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Ramnath Subbaraman, Ruvandhi R Nathavitharana, Srinath Satyanarayana, Madhukar Pai, Beena E Thomas, Vineet K Chadha, Kiran Rade, Soumya Swaminathan, Kenneth H Mayer
BACKGROUND: India has 23% of the global burden of active tuberculosis (TB) patients and 27% of the world's "missing" patients, which includes those who may not have received effective TB care and could potentially spread TB to others. The "cascade of care" is a useful model for visualizing deficiencies in case detection and retention in care, in order to prioritize interventions. METHODS AND FINDINGS: The care cascade constructed in this paper focuses on the Revised National TB Control Programme (RNTCP), which treats about half of India's TB patients...
October 2016: PLoS Medicine
Rein M G J Houben, Peter J Dodd
BACKGROUND: The existing estimate of the global burden of latent TB infection (LTBI) as "one-third" of the world population is nearly 20 y old. Given the importance of controlling LTBI as part of the End TB Strategy for eliminating TB by 2050, changes in demography and scientific understanding, and progress in TB control, it is important to re-assess the global burden of LTBI. METHODS AND FINDINGS: We constructed trends in annual risk in infection (ARI) for countries between 1934 and 2014 using a combination of direct estimates of ARI from LTBI surveys (131 surveys from 1950 to 2011) and indirect estimates of ARI calculated from World Health Organisation (WHO) estimates of smear positive TB prevalence from 1990 to 2014...
October 2016: PLoS Medicine
J L Santiago, R Borge, F Martin, D de la Paz, A Martilli, J Lumbreras, B Sanchez
The distribution of pollutants is spatially heterogeneous within urban streets making difficult to build a realistic concentration map. In this paper, a methodology based on computational fluid dynamic modeling with Reynolds-averaged Navier-Stokes approach is used to compute maps of concentration for a period of several weeks. The methodology is evaluated by comparing simulation results against experimental data from two different campaigns where a large number of passive samplers deployed in an area with heavy vehicular traffic in Madrid (Spain)...
October 22, 2016: Science of the Total Environment
Giancarlo D'Agostino, Marco Di Luzio, Giovanni Mana, Luca Martino, Massimo Oddone, Carlo Paolo Sasso
This paper investigates the use of a method based on Cu decoration and neutron activation to determine the total volume of voids in a silicon single crystal. A measurement protocol was developed and tested in an experiment carried out with a 5 cm(3) volume and 10 g mass high-purity natural silicon sample. The few percent uncertainty reached in the determination of the Cu concentration, at a 10(14) cm(-3) level, makes this method a candidate to set an upper limit to the concentration of the vacancies contributing to the void volume in the enriched silicon material used to determine the Avogadro constant...
October 25, 2016: Analytical Chemistry
D Brynn Hibbert, Pall Thordarson
Data analysis is central to understanding phenomena in host-guest chemistry. We describe here recent developments in this field starting with the revelation that the popular Job plot method is inappropriate for most problems in host-guest chemistry and that the focus should instead be on systematically fitting data and testing all reasonable binding models. We then discuss approaches for estimating uncertainties in binding studies using case studies and simulations to highlight key issues. Related to this is the need for ready access to data and transparency in the methodology or software used, and we demonstrate an example a webportal () that aims to address this issue...
October 25, 2016: Chemical Communications: Chem Comm
Yuanshui Zheng, Yixiu Kang, Omar Zeidan, Niek Schreuder
Accurate assessment of range uncertainty is critical in proton therapy. However, there is a lack of data and consensus on how to evaluate the appropriate amount of uncertainty. The purpose of this study is to quantify the range uncertainty in various treatment conditions in proton therapy, using transmission measurements through various animal tissues. Animal tissues, including a pig head, beef steak, and lamb leg, were used in this study. For each tissue, an end-to-end test closely imitating patient treatments was performed...
November 21, 2016: Physics in Medicine and Biology
Aaron E Brice, Gabriel A Hernandez, Mariluz Sanchez, Marshall Haynick, Cesar E Mendoza
Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker has been proven to reduce subsequent cardiovascular events and in-stent thrombosis in patients undergoing percutaneous coronary intervention. Newer P2Y12 antagonists with faster onset and greater inhibition of platelet activity have improved cardiovascular outcomes but have created uncertainty with the appropriate dosing when switching between agents. Currently, there are no evidence-based guidelines to aid clinicians when switching between P2Y12 receptor blockers...
