for more complex tasks such as placement of a strangle knot.

In the Numismatic Chronicle for 2013, A. Bursche put forward the proposition that the imperial treasury was seized by the Goths when in A.D. 251 they crushed the Roman army at Abritus.1 Most of the plundered Roman gold was presumably in the form of coin (ingots are neither excluded nor confirmed). This gold has now been traced with some confidence to archaeological sites of the Wielbark and the Chernyakhiv cultures, in particular to grave assemblages dated to the second half of the 3rd c. (phase C1b-C2 of the Late Roman period).2 This had even broader consequences, since the capture of an enormous amount of gold by the barbarians could have been the immediate cause of the deterioration of the aureus under Decius‘ successors.3

In this article, we empirically examine whether the relationship between risk aversion and self-reported risk mitigating behavior is similar to the relationship between risk aversion and an objective measure of risk mitigating behavior. Despite higher levels of risk mitigation in the self-reported measure relative to the objective measure, we find risk aversion is similarly correlated with both measures of wildfire risk mitigation. These results provide some confidence in the use of self-reported behaviors in examinations of risk preferences and risky behaviors, even if the self-reports understate objective behavioral measures.

Wilks’ non-parametric method for setting tolerance limits using order statistics has recently become popular in the nuclear industry. The method allows analysts to predict a desired tolerance limit with some confidence that the estimate is conservative. The method is popular because it is simple and fits well into established regulatory frameworks. A critical analysis of the underlying statistics is presented in this work, including a derivation, analytical and statistical verification, and a broad discussion. Possible impacts of the underlying assumptions for application to computational tools are discussed. An in-depth discussion of the order statistic rank used in Wilks’ formula is provided, including when it might be necessary to use a higher rank estimate.

The Australian pistachio industry is young in international terms. Until now Australian pistachio growers have relied on the leaf analysis standards developed in California to assess the nutrient status of producing orchards. The Californian standards were developed for the cultivar ‘Kerman’, whereas nearly all Australian orchards are planted to cultivar ‘Sirora’. We have used data from (a) long term on-farm monitoring samples, and (b) industry benchmark surveys, and (c) a long term nitrogen fertiliser trial, to develop some new “working standards” for use in Australian orchards. Comparative on-farm sampling showed that ‘Kerman’ shows higher values for nitrogen, phosphorus, potassium, sulfur and boron than ‘Sirora’ when grown under the same conditions. Our proposed “working standards” based on leaflets sampled from mature leaves on non-fruiting shoots, in late January or early February (southern hemisphere) are as follows: N - Critical Value 1.6% (DW basis), Satisfactory range >1.8% (%DW basis); P - Critical Value 0.11%, Satisfactory range >0.12%; K - Critical Value 1.4%, Satisfactory range >1.6%; Ca - Satisfactory range >1.5%; Mg - Critical Value >0.4%, Satisfactory range >0.5%; Na - Satisfactory range >15 mg kg-1; Mn - >30 mg kg-1. We suggest that these “working standards” should be used with caution by Australian pistachio growers until the industry as a whole has gained some confidence in their usefulness. The difficulty of developing standards for pistachio, which is so severely biennial in cropping habit, is discussed. Care should be taken when interpreting leaf analysis data, particularly for micro-nutrients, to take account of potential contamination with foliar nutrient sprays, fungal protectants and environmental dust.

Background Cardiac arrests, although rare in Paediatrics, are extremely high-pressure, high-stakes situations. Identifying any reversible causes, commonly referred to as the 4Hs and 4Ts, is an important step in the management of cardiac arrest. Ascertaining the cause more quickly has the potential to improve our currently poor outcomes. Aim To evaluate how quickly and accurately healthcare professionals can recall the reversible causes of cardiac arrests and their ability to narrate the management of each of these. Methods Using a standardised proforma, 38 APLS providers (nurses, APNPs, junior doctors and consultants) were asked to recall the 8 reversible causes of cardiac arrest whilst being timed. Next, they were asked to describe management of each. Participants were told this was a competition and therefore asked not to discuss with others. Results Only 12 of the participants were able to recall all 8 reversible causes with their times ranging from 16 to 95 seconds. There was little correlation between seniority or experience of cardiac arrests with ability to recall all 8 causes; half of those able to recall all causes were foundation or ST1–3 level doctors. The order of recall was also recorded. Despite hypoxia and hypokalaemia being the most common causes, tamponade was the most commonly recalled (86.6%) in this survey. Qualitative data showed that overall participants were able to manage hypoxia, hypovolemia, and hypothermia with some confidence but were less able to describe management of the remaining causes. Conclusion Healthcare professionals are not always able to recall all reversible causes, and as such there is potential for delay in cause identification in emergency situations. A simple aide-memoire has the potential to improve speed of identification of cause of arrest and possibly save lives and improve outcomes. This is being developed to trial locally.

