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https://www.readbyqxmd.com/read/28749604/a-simulation-of-dementia-epidemiology-and-resource-use-in-australia
#1
Lachlan B Standfield, Tracy Comans, Paul Scuffham
OBJECTIVES: The number of people in the developed world who have dementia is predicted to rise markedly. This study presents a validated predictive model to assist decision-makers to determine this population's future resource requirements and target scarce health and welfare resources appropriately. METHODS: A novel individual patient discrete event simulation was developed to estimate the future prevalence of dementia and related health and welfare resource use in Australia...
July 27, 2017: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/28749586/patient-decisions-to-receive-secondary-pharmacogenomic-findings-and-development-of-a-multidisciplinary-practice-model-to-integrate-results-into-patient-care
#2
J Kevin Hicks, Amy Shealy, Allison Schreiber, Marissa Coleridge, Ryan Noss, Marvin Natowicz, Rocio Moran, Timothy Moss, Angelika Erwin, Charis Eng
Whole exome sequencing (WES) has the potential of identifying secondary findings that are predictive of poor pharmacotherapy outcomes. The purpose of this study was to investigate patients' wishes regarding the reporting of secondary pharmacogenomic findings. WES results (n = 106 patients) were retrospectively reviewed to determine the number of patients electing to receive secondary pharmacogenomic results. Phenotypes were assigned based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines...
July 27, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28748610/using-family-and-staff-experiences-of-a-botulinum-toxin-a-service-to-improve-service-quality
#3
K L O Burton, K Bau, J Lewis, K R Aroyan, B Botha, A G M Botman, K Stewart, M-C A Waugh, S P Paget
BACKGROUND: The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care...
July 26, 2017: Child: Care, Health and Development
https://www.readbyqxmd.com/read/28748588/implementation-of-the-risk-and-harm-reduction-strategy-against-unsafe-abortion-in-uruguay-from-a-university-hospital-to-the-entire-country
#4
Ana Labandera, Monica Gorgoroso, Leonel Briozzo
The history of the creation of the risk and harm reduction model applied to unsafe abortion is reviewed, from its initial implementation by a small group of gynecologists at the Pereira Rossell Hospital Center in Uruguay to its spread to the rest of the country. Its ethical rationale, its successful application in the hospital, the decision to disseminate it with the cooperation of the International Federation of Gynecology and Obstetrics (FIGO), and the intervention procedures are explained. It was evaluated from the epidemiological and anthropological viewpoints, from the changes in professionals' and users' perception of the care offered and its impact on complications and maternal deaths...
August 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28748493/cost-effectiveness-of-preimplantation-genetic-screening-for-women-older-than-37-undergoing-in-vitro-fertilization
#5
Stephen C Collins, Xiao Xu, Winifred Mak
PURPOSE: Adding preimplantation genetic screening to in vitro fertilization has been shown to increase live birth rate in women older than 37. However, preimplantation genetic screening is an expensive procedure. Information on the cost-effectiveness of preimplantation genetic screening can help inform clinical decision making. METHODS: We constructed a decision analytic model for a hypothetical fresh, autologous in vitro fertilization cycle (with versus without preimplantation genetic screening) for women older than age 37 who had a successful oocyte retrieval and development of at least one blastocyst...
July 27, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28748450/replicating-health-economic-models-firm-foundations-or-a-house-of-cards
#6
Inigo Bermejo, Paul Tappenden, Ji-Hee Youn
Health economic evaluation is a framework for the comparative analysis of the incremental health gains and costs associated with competing decision alternatives. The process of developing health economic models is usually complex, financially expensive and time-consuming. For these reasons, model development is sometimes based on previous model-based analyses; this endeavour is usually referred to as model replication. Such model replication activity may involve the comprehensive reproduction of an existing model or 'borrowing' all or part of a previously developed model structure...
July 26, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28748429/admission-control-policies-for-surgery-patients
#7
Li Luo, Yong Luo, Chunrong Qin
In China, day surgery has been promoted because its operation time and post-operative hospital stay are shorter than those of elective surgery. Day surgery can speed up the turnover of beds and operation rooms. Usually, the conditions of elective surgery patients are more complicated than those of day surgery patients. The development of the discipline, which means that the hospital has improved the skills of the doctors and the ability of doctors to cope with serious diseases and has increased the overall medical level of the hospital, requires surgeons to operate in some complicated elective surgeries...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28748182/mycobacteria-modify-their-cell-size-control-under-sub-optimal-carbon-sources
#8
Miles Priestman, Philipp Thomas, Brian D Robertson, Vahid Shahrezaei
The decision to divide is the most important one that any cell must make. Recent single cell studies suggest that most bacteria follow an "adder" model of cell size control, incorporating a fixed amount of cell wall material before dividing. Mycobacteria, including the causative agent of tuberculosis Mycobacterium tuberculosis, are known to divide asymmetrically resulting in heterogeneity in growth rate, doubling time, and other growth characteristics in daughter cells. The interplay between asymmetric cell division and adder size control has not been extensively investigated...
