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Decision model

Julie J Miller, Wolfgang Wick
The majority of World Health Organization grade II and grade III gliomas harbor heterozygous mutations in the metabolic enzyme isocitrate dehydrogenase 1 (IDH1), and tumors with an IDH wild-type status show molecular features of a glioblastoma and simply may constitute a separate disease entity. This discovery has led to a profound shift in the way that gliomas are classified and, consequently, how treatment decisions are made. We will review the current understanding of IDH- mutant gliomagenesis and the preclinical models being used to investigate the underlying biology of these tumors and to explore new therapeutic options for these patients...
February 2018: Seminars in Neurology
Arjun Sethi, Valerie Voon, Hugo D Critchley, Mara Cercignani, Neil A Harrison
Computational models of reinforcement learning have helped dissect discrete components of reward-related function and characterize neurocognitive deficits in psychiatric illnesses. Stimulus novelty biases decision-making, even when unrelated to choice outcome, acting as if possessing intrinsic reward value to guide decisions toward uncertain options. Heightened novelty seeking is characteristic of attention deficit hyperactivity disorder, yet how this influences reward-related decision-making is computationally encoded, or is altered by stimulant medication, is currently uncertain...
March 13, 2018: Brain: a Journal of Neurology
Christine Prouty, Shima Mohebbi, Qiong Zhang
Given the increasing vulnerability of communities to the negative impacts of untreated wastewater, resource recovery (RR) systems provide a paradigm shift away from a traditional approach of waste separation and treatment towards a productive recovery of water, energy and nutrients. The aim of this research is to understand the relationships between factors that influence the adoption and sustainability of wastewater-based RR systems to inform technology implementation strategies. The study presents a theory-informed, community-influenced system dynamics (SD) model to provide decision-makers with an adaptable tool that simulates system-level responses to the strategies that are developed for the coastal town of Placencia, Belize...
March 7, 2018: Water Research
Raphaël Le Bouc, Mathias Pessiglione
Motivation can be defined as the function that orients and activates the behavior. Motivation deficits such as apathy are pervasive in both neurological and psychiatric diseases, and are currently assessed with clinical scales that do not give any mechanistic insight. Here, we present another approach that consists in phenotyping the behaviour of patients in motivation tests, using computational models. These formal models impose a precise and operational definition of motivation that is embedded in decision theory...
March 2018: Médecine Sciences: M/S
Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
Rieke Schnakenberg, Lukas Radbruch, Christine Kersting, Friederike Frank, Stefan Wilm, Denise Becka, Klaus Weckbecker, Markus Bleckwenn, Johannes M Just, Michael Pentzek, Birgitta Weltermann
BACKGROUND: Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. OBJECTIVES: This postal survey asked German GPs about their counselling for end-of-life decisions. METHODS: In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs...
December 2018: European Journal of General Practice
Laura E Erban, Stephen B Balogh, Daniel E Campbell, Henry A Walker
Urban water systems consist of natural and engineered flows of water interacting in complex ways. System complexity can be understood via mass conservative models that account for the interrelationships among all major flows and storages. We have developed a generic urban water system model in the R package CityWaterBalance . CityWaterBalance provides a reproducible workflow for studying urban water systems by facilitating automated retrievals of open data and post-processing with open source R functions. It allows the user to 1) rapidly assemble a quantitative, comprehensive assessment of flows thorough an urban area, and 2) easily change the spatial and temporal boundaries of analysis...
February 1, 2018: Open Water
David Vernez, Sandrine Fraize-Frontier, Raymond Vincent, Stéphane Binet, Christophe Rousselle
OBJECTIVES: Assessment factors (AFs) are commonly used for deriving reference concentrations for chemicals. These factors take into account variabilities as well as uncertainties in the dataset, such as inter-species and intra-species variabilities or exposure duration extrapolation or extrapolation from the lowest-observed-adverse-effect level (LOAEL) to the noobserved- adverse-effect level (NOAEL). In a deterministic approach, the value of an AF is the result of a debate among experts and, often a conservative value is used as a default choice...
March 15, 2018: International Journal of Occupational Medicine and Environmental Health
Naiding Yang, Jintao Lu, Jinfu Ye
BACKGROUND: It has been suggested that individual job characteristics have a significant impact on job burnout, and the process is subject to the regulation of demographic variables. However, the influence path of job characteristics on job burnout is still a "black box". SUBJECTS AND METHODS: On the basis of a systematic literature review by employing Pub Med, Science Direct, Web of Science, Google Scholar, CNKI and Scopus for required information with the several keywords "Job burnout", "Emotion regulation", "Personality traits", and "Psychological stress", in this study, an improved mine rescue workers-oriented job demands-resources (JD-R) model was put forward...
