Uncertainty in inherent to every aspects of medical practice. As the concept of uncertainty in healthcare is still to explore, deciphering the determinants and the roots of this uncertainty would benefit from the insights of various disciplines, such as epistemology, sociology, mathematics, or philosophy. The urgent need to improve physician's ability to cope with uncertainty, has been recently highlighted by the COVID-19 pandemic. Besides, the concept of uncertainty tolerance has been proposed, and could serve as a relevant basis for approaching uncertainty, in medical education. Thus, we propose at first to discuss the uncertainty tolerance framework from Hillen et al. Then, from an educational perspective, we outline some avenues regarding how uncertainty tolerance could be thought, in a competence-based approach, and discuss several educational activities, which have proven efficient in promoting uncertainty tolerance among medical practitioners abroad.
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http://dx.doi.org/10.1016/j.revmed.2022.10.387 | DOI Listing |
Sci Rep
January 2025
Radiological Techniques Department, College of Health and Medical Techniques, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.
This paper proposes a hybrid stochastic-robust optimization framework for sizing a photovoltaic/tidal/fuel cell (PV/TDL/FC) system to meet an annual educational building demand based on hydrogen storage via unscented transformation (UT), and information gap decision theory-based risk-averse strategy (IGDT-RA). The hybrid framework integrates the strengths of UT for scenario generation and IGDT-RA (hybrid UT-IGDT-RA) for optimizing the system robustness and maximum uncertainty radius (MRU) of building energy demand and renewable resource generation. The deterministic model focuses on minimizing the cost of energy production over the project's lifespan (CEPLS) and considers a reliability constraint defined as the demand shortage probability (DSHP).
View Article and Find Full Text PDFBull Cancer
January 2025
Palliative Care Unit, ULR 2694 METRICS, CHU de Lille, Université de Lille, 59000 Lille, France.
Introduction: Immune checkpoint inhibition has revolutionized the management of metastatic melanoma, including in the final stages of disease progression: because it is well tolerated, some teams do not discontinue it in hopes of slowing disease progression. The risks are that treatment may be continued unnecessarily, causing side effects, and reduce access to specialist palliative care, in addition to increasing the cost of treatment.
Method: We explored the experiences of 10 patients in a university hospital with metastatic melanoma under continued immune checkpoint inhibitors combined with specialist palliative care.
PLoS One
January 2025
College of Mining, Liaoning Technical University, Fuxin, Liaoning Province, People's Republic of China.
The determination of optimal production capacity for open-pit mines is influenced by various economic and technical factors and is highly susceptible to uncertainties. To effectively address the impact of uncertainty on capacity planning, this study develops a production capacity planning model for open-pit coal mines, based on the theory of economies of scale and incorporating multiple uncertainty constraints. A novel method is proposed to quantify and propagate the uncertainties of key capacity control factors, alongside a comprehensive uncertainty analysis framework for total revenue.
View Article and Find Full Text PDFAm J Physiol Heart Circ Physiol
January 2025
Department of Pharmacology, Physiology and Neurobiology, University of Cincinnati College of Medicine, Cincinnati, OH.
Lower body negative pressure (LBNP) has been used for decades in humans to model arterial baroreceptor unloading and represents a powerful tool for evaluating cardiovascular responses to orthostatic challenge. However, LBNP studies in animals have been limited to conditions of anesthesia or sedation, where cardiovascular reflexes are altered. Given the consequent uncertainties, the usefulness of LBNP studies in these preclinical models has been severely hampered.
View Article and Find Full Text PDFXenobiotica
January 2025
Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Idiopathic Pulmonary Fibrosis (IPF) is a chronic respiratory disorder for which pirfenidone is the recommended first-line anti-fibrotic treatment. While pirfenidone has demonstrated efficacy in slowing the progression of IPF, its use is associated with several challenges and unresolved issues that impact patient outcomes. Pirfenidone administration can result in gastrointestinal side effects, photosensitivity reactions, and significant drug interactions, particularly in patients with hepatic impairment.
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