International audience; Processes and techniques used for assessing the safety of a complex system are well-addressed by safety standards. These standards usually recommend to decompose the assessment process into different stages of analysis, so called tiered safety assessment. Each analysis stage should be performed by applying recommended assessment techniques. To provide confidence in the correctness of the whole analysis, some verification techniques, usually traceability checking, are applied between two stages. Even if the traceability provides some confidence in the correctness of the decomposition, the following problems remains How to model the system behaviours at each stage of safety assessment? How to efficiently use these stages during the design process? What is the formal relationship between these modelling stages? To tackle these problems, we propose a way to specify, formalize and implement the relations between assessment stages. The proposal and its pros & cons are illustrated on a Remotely Piloted Aircraft System (RPAS) use-case.; Les procédés et techniques utilisables pour évaluer la sécurité des systèmes complexes sont bien définis par les normes de sécurité. Ces normes recommande généralement de décomposer le processus d’évaluation en différents étapes de l’analyse, dite «évaluation à plusieurs niveaux de la sécurité». Chaque étape d'analyse doit être effectuée en appliquant les techniques d’évaluation recommandées. Pour donner confiance à l’exactitude de l’ensemble de l’analyse, certains techniques de vérification, généralement la vérification de la traçabilité, sont appliquées entre deux étapes. Même si la traçabilité procure une certaine confiance dans la correction de la décomposition, les problèmes suivants demeurent: Comment modéliser les comportements du système à chaque étape de l'évaluation de la sécurité? Comment utiliser efficacement ces étapes au cours du processus de conception? Quel est la relation formelle entre ces étapes de modélisation? Pour résoudre ces problèmes, nous proposer un moyen de spécifier, formaliser et mettre en œuvre les relations entre les étapes d'analyse. La proposition et ses avantages et inconvénients sont illustrés sur un cas d'étude de système d'aéronef piloté à distance (RPAS).

The pervasive influence of human induced global environmental change affects biodiversity across the globe, and there is great uncertainty as to how the biosphere will react on short and longer time scales. To adapt to what the future holds and to manage the impacts of global change, scientists need to predict theexpected effects with some confidence and communicate these predictions to policy makers. However, recent reviews found that we currently lack a clear understanding of how predictable ecology is, with views seeing it as mostly unpredictable to potentially predictable, at least over short time frames. However, in applied, ecology-related fields predictions are more commonly formulated and reported, as well as evaluated in hindsight, potentially allowing one to define baselines of predictive proficiency in these fields. We searched the literature for representative case studies in these fields and collectedinformation about modeling approaches, target variables of prediction, predictive proficiency achieved, as well as the availability of data to parameterize predictive models. We find that some fields such as epidemiology achieve high predictive proficiency, but even in the more predictive fields proficiency isevaluated in different ways. Both phenomenological and mechanistic approaches are used in most fields, but differences are often small, with no clear superiority of one approach over the other. Data availability is limiting in most fields, with long-term studies being rare and detailed data for parameterizing mechanistic models being in short supply. We suggest that ecologists adopt a more rigorous approach to report and assess predictive proficiency, and embrace the challenges of real world decision making to strengthen the practice of prediction in ecology.

This study examined the factor structure of the Self-Compassion Scale (SCS) using a bifactor model, a higher order model, a 6-factor correlated model, a 2-factor correlated model, and a 1-factor model in 4 distinct populations: college undergraduates (N = 222), community adults (N = 1,394), individuals practicing Buddhist meditation (N = 215), and a clinical sample of individuals with a history of recurrent depression (N = 390). The 6-factor correlated model demonstrated the best fit across samples, whereas the 1- and 2-factor models had poor fit. The higher order model also showed relatively poor fit across samples, suggesting it is not representative of the relationship between subscale factors and a general self-compassion factor. The bifactor model, however, had acceptable fit in the student, community, and meditator samples. Although fit was suboptimal in the clinical sample, results suggested an overall self-compassion factor could still be interpreted with some confidence. Moreover, estimates suggested a general self-compassion factor accounted for at least 90% of the reliable variance in SCS scores across samples, and item factor loadings and intercepts were equivalent across samples. Results suggest that a total SCS score can be used as an overall mesure of self-compassion.

GIVEN THAT SOME 4,600 years have elapsed since the completion of the Great Pyramid of Giza, the structure stands remarkably intact. It is a polyhedron with a regular polygon base, its volume is about 2.6 million cubic meters, and its original height was 146.6 meters, including the lost pyramidion, or capstone. We may never know exactly how the pyramid was built, but even so, we can say with some confidence how many people were required to build it.

