Possibilistic response surfaces: incorporating fuzzy thresholds into bottom-up flood vulnerability analysis

Several alternatives have been proposed to shift the paradigms of water management under uncertainty from predictive to decision-centric. An often-mentioned tool is the response surface mapping system performance with a large sample of future hydroclimatic conditions through a stress test. Dividing this exposure space between acceptable and unacceptable states requires a criterion of acceptable performance defined by a threshold. In practice, however, stakeholders and decision-makers may be confronted with ambiguous objectives for which the acceptability threshold is not clearly defined (crisp). To accommodate such situations, this paper integrates fuzzy thresholds to the response surface tool. Such integration is not straightforward when response surfaces also have their own irreducible uncertainty from the limited number of descriptors and the stochasticity of hydroclimatic conditions. Incorporating fuzzy thresholds, therefore, requires articulating categories of imperfect knowledge that are different in nature, i.e., the irreducible uncertainty of the response itself relative to the variables that describe change and the ambiguity of the acceptability threshold. We, thus, propose possibilistic surfaces to assess flood vulnerability with fuzzy acceptability thresholds. An adaptation of the logistic regression for fuzzy set theory combines the probability of an acceptable outcome and the ambiguity of the acceptability criterion within a single possibility measure. We use the flood-prone reservoir system of the Upper Saint François River basin in Canada as a case study to illustrate the proposed approach. Results show how a fuzzy threshold can be quantitatively integrated when generating a response surface and how ignoring it might lead to different decisions. This study suggests that further conceptual developments could link the reliance on acceptability thresholds in bottom-up assessment frameworks with the current uses of fuzzy set theory.

Possibilistic response surfaces: incorporating fuzzy thresholds into bottom-up flood vulnerability analysis

Several alternatives have been proposed to shift the paradigms of water management under uncertainty from predictive to decision-centric. An often-mentioned tool is the stress-test response surface, mapping system performance to a large sample of future hydro-climatic conditions. Dividing this exposure space between acceptable and unacceptable states requires a criterion of acceptable performance defined by a threshold. In practice, however, stakeholders and decision-makers may be confronted with ambiguous objectives for which the the acceptability threshold is not clearly defined (crisp). To accommodate such situations, this paper integrates fuzzy thresholds to the response surface tool. Such integration is not straightforward when response surfaces also have their own irreducible uncertainty, from the limited number of descriptors and the stochasticity of hydro-climatic conditions. Incorporating fuzzy thresholds therefore requires articulating uncertainties that are different in nature: the irreducible uncertainty of the response itself relative to the variables that describe change, and the ambiguity of the acceptability threshold. We thus propose possibilistic surfaces to assess flood vulnerability with fuzzy acceptability thresholds. An adaptation of the logistic regression for fuzzy set theory combines the probability of acceptable outcome and the ambiguity of the acceptability criterion within a single possibility measure. We use the flood-prone reservoir system of the Upper Saint-François River Basin in Canada as a case study to illustrate the proposed approach. Results show how a fuzzy threshold can be quantitatively integrated when generating a response surface, and how ignoring it might lead to different decisions. This study suggests that further theoretical development should link the decision-making under deep uncertainty framework with the existing experience of fuzzy set theory, notably for hydro-climatic vulnerability analysis.

Color Stability of Ceramic Veneers Luted With Resin Cements and Pre-Heated Composites: 12 Months Follow-Up

The objective was to evaluate the color stability of ceramic veneers luted with resin cements and pre-heated composite resins (60oC) for 12 months, and determine the degree of conversion (DC) of the luting agents. Two resin cements (AllCem Veneer, light-cured (LRC) and AllCem, dual-cured (DRC)] and three composite resins [Z100 (MNCR-minifilled), Herculite Classic (MHCR-micro-hybrid) and Durafill (MCCR-microfilled)] were used for cementing 0.8-mm-thick lithium-silicate glass-ceramic laminates (Suprinity, shade B2-HT, Vita) on bovine enamel (n=10). The specimens were stored at 37oC in distilled water. CIELab parameters were determined at 24h after luting (baseline), 7, 30, 90, 180 days and 12 months. Three specimens were prepared for DC evaluation, performed by micro-Raman spectroscopy. Data were analyzed by ANOVA and Tukey’s test (a=5%). For ΔEab and ΔE00, there were significant differences for luting material (p<0.001), time (p<0.001), and double interaction (p<0.001). The groups cemented with MHCR (1 year), MCCR (90 days and 1 year) and MCCR-PH (1 year) were the ones with ΔE values greater than the acceptability threshold. All other groups maintained their ΔE lower than the acceptability threshold after 1 year in distilled water. Regarding DC, there were no significant differences (p=0.127) among the materials. Non-significant negative correlations were observed between the mean ΔEab and DC (R=-0.65) and ΔE00 and DC (R=-0.64). A significant positive correlation was observed mean ΔEab and ΔE00 (R=0.99). It was concluded that the different luting agents influenced the final color of the restorations. The heating of the composite resins did not affect their DC.

Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations

Background. Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations are unclear. The aim of this study was to evaluate the impacts of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations. Methods. Forty A2 shade veneered zirconia disk specimens (10 mm in diameter) were fabricated, with veneering porcelain thicknesses of 1.6, 1.8, 2.0 and 2.2 mm. Three backgrounds were made of A2 shade composite resin (A2), nickel-chromium alloy (NC) and amalgam (AM). The veneered zirconia specimens were placed on the backgrounds. CIELab values were measured with a spectrophotometer. ΔE values were measured to determine color differences between the specimens and the A2 VITA classical shade (target shade). ΔE values were compared with an acceptability threshold (ΔE=3.7). Repeated measures ANOVA, Bonferroni, and 1-sample t-test were used to analyze data (P<0.05). Results. Mean ΔE values ranged between 1.9 and 5.0. The veneering porcelain thickness, the background shade and their interaction affected the ΔE (P<0.0001). The minimum veneering porcelain thickness for the shade match was 2 mm for NC and 1.8 mm for AM. Conclusion. Veneering porcelain thickness and background shade affected the shade match of zirconia-based restorations. With dark-shaded backgrounds, the amount of veneering porcelain thickness needed for the shade match might be beyond acceptable clinical limits. Tooth-shaded backgrounds are esthetically advocated rather than dark-shaded backgrounds in zirconia-based restorations.

Stochastic satisficing account of confidence in uncertain value-based decisions

Every day we make choices under uncertainty; choosing what route to work or which queue in a supermarket to take, for example. It is unclear how outcome variance, e.g. uncertainty about waiting time in a queue, affects decisions and confidence when outcome is stochastic and continuous. How does one evaluate and choose between an option with unreliable but high expected reward, and an option with more certain but lower expected reward? Here we used an experimental design where two choices’ payoffs took continuous values, to examine the effect of outcome variance on decision and confidence. We found that our participants’ probability of choosing the good (high expected reward) option decreased when the good or the bad options’ payoffs were more variable. Their confidence ratings were affected by outcome variability, but only when choosing the good option. Unlike perceptual detection tasks, confidence ratings correlated only weakly with decisions’ time, but correlated with the consistency of trial-by-trial choices. Inspired by the satisficing heuristic, we propose a “stochastic satisficing” (SSAT) model for evaluating options with continuous uncertain outcomes. In this model, options are evaluated by their probability of exceeding an acceptability threshold, and confidence reports scale with the chosen option’s thus-defined satisficing probability. Participants’ decisions were best explained by an expected reward model, while the SSAT model provided the best prediction of decision confidence. We further tested and verified the predictions of this model in a second experiment. Our model and experimental results generalize the models of metacognition from perceptual detection tasks to continuous-value based decisions. Finally, we discuss how the stochastic satisficing account of decision confidence serves psychological and social purposes associated with the evaluation, communication and justification of decision-making.Author SummaryEvery day we make several choices under uncertainty, like choosing a queue in a supermarket. However, the computational mechanisms underlying such decisions remain unknown. For example, how does one choose between an option with unreliable high expected reward, like the volatile express queue, and an option with more certain but lower expected reward in the standard queue? Inspired by bounded rationality and the notion of ‘satisficing’, i.e. settling for a good enough option, we propose that such decisions are made by comparing the likelihood of different actions to surpass an acceptability threshold. When facing uncertain decisions, our participants’ confidence ratings were not consistent with the expected outcome’s rewards, but instead followed the satisficing heuristic proposed here. Using an acceptability threshold may be especially useful when evaluating and justifying decisions under uncertainty.

