Smart Evaluation of Instrument Scan Pattern Using State Transition Model During Flight Simulator Training

Author(s):  
Kavyaganga Kilingaru ◽  
Zorica Nedic ◽  
Jeffrey Tweedale ◽  
Steve Thatcher
2020 ◽  
Vol 40 (8) ◽  
pp. 1003-1019
Author(s):  
Ingrid E. H. Kremer ◽  
Mickael Hiligsmann ◽  
Josh Carlson ◽  
Marita Zimmermann ◽  
Peter J. Jongen ◽  
...  

Background Up to 31% of patients with relapsing-remitting multiple sclerosis (RRMS) discontinue treatment with disease-modifying drug (DMD) within the first year, and of the patients who do continue, about 40% are nonadherent. Shared decision making may decrease nonadherence and discontinuation rates, but evidence in the context of RRMS is limited. Shared decision making may, however, come at additional costs. This study aimed to explore the potential cost-effectiveness of shared decision making for RRMS in comparison with usual care, from a (limited) societal perspective over a lifetime. Methods An exploratory economic evaluation was conducted by adapting a previously developed state transition model that evaluates the cost-effectiveness of a range of DMDs for RRMS in comparison with the best supportive care. Three potential effects of shared decision making were explored: 1) a change in the initial DMD chosen, 2) a decrease in the patient’s discontinuation in using the DMD, and 3) an increase in adherence to the DMD. One-way and probabilistic sensitivity analyses of a scenario that combined the 3 effects were conducted. Results Each effect separately and the 3 effects combined resulted in higher quality-adjusted life years (QALYs) and costs due to the increased utilization of DMD. A decrease in discontinuation of DMDs influenced the incremental cost-effectiveness ratio (ICER) most. The combined scenario resulted in an ICER of €17,875 per QALY gained. The ICER was sensitive to changes in several parameters. Conclusion This study suggests that shared decision making for DMDs could potentially be cost-effective, especially if shared decision making would help to decrease treatment discontinuation. Our results, however, may depend on the assumed effects on treatment choice, persistence, and adherence, which are actually largely unknown.


1982 ◽  
Vol 30 (12) ◽  
pp. 2506-2513 ◽  
Author(s):  
G. Bochmann ◽  
E. Cerny ◽  
M. Gagne ◽  
C. Jard ◽  
A. Leveille ◽  
...  

Author(s):  
Pitro Zafiropulo ◽  
Colin H. West ◽  
Harry Rudin ◽  
D. D. Cowan ◽  
Daniel Brand

Author(s):  
Satoshi Kanai ◽  
Takeshi Kishinami

Abstract This paper describes a visual simulation tool for reliable off-line development, verification and debugging of the control code of the Programmable Logic Controller (PLC) in the sequence control system. First, we discuss the uniform modeling method of the dynamic behavior of various components in a factory (actuators, sensors, operating panels, etc.) as the object model and state transition model. Then we propose the implementation method of the object model by VRML and JAVA. They enable us to uniformly describe the state-transition and corresponding dynamic behavior of the 3-D geometry of each object model. Moreover, we can use a standard VRML viewer which has the event-driven execution mechanism as a visual simulation tool. The effectiveness of proposed implementation and simulation is confirmed through the case study on the co-simulation of combining the component model with a real PLC.


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