October 25, 2016: Platelets
Peter M Chapman
Environmental quality benchmarks (EQBs) such as water or sediment quality guidelines comprise one line of evidence for assessing the potential harm from chemicals and other stressors (physical, biological). They are useful but not perfect tools, should not always be used, and should never be used alone for final decision-making. The "good" can be designed to be situation-specific and can provide understandable scientific input to decision-makers. The "bad" includes perception that they are absolutes (i.e., definitive binary decision points), no or limited adaptability based on good science or common sense, and protection of individual organisms not populations of organisms...
October 24, 2016: Environmental Science and Pollution Research International
Bing Yuan
In the field of life sciences, although system biology and "precision medicine" introduce some complex scientifific methods and techniques, it is still based on the "analysis-reconstruction" of reductionist theory as a whole. Adaptability of complex system increase system behaviour uncertainty as well as the difficulties of precise identifification and control. It also put systems biology research into trouble. To grasp the behaviour and characteristics of organism fundamentally, systems biology has to abandon the "analysis-reconstruction" concept...
October 24, 2016: Chinese Journal of Integrative Medicine
Tomiko Takeuchi, Koko Muraoka, Megumi Yamada, Yuri Nishio, Isao Hozumi
PURPOSE: Idiopathic basal ganglia calcification (IBGC) is a rare, intractable disease with unknown etiology. IBGC3 is a familial genetic disease defined by genetic mutations in the major causative gene (SLC20A2). People with IBGC3 experience distress from the uncommon nature of their illness and uncertainty about treatment and prognoses. The present study aimed to describe the lives and illness of people with IBGC3. METHODS: Participants were recruited from patients aged 20 years or older enrolled in a genetic study, who were diagnosed with IBGC3 and wanted to share their experiences...
2016: SpringerPlus
Punit Shah, Caroline Catmur, Geoffrey Bird
The way choices are framed influences decision-making. These "framing effects" emerge through the integration of emotional responses into decision-making under uncertainty. It was previously reported that susceptibility to the framing effect was reduced in individuals with autism spectrum disorder (ASD) due to a reduced tendency to incorporate emotional information into the decision-making process. However, recent research indicates that, where observed, emotional processing impairments in ASD may be due to co-occurring alexithymia...
2016: Molecular Autism
Ya-Fu Lee, Yen-Min Kuo, Wen-Chen Chu
BACKGROUND: When facing a novel situation, animals can retreat or leave to avoid risks, but will miss potential resources and opportunities. Alternatively they may reduce environmental uncertainty by exploration, while risking no energy rewards and exposure to hazards, and use the information retrieved for subsequent decision making. When exploring, however, animals may adopt different tactics according to individual states. RESULTS: We tested that energy states will affect exploratory behavior by experimenting with wild-caught untrained Eurasian tree sparrows (Passer montanus) in fasted or fed states exploring in a novel space with hidden food supply in different patch distribution patterns...
2016: Frontiers in Zoology
Julian Savulescu, Karolina Wartolowska, Andy Carr
Use of a placebo control in surgical trials is a divisive issue. We argue that, in principle, placebo controls for surgery are necessary in the same way as for medicine. However, there are important differences between these types of trial, which both increase justification and limit application of surgical studies. We propose that surgical randomised placebo-controlled trials are ethical if certain conditions are fulfilled: (1) the presence of equipoise, defined as a lack of unbiased evidence for efficacy of an intervention; (2) clinically important research question; (3) the risk to patients is minimised and reasonable; (4) there is uncertainty about treatment allocation rather than deception; (5) there is preliminary evidence for efficacy, which justifies a placebo-controlled design; and (6) ideally, the placebo procedure should have some direct benefit to the patient, for example, as a diagnostic tool...
October 24, 2016: Journal of Medical Ethics
Barbara Sibbald
No abstract text is available yet for this article.
