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https://www.readbyqxmd.com/read/28541304/digital-logic-circuits-in-yeast-with-crispr-dcas9-nor-gates
#1
Miles W Gander, Justin D Vrana, William E Voje, James M Carothers, Eric Klavins
Natural genetic circuits enable cells to make sophisticated digital decisions. Building equally complex synthetic circuits in eukaryotes remains difficult, however, because commonly used components leak transcriptionally, do not arbitrarily interconnect or do not have digital responses. Here, we designed dCas9-Mxi1-based NOR gates in Saccharomyces cerevisiae that allow arbitrary connectivity and large genetic circuits. Because we used the chromatin remodeller Mxi1, our gates showed minimal leak and digital responses...
May 25, 2017: Nature Communications
https://www.readbyqxmd.com/read/28539192/shared-decision-making-and-the-promise-of-a-respectful-and-equitable-healthcare-system-in-peru
#2
Germán Málaga, Zoila O Romero, Ariana S Málaga, Sofia Cuba-Fuentes
Peru has achieved sustained development in the last two decades. However, despite this achievement, it has not been matched with improvements in the quality of education and health; investment in both sectors is among the lowest in the region. This situation perpetuates huge gaps in infrastructure and also conditions a poor literacy level of the population specifically in health. Currently, there is a fragmented model of patient care, in which the systems are exclusive of each other. They do not cooperate or communicate with each other; and if there is no vertical communication within the system, preventing referral of patients directly from the basic level to the complex level of care when needed...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#3
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28488985/an-alternative-paradigm-for-evidence-based-medicine-revisiting-lawrence-weed-md-s-systems-approach
#4
Ali Rafik Shukor
Lawrence Weed, MD, is renowned for being the father of the Problem-Oriented Medical Record (POMR), the medical care standard for collecting, managing, and contextualizing patient data in medical records. What have been consistently overlooked are his teachings on knowledge coupling, which refers to matching patient data with associated medical knowledge. Together, the POMR standard and knowledge coupling are meant to form the basis of a systems approach that enables individualized evidence-based decision making within the context of multimorbidity and patient complexity...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28486953/sustainability-in-health-care-by-allocating-resources-effectively-share-3-examining-how-resource-allocation-decisions-are-made-implemented-and-evaluated-in-a-local-healthcare-setting
#5
Claire Harris, Kelly Allen, Cara Waller, Vanessa Brooke
BACKGROUND: This is the third in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Leaders in a large Australian health service planned to establish an organisation-wide, systematic, integrated, evidence-based approach to disinvestment. In order to introduce new systems and processes for disinvestment into existing decision-making infrastructure, we aimed to understand where, how and by whom resource allocation decisions were made, implemented and evaluated...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28485906/-complexity-of-care-and-organizational-effectiveness-a-survey-among-medical-care-units-in-nine-lombardy-region-hospitals
#6
Sara Pasquali, Enrica Capitoni, Giuseppina Tiraboschi, Adriana Alborghetti, Giuseppe De Luca, Stefania Di Mauro
AIM: Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. METHOD: Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being...
January 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28480714/nanoparticle-protein-interactions-therapeutic-approaches-and-supramolecular-chemistry
#7
Mathis Kopp, Sebastian Kollenda, Matthias Epple
Research on nanoparticles has evolved into a major topic in chemistry. Concerning biomedical research, nanoparticles have decisively entered the field, creating the area of nanomedicine where nanoparticles are used for drug delivery, imaging, and tumor targeting. Besides these functions, scientists have addressed the specific ways in which nanoparticles interact with biomolecules, with proteins being the most prominent example. Depending on their size, shape, charge, and surface functionality, specifically designed nanoparticles can interact with proteins in a defined way...
May 8, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28476159/sustainability-in-health-care-by-allocating-resources-effectively-share-2-identifying-opportunities-for-disinvestment-in-a-local-healthcare-setting
#8
Claire Harris, Kelly Allen, Richard King, Wayne Ramsey, Cate Kelly, Malar Thiagarajan
BACKGROUND: This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally...
May 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28475664/dynamical-resilience-indicators-in-time-series-of-self-rated-health-correspond-to-frailty-levels-in-older-adults
#9
Sanne M W Gijzel, Ingrid A van de Leemput, Marten Scheffer, Mattia Roppolo, Marcel G M Olde Rikkert, René J F Melis
Background: We currently still lack valid methods to dynamically measure resilience for stressors before the appearance of adverse health outcomes that hamper well-being. Quantifying an older adult's resilience in an early stage would aid complex decision-making in health care. Translating complex dynamical systems theory to humans, we hypothesized that three dynamical indicators of resilience (variance, temporal autocorrelation, and cross-correlation) in time series of self-rated physical, mental, and social health were associated with frailty levels in older adults...
May 5, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28473849/directed-bee-colony-optimization-algorithm-to-solve-the-nurse-rostering-problem
#10
M Rajeswari, J Amudhavel, Sujatha Pothula, P Dhavachelvan
The Nurse Rostering Problem is an NP-hard combinatorial optimization, scheduling problem for assigning a set of nurses to shifts per day by considering both hard and soft constraints. A novel metaheuristic technique is required for solving Nurse Rostering Problem (NRP). This work proposes a metaheuristic technique called Directed Bee Colony Optimization Algorithm using the Modified Nelder-Mead Method for solving the NRP. To solve the NRP, the authors used a multiobjective mathematical programming model and proposed a methodology for the adaptation of a Multiobjective Directed Bee Colony Optimization (MODBCO)...