Readability and Suitability of COPD Consumer Information

Background. Information leaflets have been shown to positively or negatively impact adherence, depending on their content. The objective of this study was to perform an appraisal of the consumer information provided in COPD inhaler monographs. Methods. COPD inhalers were identified from the Health Canada Drug Product Database. Medication information and instructions for inhaler use were analyzed for readability by seven formulas, with an acceptability threshold of grades 6–8. Three researchers rated suitability using a modified Suitability Assessment of Materials (SAM) tool and assessed leaflets for explicit warnings. Results. Twenty-six inhalers with a COPD indication were evaluated. Medication information sections were rated as “difficult to read” or “hard,” and 85% (22/26) had a reading level above grade 8. The instructions for inhaler use were rated as “easy” or “fairly easy” to read and 63% (16/26) met the threshold by all formulas. While all leaflets achieved superior suitability ratings, extreme warnings included risk of premature death (n=12), risks of serious injury (n=26), serious interactions (n=26), and statements that convey a serious consequence to therapy (n=26). Conclusion. While COPD information leaflets in Canada performed well in terms of readability and suitability, overemphasis on side effects, warnings, and precautions may contribute to patient fear and nonadherence.

Usefulness of Adenosinetriphosphate Bioluminescence Assay (ATPmetry) for Monitoring the Reprocessing of Endoscopes

OBJECTIVETo assess the diagnostic value of an adenosinetriphosphate bioluminescence assay (ATPmetry) to monitor the effectiveness of the reprocessing of endoscopes compared with microbiologic sampling.DESIGNDiagnostic study.SETTINGA 2,200-bed teaching hospital performing 5,000 to 6,000 endoscopic procedures annually.INCLUSION CRITERIAAll samples from bronchial or gastrointestinal endoscopes whatever the context.METHODSSamples for microbiologic analysis and ATPmetry measurements were taken when each endoscope was inspected following reprocessing. Sampling was performed by flushing each endoscope with 300 mL Neutralizing Pharmacopeia Diluent thiosulfate rinsing solution divided equally between the endoscope channels. For each endoscope a series of 3 ATPmetry measurements were made on a vial containing the first jet from each channel and a second series on the whole sample.RESULTSOf 165 samples from endoscopes, 11 exceeded the acceptability threshold of 25 colony-forming units/endoscope. In the first jet collected, the median (interquartile range) level of ATPmetry was 30.5 (15.3–37.7) relative light units (RLU) for samples with 25 or fewer colony-forming units compared with 37.0 (34.7–39.3) RLU for samples with more than 25 colony-forming units (P=.008). For the whole sample, the median (interquartile range) level of ATPmetry was 24.8 (14.3–36.3) RLU and 36.3 (36.0–38.3) RLU (P=.006), respectively. After adjusting on the batch of cleansing solution used, no difference in ATPmetry values was found between microbiologically acceptable and unacceptable samples.CONCLUSIONATPmetry cannot be used as an alternative or complementary approach to microbiologic tests for monitoring the reprocessing of endoscopes in FranceInfect. Control Hosp. Epidemiol. 2015;36(12):1437–1443

Spectrophotometric color evaluation of permanent incisors, canines and molars. A cross-sectional clinical study

Background and aims. An accurate color reproduction represents the final validation level of an esthetic anterior or posterior restoration. The aim of this study was to evaluate the color of permanent maxillary incisors, canines and molars, using a clinical spectrophotometer.Methods. The Vita Easyshade Advance 4.0® intraoral spectrophotometer was used by one clinician to determine the color of 369 permanent maxillary incisors, canines and molars. The best matches to Vitapan Classical® and 3D-Master® shade guides were recorded. A one-way analysis of variance and Kruskal-Wallis test were used to compare L*, a*, b*, c* and h* color coordinates among the 3 types of teeth. Differences between the mean values of all color coordinates were evaluated by use of Bonferroni corrections. Color difference (ΔE*) between incisors, canines and molars was calculated from ΔL*, Δa* and Δb* data and the results were compared to ΔE*=3.3 acceptability threshold.Results. Except for Δa* and Δh* between canines and molars, statistically significant differences among the mean differences of all color coordinates were found when the 3 types of teeth were compared by pairs. The most frequently measured shades were A1 (48.4%), respectively 1M1 (31.5%) for incisors, B3 (36.6%), respectively 2M3 (39.8%) for canines and B3 (44.7%), respectively 2M3 (52%) for molars. Incisors had the highest lightness values, followed by canines and molars. Molars were the most chromatic with the highest a* and b* values.Conclusions. Despite the limitations of this study, color differences among incisors, canines and molars were found to be statistically significant, above the clinical acceptability threshold established. In conclusion, successful esthetic restorations of permanent teeth of the same patient need an individual color assessment and reproduction of every type of tooth.