The effect of a Computerised Decision Support System (CDSS) on compliance with the prehospital assessment process: results of an interrupted time-series study

BACKGROUND: Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). METHODS: In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. RESULTS: In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. CONCLUSIONS: The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.

Towards a smart semi-active prosthetic leg: preliminary assessment and testing

This paper presents a development of a semi-active prosthetic knee, which can work in both active and passive modes based on the energy required during the gait cycle of various activities of daily livings (ADLs). The prosthetic limb is equipped with various sensors to measure the kinematic and kinetic parameters of both prosthetic limbs. This prosthetic knee is designed to be back-drivable in passive mode to provide a potential use in energy regeneration when there negative energy across the knee joint. Preliminary test has been performed on transfemoral amputee in passive mode to provide some insight to the amputee/prosthesis interaction and performance with the designed prosthetic knee.

Towards an assessment of on-farm niches for improved forages in Sud-Kivu, DR Congo

Inadequate quantity and quality of livestock feed is a persistent constraint to productivity for mixed crop-livestock farming in eastern Democratic Republic of Congo. To assess on-farm niches of improved forages, demonstration trials and participatory on-farm research were conducted in four different sites. Forage legumes included Canavalia brasiliensis (CIAT 17009), Stylosanthes guianensis (CIAT 11995) and Desmodium uncinatum (cv. Silverleaf), while grasses were Guatemala grass (Tripsacum andersonii), Napier grass (Pennisetum purpureum) French Cameroon, and a local Napier line. Within the first six months, forage legumes adapted differently to the four sites with little differences among varieties, while forage grasses displayed higher variability in biomass production among varieties than among sites. Farmers’ ranking largely corresponded to herbage yield from the first cut, preferring Canavalia, Silverleaf desmodium and Napier French Cameroon. Choice of forages and integration into farming systems depended on land availability, soil erosion prevalence and livestock husbandry system. In erosion prone sites, 55–60% of farmers planted grasses on field edges and 16–30% as hedgerows for erosion control. 43% of farmers grew forages as intercrop with food crops such as maize and cassava, pointing to land scarcity. Only in the site with lower land pressure, 71% of farmers grew legumes as pure stand. When land tenure was not secured and livestock freely roaming, 75% of farmers preferred to grow annual forage legumes instead of perennial grasses. Future research should develop robust decision support for spatial and temporal integration of forage technologies into diverse smallholder cropping systems and agro-ecologies.

Ecological quality assessment of transitional waters based on fish assemblages in Portuguese estuaries: The Estuarine Fish Assessment Index (EFAI)

The assessment of water quality has changed markedly worldwide over the last years, especially in Europe due to the implementation of the Water Framework Directive. Fish was considered a key-element in this context and several fish-based multi-metric indices have been proposed. In this study, we propose a multi-metric index, the Estuarine Fish Assessment Index (EFAI), developed for Portuguese estuaries, designed for the overall assessment of transitional waters, which could also be applied at the water body level within an estuary. The EFAI integrates seven metrics: species richness, percentage of marine migrants, number of species and abundance of estuarine resident species, number of species and abundance of piscivorous species, status of diadromous species, status of introduced species and status of disturbance sensitive species. Fish sampling surveys were conducted in 2006, 2009 and 2010, using beam trawl, in 13 estuarine systems along the Portuguese coast. Most of the metrics presented a high variability among the transitional systems surveyed. According to the EFAI values, Portuguese estuaries presented a "Good" water quality status (except the Douro in a particular year). The assessments in different years were generally concordant, with a few exceptions. The relationship between the EFAI and the Anthropogenic Pressure Index (API) was not significant, but a negative and significant correlation was registered between the EFAI and the expert judgement pressure index, at both estuary and water body level. The ordination analysis performed to evaluate similarities among North-East Atlantic Geographical Intercalibration Group (NEAGIG) fish-based indices put in evidence four main groups: the French index, since it is substantially different from all the other indices (uses only four metrics based on densities); indices from Ireland, United Kingdom and Spain (Asturias and Cantabria); the Dutch and German indices; and the indices of Belgium. Portugal and Spain (Basque country). The need for detailed studies, including comparative approaches, on several aspects of these assessment tools, especially in what regards their response to anthropogenic pressures was stressed. (C) 2011 Elsevier Ltd. All rights reserved.

