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https://www.readbyqxmd.com/read/27905951/expansion-or-compression-of-long-term-care-in-germany-between-2001-and-2009-a-small-area-decomposition-study-based-on-administrative-health-data
#1
Daniel Kreft, Gabriele Doblhammer
BACKGROUND: Studies state profound cross-country differences in healthy life years and its time trends, suggesting either the health scenario of expansion or compression of morbidity. A much-discussed question in public health research is whether the health scenarios are heterogeneous or homogeneous on the subnational level as well. Furthermore, the question arises whether the morbidity trends or the mortality trends are the decisive drivers of the care need-free life years (CFLY), the life years with care need (CLY), and, ultimately, the health scenarios...
July 13, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905897/cost-and-cost-effectiveness-of-tuberculosis-treatment-shortening-a-model-based-analysis
#2
G B Gomez, D W Dowdy, M L Bastos, A Zwerling, S Sweeney, N Foster, A Trajman, M A Islam, S Kapiga, E Sinanovic, G M Knight, R G White, W A Wells, F G Cobelens, A Vassall
BACKGROUND: Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. METHODS: We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27905893/computational-prediction-of-multidisciplinary-team-decision-making-for-adjuvant-breast-cancer-drug-therapies-a-machine-learning-approach
#3
Frank P Y Lin, Adrian Pokorny, Christina Teng, Rachel Dear, Richard J Epstein
BACKGROUND: Multidisciplinary team (MDT) meetings are used to optimise expert decision-making about treatment options, but such expertise is not digitally transferable between centres. To help standardise medical decision-making, we developed a machine learning model designed to predict MDT decisions about adjuvant breast cancer treatments. METHODS: We analysed MDT decisions regarding adjuvant systemic therapy for 1065 breast cancer cases over eight years. Machine learning classifiers with and without bootstrap aggregation were correlated with MDT decisions (recommended, not recommended, or discussable) regarding adjuvant cytotoxic, endocrine and biologic/targeted therapies, then tested for predictability using stratified ten-fold cross-validations...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27905693/revisiting-the-cost-effectiveness-of-screening-65-year-old-men-for-abdominal-aortic-aneurysm-based-on-data-from-an-implemented-screening-programme
#4
Jakob Hager, Martin Henriksson, Per Carlsson, Toste Länne, Fredrik Lundgren
BACKGROUND: Health economic analyses based on randomized trials have shown that screening for abdominal aortic aneurysm (AAA) cost-effectively decreases AAA-related, as well as all- cause mortality. However, follow-up from implemented screening programmes now reveal substantially changed conditions in terms of prevalence, attendance rate, costs and mortality after intervention. Our aim was to evaluate whether screening for AAA among 65-year-old men is cost-effective based on contemporary data on prevalence and attendance rates from an ongoing AAA screening programme...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27905316/recombination-dynamics-of-type-ii-excitons-in-ga-in-as-gaas-ga-as-sb-heterostructures
#5
S Gies, B Holz, C Fuchs, W Stolz, W Heimbrodt
(Ga,In)As/GaAs/Ga(As,Sb) multi-quantum well heterostructures have been investigated using continuous wave and time-resolved photoluminescence spectroscopy at various temperatures. A complex interplay was observed between the excitonic type-II transitions with electrons in the (Ga,In)As well and holes in the Ga(As,Sb) well and the type-I excitons in the (Ga,In)As and Ga(As,Sb) wells. The type-II luminescence exhibits a strongly non-exponential temporal behavior below a critical temperature of T c = 70 K. The transients were analyzed in the framework of a rate-equation model...
December 1, 2016: Nanotechnology
https://www.readbyqxmd.com/read/27905078/improving-the-provision-of-otc-medication-information-in-community-pharmacies-in-poland
#6
Anna Piecuch, Magdalena Makarewicz-Wujec, Małgorzata Kozłowska-Wojciechowska
Background An informed or shared decision-making model is desirable to support the choice of over-the-counter (OTC) medications in pharmacies: it respects patient empowerment in self-medication. Such a model is achievable provided that pharmacists are a credible, competent information source open to patient needs. Objective To study the dependencies among selected factors that may influence the provision of OTC medication information. The study was conducted from the perspective of a community pharmacist. Method The study consisted of an auditorium survey with a self-administered questionnaire...
