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Dynamic decision making

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https://www.readbyqxmd.com/read/29784812/distributed-and-dynamic-intracellular-organization-of-extracellular-information
#1
Alejandro A Granados, Julian M J Pietsch, Sarah A Cepeda-Humerez, Iseabail L Farquhar, Gašper Tkačik, Peter S Swain
Although cells respond specifically to environments, how environmental identity is encoded intracellularly is not understood. Here, we study this organization of information in budding yeast by estimating the mutual information between environmental transitions and the dynamics of nuclear translocation for 10 transcription factors. Our method of estimation is general, scalable, and based on decoding from single cells. The dynamics of the transcription factors are necessary to encode the highest amounts of extracellular information, and we show that information is transduced through two channels: Generalists (Msn2/4, Tod6 and Dot6, Maf1, and Sfp1) can encode the nature of multiple stresses, but only if stress is high; specialists (Hog1, Yap1, and Mig1/2) encode one particular stress, but do so more quickly and for a wider range of magnitudes...
May 21, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29781890/complexities-of-the-diagnostic-process
#2
Barbara Schildkrout
The diagnostic process is a highly complex, problem-solving enterprise. Yet, traditional case reports have not focused directly on this endeavor. Physicians could use the case format to present actual experiences of getting to a diagnosis. This approach would allow for modeling of nonjudgmental, self-reflective practices and also provide information to aid in studying the diagnostic endeavor. Given that diagnostic errors in medicine are widespread and constitute a serious public health problem, it is crucial for physicians to understand the diagnostic process as one step toward improving error rates...
May 17, 2018: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29781587/patients-concerns-and-perceptions-regarding-biologic-therapies-in-ankylosing-spondylitis-insights-from-a-large-scale-survey-of-social-media-platforms
#3
Eldin Dzubur, Carine Khalil, Christopher V Almario, Benjamin Noah, Deeba Minhas, Mariko Ishimori, Corey Arnold, Yujin Park, Jonathan Kay, Michael H Weisman, Brennan M R Spiegel
OBJECTIVE: Few studies have examined ankylosing spondylitis (AS) patients' concerns and perceptions of biologic therapies outside of traditional surveys. In this study, we used social media data to examine AS patients' knowledge, attitudes, and beliefs regarding biologic therapies. METHODS: We collected posts from 601 social media sites made between 1/1/06-4/26/17. Each post mentioned both an AS keyword and a biologic. To explore themes within the collection in an unsupervised manner, a latent Dirichlet allocation topic model was fit to the dataset...
May 21, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29778777/modeling-the-dynamics-of-recognition-memory-testing-with-an-integrated-model-of-retrieval-and-decision-making
#4
Adam F Osth, Anna Jansson, Simon Dennis, Andrew Heathcote
A robust finding in recognition memory is that performance declines monotonically across test trials. Despite the prevalence of this decline, there is a lack of consensus on the mechanism responsible. Three hypotheses have been put forward: (1) interference is caused by learning of test items (2) the test items cause a shift in the context representation used to cue memory and (3) participants change their speed-accuracy thresholds through the course of testing. We implemented all three possibilities in a combined model of recognition memory and decision making, which inherits the memory retrieval elements of the Osth and Dennis (2015) model and uses the diffusion decision model (DDM: Ratcliff, 1978) to generate choice and response times...
May 17, 2018: Cognitive Psychology
https://www.readbyqxmd.com/read/29778474/a-longitudinal-observational-study-of-the-dynamics-of-mycoplasma-bovis-antibodies-in-naturally-exposed-and-diseased-dairy-cows
#5
Mette B Petersen, Jeanette Pedersen, Dinah L Holm, Matthew Denwood, Liza R Nielsen
Mycoplasma bovis is an important pathogen causing disease and substantial economic losses in cattle. However, knowledge of the dynamics of antibody responses in individual cows in the face of an outbreak is currently extremely limited. The use of commercial antibody tests to support clinical decision-making and for surveillance purposes is therefore challenging. Our objective was to describe the dynamics of M. bovis antibody responses in 4 Danish dairy herds experiencing an acute outbreak of M. bovis-associated disease, and to compare the antibody dynamics between dairy cows with different disease manifestations...
May 16, 2018: Journal of Dairy Science
https://www.readbyqxmd.com/read/29776127/collective-conflict-resolution-in-groups-on-the-move
#6
Itai Pinkoviezky, Iain D Couzin, Nir S Gov
Collective decision-making regarding direction of travel is observed during natural motion of animal and cellular groups. This phenomenon is exemplified, in the simplest case, by a group that contains two informed subgroups that hold conflicting preferred directions of motion. Under such circumstances, simulations, subsequently supported by experimental data with birds and primates, have demonstrated that the resulting motion is either towards a compromise direction or towards one of the preferred targets (even when the two subgroups are equal in size)...
