Computer-based summative assessment of clinical reasoning in clerkships: A mixed-method comparison of key feature problems with case-based multiple choice questions

Background: It is yet unclear if there are differences between using electronic key feature problems (KFPs) or electronic case-based multiple choice questions (cbMCQ) for the assessment of clinical decision making. Summary of Work: Fifth year medical students were exposed to clerkships which ended with a summative exam. Assessment of knowledge per exam was done by 6-9 KFPs, 9-20 cbMCQ and 9-28 MC questions. Each KFP consisted of a case vignette and three key features (KF) using “long menu” as question format. We sought students’ perceptions of the KFPs and cbMCQs in focus groups (n of students=39). Furthermore statistical data of 11 exams (n of students=377) concerning the KFPs and (cb)MCQs were compared. Summary of Results: The analysis of the focus groups resulted in four themes reflecting students’ perceptions of KFPs and their comparison with (cb)MCQ: KFPs were perceived as (i) more realistic, (ii) more difficult, (iii) more motivating for the intense study of clinical reasoning than (cb)MCQ and (iv) showed an overall good acceptance when some preconditions are taken into account. The statistical analysis revealed that there was no difference in difficulty; however KFP showed a higher discrimination and reliability (G-coefficient) even when corrected for testing times. Correlation of the different exam parts was intermediate. Conclusions: Students perceived the KFPs as more motivating for the study of clinical reasoning. Statistically KFPs showed a higher discrimination and higher reliability than cbMCQs. Take-home messages: Including KFPs with long menu questions into summative clerkship exams seems to offer positive educational effects.

Desing and Validation of a Light Inference System to Support Embedded Context Reasoning

Embedded context management in resource-constrained devices (e.g. mobile phones, autonomous sensors or smart objects) imposes special requirements in terms of lightness for data modelling and reasoning. In this paper, we explore the state-of-the-art on data representation and reasoning tools for embedded mobile reasoning and propose a light inference system (LIS) aiming at simplifying embedded inference processes offering a set of functionalities to avoid redundancy in context management operations. The system is part of a service-oriented mobile software framework, conceived to facilitate the creation of context-aware applications—it decouples sensor data acquisition and context processing from the application logic. LIS, composed of several modules, encapsulates existing lightweight tools for ontology data management and rule-based reasoning, and it is ready to run on Java-enabled handheld devices. Data management and reasoning processes are designed to handle a general ontology that enables communication among framework components. Both the applications running on top of the framework and the framework components themselves can configure the rule and query sets in order to retrieve the information they need from LIS. In order to test LIS features in a real application scenario, an ‘Activity Monitor’ has been designed and implemented: a personal health-persuasive application that provides feedback on the user’s lifestyle, combining data from physical and virtual sensors. In this case of use, LIS is used to timely evaluate the user’s activity level, to decide on the convenience of triggering notifications and to determine the best interface or channel to deliver these context-aware alerts.d

Multi-agent Architecture for Heterogeneous Reasoning under Uncertainty Combining MSBN and Ontologies in Distributed Network Diagnosis

This article proposes a MAS architecture for network diagnosis under uncertainty. Network diagnosis is divided into two inference processes: hypothesis generation and hypothesis confirmation. The first process is distributed among several agents based on a MSBN, while the second one is carried out by agents using semantic reasoning. A diagnosis ontology has been defined in order to combine both inference processes. To drive the deliberation process, dynamic data about the influence of observations are taken during diagnosis process. In order to achieve quick and reliable diagnoses, this influence is used to choose the best action to perform. This approach has been evaluated in a P2P video streaming scenario. Computational and time improvements are highlight as conclusions.