Quality of Judgment Assessment

The intersection of Artificial Intelligence and The Law stands for a multifaceted matter, and its effects set the advances on culture, organization, as well as the social matters, when the emergent information technologies are taken into consideration. From this point of view, the weight of formal and informal Conflict Resolution settings should be highlighted, and the use of defective data, information or knowledge must be emphasized. Indeed, it is hard to do it with traditional problem solving methodologies. Therefore, in this work the focus is on the development of decision support systems, in terms of its knowledge representation and reasoning procedures, under a formal framework based on Logic Programming, complemented with an approach to computing centered on Artificial Neural Networks. It is intended to evaluate the Quality-of-Judgments and the respective Degree-of-Confidence that one has on such happenings.

An Assessment to Toxicological Risk of Pesticide Exposure

On the one hand, pesticides may be absorbed into the body orally, dermally, ocularly and by inhalation and the human exposure may be dietary, recreational and/or occupational where toxicity could be acute or chronic. On the other hand, the environmental fate and toxicity of the pesticide is contingent on the physico-chemical characteristics of pesticide, the soil composition and adsorption. Human toxicity is also dependent on the exposure time and individual’s susceptibility. Therefore, this work will focus on the development of an Artificial Intelligence based diagnosis support system to assess the pesticide toxicological risk to humanoid, built under a formal framework based on Logic Programming to knowledge representation and reasoning, complemented with an approach to computing grounded on Artificial Neural Networks. The proposed solution is unique in itself, once it caters for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in terms of a qualitative or quantitative setting.

ASSESSMENT OF ENERGY CONSUMPTION IN GREENHOUSE PRODUCTION IN THE WEST REGION OF PORTUGAL

Greenhouse production is a very important activity in the West region of Portugal, with an area of approximately 800 ha where the regular production consists in two crops per year, one in winter-spring and the other in summer-autumn. Many growers are now prepared to better exploit market opportunities, since they know that the big export window opportunity is from June to September, when the production is difficult in other regions of south due to high temperatures. Grower’s use new and more productive varieties, either in soil or hydroponic systems, mostly in unheated greenhouses, naturally ventilated, and equipped with modern fertigation systems. Greenhouse production causes some environmental impacts due to the high use of inputs. Several improvements in technologies and crop practices may contribute to increase the use efficiency of resources, decreasing the negative environmental impacts. Greenhouse vegetable production in Northern EU countries is based on the supply of heating and differs significantly from the production system in the Southern EU countries. In the Northern countries, direct energy inputs, mostly for heating, are predominant while in the South the indirect energy input is also important, mainly associated with fertilizers, plastic cover materials and other auxiliary materials. The main objective of this work was to characterise the greenhouse production systems in the West region of Portugal, in order to evaluate the energetic consumptions (direct and indirect), the GHH emissions, the production costs and the farmer’s income. With this work the mostly important inputs were identified, allowing proposing alternative measures to improve efficiency and sustainability. All the data was obtained by surveys performed directly with growers, previously selected to be representative of the crop practices and greenhouse type of the region. However, more research should be performed in order to develop and to test technologies capable to improve resources use efficiency in greenhouse production.

A Case-base Approach to Workforces’ Satisfaction Assessment

It is well known that human resources play a valuable role in a sustainable organizational development. Indeed, this work will focus on the development of a decision support system to assess workers’ satisfaction based on factors related to human resources management practices. The framework is built on top of a Logic Programming approach to Knowledge Representation and Reasoning, complemented with a Case Based approach to computing. The proposed solution is unique in itself, once it caters for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in terms of a qualitative or quantitative setting. Furthermore, clustering methods based on similarity analysis among cases were used to distinguish and aggregate collections of historical data or knowledge in order to reduce the search space, therefore enhancing the cases retrieval and the overall computational process.

Control and Supervision of Wind Energy Conversion Systems

This paper is about a PhD thesis and includes the study and analysis of the performance of an onshore wind energy conversion system. First, mathematical models of a variable speed wind turbine with pitch control are studied, followed by the study of different controller types such as integer-order controllers, fractional-order controllers, fuzzy logic controllers, adaptive controllers and predictive controllers and the study of a supervisor based on finite state machines is also studied. The controllers are included in the lower level of a hierarchical structure composed by two levels whose objective is to control the electric output power around the rated power. The supervisor included at the higher level is based on finite state machines whose objective is to analyze the operational states according to the wind speed. The studied mathematical models are integrated into computer simulations for the wind energy conversion system and the obtained numerical results allow for the performance assessment of the system connected to the electric grid. The wind energy conversion system is composed by a variable speed wind turbine, a mechanical transmission system described by a two mass drive train, a gearbox, a doubly fed induction generator rotor and by a two level converter.

