A cloud-based system for measuring radiation treatment plan similarity

PURPOSE: Radiation therapy is used to treat cancer using carefully designed plans that maximize the radiation dose delivered to the target and minimize damage to healthy tissue, with the dose administered over multiple occasions. Creating treatment plans is a laborious process and presents an obstacle to more frequent replanning, which remains an unsolved problem. However, in between new plans being created, the patient's anatomy can change due to multiple factors including reduction in tumor size and loss of weight, which results in poorer patient outcomes. Cloud computing is a newer technology that is slowly being used for medical applications with promising results. The objective of this work was to design and build a system that could analyze a database of previously created treatment plans, which are stored with their associated anatomical information in studies, to find the one with the most similar anatomy to a new patient. The analyses would be performed in parallel on the cloud to decrease the computation time of finding this plan. METHODS: The system used SlicerRT, a radiation therapy toolkit for the open-source platform 3D Slicer, for its tools to perform the similarity analysis algorithm. Amazon Web Services was used for the cloud instances on which the analyses were performed, as well as for storage of the radiation therapy studies and messaging between the instances and a master local computer. A module was built in SlicerRT to provide the user with an interface to direct the system on the cloud, as well as to perform other related tasks. RESULTS: The cloud-based system out-performed previous methods of conducting the similarity analyses in terms of time, as it analyzed 100 studies in approximately 13 minutes, and produced the same similarity values as those methods. It also scaled up to larger numbers of studies to analyze in the database with a small increase in computation time of just over 2 minutes. CONCLUSION: This system successfully analyzes a large database of radiation therapy studies and finds the one that is most similar to a new patient, which represents a potential step forward in achieving feasible adaptive radiation therapy replanning.

Ethical reasoning through simulation: a phenomenological analysis of student experience

Background
Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students’ lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment.

Methods
This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data.

Results
Four main themes emerged from the analysis: (1) ‘Authentic on all levels?’, (2)‘Letting the emotions flow’, (3) ‘Ethical alarm bells’ and (4) ‘Voices of children and ghosts’. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences.

Conclusions
This study provided deep insights into medical students’ immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

Hierarchical Task Network Planning with Common-Sense Reasoning for Multiple-People Behaviour Analysis

Safety on public transport is a major concern for the relevant authorities. We
address this issue by proposing an automated surveillance platform which combines data from video, infrared and pressure sensors. Data homogenisation and integration is achieved by a distributed architecture based on communication middleware that resolves interconnection issues, thereby enabling data modelling. A common-sense knowledge base models and encodes knowledge about public-transport platforms and the actions and activities of passengers. Trajectory data from passengers is modelled as a time-series of human activities. Common-sense knowledge and rules are then applied to detect inconsistencies or errors in the data interpretation. Lastly, the rationality that characterises human behaviour is also captured here through a bottom-up Hierarchical Task Network planner that, along with common-sense, corrects misinterpretations to explain passenger behaviour. The system is validated using a simulated bus saloon scenario as a case-study. Eighteen video sequences were recorded with up to six passengers. Four metrics were used to evaluate performance. The system, with an accuracy greater than 90% for each of the four metrics, was found to outperform a rule-base system and a system containing planning alone.

Similarity between the in vitro activity and toxicity of two different fungizone™ / lipofundin™ admixtures

Amphotericin B (AmB), an antifungal agent that presents a broad spectrum of activity, remains the gold standard in the antifungal therapy. However, sometimes the high level of toxicity forbids its clinical use. The aim of this work was to evaluate and compare the efficacy and toxicity in vitro of Fungizon™ (AmB-D) and two new different AmB formulations. Methods: three products were studied: Fungizon™, and two Fungizon™ /Lipofundin™ admixtures, which were diluted through two methods: in the first one, Fungizon™ was previously diluted with water for injection and then, in Lipofundin™ (AmB-DAL); the second method consisted of a primary dilution of AmB-D as a powder in the referred emulsion (AmB-DL). For the in vitro assay, two cell models were used: Red Blood Cells (RBC) from human donors and Candida tropicallis (Ct). The in vitro evaluation (K+ leakage, hemoglobin leakage and cell survival rate-CSR) was performed at four AmB concentrations (from 50 to 0.05mg.L-1). Results: The results showed that the action of AmB was not only concentration dependent, but also cellular type and vehicle kind dependent. At AmB concentrations of 50 mg.L-1, although the hemoglobin leakage for AmB-D was almost complete (99.51), for AmB-DAL and AmB-DL this value tended to zero. The p = 0.000 showed that AmB-D was significantly more hemolytic. Conclusion: The Fungizon™- Lipofundin™ admixtures seem to be the more valuable AmB carrier systems due to their best therapeutic index presented

Probabilistic Graphical Modelling for Software Product Lines: A Frameweork for Modeling and Reasoning under Uncertainty