March 2018: Psychiatria Danubina
Andre Roelke, Nicole Franke, Chris Biemann, Ralph Radach, Arthur M Jacobs, Markus J Hofmann
The theoretical "difficulty in separating association strength from [semantic] feature overlap" has resulted in inconsistent findings of either the presence or absence of "pure" associative priming in recent literature (Hutchison, 2003, Psychonomic Bulletin & Review, 10(4), p. 787). The present study used co-occurrence statistics of words in sentences to provide a full factorial manipulation of direct association (strong/no) and the number of common associates (many/no) of the prime and target words...
March 15, 2018: Psychonomic Bulletin & Review
Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
Lyndsey M Miller, Carol J Whitlatch, Christopher S Lee, Michael S Caserta
Background and Objectives: Persons with dementia (PWDs) often place greater importance on their care values (i.e., maintaining autonomy and social relations, choosing caregivers, avoiding being a burden) than family caregivers (CGs) perceive, which can detract from dementia care planning (e.g., care arrangements or surrogate decisions). Notable variability has been found across family care dyads (PWD and CG) in their perceptions of care values, suggesting that there may be multiple patterns of perception...
March 12, 2018: Gerontologist
Jason M Stephens
There is often a divide between moral judgment and moral action; between what we believe we ought to do (or not do) and what we do. Knowledge of this divide is not new, and numerous theories have attempted to offer more robust accounts of ethical decision-making and moral functioning. Knowledge of widespread academic dishonesty among students is also not new, and several studies have revealed that many students report cheating despite believing it is wrong. The present study, involving cross-sectional survey data from a sample of secondary students ( N = 380) in the United States, contributes to the literature on this important area of theory and research by fulfilling three broad purposes...
2018: Frontiers in Psychology
Tolulope T Sajobi, Meng Wang, Oluwagbohunmi Awosoga, Maria Santana, Danielle Southern, Zhiying Liang, Diane Galbraith, Stephen B Wilton, Hude Quan, Michelle M Graham, Matthew T James, William A Ghali, Merrill L Knudtson, Colleen Norris
BACKGROUND: Health-related quality of life (HRQOL) assessment is an important health outcome for measuring the efficacy of treatments and interventions for coronary artery disease (CAD). HRQOL is known to improve over the first year after interventions for CAD, but there is limited knowledge of the changes in HRQOL beyond 1 year. We investigated heterogeneity in long-term trajectories of HRQOL in patients with CAD. METHODS AND RESULTS: Data were obtained from 6226 patients identified from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease with at least 1-vessel CAD who underwent their first catheterization between 2006 and 2009...
March 2018: Circulation. Cardiovascular Quality and Outcomes
Todd A Miano, Ebbing Lautenbach, F Perry Wilson, Wensheng Guo, Yuliya Borovskiy, Sean Hennessy
BACKGROUND AND OBJECTIVES: Despite colistin's longstanding reported association with nephrotoxicity, the attributable risk and timing of toxicity onset are still unknown. Whether substantial toxicity occurs during the initial 72 hours of exposure has important implications for early treatment decisions. The objective of this study was to compare colistin-exposed patients with a matched control group given other broad spectrum antibiotics. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective cohort study in patients treated for multidrug-resistant Pseudomonas , Klebsiella , or Acinetobacter spp...
March 15, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
Ying Han, Zhenyu Lu, Zhenguang Du, Qi Luo, Sheng Chen
BACKGROUND AND OBJECTIVE: Bipolar disorder is often mis-diagnosed as unipolar depression in the clinical diagnosis. The main reason is that, different from other diseases, bipolarity is the norm rather than exception in bipolar disorder diagnosis. YinYang bipolar fuzzy set captures bipolarity and has been successfully used to construct a unified inference mathematical modeling method to bipolar disorder clinical diagnosis. Nevertheless, symptoms and their interrelationships are not considered in the existing method, circumventing its ability to describe complexity of bipolar disorder...
May 2018: Computer Methods and Programs in Biomedicine
Mark T Corkum, Wei Liu, David A Palma, Glenn S Bauman, Robert E Dinniwell, Andrew Warner, Mark V Mishra, Alexander V Louie
BACKGROUND: Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. Guidelines support the use of proton radiotherapy in specific disease sites or on clinical trials. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide. METHODS: Operational PTC websites in English were identified through the Particle Therapy Co-Operative Group website...
March 15, 2018: Radiation Oncology
M Elizabeth Snow, Katherine Tweedie, Ann Pederson
BACKGROUND: Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences...
March 15, 2018: BMC Health Services Research
Schirin Akhbari Ziegler, Tineke Dirks, Mijna Hadders-Algra
BACKGROUND: Coaching is en vogue in pediatric physiotherapy, but often applied rather unspecific and undefined. METHODS: This paper aims to describe coaching in early physiotherapy intervention, taking the specific coaching approach of the family-centered program "COPing with and CAring for infants with special needs" (COPCA) as a case in point. RESULTS: The theoretical underpinnings of coaching in COPCA, including a meta-model, family-centered practice, the Neuronal Group Selection Theory and the goal-oriented coaching approach, are discussed...
March 16, 2018: Disability and Rehabilitation
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