The Capricorn Orogen is located in central Western Australia and includes several Proterozoic sedimentary basins. The Yerrida and Earaheedy basins are located in the south-east of the orogen and were formed, and deformed, over multiple orogenic events. The complexity and thickness of these basins and presence of conductive regolith has hindered minerals exploration within the region. A recently acquired TEMPEST AEM survey across the Capricorn provides an extensive dataset to aid in the mapping of the basin lithologies and assessment of the potential for mineralisation within these basins. Before detailed interpretations can be made from 1D inversions of these data, an understanding of the reliability of TEMPEST AEM inversions is desirable. 1D time-domain inversion algorithms are useful for interpreting TEMPEST AEM data. However, it is important to understand the limitations of using such codes in geologically complex regions such as the Capricorn Orogen. The response from three simple scenarios involving a dipping conductive contact within a resistive basement, and a dipping conductive contact under a varying conductive regolith have been inverted using a 1D layered earth algorithm. Results show that conductive units in a resistive host dipping steeper than 25° are poorly resolved. When moderately conductive to resistive cover is present, the dip and thickness of dipping features can be defined, however, this is dependent on the depth of the conductive unit. Knowledge of the limitations of 1D AEM modelling provides some confidence for making geological interpretations from 1D inversions, as falsely resolved dipping features can be eliminated from the interpretation process.

Reducing preference elicitation when selecting a winner item.Computing approximate winners with some confidence level.Terminating preference elicitation sooner by returning k alternatives.Two preference aggregation strategies: Least Misery and Majority.A user study on collected data from a group recommender system. Groups may need assistance in reaching a joint decision. Elections can reveal the winning item, but this means the group members need to vote on, or at least consider all available items. Our challenge is to minimize the amount of preferences that need to be elicited and thus reduce the effort required from the group members. We present a model that offers a few innovations. First, rather than offering a single winner, we propose to offer the group the best top-k alternatives. This can be beneficial if a certain item suddenly becomes unavailable, or if the group wishes to choose manually from a few selected items. Secondly, rather than offering a definite winning item, we suggest to approximate the item or the top-k items that best suit the group, according to a predefined confidence level. We study the tradeoff between the accuracy of the proposed winner item and the amount of preference elicitation required. Lastly, we offer to consider different preference aggregation strategies. These strategies differ in their emphasis: towards the individual users (Least Misery Strategy) or towards the majority of the group (Majority Based Strategy). We evaluate our findings on data collected in a user study as well as on real world and simulated datasets and show that selecting the suitable aggregation strategy and relaxing the termination condition can reduce communication cost up to 90%. Furthermore, the commonly used Majority strategy does not always outperform the Least Misery strategy. Addressing these three challenges contributes to the minimization of preference elicitation in expert systems.

This paper aims to compare the performance of proposed confidence intervals for population coefficient of variation (CV) with the existing confidence intervals, namely, McKay, Miller, and Gulher et al. confidence intervals under both symmetric and skewed distributions. We observed that the proposed augmented-large-sample (AA&K-ALS) confidence interval performed well in terms of coverage probability in all cases. The large-sample (AA&K-LS) and adjusted degrees of freedom (AA&K-ADJ) confidence intervals had much lower coverage probability than the nominal level for skewed distributions. However, the average widths of the AA&K-LS confidence interval are narrower than that of the rest confidence intervals. Two real-life data are analyzed to illustrate the implementation of the several methods .

Analysing the data recently presented by Jiankui He and assuming that it is authentic shows that the goal of abolishing the expression of CCR5 may have been reached for one of the resulting twins, although this remains to be proven. However, the canonical delta32 mutation has not been achieved. The various preliminary experiments and controls give some confidence that major off-target modifications have not occurred; again, this is difficult to exclude. Clearly, the requirements of perfect technical mastery of the process have not been met, to say nothing of the requirements for complete transparency and full societal approval.

There are examples in the literature whereby exotic phenomena are invoked to explain deficiencies between model predictions of observables with data. Those include such things as the use of exotic three-body terms in the nucleon-nucleon interaction, of asymptotic normalisation coefficients, of effective charges for nucleons, and the like. To recognise such “new” physics, one should endeavour to exhaust all possible explanations of data first using established theories of nuclear structure and reactions. Should such comparisons with data prove wanting, then one may claim with some confidence the existence of new phenomena. This chapter looks at aspects of some of these claims.

In recent years, the concept of hypomyelinating disorders has been proposed as a group of disorders with varying systemic manifestations that are identified by MR findings of absence or near absence of the T2 hypointensity that develops in white matter as a result of myelination. Initially proposed as a separate group because they were the largest single category of undiagnosed leukodystrophies, their separation as a distinct group that can be recognized by looking for a specific MRI feature has resulted in a marked increase in their diagnosis and a better understanding of the different causes of hypomyelination. This review will discuss the clinical presentations, imaging findings on standard MRI, and new MRI-related techniques that allow a better understanding of these disorders and proposed methods for quantifying the myelination as a potential means of assessing disease course and the effects of proposed treatments. Disorders with hypomyelination of white matter, or hypomyelinating disorders (HMDs), represent the single largest category among undiagnosed genetic leukoencephalopathies (Schiffmann and van der Knaap, 2009; Steenweg et al., 2010). This group of inborn errors of metabolism is characterized by a magnetic resonance imaging (MRI) appearance of reduced or absent myelin development: delay in the development of T2 hypointensity and, often, T1 hyperintensity in the white matter of the brain. The concept of hypomyelination was first conceptualized by (Schiffmann and van der Knaap, 2009; Steenweg et al., 2010; Schiffmann et al., 1994) in a series of papers that showed that these MRI characteristics were easily recognized, were different from the MRI characteristics of dysmyelinating and demyelinating disorders, and that the combination of these imaging findings with specific other clinical and imaging features could be used to make diagnoses with some confidence. In this manuscript, we will discuss the physiologic and genetic bases of hypomyelinating disorders, as well as their classification, clinical manifestations and imaging characteristics.

