Computerised Diagnostic Decision Support System for the Classification of Pre-Invasive Cervical Squamous Lesions.

Previous studies have revealed considerable interobserver and intraobserver variation in the histological classification of preinvasive cervical squamous lesions. The aim of the present study was to develop a decision support system (DSS) for the histological interpretation of these lesions. Knowledge and uncertainty were represented in the form of a Bayesian belief network that permitted the storage of diagnostic knowledge and, for a given case, the collection of evidence in a cumulative manner that provided a final probability for the possible diagnostic outcomes. The network comprised 8 diagnostic histological features (evidence nodes) that were each independently linked to the diagnosis (decision node) by a conditional probability matrix. Diagnostic outcomes comprised normal; koilocytosis; and cervical intraepithelial neoplasia (CIN) 1, CIN II, and CIN M. For each evidence feature, a set of images was recorded that represented the full spectrum of change for that feature. The system was designed to be interactive in that the histopathologist was prompted to enter evidence into the network via a specifically designed graphical user interface (i-Path Diagnostics, Belfast, Northern Ireland). Membership functions were used to derive the relative likelihoods for the alternative feature outcomes, the likelihood vector was entered into the network, and the updated diagnostic belief was computed for the diagnostic outcomes and displayed. A cumulative probability graph was generated throughout the diagnostic process and presented on screen. The network was tested on 50 cervical colposcopic biopsy specimens, comprising 10 cases each of normal, koilocytosis, CIN 1, CIN H, and CIN III. These had been preselected by a consultant gynecological pathologist. Using conventional morphological assessment, the cases were classified on 2 separate occasions by 2 consultant and 2 junior pathologists. The cases were also then classified using the DSS on 2 occasions by the 4 pathologists and by 2 medical students with no experience in cervical histology. Interobserver and intraobserver agreement using morphology and using the DSS was calculated with K statistics. Intraobserver reproducibility using conventional unaided diagnosis was reasonably good (kappa range, 0.688 to 0.861), but interobserver agreement was poor (kappa range, 0.347 to 0.747). Using the DSS improved overall reproducibility between individuals. Using the DSS, however, did not enhance the diagnostic performance of junior pathologists when comparing their DSS-based diagnosis against an experienced consultant. However, the generation of a cumulative probability graph also allowed a comparison of individual performance, how individual features were assessed in the same case, and how this contributed to diagnostic disagreement between individuals. Diagnostic features such as nuclear pleomorphism were shown to be particularly problematic and poorly reproducible. DSSs such as this therefore not only have a role to play in enhancing decision making but also in the study of diagnostic protocol, education, self-assessment, and quality control. (C) 2003 Elsevier Inc. All rights reserved.

Farmer perception of suitable conditions for slurry application compared with decision support system recommendations

The application of slurry nutrients to land can be associated with unintended losses to the environment depending on soil and weather conditions. Correct timing of slurry application, however, can increase plant nutrient uptake and reduce losses. A decision support system (DSS), which predicts optimum conditions for slurry spreading based on the Hybrid Soil Moisture Deficit (HSMD) model, was investigated for use as a policy tool. The DSS recommendations were compared to farmer perception of suitable conditions for slurry spreading for three soil drainage classes (well, moderate and poorly drained) to better understand on farm slurry management practices and to identify potential conflict with farmer opinion. Six farmers participated in a survey over two and a half years, during which they completed a daily diary, and their responses were compared to Soil Moisture Deficit (SMD) calculations and weather data recorded by on farm meteorological stations. The perception of land drainage quality differed between farmers and was related to their local knowledge and experience. It was found that the allocation of grass fields to HSMD drainage classes using a visual assessment method aligned farmer perception of drainage at the national scale. Farmer opinion corresponded to the theoretical understanding that slurry should not be applied when the soil is wetter than field capacity, i.e. when drainage can occur. While weather and soil conditions (especially trafficability) were the principal reasons given by farmers not to spread slurry, farm management practices (grazing and silage) and current Nitrates Directive policies (closed winter period for spreading) combined with limited storage capacities were obstacles to utilisation of slurry nutrients. Despite the slightly more restrictive advice of the DSS regarding the number of suitable spreading opportunities, the system has potential to address an information deficit that would help farmers to reduce nutrient losses and optimise plant nutrient uptake by improved slurry management. The DSS advice was in general agreement with the farmers and, therefore, they should not be resistant to adopting the tool for day to day management.

A decision support system for managing irrigation in agriculture

In this paper, an automatic Smart Irrigation Decision Support System, SIDSS, is proposed to manage irrigation in agriculture. Our system estimates the weekly irrigations needs of a plantation, on the basis of both soil measurements and climatic variables gathered by several autonomous nodes deployed in field. This enables a closed loop control scheme to adapt the decision support system to local perturbations and estimation errors. Two machine learning techniques, PLSR and ANFIS, are proposed as reasoning engine of our SIDSS. Our approach is validated on three commercial plantations of citrus trees located in the South-East of Spain. Performance is tested against decisions taken by a human expert.

