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Decision model

Emma Monte, Manuel Rosa Garrido, Thomas M Vondriska, Jessica Wang
The past two decades have witnessed a rapid evolution in our ability to measure RNA and protein from biological systems. As a result, new principles have arisen regarding how information is processed in cells, how decisions are made, and the role of networks in biology. This essay examines this technological evolution, reviewing (and critiquing) the conceptual framework that has emerged to explain how RNA and protein networks control cellular function. We identify how future investigations into transcriptomes, proteomes, and other cellular networks will enable development of more robust, quantitative models of cellular behavior whilst also providing new avenues to use knowledge of biological networks to improve human health...
September 15, 2016: Comprehensive Physiology
Catherine Hankins, Mitchell Warren, Emmanuel Njeuhmeli
Over 11 million voluntary medical male circumcisions (VMMC) have been performed of the projected 20.3 million needed to reach 80% adult male circumcision prevalence in priority sub-Saharan African countries. Striking numbers of adolescent males, outside the 15-49-year-old age target, have been accessing VMMC services. What are the implications of overall progress in scale-up to date? Can mathematical modeling provide further insights on how to efficiently reach the male circumcision coverage levels needed to create and sustain further reductions in HIV incidence to make AIDS no longer a public health threat by 2030? Considering ease of implementation and cultural acceptability, decision makers may also value the estimates that mathematical models can generate of immediacy of impact, cost-effectiveness, and magnitude of impact resulting from different policy choices...
2016: PloS One
Wendy S Bibeau, Haoda Fu, April D Taylor, Anita Y M Kwan
BACKGROUND: Medication adherence is pivotal for the successful treatment of diabetes. However, medication adherence remains a major concern, as nonadherence is associated with poor health outcomes. Studies have indicated that increasing patients' share of medication costs significantly reduces adherence. Little is known about a potential out-of-pocket (OOP) cost threshold where substantial reduction in adherence may occur. OBJECTIVE: To examine the impact of diabetes OOP pharmacy costs on antihyperglycemic medication adherence and identify the potential threshold at which significant reduction in adherence may occur among patients with type 2 diabetes mellitus (T2DM)...
November 2016: Journal of Managed Care & Specialty Pharmacy
JaeJin An
BACKGROUND: Current evidence suggests that patient-centered medical homes (PCMHs) potentially increase overall quality of disease management, including preventive care. However, there are mixed findings regarding quality of diabetes care, and little evidence exists with respect to the effect of PCMHs on medication adherence in patients with diabetes. OBJECTIVE: To investigate associations between PCMHs and process measures of diabetes care, as well as adherence to oral hypoglycemic agents (OHAs) in patients with diabetes in a nationally representative U...
November 2016: Journal of Managed Care & Specialty Pharmacy
Jason Shafrin, Taylor T Schwartz, Darius N Lakdawalla, Felicia M Forma
BACKGROUND: Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Samantha N Hood, Ivan Kassal
Although organic heterojunctions can separate charges with near-unity efficiency and on a sub-picosecond timescale, the full details of the charge-separation process remain unclear. In typical models, the Coulomb binding between the electron and the hole can exceed the thermal energy kT by an order of magnitude, suggesting that it is impossible for the charges to separate before recombining. Here, we consider the entropic contribution to charge separation in the presence of disorder and find that even modest amounts of disorder have a decisive effect, reducing the charge-separation barrier to about kT or eliminating it altogether...
October 26, 2016: Journal of Physical Chemistry Letters
Linhai Wu, Guoyan Xu, Qingguang Li, Bo Hou, Wuyang Hu, Jianhua Wang
Dead pigs are a major waste by-product of pig farming. Thus, safe disposal of dead pigs is important to the protection of consumer health and the ecological environment by preventing marketing of slaughtered and processed dead pigs and improper dumping of dead pigs. In this study, a probability model was constructed for the disposal of dead pigs by pig farmers by selecting factors affecting disposal. To that end, we drew on the definition and meaning of behavior probability based on survey data collected from 654 pig farmers in Funing County, Jiangsu Province, China...
October 26, 2016: Environmental Science and Pollution Research International
L Guariguata, C Guell, T A Samuels, E A J A Rouwette, J Woodcock, I R Hambleton, N Unwin
BACKGROUND: Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries...
October 26, 2016: Health Research Policy and Systems
Vaibhav Jain, Prabal K Maiti, Prasad V Bharatam
Computational studies performed on dendrimer-drug complexes usually consider 1:1 stoichiometry, which is far from reality, since in experiments more number of drug molecules get encapsulated inside a dendrimer. In the present study, molecular dynamic (MD) simulations were implemented to characterize the more realistic molecular models of dendrimer-drug complexes (1:n stoichiometry) in order to understand the effect of high drug loading on the structural properties and also to unveil the atomistic level details...
September 28, 2016: Journal of Chemical Physics
Yu-Ming Shen, Lien D Le, Rory Wilson, Ulrich Mansmann
BACKGROUND: Biomarkers providing evidence for patient-treatment interaction are key in the development and practice of personalized medicine. Knowledge that a patient with a specific feature - as demonstrated through a biomarker - would have an advantage under a given treatment vs. a competing treatment can aid immensely in medical decision-making. Statistical strategies to establish evidence of continuous biomarkers are complex and their formal results are thus not easy to communicate...
October 26, 2016: Methods of Information in Medicine
Benoit Goussen, Oliver R Price, Cecilie Rendal, Roman Ashauer
Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk...