While Bede did not know the year of Augustine's death, he possessed papal letters which provide sufficient information to deduce it with some confidence. The early epistles from popes which Bede quoted or referred to in the ‘Historia ecclesiastica’ associated journeys by delegations sent by the early Church in Kent to Rome with the request for, and collection of, the pallium for the new bishop of Canterbury. In this light the likely purpose for the otherwise unexplained visit of Mellitus to Rome in 610 becomes clear: he had come to ask Pope Boniface IV for the pallium for Laurence, following the death of Augustine on 26 May 609.

In recent years, the concept of hypomyelinating disorders has been proposed as a group of disorders with varying systemic manifestations that are identified by MR findings of absence or near absence of the T2 hypointensity that develops in white matter as a result of myelination. Initially proposed as a separate group because they were the largest single category of undiagnosed leukodystrophies, their separation as a distinct group that can be recognized by looking for a specific MRI feature has resulted in a marked increase in their diagnosis and a better understanding of the different causes of hypomyelination. This review will discuss the clinical presentations, imaging findings on standard MRI, and new MRI-related techniques that allow a better understanding of these disorders and proposed methods for quantifying the myelination as a potential means of assessing disease course and the effects of proposed treatments. Disorders with hypomyelination of white matter, or hypomyelinating disorders (HMDs), represent the single largest category among undiagnosed genetic leukoencephalopathies (Schiffmann and van der Knaap, 2009; Steenweg et al., 2010). This group of inborn errors of metabolism is characterized by a magnetic resonance imaging (MRI) appearance of reduced or absent myelin development: delay in the development of T2 hypointensity and, often, T1 hyperintensity in the white matter of the brain. The concept of hypomyelination was first conceptualized by (Schiffmann and van der Knaap, 2009; Steenweg et al., 2010; Schiffmann et al., 1994) in a series of papers that showed that these MRI characteristics were easily recognized, were different from the MRI characteristics of dysmyelinating and demyelinating disorders, and that the combination of these imaging findings with specific other clinical and imaging features could be used to make diagnoses with some confidence. In this manuscript, we will discuss the physiologic and genetic bases of hypomyelinating disorders, as well as their classification, clinical manifestations and imaging characteristics.

Based on the Confidence Distribution method to the Behrens-Fisher problem, we consider two approaches of combining Confidence Distributions: P Combination and AN Combination to solve the Behrens-Fisher problem. Firstly, we provide some Confidence Distributions to the Behrens-Fisher problem, and then we give the Confidence Distribution method to the Behrens-Fisher problem. Finally, we compare the “combination” and the “single” through the numerical simulation.

In a multi-sample model of multivariate normal distributions with covariance matrices being known or known except for unknown multipliers, simultaneous confidence regions for the mean vectors are provided with minimum volume properties. The univariate case with unknown variances is included.

The origin of the autophagosomal membrane started to be debated by scientists working in the field within one year of the modern definition of autophagy in 1963. There is now converging evidence from older and newer studies that the endoplasmic reticulum is involved in formation of autophagosomes. Thus, it is possible to trace from early morphological work - done without the benefit of molecular descriptions - to recent studies - dissecting how specific proteins nucleate autophagosome biogenesis - a long series of experimental findings that are beginning to answer the 55-year old question with some confidence. The view that has emerged is that specialised regions of the endoplasmic reticulum, in dynamic cross talk with most intracellular organelles via membrane contact sites, provide a platform for autophagosome biogenesis.

The existence of fuzzy priorities is here grounded on a recent proposal for fuzzy-linguistic preference structures (Franco, Knowledge-Based Systems 70 (2014) 203), where the outcome of the decision ordering-process is a fuzzy weight for every decision object. Hence, a procedure is needed for ranking such fuzzy priorities. Here a ranking methodology is suggested based on the core and support of fuzzy weights, which represent the priority intensity for decision objects. In this way, the available evidence is evaluated according to its relative importance, allowing the inclusion of human-expert knowledge, where an automatic search is performed by computing the robustness/stability of the solution, identifying some confidence bounds for the estimated degrees of importance. As a result, building on the linguistic preference statements of experts, the system recommends informative and robust ranking-solutions.