2017: Frontiers in Cell and Developmental Biology
https://www.readbyqxmd.com/read/28747901/could-the-recent-zika-epidemic-have-been-predicted
#9
Ángel G Muñoz, Madeleine C Thomson, Anna M Stewart-Ibarra, Gabriel A Vecchi, Xandre Chourio, Patricia Nájera, Zelda Moran, Xiaosong Yang
Given knowledge at the time, the recent 2015-2016 zika virus (ZIKV) epidemic probably could not have been predicted. Without the prior knowledge of ZIKV being already present in South America, and given the lack of understanding of key epidemiologic processes and long-term records of ZIKV cases in the continent, the best related prediction could be carried out for the potential risk of a generic Aedes-borne disease epidemic. Here we use a recently published two-vector basic reproduction number model to assess the predictability of the conditions conducive to epidemics of diseases like zika, chikungunya, or dengue, transmitted by the independent or concurrent presence of Aedes aegypti and Aedes albopictus...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28747744/predicting-trend-of-early-childhood-caries-in-mainland-china-a-combined-meta-analytic-and-mathematical-modelling-approach-based-on-epidemiological-surveys
#10
Xiaonan Zhang, Lei Zhang, Yonghong Zhang, Zhaoying Liao, Jinlin Song
Early childhood caries (ECC) is the most common chronic disease in young children. A reliable predictive model for ECC prevalence is needed in China as a decision supportive tool for planning health resources. In this study, we first established the autoregressive integrated moving average (ARIMA) model and grey predictive model (GM) based on the estimated national prevalence of ECC with meta-analysis from the published articles. The pooled data from 1988 to 2010 were used to establish the model, while the data from 2011 to 2013 were used to validate the models...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28747627/metacognitive-impairments-extend-perceptual-decision-making-weaknesses-in-compulsivity
#11
Tobias U Hauser, Micah Allen, Geraint Rees, Raymond J Dolan
Awareness of one's own abilities is of paramount importance in adaptive decision making. Psychotherapeutic theories assume such metacognitive insight is impaired in compulsivity, though this is supported by scant empirical evidence. In this study, we investigate metacognitive abilities in compulsive participants using computational models, where these enable a segregation between metacognitive and perceptual decision making impairments. We examined twenty low-compulsive and twenty high-compulsive participants, recruited from a large population-based sample, and matched for other psychiatric and cognitive dimensions...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28747465/unbounded-evidence-accumulation-characterizes-subjective-visual-vertical-svv-forced-choice-perceptual-choice-and-confidence
#12
Koeun Lim, Wei Wang, Daniel M Merfeld
Humans can subjectively yet quantitatively assess choice confidence based on perceptual precision even when a perceptual decision is made without an immediate reward or feedback. However, surprisingly little is known about choice confidence. Here we investigate the dynamics of choice confidence by merging two parallel conceptual frameworks of decision-making, signal detection theory and sequential analyses (i.e., drift diffusion modeling). Specifically, in order to capture end-point statistics of binary choice and confidence, we built on a previous study that defined choice confidence in terms of psychophysics derived from signal detection theory...
July 26, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28747313/long-term-complications-reoperations-and-survival-following-cardioverter-defibrillator-implant
#13
Nathaniel Mark Hawkins, Maja Grubisic, Jason G Andrade, Flora Huang, Lillian Ding, Min Gao, Jamil Bashir
OBJECTIVE: Implantable cardioverter-defibrillators (ICDs) reduce risk of death in select populations, but are also associated with harms. We aimed to characterise long-term complications and reoperation rate. METHODS: We assessed the rate, cumulative incidence and predictors of long-term reoperation and survival using a prospective, multicentre registry serving British Columbia in Canada, a universal single payer healthcare system with 4.5 million residents. 3410 patients (mean 63...