November 30, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27904602/comparison-of-different-risk-stratification-systems-in-predicting-short-term-serious-outcome-of-syncope-patients
#7
Saeed Safari, Alireza Baratloo, Behrooz Hashemi, Farhad Rahmati, Mohammad Mehdi Forouzanfar, Maryam Motamedi, Ladan Mirmohseni
BACKGROUND: Determining etiologic causes and prognosis can significantly improve management of syncope patients. The present study aimed to compare the values of San Francisco, Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL), Boston, and Risk Stratification of Syncope in the Emergency Department (ROSE) score clinical decision rules in predicting the short-term serious outcome of syncope patients. MATERIALS AND METHODS: The present diagnostic accuracy study with 1-week follow-up was designed to evaluate the predictive values of the four mentioned clinical decision rules...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903717/deciphering-decision-making-variation-in-animal-models-of-effort-and-uncertainty-based-choice-reveals-distinct-neural-circuitries-underlying-core-cognitive-processes
#8
Catharine A Winstanley, Stan B Floresco
Maladaptive decision-making is increasingly recognized to play a significant role in numerous psychiatric disorders, such that therapeutics capable of ameliorating core impairments in judgment may be beneficial in a range of patient populations. The field of "decision neuroscience" is therefore in its ascendancy, with researchers from diverse fields bringing their expertise to bear on this complex and fascinating problem. In addition to the advances in neuroimaging and computational neuroscience that contribute enormously to this area, an increase in the complexity and sophistication of behavioral paradigms designed for nonhuman laboratory animals has also had a significant impact on researchers' ability to test the causal nature of hypotheses pertaining to the neural circuitry underlying the choice process...
November 30, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27903479/cost-effectiveness-analysis-of-the-use-of-a-prophylactic-antibiotic-for-patients-undergoing-lower-limb-amputation-due-to-diabetes-or-vascular-illness-in-colombia
#9
REVIEW
Mateo Ceballos, Luis Esteban Orozco, Carlos Oliver Valderrama, Diana Isabel Londoño, Luz Helena Lugo
BACKGROUND: The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. METHODS: A decision tree was constructed to compare the use and non-use of a prophylactic antibiotic...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903334/applying-an-evidence-based-assessment-model-to-identify-students-at-risk-for-perceived-academic-problems-following-concussion
#10
Danielle M Ransom, Alison R Burns, Eric A Youngstrom, Christopher G Vaughan, Maegan D Sady, Gerard A Gioia
OBJECTIVES: The aim of this study was to demonstrate the utility of an evidence-based assessment (EBA) model to establish a multimodal set of tools for identifying students at risk for perceived post-injury academic problems. METHODS: Participants included 142 students diagnosed with concussion (age: M=14.95; SD=1.80; 59% male), evaluated within 4 weeks of injury (median=16 days). Demographics, pre-injury history, self- and parent-report measures assessing symptom severity and executive functions, and cognitive test performance were examined as predictors of self-reported post-injury academic problems...
November 2016: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/27903120/molecular-pathology-of-adamantinomatous-craniopharyngioma-review-and-opportunities-for-practice
#11
John Richard Apps, Juan Pedro Martinez-Barbera
Since the first identification of CTNNB1 mutations in adamantinomatous craniopharyngioma (ACP), much has been learned about the molecular pathways and processes that are disrupted in ACP pathogenesis. To date this understanding has not translated into tangible patient benefit. The recent development of novel techniques and a range of preclinical models now provides an opportunity to begin to support treatment decisions and develop new therapeutics based on molecular pathology. In this review the authors summarize many of the key findings and pathways implicated in ACP pathogenesis and discuss the challenges that need to be tackled to translate these basic science findings for the benefit of patients...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27902916/use-of-molecular-pathogenicity-indices-to-identify-pathogenic-strains-of-pasteurella-multocida
#12
Thales Quedi Furian, Karen Apellanis Borges, Roberta Marmitt Pilatti, Camila Neves de Almeida, André Felipe Streck, Brunna Dias de Emery, Vladimir Pinheiro do Nascimento, Carlos Tadeu Pippi Salle, Hamilton Luiz de Souza Moraes
In addition to being the causative agent of fowl cholera (FC), Pasteurella multocida is also one of the most prevalent opportunistic pathogens associated with respiratory diseases in various hosts. However, understanding of the traits that distinguish the virulent isolates that cause FC is still limited. The objective of this study was to characterize P. multocida isolates of Brazil by PCR-restriction fragment length polymorphism (PCR-RFLP) analysis in order to determine if strain-type correlates with virulence or with 22 previously studied virulence genes...
December 2016: Avian Diseases
https://www.readbyqxmd.com/read/27902699/modeling-cellular-noise-underlying-heterogeneous-cell-responses-in-the-epidermal-growth-factor-signaling-pathway
#13
Kazunari Iwamoto, Yuki Shindo, Koichi Takahashi
Cellular heterogeneity, which plays an essential role in biological phenomena, such as drug resistance and migration, is considered to arise from intrinsic (i.e., reaction kinetics) and extrinsic (i.e., protein variability) noise in the cell. However, the mechanistic effects of these types of noise to determine the heterogeneity of signal responses have not been elucidated. Here, we report that the output of epidermal growth factor (EGF) signaling activity is modulated by cellular noise, particularly by extrinsic noise of particular signaling components in the pathway...