This work provides a holistic investigation into the realm of feature modeling within software product lines. The work presented identifies limitations and challenges within the current feature modeling approaches. Those limitations include, but not limited to, the dearth of satisfactory cognitive presentation, inconveniency in scalable systems, inflexibility in adapting changes, nonexistence of predictability of models behavior, as well as the lack of probabilistic quantification of model’s implications and decision support for reasoning under uncertainty. The work in this thesis addresses these challenges by proposing a series of solutions. The first solution is the construction of a Bayesian Belief Feature Model, which is a novel modeling approach capable of quantifying the uncertainty measures in model parameters by a means of incorporating probabilistic modeling with a conventional modeling approach. The Bayesian Belief feature model presents a new enhanced feature modeling approach in terms of truth quantification and visual expressiveness. The second solution takes into consideration the unclear support for the reasoning under the uncertainty process, and the challenging constraint satisfaction problem in software product lines. This has been done through the development of a mathematical reasoner, which was designed to satisfy the model constraints by considering probability weight for all involved parameters and quantify the actual implications of the problem constraints. The developed Uncertain Constraint Satisfaction Problem approach has been tested and validated through a set of designated experiments. Profoundly stating, the main contributions of this thesis include the following: • Develop a framework for probabilistic graphical modeling to build the purported Bayesian belief feature model. • Extend the model to enhance visual expressiveness throughout the integration of colour degree variation; in which the colour varies with respect to the predefined probabilistic weights. • Enhance the constraints satisfaction problem by the uncertainty measuring of the parameters truth assumption. • Validate the developed approach against different experimental settings to determine its functionality and performance.

On the effect of word frequency on distributional similarity

The dependency of word similarity in vector space models on the frequency of words has been noted in a few studies, but has received very little attention. We study the influence of word frequency in a set of 10 000 randomly selected word pairs for a number of different combinations of feature weighting schemes and similarity measures. We find that the similarity of word pairs for all methods, except for the one using singular value decomposition to reduce the dimensionality of the feature space, is determined to a large extent by the frequency of the words. In a binary classification task of pairs of synonyms and unrelated words we find that for all similarity measures the results can be improved when we correct for the frequency bias.

Temporal reasoning about action and change

Abstract not available

A discrete formalism for reasoning about action and change

This paper presents a discrete formalism for temporal reasoning about actions and change, which enjoys an explicit representation of time and action/event occurrences. The formalism allows the expression of truth values for given fluents over various times including nondecomposable points/moments and decomposable intervals. Two major problems which beset most existing interval-based theories of action and change, i.e., the so-called dividing instant problem and the intermingling problem, are absent from this new formalism. The dividing instant problem is overcome by excluding the concepts of ending points of intervals, and the intermingling problem is bypassed by means of characterising the fundamental time structure as a well-ordered discrete set of non-decomposable times (points and moments), from which decomposable intervals are constructed. A comprehensive characterisation about the relationship between the negation of fluents and the negation of involved sentences is formally provided. The formalism provides a flexible expression of temporal relationships between effects and their causal events, including delayed effects of events which remains a problematic question in most existing theories about action and change.

Reasoning about change over time: Actions, events and their effects

This paper presents a new formalism for reasoning about change over time. The formalism derives a clean separation between the notion of states and situations. It allows more flexible temporal causal relationships than do other formalisms for reasoning about causal change, such as the situation calculus and the event calculus. It includes effects that start during, immediately after, or some time after their causes, and which end before, simultaneously with, or after their causes. A formal distinction between actions, action-types and events is proposed, which allows the expression of common-sense causal laws at high level. It is shown how these laws can be used to deduce state change over time at low level, when events occur under certain preconditions hold. Two problems that beset most interval-based temporal systems, i.e., the so-called dividing instant problem and intermingling problem, are absent from the formalism.

Case-based reasoning as a tool to improve the usability of numerical models

There may be advantages to be gained by combining Case-Based Reasoning (CBR) techniques with numerical models. In this paper we consider how CBR can be used as a flexible query engine to improve the usability of numerical models. Particularly they can help to solve inverse and mixed problems, and to solve constraint problems. We discuss this idea with reference to the illustrative example of a pneumatic conveyor. We describe a model of the problem of particle degradation in such a conveyor, and the problems faced by design engineers. The solution of these problems requires a system that allows iterative sharing of control between user, CBR system, and numerical model. This multi-initiative interaction is illustrated for the pneumatic conveyor by means of Unified Modeling Language (UML) collaboration and sequence diagrams. We show approaches to the solution of these problems via a CBR tool.

fuzzySim: Fuzzy similarity in species distributions

fuzzySim is an R package for calculating fuzzy similarity in species occurrence patterns. It includes functions for data preparation, such as converting species lists (long format) to presence-absence tables (wide format), obtaining unique abbreviations of species names, or transposing (parts of) complex data frames; and sample data sets for providing practical examples. It can convert binary presence-absence to fuzzy occurrence data, using e.g. trend surface analysis, inverse distance interpolation or prevalence-independent environmental favourability modelling, for multiple species simultaneously. It then calculates fuzzy similarity among (fuzzy) species distributions and/or among (fuzzy) regional species compositions. Currently available similarity indices are Jaccard, Sørensen, Simpson, and Baroni-Urbani & Buser.