Background: literature that reports the experiences of facilitating reasonable adjustments for student nurses who have a learning difficulty (LD) in clinical placement from the viewpoint of link lecturers is limited and warrants further exploration. Research aim: to explore link lecturers' views on reasonable adjustments in clinical placement and whether they are confident with their own knowledge of the processes involved. Methodology: data were collected using interviews with three link lecturers from three fields of nursing (adult, child and mental health). Audio-recorded interviews were transcribed, coded and thematically analysed. Findings: three main themes were identified: student engagement, clarity of link lecturer role and external barriers. Conclusion: findings demonstrate that link lecturers have some confidence with their own knowledge of the processes involved with supporting student nurses with an LD in clinical placement, but these processes are complex with many barriers preventing successful facilitation of available reasonable adjustments.

Single-walled carbon nanotubes (SWCNTs) coated with single-stranded DNA can be effectively separated into various chiralities using an aqueous two-phase (ATP) system. Partitioning is driven by small differences in the dissolution characteristics of the hybrid between the two phases. Thus, in addition to being a separation technique, the ATP system potentially also offers a way to quantify and rank the dissolution properties of the solute (here the DNA/SWCNT hybrids), such as the solvation free energy and solubility. In this study, we propose two different approaches to quantitatively analyze the ATP partitioning of DNA/SWCNT hybrids. First, we present a model that extracts the relative solvation free energy of various DNA/SWCNT hybrids by using an expansion relative to a standard state. Second, we extract a solubility parameter by analyzing the partitioning of hybrids in the ATP system. The two approaches are found to be consistent, providing some confidence in each as a method of quantifying differences in the solubility of various DNA/SWCNT hybrids.

It is not currently known how to put the Kerr spacetime metric into the so-called Gordon form, although the closely related Kerr-Schild form of the Kerr metric is well known. A Gordon form for the Kerr geometry, if it could be found, would be particularly useful in developing analogue models for the Kerr spacetime, since the Gordon form is explicitly given in terms of the 4-velocity and "refractive index" of an effective medium. In the current article we report progress toward this goal. First we present the Gordon form for an approximation to Kerr spacetime in the slow-rotation limit, obtained by suitably modifying the well-known Lense-Thirring form of the slow-rotation metric. Second we present the Gordon form for the Kerr spacetime in the near-null limit, (the 4-velocity of the medium being close to null). That these two perturbative approximations to the Kerr spacetime in Gordon form exist gives us some confidence that ultimately one might be able to write the exact Kerr spacetime in this form., Comment: 20 pages

The Global Optimiser used by Whittle Consulting has gone through three major versions to date. The first was based on the Milawa optimisation algorithm; it worked, but had many shortcomings. The second, known internally as ProberA, had a different approach to optimisation in that it used a series of random starting points and found the nearest local NPV maximum to each. It did this a sufficient number of times to give us some confidence that the best result found was close to optimal. ProberB was an enhanced version of ProberA, with the ability to handle a wider range of constraints, particularly with regard to limits on the differences in depth between adjacent areas of a pit. ProberB has been used successfully for some time now. It has produced excellent Life of Project schedules for a wide range of very large mining complexes. However, like any piece of software, it has its limitations. For example, it only copes directly with three steps—mining, processing, and blending.

The British National Health Service (NHS) celebrates its 70th birthday on July 5, 2018. This article examines this anniversary through the lens of previous anniversaries. It examines seven documents close to each anniversary over a period of some 60 years, drawing on interpretive content analysis, based on the narrative dimensions of context (structure and finance); success or achievements; problems; and solutions or recommendations. It finds that the anniversary documents tend to show change rather than consistency. For example, the Guillebaud Report tended to dismiss the problem of ageing populations, for it to reappear in 1979 and 1989, to fade in 2009, and reappear once more in 2017. Despite being downplayed or ignored in some years, the problems identified by most of the documents such as demography and technology are unlikely to disappear. Some solutions such as market-based reform have flowed and ebbed over the years, and the ‘solution’ of structural reorganisation in one year has become the ‘problem’ in a future year. While predicting the future is always hazardous, it can be said with some confidence that future anniversaries are likely to see discussion of similar themes.

The volume of data being currently generated poses various challenges for machine learning. One of these challenges is the fact that just a small portion of the data can be manually labeled by human experts. Semi-supervised learning addresses this problem by handling unlabeled data alongside labeled ones. However, if only a small quantity of labeled examples is available, the performance of the classification can be unsatisfactory. Algorithms such as co-training and tri-training use multiple views or multiple learning algorithms to improve the classification of unlabeled instances through simple majority agreement. Also, there are approaches that use less trivial voting processes such as weighted majority voting. Nevertheless, these solutions require some confidence level on the label in order to use it for training. Hence, not all information is used, i.e., information associated with lower confidence level is disregarded completely. We propose an approach called social-training, which uses all information available in the semi-supervised learning task. For this, a classifier ensemble that encapsulates multiple heterogeneous classifiers generates labels for the instances. Social-training then aggregates these results into a single label by means of social choice functions that work with rank aggregation. Our results show that working with full ranking is able to reduce the classification error for some UCI data sets.