Distributed Fault Diagnosis Using Bayesian Reasoning in MAGNETO

Many of the emerging telecom services make use of Outer Edge Networks, in particular Home Area Networks. The configuration and maintenance of such services may not be under full control of the telecom operator which still needs to guarantee the service quality experienced by the consumer. Diagnosing service faults in these scenarios becomes especially difficult since there may be not full visibility between different domains. This paper describes the fault diagnosis solution developed in the MAGNETO project, based on the application of Bayesian Inference to deal with the uncertainty. It also takes advantage of a distributed framework to deploy diagnosis components in the different domains and network elements involved, spanning both the telecom operator and the Outer Edge networks. In addition, MAGNETO features self-learning capabilities to automatically improve diagnosis knowledge over time and a partition mechanism that allows breaking down the overall diagnosis knowledge into smaller subsets. The MAGNETO solution has been prototyped and adapted to a particular outer edge scenario, and has been further validated on a real testbed. Evaluation of the results shows the potential of our approach to deal with fault management of outer edge networks.

Towards Understanding Reasoning Complexity in Practice

Although the computational complexity of the logic underlying the standard OWL 2 for the Web Ontology Language (OWL) appears discouraging for real applications, several contributions have shown that reasoning with OWL ontologies is feasible in practice. It turns out that reasoning in practice is often far less complex than is suggested by the established theoretical complexity bound, which reflects the worstcase scenario. State-of-the reasoners like FACT++, HERMIT, PELLET and RACER have demonstrated that, even with fairly expressive fragments of OWL 2, acceptable performances can be achieved. However, it is still not well understood why reasoning is feasible in practice and it is rather unclear how to study this problem. In this paper, we suggest first steps that in our opinion could lead to a better understanding of practical complexity. We also provide and discuss some initial empirical results with HERMIT on prominent ontologies