Spatial Allocation of Material Flow Analysis: A Geographic Information System Application of Material Flow Analysis in Ireland

This study concerns the spatial allocation of material flows, with emphasis on construction material in the Irish housing sector. It addresses some of the key issues concerning anthropogenic impact on the environment through spatial temporal visualisation of the flow of materials, wastes and emissions at different spatial levels. This is presented in the form of a spatial model, Spatial Allocation of Material Flow Analysis (SAMFA), which enables the simulation of construction material flows and associated energy use. SAMFA parallels the Island Limits project (EPA funded under 2004-SD-MS-22-M2), which aimed to create a material flow analysis of the Irish economy classified by industrial sector. SAMFA further develops this by attempting to establish the material flows at the subnational geographical scale that could be used in the development of local authority (LA) sustainability strategies and spatial planning frameworks by highlighting the cumulative environmental impacts of the development of the built environment. By drawing on the idea of planning support systems, SAMFA also aims to provide a cross-disciplinary, integrative medium for involving stakeholders in strategies for a sustainable built environment and, as such, would help illustrate the sustainability consequences of alternative The pilot run of the model in Kildare has shown that the model can be successfully calibrated and applied to develop alternative material flows and energy-use scenarios at the ED level. This has been demonstrated through the development of an integrated and a business-as-usual scenario, with the former integrating a range of potential material efficiency and energysaving policy options and the latter replicating conditions that best describe the current trend. Their comparison shows that the former is better than the latter in terms of both material and energy use. This report also identifies a number of potential areas of future research and areas of broader application. This includes improving the accuracy of the SAMFA model (e.g. by establishing actual life expectancy of buildings in the Irish context through field surveys) and the extension of the model to other Irish counties. This would establish SAMFA as a valuable predicting and monitoring tool that is capable of integrating national and local spatial planning objectives with actual environmental impacts. Furthermore, should the model prove successful at this level, it then has the potential to transfer the modelling approach to other areas of the built environment, such as commercial development and other key contributors of greenhouse emissions. The ultimate aim is to develop a meta-model for predicting the consequences of consumption patterns at the local scale. This therefore offers the possibility of creating critical links between socio technical systems with the most important challenge of all the limitations of the biophysical environment.

Posting Incognito ... Males with Eating Problems: Online Emotional Expression and Support

Qualitative research in the area of eating disorders (eds) has predominantly focused on females,whilst the experiences of males’ remains poorly understood. due to the secretive nature of eating problems/eds it can be difficult to explore the experiences of males with these problems; however, online support groups/message boards, which are common and popular, provide a non-invasive
forum for researchers to conduct research. This study analyzed naturally occurring discussions on an internet message board dedicated to males and eating problems using content analysis. Two major overarching themes of emotional expression (sharing feelings of disturbed eating attitudes and emotions; being secretive) and support (informational and emotional) were identified. The message board provided a vital support system for this group, suggesting that online message boards may be an important avenue for health professionals to provide information, support, and advice.

Between Order and Modernity: Resurgence Planning in Revolutionary Egypt

Egypt’s Revolution of 1952 presented a major historical change to its political and economic structure, its society, and its institutions. This paper examines how Nasser’s regime operated through the state apparatus to exhibit features of modernity. Under the pretext of modernization, renovating Cairo’s authentic urban fabric was one of the channels that displayed the new ambitions to unveil a centralized system of governance and ideologies of socialism. The paper particularly looks at the city’s resurgence attempts, promoted by upgrading practices that displayed Western ideals of planning. Eventually, the contradictory planning legislative system introduced by the government raised early alarms at the problems encountered in the planning institution that was not only unable to liberate Cairo’s urban districts from its long-rooted decay, but also struggled to implement the regime’s flagship policy of social justice in a context wherein it was much needed.

Attitudes and Ethics: Evaluating Knowledge and Regulatory Constructs in Planning Enforcement Practice

The departure point for the paper is the need to scrutinise previously unconsidered dimensions which are fundamental to understanding the dynamics of the planning enforcement system. Drawing upon emerging themes in regulation theory the paper fuses these with knowledge constructs. The rationale is that regulatory regimes must be informed by knowledge imparted from a range of sources and the resultant quality of decision making is inextricably linked to the robustness and completeness of the evidence base collated.
The theoretical analysis, coupled with proposed radical legislative changes, provides a lens for an empirical investigation which scrutinises tactics, strategies, operational mechanisms, attitudinal dimensions and ethics with a view to identifying key factors impacting upon enforcement efficacy. Prizes and pitfalls are identified in the course of the analysis and evaluation, with evidence-based remedies suggested where appropriate. The paper concludes by reflecting on the importance of theoretical synergy, epistemological advancement, taking cognisance of ethical and attitudinal challenges facing the planning profession; and, stresses the importance of identifying and bringing to book those who flagrantly breach the Code of Professional Conduct.