An Artificial Intelligence Approach to Individuals' Age Assessment

A link between patterns of pelvic growth and human life history is supported by the finding that, cross-culturally, variation in maturation rates of female pelvis are correlated with variation in ages of menarche and first reproduction, i.e., it is well known that the human dimensions of the pelvic bones depend on the gender and vary with the age. Indeed, one feature in which humans appear to be unique is the prolonged growth of the pelvis after the age of sexual maturity. Both the total superoinferior length and mediolateral breadth of the pelvis continues to grow markedly after puberty, and do not reach adult proportions until the late teens years. This continuation of growth is accomplished by relatively late fusion of the separate centers of ossification that form the bones of the pelvis. Hence, in this work we will focus on the development of an intelligent decision support system to predict individual’s age based on a pelvis' dimensions criteria. Some basic image processing techniques were applied in order to extract the relevant features from pelvic X-rays, being the computational framework built on top of a Logic Programming approach to Knowledge Representation and Reasoning that caters for the handling of incomplete, unknown, or even self-contradictory information, complemented with a Case Base approach to computing.

Assessment of environment, land management, and spatial variables on recent changes in montado land cover in southern Portugal

Montado decline has been reported since the end of the nineteenth century in southern Portugal and increased markedly during the 1980s. Consensual reports in the literature suggest that this decline is due to a number of factors, such as environmental constraints, forest diseases, inappropriate management, and socioeconomic issues. An assessment on the pattern of montado distribution was conducted to reveal how the extent of land management, environmental variables, and spatial factors contributed to montado area loss in southern Portugal from 1990 to 2006. A total of 14 independent variables, presumably related to montado loss, were grouped into three sets: environmental variables, land management variables, and spatial variables. From 1990 to 2006, approximately 90,054 ha disappeared in the montado area, with an estimated annual regression rate of 0.14 % year-1. Variation partitioning showed that the land management model accounted for the highest percentage of explained variance (51.8 %), followed by spatial factors (44.6 %) and environmental factors (35.5 %). These results indicate that most variance in the large-scale distribution of recent montado loss is due to land management, either alone or in combination with environmental and spatial factors. The full GAM model showed that different livestock grazing is one of the most important variables affecting montado loss. This suggests that optimum carrying capacity should decrease to 0.18–0.60 LU ha-1 for livestock grazing in montado under current ecological conditions in southern Portugal.

An Integrated Soft Computing Approach to Hughes Syndrome Risk Assessment

The AntiPhospholipid Syndrome (APS) is an acquired autoimmune disorder induced by high levels of antiphospholipid antibodies that cause arterial and veins thrombosis, as well as pregnancy-related complications and morbidity, as clinical manifestations. This autoimmune hypercoagulable state, usually known as Hughes syndrome, has severe consequences for the patients, being one of the main causes of thrombotic disorders and death. Therefore, it is required to be preventive; being aware of how probable is to have that kind of syndrome. Despite the updated of antiphospholipid syndrome classification, the diagnosis remains difficult to establish. Additional research on clinically relevant antibodies and standardization of their quantification are required in order to improve the antiphospholipid syndrome risk assessment. Thus, this work will focus on the development of a diagnosis decision support system in terms of a formal agenda built on a Logic Programming approach to knowledge representation and reasoning, complemented with a computational framework based on Artificial Neural Networks. The proposed model allows for improving the diagnosis, classifying properly the patients that really presented this pathology (sensitivity higher than 85%), as well as classifying the absence of APS (specificity close to 95%).

Methodology for climate risk assessment of maize intercropped with Brachiaria in the Cerrado of Brazil.

2015

Land quality monitoring systems that integrate local and technical knowledge contribute to sustainability valuation in agricultural landscapes.

2008

Assessment of heavy metals in soils of a vineyard region with the use of principal component analysis.

Agricultural management with chemicals may contaminate the soil with heavy metals. The objective of this study was to apply Principal Component Analysis and geoprocessing techniques to identify the origin of the metals Cu, Fe, Mn, Zn, Ni, Pb, Cr and Cd as potential contaminants of agricultural soils. The study was developed in an area of vineyard cultivation in the State of São Paulo, Brazil. Soil samples were collected and GPS located under different uses and coverings. The metal concentrations in the soils were determined using the DTPA method. The Cu and Zn content was considered high in most of the samples, and was larger in the areas cultivated with vineyards that had been under the application of fungicides for several decades. The concentrations of Cu and Zn were correlated. The geoprocessing techniques and the Principal Component Analysis confirmed the enrichment of the soil with Cu and Zn because of the use and management of the vineyards with chemicals in the preceding decades.