Desarrollo de una GUI para el estudio de Sistemas de Comunicaciones Ópticas

El peso específico de las Comunicaciones Ópticas dentro del ámbito de la Ingeniería de Telecomunicación no cesa de crecer. Sus aplicaciones, inicialmente dedicadas a las grandes líneas que enlazan las centrales de conmutación, alcanzan en la actualidad, como se ha mencionado, hasta los mismos hogares. Los progresos en este campo, con una sucesión sin tregua, no sólo se destinan a incrementar la capacidad de transmisión de los sistemas, sino a ampliar la diversidad de los procesos que sobre las señales se efectúan en el dominio óptico. Este dinamismo demanda a los profesionales del sector una revisión y actualización de sus conocimientos que les permitan resolver con soltura las cuestiones de su actividad de ingeniería. Por otra parte, durante los últimos años la importancia de las Comunicaciones Ópticas también se ha reflejado en las diferentes titulaciones de Ingenierías de Telecomunicación, cuyos planes de estudio contemplan esta materia tanto en asignaturas troncales como optativas. A menudo, las fuentes de información disponibles abordan esta disciplina con una orientación principalmente teórica. Profesionales y estudiantes de Ingeniería, pues, frente a esta materia se encuentran unos temas que tratan fenómenos físicos complejos, abundantes en conceptos abstractos y con un florido aparato matemático, pero muchas veces carentes de una visión práctica, importantísima en ingeniería, y que es, en definitiva, lo que se exige a alumnos e ingenieros: saber resolver problemas y cuestiones relacionados con las Comunicaciones Ópticas. Los sistemas de comunicaciones ópticas, y en especial aquellos que utilizan la fibra óptica como medio para la transmisión de información, como se ha dicho, están alcanzando un desarrollo importante en el campo de las telecomunicaciones. Las bondades que ofrece la fibra, de sobra conocidos y mencionados en el apartado que antecede (gran ancho de banda, inmunidad total a las perturbaciones de origen electromagnético, así como la no producción de interferencias, baja atenuación, etc.), han hecho que, hoy en día, sea uno de los campos de las llamadas tecnologías de la información y la comunicación que presente mayor interés por parte de científicos, ingenieros, operadores de telecomunicaciones y, por supuesto, usuarios. Ante esta realidad, el objetivo y justificación de la realización de este proyecto, por tanto, no es otro que el de acercar esta tecnología al futuro ingeniero de telecomunicaciones, y/o a cualquier persona con un mínimo de interés en este tema, y mostrarle de una forma práctica y visual los diferentes fenómenos que tienen lugar en la transmisión de información por medio de fibra óptica, así como los diferentes bloques y dispositivos en que se divide dicha comunicación. Para conseguir tal objetivo, el proyecto fin de carrera aquí presentado tiene como misión el desarrollo de una interfaz gráfica de usuario (GUI, del inglés Graphic User Interface) que permita a aquel que la utilice configurar de manera sencilla cada uno de los bloques en que se compone un enlace punto a punto de fibra óptica. Cada bloque en que se divide este enlace estará compuesto por varias opciones, que al elegir y configurar como se quiera, hará variar el comportamiento del sistema y presentará al usuario los diferentes fenómenos presentes en un sistema de comunicaciones ópticas, como son el ruido, la dispersión, la atenuación, etc., para una mejor comprensión e interiorización de la teoría estudiada. Por tanto, la aplicación, implementada en MATLAB, fruto de la realización de este PFC pretende servir de complemento práctico para las asignaturas dedicadas al estudio de las comunicaciones ópticas a estudiantes en un entorno amigable e intuitivo. Optical Communications in the field of Telecommunications Engineering continues to grow. Its applications, initially dedicated to large central lines that link the switching currently achieved, as mentioned, to the same household nowadays. Progress in this field, with a relentless succession, not only destined to increase the transmission capacity of the systems, but to broaden the diversity of the processes that are performed on the signals in the optical domain. This demands to professionals reviewing and updating their skills to enable them resolve issues easily. Moreover, in recent years the importance of optical communications is also reflected in the different degrees of Telecommunications Engineering, whose curriculum contemplates this area. Often, the information sources available to tackle this discipline mainly theoretical orientation. Engineering professionals and students are faced this matter are few topics discussing complex physical phenomena, and abstract concepts abundant with a flowery mathematical apparatus, but often wotput a practical, important in engineering, and that is what is required of students and engineers: knowing how to solve problems and issues related to optical communications. Optical communications systems, particularly those using optical fiber as a medium for transmission of information, as stated, are reaching a significant development in the field of telecommunications. The advantages offered by the fiber, well known and referred to in the preceding paragraph (high bandwidth, immunity to electromagnetic disturbances of origin and production of non interference, low attenuation, etc..), have made today, is one of the fields of information and communication technology that this increased interest by scientists, engineers, telecommunications operators and, of course, users. Given this reality, the purpose and justification of this project is not other than to bring this technology to the future telecommunications engineer, and / or anyone with a passing interest in this subject, and showing of a practical and various visual phenomena occurring in the transmission of information by optical fiber, as well as different blocks and devices in which said communication is divided. To achieve that objective, the final project presented here has as its mission the development of a graphical user interface (GUI) that allows the user to configure each of the blocks in which divided a point-to-point optical fiber. Each block into which this link will consist of several options to choose and configure it as you like, this will change the behavior of the system and will present to the user with the different phenomena occurring in an optical communication system, such as noise, dispersion, attenuation, etc., for better understanding and internalization of the theory studied. Therefore, the application, implemented in MATLAB, the result of the completion of the thesis is intended to complement practical subjects for the study of optical communications students in a friendly and intuitive environment.

Design and Validation of a Light Inference System to Support Embedded Context Reasoning

Embedded context management in resource-constrained devices (e.g. mobile phones, autonomous sensors or smart objects) imposes special requirements in terms of lightness for data modelling and reasoning. In this paper, we explore the state-of-the-art on data representation and reasoning tools for embedded mobile reasoning and propose a light inference system (LIS) aiming at simplifying embedded inference processes offering a set of functionalities to avoid redundancy in context management operations. The system is part of a service-oriented mobile software framework, conceived to facilitate the creation of context-aware applications?it decouples sensor data acquisition and context processing from the application logic. LIS, composed of several modules, encapsulates existing lightweight tools for ontology data management and rule-based reasoning, and it is ready to run on Java-enabled handheld devices. Data management and reasoning processes are designed to handle a general ontology that enables communication among framework components. Both the applications running on top of the framework and the framework components themselves can configure the rule and query sets in order to retrieve the information they need from LIS. In order to test LIS features in a real application scenario, an ?Activity Monitor? has been designed and implemented: a personal health-persuasive application that provides feedback on the user?s lifestyle, combining data from physical and virtual sensors. In this case of use, LIS is used to timely evaluate the user?s activity level, to decide on the convenience of triggering notifications and to determine the best interface or channel to deliver these context-aware alerts.