March 2018: Physical Review. E
https://www.readbyqxmd.com/read/29775628/-cost-effectiveness-of-interventions-to-improve-hand-hygiene-in-healthcare-workers-in-middle-income-hospital-settings-a-model-based-analysis
#7
Nantasit Luangasanatip, Maliwan Hongsuwan, Yoel Lubell, Direk Limmathurotsakul, Pramot Srisamang, Nicholas Pj Day, Nicholas Graves, Ben S Cooper
BACKGROUND: Multimodal interventions are effective in increasing hand hygiene (HH) compliance amongst healthcare workers, but it is not known whether such interventions are cost-effective outside high-income countries. AIM: To evaluate the cost-effectiveness of multimodal hospital interventions to improve hand hygiene (HH) compliance in a middle-income country. METHOD: We adopted a conservative approach by developing a model to determine whether reductions in Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) alone would make HH interventions cost-effective in intensive care units (ICUs)...
May 15, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29775203/optimal-two-stage-dynamic-treatment-regimes-from-a-classification-perspective-with-censored-survival-data
#8
Rebecca Hager, Anastasios A Tsiatis, Marie Davidian
Clinicians often make multiple treatment decisions at key points over the course of a patient's disease. A dynamic treatment regime is a sequence of decision rules, each mapping a patient's observed history to the set of available, feasible treatment options at each decision point, and thus formalizes this process. An optimal regime is one leading to the most beneficial outcome on average if used to select treatment for the patient population. We propose a method for estimation of an optimal regime involving two decision points when the outcome of interest is a censored survival time, which is based on maximizing a locally efficient, doubly robust, augmented inverse probability weighted estimator for average outcome over a class of regimes...
May 18, 2018: Biometrics
https://www.readbyqxmd.com/read/29765693/homophily-heterophily-and-the-diversity-of-messages-among-decision-making-individuals
#9
Pouria Ramazi, James Riehl, Ming Cao
To better understand the intriguing mechanisms behind cooperation among decision-making individuals, we study the simple yet appealing use of preplay communication or cheap talk in evolutionary games, when players are able to choose strategies based on whether an opponent sends the same message as they do. So when playing games, in addition to pure cooperation and defection, players have two new strategies in this setting: homophilic (respectively, heterophilic) cooperation which is to cooperate (respectively, defect) only with those who send the same message as they do...
April 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29759070/identifying-frailty-in-primary-care-a-qualitative-description-of-family-physicians-gestalt-impressions-of-their-older-adult-patients
#10
Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R Whitehead, Paula A Rochon, Lisa M McCarthy
BACKGROUND: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. METHODS: Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over...
May 14, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29757065/the-impact-of-an-evolving-profession-on-the-frequency-and-perceived-difficulty-of-ethical-encounters-among-physical-therapists-in-the-clinic
#11
Patti Berg-Poppe, Angela MacCabe, Joy Karges
BACKGROUND: Ethical decision making is situated within dynamic contexts specific to practice standards and environments, contemporary policy, and responsive educational systems. Reflecting on an evolving profession lends insight into the role of ethical codes of conduct. OBJECTIVE: The purpose of this study was to gather information about the frequency and perceived difficulty physical therapists (PTs) experience with common ethical situations within contemporary clinical practice...
May 14, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29755403/has-the-time-come-to-stratify-and-score-sudep-risk-to-inform-people-with-epilepsy-of-their-changes-in-safety
#12
Rohit Shankar, Craig Newman, Alistair Gales, Brendan N McLean, Jane Hanna, Samantha Ashby, Matthew C Walker, Josemir W Sander
Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29753616/an-interoperable-clinical-decision-support-system-for-early-detection-of-sirs-in-pediatric-intensive-care-using-openehr
#13
Antje Wulff, Birger Haarbrandt, Erik Tute, Michael Marschollek, Philipp Beerbaum, Thomas Jack
BACKGROUND: Clinical decision-support systems (CDSS) are designed to solve knowledge-intensive tasks for supporting decision-making processes. Although many approaches for designing CDSS have been proposed, due to high implementation costs, as well as the lack of interoperability features, current solutions are not well-established across different institutions. Recently, the use of standardized formalisms for knowledge representation as terminologies as well as the integration of semantically enriched clinical information models, as openEHR Archetypes, and their reuse within CDSS are theoretically considered as key factors for reusable CDSS...
