Background: The reported incidence of postoperative residual curarisation (PORC) is still unacceptably high. The capacity of intraoperative neuromuscular monitoring (NMM) to reduce the incidence of PORC has yet to be established from pooled clinical studies. We conducted a meta-analysis of data from 1979 to 2019 to reanalyse this relationship. Methods: English language, peer-reviewed, and operation room adult anaesthesia setting articles published between 1979 and 2019 were searched for on PubMed, Cochrane Central Register of Controlled Trials, ISI-WoK, and Scopus. The primary outcome was PORC incidence as defined by an at-or post-extubation train-of-four ratio (TOFR) of lower than 0.7, 0.9, or 1.0. Additional collected variables included the duration of action of neuromuscular blocking agents (NMBAs) used, sugammadex or neostigmine use, and the technique of anaesthesia maintenance. Results: Fifty-three studies (109 study arms, 12 664 patients) were included. The pooled PORC incidence associated with the use of intermediate duration NMBAs and quantitative NMM was 0.115 (95% confidence interval [CI], 0.057e0.188). This was significantly lower than the PORC rate for both qualitative NMM (0.306; 95% CI, 0.09e0.411) and no NMM (0.331; 95% CI, 0.234e0.435). Anaesthesia type did not significantly affect PORC incidence. Sugammadex use was associated with lower PORC rates. The GRADE global level of evidence was very low and the refined assessment of the network metaanalysis by means of a confidence in network meta-analysis raised concerns on within-and across-study bias. Conclusions: Quantitative NMM outperforms both subjective and no NMM monitoring in reducing PORC as defined by a TOFR of <0.9.

This paper conducts an empirical study that explores the differences between adopting a traditional conceptual modeling (TCM) technique and an ontology-driven conceptual modeling (ODCM) technique with the objective to understand and identify in which modeling situations an ODCM technique can prove beneficial compared to a TCM technique. More specifically, we asked ourselves if there exist any meaningful differences in the resulting conceptual model and the effort spent to create such model between novice modelers trained in an ontologydriven conceptual modeling technique and novice modelers trained in a traditional conceptual modeling technique. To answer this question, we discuss previous empirical research efforts and distill these efforts into two hypotheses. Next, these hypotheses are tested in a rigorously developed experiment, where a total of 100 students from two different Universities participated. The findings of our empirical study confirm that there do exist meaningful differences between adopting the two techniques. We observed that novice modelers applying the ODCM technique arrived at higher quality models compared to novice modelers applying the TCM technique. More specifically, the results of the empirical study demonstrated that it is advantageous to apply an ODCM technique over an TCM when having to model the more challenging and advanced facets of a certain domain or scenario. Moreover, we also did not find any significant difference in effort between applying these two techniques. Finally, we specified our results in three findings that aim to clarify the obtained results.

No abstract

Abstract. Ontology-driven conceptual modeling (ODCM) is still a relatively new research domain in the field of information systems and there is still much discussion on how the research in ODCM should be performed and what the focus of this research should be. Therefore, this article aims to critically survey the existing literature in order to assess the kind of research that has been performed over the years, analyze the nature of the research contributions and establish its current state of the art by positioning, evaluating and interpreting relevant research to date that is related to ODCM. To understand and identify any gaps and research opportunities, our literature study is composed of both a systematic mapping study and a systematic review study. The mapping study aims at structuring and classifying the area that is being investigated in order to give a general overview of the research that has been performed in the field. A review study on the other hand is a more thorough and rigorous inquiry and provides recommendations based on the strength of the found evidence. Our results indicate that there are several research gaps that should be addressed and we further composed several research opportunities that are possible areas for future research. IntroductionConceptual models were introduced to increase understanding and communication of a system or domain among stakeholders. According to Stachowiak (1973), a conceptual model possesses three features: (1) a mapping feature, meaning that a model can be seen as a representation of the 'original' system, which is expressed through a modeling language; (2) a reduction feature, characterizing the model as only a subset of the original system and (3) the pragmatics of a model which describes its intended purpose or objective.Conceptual modeling is the activity of representing aspects of the physical and social world for the purpose of communication, learning and problem solving among human users (Mylopoulos, 1992). Conceptual modeling has gained much attention especially in the field of information systems, for design, analysis and development purposes. Their importance was understood in the 1960s, since they facilitate detection and correction of system development errors (Wand & Weber, 2002). The higher the quality of conceptual models, the earlier the 2 detection and correction of these errors occurs. This increase in attention and importance attributed to conceptual modeling led to the development and introduction of a wide range of various conceptual modeling approaches and techniques. Criticism however arose, stating that these approaches and techniques still lacked a comprehensive and generally acknowledged understanding (Moody, 2005). In addition, many conceptual models lacked an adequate specification of the semantics of the terminology of the underlying models, which led to inconsistent interpretations and uses of knowledge (Grüninger, Atefi, & Fox, 2000). In order to provide a foundation for conceptual modeling, ontologies were introduced. As mentio...