Probabilistic reasoning with a bayesian DNA device based on strand displacement

We present a computing model based on the DNA strand displacement technique which performs Bayesian inference. The model will take single stranded DNA as input data, representing the presence or absence of a specific molecular signal (evidence). The program logic encodes the prior probability of a disease and the conditional probability of a signal given the disease playing with a set of different DNA complexes and their ratios. When the input and program molecules interact, they release a different pair of single stranded DNA species whose relative proportion represents the application of Bayes? Law: the conditional probability of the disease given the signal. The models presented in this paper can empower the application of probabilistic reasoning in genetic diagnosis in vitro.

An attitude-based reasoning strategy to enhance interaction with augmented objects

This paper describes a mobile-based system to interact with objects in smart spaces, where the offer of resources may be extensive. The underlying idea is to use the augmentation capabilities of the mobile device to enable it as user-object mediator. In particular, the paper details how to build an attitude-based reasoning strategy that facilitates user-object interaction and resource filtering. The strategy prioritizes the available resources depending on the spatial history of the user, his real-time location and orientation and, finally, his active touch and focus interactions with the virtual overlay. The proposed reasoning method has been partially validated through a prototype that handles 2D and 3D visualization interfaces. This framework makes possible to develop in practice the IoT paradigm, augmenting the objects without physically modifying them.

A multi-agent system with distributed bayesian reasoning for network fault diagnosis

In this paper, an innovative approach to perform distributed Bayesian inference using a multi-agent architecture is presented. The final goal is dealing with uncertainty in network diagnosis, but the solution can be of applied in other fields. The validation testbed has been a P2P streaming video service. An assessment of the work is presented, in order to show its advantages when it is compared with traditional manual processes and other previous systems.