October 26, 2016: Scientific Reports
Yeliz Karaca, Yudong Zhang, Carlo Cattani
Our purpose is to develop a clinical decision support system to classify the patients' diagnostics based on features gathered from Magnetic Resonance Imaging (MRI) and Expanded Disability Status Scale (EDSS). We studied 120 patients and 19 healthy individuals (not afflicted with MS) have been studied for this study. Healthy individuals in the control group do not have any complaint or drug use history. For the kernel trick, efficient performance in non-linear classification, the Convex Combination of Infinite Kernels model was developed to measure the health status of patients based on features gathered from MRI and EDSS...
October 24, 2016: CNS & Neurological Disorders Drug Targets
David A Balota, Andrew J Aschenbrenner, Melvin J Yap
There has been growing interest in dynamic changes in the lexical processing system across trials, which have typically been assessed via linear mixed effect modelling. In the current study, we explore the influence of previous trial lexicality and previous trial perceptual degradation on the effect of lexicality and degradation on the current trial. The results of analyses of three datasets (two previously published studies and a new study) provide evidence for a robust four-way interaction among previous trial lexicality and degradation and current trial lexicality and degradation effects...
October 26, 2016: Quarterly Journal of Experimental Psychology: QJEP
Daland R Juberg, Thomas B Knudsen, Miriam Sander, Nancy B Beck, Elaine M Faustman, Donna L Mendrick, John R Fowle, Thomas Hartung, Raymond R Tice, Emmanuel Lemazurier, Richard A Becker, Suzanne Compton Fitzpatrick, George P Daston, Alison Harrill, Ronald N Hines, Douglas A Keller, John C Lipscomb, David Watson, Tina Bahadori, Kevin M Crofton
Future Tox III, a Society of Toxicology Contemporary Concepts in Toxicology workshop, was held in November 2015. Building upon Future Tox I and II, Future Tox III was focused on developing the high throughput risk assessment paradigm and taking the science of in vitro data and in silico models forward to explore the question-what progress is being made to address challenges in implementing the emerging big-data toolbox for risk assessment and regulatory decision-making. This article reports on the outcome of the workshop including 2 examples of where advancements in predictive toxicology approaches are being applied within Federal agencies, where opportunities remain within the exposome and AOP domains, and how collectively the toxicology community across multiple sectors can continue to bridge the translation from historical approaches to Tox21 implementation relative to risk assessment and regulatory decision-making...
October 25, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
Thomas Peach, Katerina Spranger, Yiannis Ventikos
Bifurcation aneurysms account for a large fraction of cerebral aneurysms and often present morphologies that render traditional endovascular treatments, such as coiling, challenging and problematic. Flow-diverter stents offer a potentially elegant treatment option for such aneurysms, but clinical use of these devices remains controversial. Specifically, the deployment of a flow-diverter device in a bifurcation entails jailing one or more potentially vital vessels with a low-porosity mesh designed to restrict the flow...
October 25, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Jane Koziol-McLain, Christine McLean, Maheswaran Rohan, Rose Sisk, Terry Dobbs, Shyamala Nada-Raja, Denise Wilson, Alain C Vandal
BACKGROUND: Automated eHealth Web-based research trials offer people an accessible, confidential opportunity to engage in research that matters to them. eHealth trials may be particularly useful for sensitive issues when seeking health care may be accompanied by shame and mistrust. Yet little is known about people's early engagement with eHealth trials, from recruitment to preintervention autoregistration processes. A recent randomized controlled trial that tested the effectiveness of an eHealth safety decision aid for New Zealand women in the general population who experienced intimate partner violence (isafe) provided the opportunity to examine recruitment and preintervention participant engagement with a fully automated Web-based registration process...
October 25, 2016: Journal of Medical Internet Research
Ana María Porcel-Gálvez, Betina Hörner Schlindwein-Meirelles, Eugenia Gil-García, José Miguel Morales-Asencio, María Dolores Guerra-Martín
OBJECTIVE: To know the opinions and satisfaction of nurses with the use of INICIARE, an instrument developed for assessment of nursing care needs in hospitalized patients. INICIARE is based on Virginia Henderson's conceptual model, and built up with indicators of Nursing Outcomes Classification (NOC) taxonomy. METHOD: Exploratory qualitative study, using focus group technique for data collection. The sessions were recorded until saturation of information. A content analysis of syntactic, semantic and pragmatic levels of transcripts was performed...
October 22, 2016: Enfermería Clínica
Faina Linkov, Benita Valappil, Jacob McAfee, Sharon L Goughnour, Douglas M Hildrew, Andrew A McCall, Igor Linkov, Barry Hirsch, Carl Snyderman
OBJECTIVE: To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). METHODS: This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator...
September 30, 2016: American Journal of Otolaryngology
Jan M Sargeant, Annette M O'Connor
Meta-analysis, the statistical combination of results from multiple studies, can be used to summarize all of the available research on an intervention, etiology, descriptive, or diagnostic test accuracy question. Meta-analysis should be conducted as a component of a systematic review, to increase transparency in the selection of studies and to incorporate an evaluation of the risk of bias in the individual studies included in the meta-analysis. The process of meta-analysis may include a forest plot to graphically display the study results and the calculation of a weighted average summary effect size...
October 2016: Microbiology Spectrum
Dominic Micklewright, Sue Kegerreis, John Raglin, Florentina Hettinga
The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious-subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments...
October 25, 2016: Sports Medicine
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