Mit zweierlei Maß: Die mangelnde Verbindlichkeit von Patientenverfügungen bei untergebrachten Personen mit psychischen Störungen in der Schweiz

Definition of the problem

Full age patients with mental disorders and preserved decision-making capacity are increasingly interested in drafting advance directives. Whereas in Switzerland (as well as in Germany) advance directives are binding in principle, an advance directive is not binding and has only to be considered in case of involuntary admission due to a mental disorder. Thereby, the virtual aim of an advance directive – the anticipated self-determination – is questioned.

Arguments

From an ethical perspective, patients with mental disorders have the same rights as patients with somatic diseases. Therefore, the question arises if there are good reasons for this unequal treatment. In the present contribution, four possible reasons are analyzed: (1) persons with mental disorders are “different”; (2) protection from self-harm; (3) often not present end-of-life context; (4) reduced bindingness as the more appropriate standard in general.

Conclusion

The authors come to the conclusion that patients with mental disorders are often capable of composing a valid advance directive, and just as any other human being, they have a principal and binding right for self-determination, even though they are particularly vulnerable in crisis situations.

     

Extended Reflexive Ontologies for the Generation of Clinical Recommendations

Decision recommendations are a set of alternative options for clinical decisions (e.g., diagnosis, prognosis, treatment selection, follow-up, and prevention) that are provided to decision makers by knowledge-based Clinical Decision Support Systems (k-CDSS) as aids. We propose to follow a “reasoning over domain” approach for the generation of decision recommendations by gathering and inferring conclusions from production rules. In order to rationalize our approach, we present a specification that will sustain the logic models supported in the knowledge bases we use for persistence. We introduce first the underlying knowledge model and then the necessary extensions that will convey toward the solution of the reported needs. The starting point of our approach is the proposition of Reflexive Ontologies (RO). Here, we go a step further, proposing an extension of RO that includes the handling and reasoning that production rules provide. Our approach speeds up the recommendation generation process.     

Real time motion estimation using a neural architecture implemented on GPUs

This work describes a neural network based architecture that represents and estimates object motion in videos. This architecture addresses multiple computer vision tasks such as image segmentation, object representation or characterization, motion analysis and tracking. The use of a neural network architecture allows for the simultaneous estimation of global and local motion and the representation of deformable objects. This architecture also avoids the problem of finding corresponding features while tracking moving objects. Due to the parallel nature of neural networks, the architecture has been implemented on GPUs that allows the system to meet a set of requirements such as: time constraints management, robustness, high processing speed and re-configurability. Experiments are presented that demonstrate the validity of our architecture to solve problems of mobile agents tracking and motion analysis.     

Proteomics in aortic aneurysm – What have we learnt so far?

Aortic aneurysm is a deceptively indolent disease that can cause severe complications such as aortic rupture and dissection. In the normal aorta, vascular smooth muscle cells within the medial layer produce and sustain the extracellular matrix (ECM) that provides structural support but also retains soluble growth factors and regulates their distribution. Although the ECM is an obvious target to identify molecular processes leading to structural failure within the vessel wall, an in-depth proteomics analysis of this important sub-proteome has not been performed. Most proteomics analyses of the vasculature to date used homogenized tissue devoid of spatial information. In such homogenates, quantitative proteomics comparisons are hampered by the heterogeneity of clinical samples (i.e. cellular composition) and the dynamic range limitations stemming from highly abundant cellular proteins. An unbiased proteomics discovery approach targeting the ECM instead of the cellular proteome may decipher the complex, multivalent signals that are presented to cells during aortic remodelling. A better understanding of the ECM in healthy and diseased vessels will provide important pathogenic insights and has potential to reveal novel biomarkers.     

Interior-point methods for symmetric optimization based on a class of non-coercive kernel functions

In this paper, we generalize polynomial-time primal–dual interior-point methods for symmetric optimization based on a class of kernel functions, which is not coercive. The corresponding barrier functions have a finite value at the boundary of the feasible region. They are not exponentially convex and also not strongly convex like many usual barrier functions. Moreover, we analyse the accuracy of the algorithm for this class of functions and we obtain an upper bound for the accuracy which depends on a parameter of the class.     

Variable Structure Control with chattering elimination and guaranteed stability for a generalized T-S model

In this paper, a fuzzy based Variable Structure Control (VSC) with guaranteed stability is presented. The main objective is to obtain an improved performance of highly non-linear unstable systems. The main contribution of this work is that, firstly, new functions for chattering reduction and error convergence without sacrificing invariant properties are proposed, which is considered the main drawback of the VSC control. Secondly, the global stability of the controlled system is guaranteed.The well known weighting parameters approach, is used in this paper to optimize local and global approximation and modeling capability of T-S fuzzy model.A one link robot is chosen as a nonlinear unstable system to evaluate the robustness, effectiveness and remarkable performance of optimization approach and the high accuracy obtained in approximating nonlinear systems in comparison with the original T-S model. Simulation results indicate the potential and generality of the algorithm. The application of the proposed FLC-VSC shows that both alleviation of chattering and robust performance are achieved with the proposed FLC-VSC controller. The effectiveness of the proposed controller is proven infront of disturbances and noise effects.     

A document is known by the company it keeps: neighborhood consensus for short text categorization

During the last decades the Web has become the greatest repository of digital information. In order to organize all this information, several text categorization methods have been developed, achieving accurate results in most cases and in very different domains. Due to the recent usage of Internet as communication media, short texts such as news, tweets, blogs, and product reviews are more common every day. In this context, there are two main challenges; on the one hand, the length of these documents is short, and therefore, the word frequencies are not informative enough, making text categorization even more difficult than usual. On the other hand, topics are changing constantly at a fast rate, causing the lack of adequate amounts of training data. In order to deal with these two problems we consider a text classification method that is supported on the idea that similar documents may belong to the same category. Mainly, we propose a neighborhood consensus classification method that classifies documents by considering their own information as well as information about the category assigned to other similar documents from the same target collection. In particular, the short texts we used in our evaluation are news titles with an average of 8 words. Experimental results are encouraging; they indicate that leveraging information from similar documents helped to improve classification accuracy and that the proposed method is especially useful when labeled training resources are limited.     

Forecasting binary longitudinal data by a functional PC-ARIMA model

In order to forecast time evolution of a binary response variable from a related continuous time series a functional logit model is proposed. The estimation of this model from discrete time observations of the predictor is solved by using functional principal component analysis and ARIMA modelling of the associated discrete time series of principal components. The proposed model is applied to forecast the risk of drought from El Niño phenomenon.     

Recognition of circular patterns on GPUs: Performance analysis and contributions

We develop a novel approach for computing the circle Hough transform entirely on graphics hardware (GPU). A primary role is assigned to vertex processors and the rasterizer, overshadowing the traditional foreground of pixel processors and enhancing parallel processing. Resources like the vertex cache or blending units are studied too, with our set of optimizations leading to extraordinary peak gain factors exceeding 358x over a typical CPU execution. Software optimizations, like the use of precomputed tables or gradient information and hardware improvements, like hyperthreading and multicores are explored on CPUs as well. Overall, the GPU exhibits better scalability and much greater parallel performance to become a solid alternative for computing the classical circle Hough transform versus those optimal methods run on emerging multicore architectures.