The further refinement and re-assessment of human–elephant conflict (HEC) mitigation methods that has occurred since 2003 can be summarized into biological, physical, and governance categories. The most important distinction is between those measures applied against animals and used within the conflict zone, which are mostly used in the shorter term (except some fencing), and those measures working with people in the longer term, which rely heavily on official policy and administration often situated beyond the conflict zone. Effective HEC mitigation is difficult to understand and problematic to implement; it remains a complex package of apparently disparate measures that have to be used in combination and flexibly, at different scales, for both animals and people. Future HEC mitigation will be as much an art as a science, but since we now have a solid research foundation, we can proceed with some confidence to address the inherent sociopolitical difficulties.

This chapter reports the findings from an investigation exploring the hidden inequalities that employees with Asperger Syndrome experience in the workplace, providing new knowledge for those concerned with diversity and inclusion including HR specialists and line managers. Rich descriptions of AS characteristics raise awareness of how skills can be best utilised and accommodated and how at the same time these characteristics can also create hidden inequalities. These discussions also seek to build some confidence in AS individuals that their unique blend of skills is valuable in contemporary organisations and in roles which hitherto neither they nor HR specialists may have considered.

In preparation for the 2017 total solar eclipse, St. Catherine University developed a calibration protocol for the temperature sensors flown during thermal wake boom experiments. The calibration method used a standard two-point technique that corrected each individual sensor for both slope and offset errors using a high quality NIST certified thermocouple as the temperature standard. Our method is not absolute but corrects each sensor relative to the NIST standard so that we feel some confidence that individual sensor variations are mitigated. In preparation for the eclipse, calibration curves were generated for over 200 individual digital and thermistor temperature sensors.

Background Skills in aseptic technique are essential competencies for preventing infection; yet, aseptic technique is a difficult concept to master. During urinary catheter insertion, failure to properly adhere to strict aseptic technique has been linked to infections and sepsis. This pilot study used simulation to identify the most common breaches in aseptic technique during urinary catheter insertion. Methods Baccalaureate nursing students with prior documentation of competency were recruited to demonstrate performance of urinary catheterization on a task trainer. The procedure was recorded, and breaches in technique were identified through review of the digital recordings. Results Data were available for 13 participants. Participants ranged in age from 21 to 43 years (mean, 26.6). Ten participants (77%) were female and three (23%) were male. The participants' mean self-rating of confidence was 3.6 on a 5-point scale (range, 3-5), indicating some confidence in performing the skill. Examination of the video recorded data showed that 10 participants (77%) breached aseptic technique in at least one category and in some instances several categories. The most common breach was cleansing the meatus; seven participants (54%) performed it incorrectly. Conclusions One-time competency validation using a simulator is not enough to ensure skill mastery or retention. Urinary catheter insertion is a high-risk skill and therefore should be afforded ample time to practice. Innovative approaches to ensure skill mastery, including urinary catheterization and other skills requiring sterile techniques, are needed.

We conducted a field trial to determine whether percutaneous challenge of wild brushtail possums (Trichosurus vulpecula) with virulent Mycobacterium bovis, the causative agent of bovine tuberculosis (TB), resulted in subsequent transmission of M. bovis to other possums. We then used our results to make a preliminary first direct estimate of the ‘TB detection probability’ or transmission rate in wild possums. Seven free-living adult possums in the Rimutaka Forest Park, New Zealand, were captured, GPS-collared, experimentally challenged and then released. Possum populations surrounding the challenged individuals were examined for secondary cases 4–8 months post-challenge. Of 37 possums caught within the home ranges of the challenged individuals, one had confirmed TB. As no TB was detected in 355 other possums examined in this study, or 659 possums in a concurrent study in the immediate vicinity, we conclude that this represents the first documented case of onward transmission of M. bovis from an experimentally challenged possum in the wild. This pilot trial therefore gives some confidence that the new percutaneous challenge model for TB in possums can be used to obtain empirical estimates of TB detection probabilities. The calculated probability of onward transmission (‘detection’) here was just 0.027; however, with the possibility that further transmission events would have occurred from the one challenged possum removed from the trial before it had died, or if our trapping missed secondary cases, this value could be an underestimate. The implications of this low preliminary estimate are discussed.

Evaluation of medical students during the surgical clerkship is controversial. Performance is often based on subjective scoring, whereas objective knowledge is based on written examinations. Whether these measures correspond or are relevant to assess student performance is unknown. We hypothesized that student evaluations correlate with performance on the National Board Of Medical Examiners (NBME) examination.Data were collected from the 2011-2012 academic year. Medical students underwent a ward evaluation using a seven-point Likert scale assessing six educational competencies. Students also undertook the NBME examination, where performance was recorded as a percentile score adjusted to national standards.A total of 129 medical students were studied. Scores on the NBME ranged from the 52nd to the 96th percentile with an average in the 75th percentile (±9). Clerkship scores ranged from 3.2-7.0 with a mean of 5.7 (±0.8). There was a strong positive association between higher NBME scores and higher clerkship evaluations shown by a Pearson correlation coefficient of 0.47 (P0.001). Students clustered with below average ward evaluations (3.0-4.0) were in the 69.5th percentile of NBME scores, whereas students clustered with above average ward evaluations (6.0-7.0) were in the 79.2th percentile (P0.001).A strong positive relationship exists between subjective ward evaluations and NBME performance. These data may afford some confidence to surgical faculty and surgical resident ability to accurately evaluate medical students during clinical clerkships. Understanding factors in student performance may help in improving the surgical clerkship experience.