May 9, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29750811/germination-fitness-of-two-temperate-epiphytic-ferns-shifts-under-increasing-temperatures-and-forest-fragmentation
#14
Jose María Gabriel Y Galán, Antonio Murciano, Laure Sirvent, Abel Sánchez, James E Watkins
Ferns are an important component of ecosystems around the world. Studies of the impacts that global changes may have on ferns are scarce, yet emerging studies indicate that some species may be particularly sensitive to climate change. The lack of research in this subject is much more aggravated in the case of epiphytes, and especially those that live under temperate climates. A mathematical model was developed for two temperate epiphytic ferns in order to predict potential impacts on spore germination kinetics, in response to different scenarios of global change, coming from increasing temperature and forest fragmentation...
2018: PloS One
https://www.readbyqxmd.com/read/29748042/social-information-links-individual-behavior-to-population-and-community-dynamics
#15
REVIEW
Michael A Gil, Andrew M Hein, Orr Spiegel, Marissa L Baskett, Andrew Sih
When individual animals make decisions, they routinely use information produced intentionally or unintentionally by other individuals. Despite its prevalence and established fitness consequences, the effects of such social information on ecological dynamics remain poorly understood. Here, we synthesize results from ecology, evolutionary biology, and animal behavior to show how the use of social information can profoundly influence the dynamics of populations and communities. We combine recent theoretical and empirical results and introduce simple population models to illustrate how social information use can drive positive density-dependent growth of populations and communities (Allee effects)...
May 7, 2018: Trends in Ecology & Evolution
https://www.readbyqxmd.com/read/29747633/a-critique-of-the-uganda-district-league-table-using-a-normative-health-system-performance-assessment-framework
#16
Christine KirungaTashobya, Freddie Ssengooba, Juliet Nabyonga-Orem, Juliet Bataringaya, Jean Macq, Bruno Marchal, Timothy Musila, Bart Criel
BACKGROUND: In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality. METHODS: A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29747569/systolic-characteristics-and-dynamic-changes-of-the-mitral-valve-in-different-grades-of-ischemic-mitral-regurgitation-insights-from-3d-transesophageal-echocardiography
#17
Caroline Morbach, Diego Bellavia, Stefan Störk, Lissa Sugeng
BACKGROUND: Mitral regurgitation in ischemic heart disease (IMR) is a strong predictor of outcome but until now, pathophysiology is not sufficiently understood and treatment is not satisfying. We aimed to systematically evaluate structural and functional mitral valve leaflet and annular characteristics in patients with IMR to determine the differences in geometric and dynamic changes of the MV between significant and mild IMR. METHODS: Thirty-seven patients with IMR (18 mild (m)MR, 19 significant (moderate+severe) (s)MR) and 33 controls underwent TEE...
May 10, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29746722/pharmacometric-analysis-of-the-relationship-between-absolute-lymphocyte-count-and-expanded-disability-status-scale-and-relapse-rate-efficacy-end-points-in-multiple-sclerosis-trials
#18
A M Novakovic, A Thorsted, E Schindler, S Jönsson, A Munafo, M O Karlsson
The aim of this work was to assess the relationship between the absolute lymphocyte count (ALC), and disability (as measured by the Expanded Disability Status Scale [EDSS]) and occurrence of relapses, 2 efficacy endpoints, respectively, in patients with remitting-relasping multiple sclerosis. Data for ALC, EDSS, and relapse rate were available from 1319 patients receiving placebo and/or cladribine tablets. Pharmacodynamic models were developed to characterize the time course of the endpoints. ALC-related measures were then evaluated as predictors of the efficacy endpoints...
May 10, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29744583/a-switching-model-for-the-impact-of-toxins-on-the-spread-of-infectious-diseases
#19
Lulu Wang, Zhen Jin, Hao Wang
To study the effects of an environmental toxin, such as fine particles in hazy weather, on the spread of infectious diseases, we derive a toxin-dependent dynamic model that incorporates the birth rate with the toxin-dependent switching mode, the mortality rate, and infection rate with the toxin-dependent saturation effect. We analyze the model by showing the positive invariance, existence and stability of equilibria, and bifurcations. Numerical simulation is adopted to verify the mathematical results and exhibit transcritical and Hopf bifurcations...
May 9, 2018: Journal of Mathematical Biology
https://www.readbyqxmd.com/read/29742590/a-multicenter-observational-study-of-family-participation-in-icu-rounds
#20
Selena S Au, Amanda L Roze des Ordons, Jeanna Parsons Leigh, Andrea Soo, Simon Guienguere, Sean M Bagshaw, Henry T Stelfox
OBJECTIVES: Guidelines recommend offering family members of critically ill patients the option to attend interdisciplinary team rounds as a way to improve communication and satisfaction. Uncertainty remains around the benefits and risks. DESIGN: We conducted an observational study to describe family participation in ICU rounds and its association with rounding processes. SETTING: Rounds conducted under the leadership of 33 attending physicians in seven hospitals across three Canadian cities...
May 7, 2018: Critical Care Medicine
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