Approximate Relational Reasoning for Probabilistic Programs

La seguridad verificada es una metodología para demostrar propiedades de seguridad de los sistemas informáticos que se destaca por las altas garantías de corrección que provee. Los sistemas informáticos se modelan como programas probabilísticos y para probar que verifican una determinada propiedad de seguridad se utilizan técnicas rigurosas basadas en modelos matemáticos de los programas. En particular, la seguridad verificada promueve el uso de demostradores de teoremas interactivos o automáticos para construir demostraciones completamente formales cuya corrección es certificada mecánicamente (por ordenador). La seguridad verificada demostró ser una técnica muy efectiva para razonar sobre diversas nociones de seguridad en el área de criptografía. Sin embargo, no ha podido cubrir un importante conjunto de nociones de seguridad “aproximada”. La característica distintiva de estas nociones de seguridad es que se expresan como una condición de “similitud” entre las distribuciones de salida de dos programas probabilísticos y esta similitud se cuantifica usando alguna noción de distancia entre distribuciones de probabilidad. Este conjunto incluye destacadas nociones de seguridad de diversas áreas como la minería de datos privados, el análisis de flujo de información y la criptografía. Ejemplos representativos de estas nociones de seguridad son la indiferenciabilidad, que permite reemplazar un componente idealizado de un sistema por una implementación concreta (sin alterar significativamente sus propiedades de seguridad), o la privacidad diferencial, una noción de privacidad que ha recibido mucha atención en los últimos años y tiene como objetivo evitar la publicación datos confidenciales en la minería de datos. La falta de técnicas rigurosas que permitan verificar formalmente este tipo de propiedades constituye un notable problema abierto que tiene que ser abordado. En esta tesis introducimos varias lógicas de programa quantitativas para razonar sobre esta clase de propiedades de seguridad. Nuestra principal contribución teórica es una versión quantitativa de una lógica de Hoare relacional para programas probabilísticos. Las pruebas de correción de estas lógicas son completamente formalizadas en el asistente de pruebas Coq. Desarrollamos, además, una herramienta para razonar sobre propiedades de programas a través de estas lógicas extendiendo CertiCrypt, un framework para verificar pruebas de criptografía en Coq. Confirmamos la efectividad y aplicabilidad de nuestra metodología construyendo pruebas certificadas por ordendor de varios sistemas cuyo análisis estaba fuera del alcance de la seguridad verificada. Esto incluye, entre otros, una meta-construcción para diseñar funciones de hash “seguras” sobre curvas elípticas y algoritmos diferencialmente privados para varios problemas de optimización combinatoria de la literatura reciente. ABSTRACT The verified security methodology is an emerging approach to build high assurance proofs about security properties of computer systems. Computer systems are modeled as probabilistic programs and one relies on rigorous program semantics techniques to prove that they comply with a given security goal. In particular, it advocates the use of interactive theorem provers or automated provers to build fully formal machine-checked versions of these security proofs. The verified security methodology has proved successful in modeling and reasoning about several standard security notions in the area of cryptography. However, it has fallen short of covering an important class of approximate, quantitative security notions. The distinguishing characteristic of this class of security notions is that they are stated as a “similarity” condition between the output distributions of two probabilistic programs, and this similarity is quantified using some notion of distance between probability distributions. This class comprises prominent security notions from multiple areas such as private data analysis, information flow analysis and cryptography. These include, for instance, indifferentiability, which enables securely replacing an idealized component of system with a concrete implementation, and differential privacy, a notion of privacy-preserving data mining that has received a great deal of attention in the last few years. The lack of rigorous techniques for verifying these properties is thus an important problem that needs to be addressed. In this dissertation we introduce several quantitative program logics to reason about this class of security notions. Our main theoretical contribution is, in particular, a quantitative variant of a full-fledged relational Hoare logic for probabilistic programs. The soundness of these logics is fully formalized in the Coq proof-assistant and tool support is also available through an extension of CertiCrypt, a framework to verify cryptographic proofs in Coq. We validate the applicability of our approach by building fully machine-checked proofs for several systems that were out of the reach of the verified security methodology. These comprise, among others, a construction to build “safe” hash functions into elliptic curves and differentially private algorithms for several combinatorial optimization problems from the recent literature.

A formalism and method for representing and reasoning with process models authored by subject matter experts

Enabling Subject Matter Experts (SMEs) to formulate knowledge without the intervention of Knowledge Engineers (KEs) requires providing SMEs with methods and tools that abstract the underlying knowledge representation and allow them to focus on modeling activities. Bridging the gap between SME-authored models and their representation is challenging, especially in the case of complex knowledge types like processes, where aspects like frame management, data, and control flow need to be addressed. In this paper, we describe how SME-authored process models can be provided with an operational semantics and grounded in a knowledge representation language like F-logic in order to support process-related reasoning. The main results of this work include a formalism for process representation and a mechanism for automatically translating process diagrams into executable code following such formalism. From all the process models authored by SMEs during evaluation 82% were well-formed, all of which executed correctly. Additionally, the two optimizations applied to the code generation mechanism produced a performance improvement at reasoning time of 25% and 30% with respect to the base case, respectively.

Probabilistic reasoning with an enzyme-driven DNA device

We present a biomolecular probabilistic model driven by the action of a DNA toolbox made of a set of DNA templates and enzymes that is able to perform Bayesian inference. The model will take single-stranded DNA as input data, representing the presence or absence of a specific molecular signal (the evidence). The program logic uses different DNA templates and their relative concentration ratios to encode the prior probability of a disease and the conditional probability of a signal given the disease. When the input and program molecules interact, an enzyme-driven cascade of reactions (DNA polymerase extension, nicking and degradation) is triggered, producing a different pair of single-stranded DNA species. Once the system reaches equilibrium, the ratio between the output species will represent the application of Bayes? law: the conditional probability of the disease given the signal. In other words, a qualitative diagnosis plus a quantitative degree of belief in that diagno- sis. Thanks to the inherent amplification capability of this DNA toolbox, the resulting system will be able to to scale up (with longer cascades and thus more input signals) a Bayesian biosensor that we designed previously.