October 24, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
S Rodríguez-Segade, J Rodríguez, F Camiña
AIMS: There is increasing interest in using fructosamine measurements in screening for or managing diabetes, yet uncertainty remains as to whether these measurements should be corrected for variation in serum protein concentrations. METHODS: We considered all sets of simultaneous measurements of fructosamine, albumin, total serum protein (TP), fasting plasma glucose (FPG) and HbA1C recorded in our laboratory over 10years. The relationships between fructosamine and other variables were studied by multivariate linear regression and other analyses, and receiver operating curves (ROCs) were analysed to compare the diabetes screening performance of uncorrected fructosamine to those of albumin-corrected fructosamine (FAAlb) and TP-corrected fructosamine (FATP)...
October 21, 2016: Clinical Biochemistry
Sebastian Jobjörnsson, Martin Forster, Paolo Pertile, Carl-Fredrik Burman
We present a model combining the two regulatory stages relevant to the approval of a new health technology: the authorisation of its commercialisation and the insurer's decision about whether to reimburse its cost. We show that the degree of uncertainty concerning the true value of the insurer's maximum willingness to pay for a unit increase in effectiveness has a non-monotonic impact on the optimal price of the innovation, the firm's expected profit and the optimal sample size of the clinical trial. A key result is that there exists a range of values of the uncertainty parameter over which a reduction in uncertainty benefits the firm, the insurer and patients...
October 5, 2016: Journal of Health Economics
Micah Allen, Darya Frank, D Samuel Schwarzkopf, Francesca Fardo, Joel S Winston, Tobias U Hauser, Geraint Rees
Human perception is invariably accompanied by a graded feeling of confidence that guides metacognitive awareness and decision-making. It is often assumed that this arises solely from the feed-forward encoding of the strength or precision of sensory inputs. In contrast, interoceptive inference models suggest that confidence reflects a weighted integration of sensory precision and expectations about internal states, such as arousal. Here we test this hypothesis using a novel psychophysical paradigm, in which unseen disgust-cues induced unexpected, unconscious arousal just before participants discriminated motion signals of variable precision...
October 25, 2016: ELife
Eric P M Grist, Jennifer A Flegg, Georgina Humphreys, Ignacio Suay Mas, Tim J C Anderson, Elizabeth A Ashley, Nicholas P J Day, Mehul Dhorda, Arjen M Dondorp, M Abul Faiz, Peter W Gething, Tran T Hien, Tin M Hlaing, Mallika Imwong, Jean-Marie Kindermans, Richard J Maude, Mayfong Mayxay, Marina McDew-White, Didier Menard, Shalini Nair, Francois Nosten, Paul N Newton, Ric N Price, Sasithon Pukrittayakamee, Shannon Takala-Harrison, Frank Smithuis, Nhien T Nguyen, Kyaw M Tun, Nicholas J White, Benoit Witkowski, Charles J Woodrow, Rick M Fairhurst, Carol Hopkins Sibley, Philippe J Guerin
BACKGROUND: Artemisinin-resistant Plasmodium falciparum malaria parasites are now present across much of mainland Southeast Asia, where ongoing surveys are measuring and mapping their spatial distribution. These efforts require substantial resources. Here we propose a generic 'smart surveillance' methodology to identify optimal candidate sites for future sampling and thus map the distribution of artemisinin resistance most efficiently. METHODS: The approach uses the 'uncertainty' map generated iteratively by a geostatistical model to determine optimal locations for subsequent sampling...
October 24, 2016: International Journal of Health Geographics
Dean R Freestone, Kelvin J Layton, Levin Kuhlmann, Mark J Cook
Data-driven model-based analysis of electrophysiological data is an emerging technique for understanding the mechanisms of seizures. Model-based analysis enables tracking of hidden brain states that are represented by the dynamics of neural mass models. Neural mass models describe the mean firing rates and mean membrane potentials of populations of neurons. Various neural mass models exist with different levels of complexity and realism. An ideal data-driven model-based analysis framework will incorporate the most realistic model possible, enabling accurate imaging of the physiological variables...
June 9, 2016: International Journal of Neural Systems
Martin Paparella, Annamaria Colacci, Miriam N Jacobs
An approach for a systematic description of the uncertainties and complexity of the standard animal testing and assessment approach for carcinogenicity is explored by using a draft OECD Guidance document that was originally developed for reporting defined in vitro approaches to testing and assessment (OECD, 2016). The format is suitable for this re-purposing and it appears that the potential multitude of approaches for integrating and interpreting data from standard animal testing may ultimately be conceptually similar to the challenge of integrating relevant in vitro and in silico data...
October 24, 2016: ALTEX
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