Aim Musculoskeletal symptoms are a common cause for presentation of children and adolescents to health-care settings. Junior doctors report lack of confidence in assessment of the paediatric musculoskeletal system. Our aim was to assess the confidence of junior medical officers (JMOs) working in the emergency department (ED) with paediatric musculoskeletal assessment and determine if a readily available teaching module would improve confidence. Methods JMOs rostered to the paediatric ED were surveyed regarding their confidence in paediatric musculoskeletal assessment at the start and end of their ED rotation. A subgroup of these JMOs received formal teaching on paediatric musculoskeletal assessment using the paediatric gait, arm, leg and spine examination as part of their protected teaching time during their rotation. Results Forty-three JMOs were considered in the final analysis. Of those, 27 received teaching (intervention group), and 16 received no teaching (non-intervention group). In the intervention subgroup, there was a trend towards an increase in confidence in paediatric musculoskeletal assessment with the commonest response prior to the teaching intervention being ‘some confidence’ (11/27 41%) and the commonest response after teaching being ‘fairly confident’ (14/27 52%) without achieving statistical significance (P = 0.068). Of the JMOs in the intervention group, 26/27 (96%) found the teaching session useful, and 25/27 (93%) considered it relevant to their future practice. Conclusions A clinical examination teaching intervention resulted in a trend towards an increase in confidence for JMOs in paediatric musculoskeletal assessment. Formal evaluation of a teaching module was feasible within the ED.

In actuality, for example, the review of the National Science Foundation and the blind peer review of doctoral dissertation in China, the evaluation experts are requested to provide two types of information such as the performance of the evaluation objects and the familiarity with the evaluation areas (called confidence levels). However, existing information aggregation research achievements cannot be used to fusion the two types information described above effectively. In this paper, we focus on the information aggregation issue in the situation where there are confidence levels of the aggregated arguments under intuitionistic fuzzy environment. Firstly, we develop some confidence intuitionistic fuzzy weighted aggregation operators, such as the confidence intuitionistic fuzzy weighted averaging (CIFWA) operator and the confidence intuitionistic fuzzy weighted geometric (CIFWG) operator. Then, based on the Einstein operations, we proposed the confidence intuitionistic fuzzy Einstein weighted averaging (CIFEWA) operator and the confidence intuitionistic fuzzy Einstein weighted geometric (CIFEWG) operator. Finally, a practical example about the review of the doctoral dissertation in Chinese universities is provided to illustrate the developed intuitionistic fuzzy information aggregation operators.

While many connections can be drawn with some confidence between neoliberalism and penal policy and practice, it is difficult to support Loïc Wacquant’s attempt to render punitive penality integral to neoliberalism, and to regard both as being strategically exported from the US. Neoliberalism is a fluid and variable political formation, both over time and internationally, and is impossible to reduce to a few primary characteristics such as a specific penal policy. Correspondingly, neoliberal doctrines and regimes appear to be consistent with many forms of penal policy other than punitive imprisonment. This is partly because of neoliberalism’s own variability, but also because of the impact of local conditions and the multiple ways through which penal policy may (or may not) be linked with particular political formations. Not only theoretically but also politically, Wacquant’s thesis remains of questionable strategic utility although evidently valuable in consciousness raising.

A mathematical model is developed - using MATLAB Simulink software package - to simulate, predict, and evaluate the performance of gun recoil system. The used gun is a tank gun with a concentric recoil mechanism. The results are presented in this paper can provide a clear understanding of design parameters affecting the behavior of recoil mechanism and/or improving the performance of recoil mechanisms in the future.A complete study of the constructional parameters that affect the performance of the concentric recoil system is carried out. Then, a mathematical model that includes all governing equations of recoil cycle is developed. Finally, the model is tested for a case study and the results is recorded and compared with others resulting from actual firing test.This paper starts with studying the construction of concentric recoil mechanism for tank gun and analysis of the different forces and resistances influencing the recoiling parts during recoil cycle; then, introducing the equation of motion of recoiling parts during recoil cycle and finally, constructing the simulation program to obtain results.Comparison of simulation results and others obtained from actual firing shows a good match that creates some confidence in the mathematical model. This confidence encourages reliance on this model in evaluation, development, and design of such systems.