November 2016: PLoS Computational Biology
https://www.readbyqxmd.com/read/27901055/mediboost-a-patient-stratification-tool-for-interpretable-decision-making-in-the-era-of-precision-medicine
#14
Gilmer Valdes, José Marcio Luna, Eric Eaton, Charles B Simone, Lyle H Ungar, Timothy D Solberg
Machine learning algorithms that are both interpretable and accurate are essential in applications such as medicine where errors can have a dire consequence. Unfortunately, there is currently a tradeoff between accuracy and interpretability among state-of-the-art methods. Decision trees are interpretable and are therefore used extensively throughout medicine for stratifying patients. Current decision tree algorithms, however, are consistently outperformed in accuracy by other, less-interpretable machine learning models, such as ensemble methods...
November 30, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27900810/population-based-study-of-attitudes-toward-brca-genetic-testing-among-orthodox-jewish-women
#15
Eve Y Tang, Meghna S Trivedi, Rita Kukufka, Wendy K Chung, Raven David, Leah Respler, Sarah Leifer, Isaac Schechter, Katherine D Crew
Given the high prevalence (1 in 40) of BRCA1 and BRCA2 mutations among Ashkenazi Jews, population-based BRCA genetic testing in this ethnic subgroup may detect more mutation carriers. We conducted a cross-sectional survey among Orthodox Jewish women in New York City to assess breast cancer risk, genetic testing knowledge, self-efficacy, perceived breast cancer risk and worry, religious and cultural factors affecting medical decision-making. We used descriptive statistics and multivariable logistic regression models to identify predictors of genetic testing intention/uptake...
November 30, 2016: Breast Journal
https://www.readbyqxmd.com/read/27900388/data-driven-modeling-for-precision-medicine-in-pediatric-acute-liver-failure
#16
Ruben Zamora, Yoram Vodovotz, Qi Mi, Derek Barclay, Jinling Yin, Simon Horslen, David Rudnick, Kathleen M Loomes, Robert H Squires
Absence of early outcome biomarkers for Pediatric Acute Liver Failure (PALF) hinders medical and liver transplant decisions. We sought to define dynamic interactions among circulating inflammatory mediators to gain insights into PALF outcome sub-groups. Serum samples from 101 participants in the PALF study, collected over the first 7 days following enrollment, were assayed for 27 inflammatory mediators. Outcomes (Spontaneous survivors [S, n=61], Non-survivors [NS, n=12], and liver transplant patients [LTx, n=28]) were assessed at 21 days post-enrollment...
November 23, 2016: Molecular Medicine
https://www.readbyqxmd.com/read/27900238/power-flow-analysis-and-optimal-locations-of-resistive-type-superconducting-fault-current-limiters
#17
Xiuchang Zhang, Harold S Ruiz, Jianzhao Geng, Boyang Shen, Lin Fu, Heng Zhang, Tim A Coombs
Based on conventional approaches for the integration of resistive-type superconducting fault current limiters (SFCLs) on electric distribution networks, SFCL models largely rely on the insertion of a step or exponential resistance that is determined by a predefined quenching time. In this paper, we expand the scope of the aforementioned models by considering the actual behaviour of an SFCL in terms of the temperature dynamic power-law dependence between the electrical field and the current density, characteristic of high temperature superconductors...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27899165/cognitive-dysfunction-in-body-dysmorphic-disorder-new-implications-for-nosological-systems-and-neurobiological-models
#18
Kiri Jefferies-Sewell, Samuel R Chamberlain, Naomi A Fineberg, Keith R Laws
: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS: Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task)...
November 30, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27899106/which-aspects-of-health-care-are-most-valued-by-people-living-with-hiv-in-high-income-countries-a-systematic-review
#19
V Cooper, J Clatworthy, E Youssef, C Llewellyn, A Miners, M Lagarde, M Sachikonye, N Perry, E Nixon, A Pollard, C Sabin, C Foreman, M Fisher
BACKGROUND: Increasing numbers of people with HIV are living into older age and experiencing comorbidities. The development of new models of care to meet the needs of this population is now a priority. It is important that the views and preferences of patients inform the development of services in order to maintain high levels of patient satisfaction and engagement. The aim of this systematic review was to determine which aspects of healthcare are particularly valued by people living with HIV...
November 30, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27899103/time-to-event-versus-ten-year-absolute-risk-in-cardiovascular-risk-prevention-does-it-make-a-difference-results-from-the-optimizing-risk-communication-optrisk-randomized-controlled-trial
#20
Charles Christian Adarkwah, Nikita Jegan, Monika Heinzel-Gutenbrunner, Felicitas Kühne, Uwe Siebert, Uwe Popert, Norbert Donner-Banzhoff, Sarah Kürwitz
BACKGROUND: The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk illustration in the decision-aid-software arriba(TM) (emoticons), is compared within a randomised trial to a new-developed TTE illustration, which is based on a Markov model...
November 29, 2016: BMC Medical Informatics and Decision Making
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