July 26, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28747103/a-deliberative-framework-to-identify-the-need-for-real-life-evidence-building-of-new-cancer-drugs-after-interim-funding-decision
#14
Leanne Leung, Mário L de Lemos, Laurel Kovacic
Background With the rising cost of new oncology treatments, it is no longer sustainable to base initial drug funding decisions primarily on prospective clinical trials as their performance in real-life populations are often difficult to determine. In British Columbia, an approach in evidence building is to retrospectively analyse patient outcomes using observational research on an ad hoc basis. Methods The deliberative framework was constructed in three stages: framework design, framework validation and treatment programme characterization, and key informant interview...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28747088/hierarchical-bayes-approach-for-subgroup-analysis
#15
Yu-Yi Hsu, Jyoti Zalkikar, Ram C Tiwari
In clinical data analysis, both treatment effect estimation and consistency assessment are important for a better understanding of the drug efficacy for the benefit of subjects in individual subgroups. The linear mixed-effects model has been used for subgroup analysis to describe treatment differences among subgroups with great flexibility. The hierarchical Bayes approach has been applied to linear mixed-effects model to derive the posterior distributions of overall and subgroup treatment effects. In this article, we discuss the prior selection for variance components in hierarchical Bayes, estimation and decision making of the overall treatment effect, as well as consistency assessment of the treatment effects across the subgroups based on the posterior predictive p-value...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28746975/breeding-habitat-selection-across-spatial-scales-is-grass-always-greener-on-the-other-side
#16
Paul Acker, Aurélien Besnard, Jean-Yves Monnat, Emmanuelle Cam
Habitat selection theory predicts that natural selection should favor mechanisms allowing individuals to choose habitats associated with the highest fitness prospects. However, identifying sources of information on habitat quality that individuals use to choose their breeding habitat has proved to be difficult. It has also proven difficult to identify dispersal costs that prevent individuals from joining the highest-quality sites. A synthesis that integrates dispersal costs and habitat selection mechanisms across space has remained elusive...
July 26, 2017: Ecology
https://www.readbyqxmd.com/read/28746867/tcr-signal-quality-modulates-fate-decisions-of-single-cd4-t-cells-in-a-probabilistic-manner
#17
Yi-Li Cho, Michael Flossdorf, Lorenz Kretschmer, Thomas Höfer, Dirk H Busch, Veit R Buchholz
To what extent the lineage decisions of activated CD4(+) T cells are determined by the quality of T cell receptor (TCR) ligation is incompletely understood. Here, we show that individual T cells expressing identical TCRs take highly variable fate decisions despite binding the same ligand. We identify a mathematical model that correctly captures this probabilistic behavior and allows one to formalize changes in TCR signal quality-due to cognate versus altered peptide ligation-as changes of lineage-specific proliferation and differentiation rates...
July 25, 2017: Cell Reports
https://www.readbyqxmd.com/read/28746709/association-of-coronary-artery-calcium-score-vs-age-with-cardiovascular-risk-in-older-adults-an-analysis-of-pooled-population-based-studies
#18
Yuichiro Yano, Christopher J O'Donnell, Lewis Kuller, Maryam Kavousi, Raimund Erbel, Hongyan Ning, Ralph D'Agostino, Anne B Newman, Khurram Nasir, Albert Hofman, Nils Lehmann, Klodian Dhana, Ron Blankstein, Udo Hoffmann, Stefan Möhlenkamp, Joseph M Massaro, Amir-Abbas Mahabadi, Joao A C Lima, M Arfan Ikram, Karl-Heinz Jöckel, Oscar H Franco, Kiang Liu, Donald Lloyd-Jones, Philip Greenland
Importance: Besides age, other discriminators of atherosclerotic cardiovascular disease (ASCVD) risk are needed in older adults. Objectives: To examine the predictive ability of coronary artery calcium (CAC) score vs age for incident ASCVD and how risk prediction changes by adding CAC score and removing only age from prediction models. Design, Setting, and Participants: We conducted an analysis of pooled US population-based studies, including the Framingham Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study...
July 26, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28746377/evaluating-the-impact-of-a-mandatory-pre-abortion-ultrasound-viewing-law-a-mixed-methods-study
#19
Ushma D Upadhyay, Katrina Kimport, Elise K O Belusa, Nicole E Johns, Douglas W Laube, Sarah C M Roberts
BACKGROUND: Since mid-2013, Wisconsin abortion providers have been legally required to display and describe pre-abortion ultrasound images. We aimed to understand the impact of this law. METHODS: We used a mixed-methods study design at an abortion facility in Wisconsin. We abstracted data from medical charts one year before the law to one year after and used multivariable models, mediation/moderation analysis, and interrupted time series to assess the impact of the law, viewing, and decision certainty on likelihood of continuing the pregnancy...
2017: PloS One
https://www.readbyqxmd.com/read/28746348/adolescent-values-for-immunisation-programs-in-australia-a-discrete-choice-experiment
#20
Bing Wang, Gang Chen, Julie Ratcliffe, Hossein Haji Ali Afzali, Lynne Giles, Helen Marshall
OBJECTIVES: The importance of adolescent engagement in health decisions and public health programs such as immunisation is becoming increasingly recognised. Understanding adolescent preferences and further identifying barriers and facilitators for immunisation acceptance is critical to the success of adolescent immunisation programs. This study applied a discrete choice experiment (DCE) to assess vaccination preferences in adolescents. METHODS: This study was conducted as a cross-sectional, national online survey in Australian adolescents...
2017: PloS One
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