The relevant literature on extreme rainfall events in the Pacific remains relatively sparse compared to other regions (e.g. the coterminous United States, Europe, etc.). Moreover, several recent reports on climate in the Pacific mention the paucity of extremes information and often list ‘trends in historical climate’ as a necessary next step. This scientific assessment meets this need by examining historical trends in and drivers of extreme rainfall events across the entire Pacific Basin, inclusive from Alaska southward to Australia, and longitudinally from the Philippines eastward to North America, with an emphasis on island and coastal locations (within 200 km of the coastline). There is evidence of a general decrease in the frequency of annual extreme rainfall events, yet the amount of extreme precipitation contributing to annual and seasonal totals appears to be on the rise. Region-wide, the number of consecutive dry days is increasing for those locations that are already dry, while the number of consecutive wet days is increasing for the already wet locales. The data for extreme rainfall statistics are considered to be relatively high quality for trend detection, while the level of understanding of the physical causes behind extreme rainfall is positively high. Since the ability to analyze the changes in historical rainfall extremes with some confidence is relatively recent, understanding is expected to improve in the future with the advancement of new datasets and ‘climate reanalysis’ projects.

Imine-bond formation between a chiral amine analyte and 3-hydroxypyridine-2-carboxaldehyde (HCA) was used to create a fast and robust method for enantiopurity analysis. This approach showed good universality, and was applied to a variety of different classes of chiral amines. The sign of the measured CD signal was enantiospecific across the range of amines tested, allowing some confidence in absolute configuration determination. This technique was transitioned to an HPLC-CD detector to allow for rapid and automated sample introduction, while maintaining the level of accuracy noted for the standalone CD spectrophotometer. Finally, the enantiomeric purity of a series of crude reaction mixtures of synthetic amines produced by biocatalytic transamination was accurately determined using this approach.

We discuss to what extent disease transmission models provide reliable predictions. The concept of prediction is delineated as it is understood by modellers, and illustrated by some classic and recent examples. A precondition for a model to provide valid predictions is that the assumptions underlying it correspond to the reality, but such correspondence is always limited—all models are simplifications of reality. A central tenet of the modelling enterprise is what we may call the ‘robustness thesis': a model whose assumptions approximately correspond to reality will make predictions that are approximately valid. To examine which of the predictions made by a model are trustworthy, it is essential to examine the outcomes of different models. Thus, if a highly simplified model makes a prediction, and if the same or a very similar prediction is made by a more elaborate model that includes some mechanisms or details that the first model did not, then we gain some confidence that the prediction is robust. An important benefit derived from mathematical modelling activity is that it demands transparency and accuracy regarding our assumptions, thus enabling us to test our understanding of the disease epidemiology by comparing model results and observed patterns. Models can also assist in decision-making by making projections regarding important issues such as intervention-induced changes in the spread of disease.

Hydrologic alteration can be attributed to climate and human effects with some confidence. However, when quantifying the hydrologic alteration induced by dams using historical flow records, there is a lack of consideration concerning the impacts of climate variability on hydrologic alteration. Evaluating dam-induced and climate-influence-induced hydrologic alteration has emerged as a key problem, which is the process of quantifying the extent that they have altered the river’s hydrologic attributes. Central to this process is restoring the hydrologic attributes without dam influence. This study simulates hydrologic regimes without dam influence and evaluates the dam and climate influences on hydrologic processes in the Lancang-Mekong River. The results showed that the meteorological variables were closely related with runoff. Therefore, a stepwise-regression model was established and validated using meteorological variables with their time lags, and it showed good performance. The simulative evalu...

Social media platforms are effective tools used to help communicate and increase involvement in cultural, political, and scientific circles. In 2012, an ad hoc committee was established to explore online fisheries science communication and how social media platforms can be utilized by the American Fisheries Society (AFS). A survey was disseminated to all AFS units (chapters, sections, divisions) and student subunits to better understand the current use of social media within the AFS. A relatively high response rate (82%) provided some confidence in the survey results—namely, that nearly 69% or more of units and subunits used social media. Facebook was the dominant platform used (59%; all others < 15%) and almost exclusively (97%) for the purpose of communication. Education, outreach, and member recruitment were other reasons for social media use. Finally, whether units currently use social media or not at all, it was recommended that AFS-led workshops and assistance would increase the usefulness ...

Maintaining beach water quality and cleanliness of shorelines is expensive. Demonstrating that water quality regulations and shoreline maintenance are economical is aided by defensible non-market values. Defensible values are robust to the chosen valuation method. This article compares values from the contingent valuation method (CVM) and choice experiments (CE). Using a survey of beach visitors, our results show that the increased economic value per visitor day for increasing beach water clarity is estimated by CVM at $54 ($39–73 CI), while CE estimated $51 ($34–70 CI). Eliminating trash on beaches is estimated using CVM at $103 ($83–131 CI) while CE estimated $98 ($77–126 CI) per visitor day. A comparison of the two methods’ benefit estimates shows that CE and CVM 90% confidence intervals overlap, indicating statistically equivalent values. This indicates defensible values of the two valuation methods. Our analysis suggests managers can have some confidence in non-market valuation.