This paper presents an empirical study that investigates the extent to which the pragmatic quality of ontology-driven models is influenced by the choice of a particular ontology, given a certain understanding of that ontology. To this end, we analyzed previous research efforts and distilled three hypotheses based on different metaphysical characteristics. An experiment based on two foundational ontologies (UFO and BORO) involving 158 participants was then carried out, followed by a protocol analysis to gain further insights into the results of experiment. We then extracted five derivations from the results of the empirical study in order to summarize our findings. Overall, the results confirm that the choice of a foundational ontology can lead to significant differences in the interpretation and comprehension of the conceptual models produced. Moreover, the effect of applying a certain foundational ontology can cause considerable variations in the effort required to comprehend these models.

No abstract

Many Distributed Ledger Technology (DLT) projects end prematurely without reaping benefits. Previous research has indicated a lack of sustainable business cases for many Blockchain projects. A successful project has a disruptive impact on the business ecosystem. The paper investigates how e 3 value modeling can contribute to identifying the potential success of DLT implementation. Using insights from a first DLT case-study, an abstract e 3 value model fragment is defined that indicates potential success. As a test, the e 3 value model fragment is subsequently applied to a second case-study that is currently being implemented as a DLT-based platform. The paper concludes by reflecting on how an e 3 value model can provide evidence of meeting the requirements for building a sustainable DLT business case.

In a double-masked group comparative study, 20 patients received 2% nedocromil sodium four times daily and 23 placebo eye drops, for treatment of perennial allergic conjunctivitis (PAC). All had at least a one-year diagnosis of bilateral PAC and remained symptomatic despite using 2% sodium cromoglycate eye drops four times daily for at least 14 days Symptom severity (0-4) during sodium cromoglycate monotherapy was then recorded in a one-week baseline prior to randomisation, a minimum total score of 11 being mandatory. During the trial, no eye medication was allowed other than the test treatment. Clinic examinations were made before and after baseline and after one, three and six weeks' treatment, and patients kept daily diary cards of eye symptom severity. Compared to placebo, nedocromil sodium significantly (p<0.05) improved diary scores for itching (weeks 3, 4, 5, 6), total symptoms (weeks 5, 6) and general eye condition (week 6). Mean scores over the final four weeks, allowing a two-week washout, showed similar improvements in itching (p = 0.01), total symptoms (p = 0.05) and general eye condition (p = 0.04). Clinical assessments again favoured nedocromil sodium, which improved itching (week 3, p = 0.002), burning (week 6, p = 0.007), overall eye condition (weeks 3-6, p<0.05). and conjunctival thickening and hyperaemia (weeks 3-6, p<0.05). Finally, both patient (p = 0.02) and clinician (p = 0.0015) opinions of efficacy favoured nedocromil sodium over placebo. These results show nedocromil sodium to be effective in controlling symptoms of perennial allergic conjunctivitis which persisted during treatment with sodium cromoglycate.