2017: Computational Intelligence and Neuroscience
https://www.readbyqxmd.com/read/28471111/intelligent-diagnosis-of-jaundice-with-dynamic-uncertain-causality-graph-model
#11
Shao-Rui Hao, Shi-Chao Geng, Lin-Xiao Fan, Jia-Jia Chen, Qin Zhang, Lan-Juan Li
Jaundice is a common and complex clinical symptom potentially occurring in hepatology, general surgery, pediatrics, infectious diseases, gynecology, and obstetrics, and it is fairly difficult to distinguish the cause of jaundice in clinical practice, especially for general practitioners in less developed regions. With collaboration between physicians and artificial intelligence engineers, a comprehensive knowledge base relevant to jaundice was created based on demographic information, symptoms, physical signs, laboratory tests, imaging diagnosis, medical histories, and risk factors...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28467434/a-concept-for-optimizing-avalanche-rescue-strategies-using-a-monte-carlo-simulation-approach
#12
Ingrid Reiweger, Manuel Genswein, Peter Paal, Jürg Schweizer
Recent technical and strategical developments have increased the survival chances for avalanche victims. Still hundreds of people, primarily recreationists, get caught and buried by snow avalanches every year. About 100 die each year in the European Alps-and many more worldwide. Refining concepts for avalanche rescue means to optimize the procedures such that the survival chances are maximized in order to save the greatest possible number of lives. Avalanche rescue includes several parameters related to terrain, natural hazards, the people affected by the event, the rescuers, and the applied search and rescue equipment...
2017: PloS One
https://www.readbyqxmd.com/read/28458200/conservation-of-groundwater-from-over-exploitation-scientific-analyses-for-groundwater-resources-management
#13
Fi-John Chang, Chien-Wei Huang, Su-Ting Cheng, Li-Chiu Chang
Groundwater over-exploitation has produced many critical problems in the southern Taiwan. The accumulated stresses and demands make groundwater management a complex issue that needs innovative scientific analyses for deriving better water management strategies. In this study, we aimed to provide scientific analyses of the groundwater systems in the Pingtung Plain through soft-computing techniques to explore its spatial-temporal and hydro-geological characteristics for the elaboration of future groundwater management plans and in decision-making process...
April 27, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28442714/mitigating-herding-in-hierarchical-crowdsourcing-networks
#14
Han Yu, Chunyan Miao, Cyril Leung, Yiqiang Chen, Simon Fauvel, Victor R Lesser, Qiang Yang
Hierarchical crowdsourcing networks (HCNs) provide a useful mechanism for social mobilization. However, spontaneous evolution of the complex resource allocation dynamics can lead to undesirable herding behaviours in which a small group of reputable workers are overloaded while leaving other workers idle. Existing herding control mechanisms designed for typical crowdsourcing systems are not effective in HCNs. In order to bridge this gap, we investigate the herding dynamics in HCNs and propose a Lyapunov optimization based decision support approach - the Reputation-aware Task Sub-delegation approach with dynamic worker effort Pricing (RTS-P) - with objective functions aiming to achieve superlinear time-averaged collective productivity in an HCN...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/28438806/emerging-affinity-based-proteomic-technologies-for-large-scale-plasma-profiling-in-cardiovascular-disease
#15
REVIEW
J Gustav Smith, Robert E Gerszten
Plasma biomarkers that reflect molecular states of the cardiovascular system are central for clinical decision making. Routinely used plasma biomarkers include troponins, natriuretic peptides, and lipoprotein particles, yet interrogate only a modest subset of pathways relevant to cardiovascular disease. Systematic profiling of a larger portion of circulating plasma proteins (the plasma proteome) will provide opportunities for unbiased discovery of novel markers to improve diagnostic or predictive accuracy. In addition, proteomic profiling may inform pathophysiological understanding and point to novel therapeutic targets...
April 25, 2017: Circulation
https://www.readbyqxmd.com/read/28437869/risk-modeling-of-interdependent-complex-systems-of-systems-theory-and-practice
#16
Yacov Y Haimes
The emergence of the complexity characterizing our systems of systems (SoS) requires a reevaluation of the way we model, assess, manage, communicate, and analyze the risk thereto. Current models for risk analysis of emergent complex SoS are insufficient because too often they rely on the same risk functions and models used for single systems. These models commonly fail to incorporate the complexity derived from the networks of interdependencies and interconnectedness (I-I) characterizing SoS. There is a need to reevaluate currently practiced risk analysis to respond to this reality by examining, and thus comprehending, what makes emergent SoS complex...
April 24, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28434433/overview-on-the-current-implementation-of-health-technology-assessment-in-the-healthcare-system-in-hungary
#17
Bertalan Németh, Marcell Csanádi, Zoltán Kaló
OBJECTIVES: Our objectives were to assess the current implementation of health technology assessment (HTA) in Hungary and to identify country-specific patterns of challenges and potential improvements. METHODS: We applied a structure that can be used to create HTA implementation roadmaps to evaluate various issues regarding HTA implementation. A comprehensive description of the Hungarian HTA system is presented according to relevant literature and experiences of the authors...
April 24, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28428392/ecosystem-management-as-a-wicked-problem
#18
REVIEW
Ruth DeFries, Harini Nagendra
Ecosystems are self-regulating systems that provide societies with food, water, timber, and other resources. As demands for resources increase, management decisions are replacing self-regulating properties. Counter to previous technical approaches that applied simple formulas to estimate sustainable yields of single species, current research recognizes the inherent complexity of ecosystems and the inability to foresee all consequences of interventions across different spatial, temporal, and administrative scales...
April 21, 2017: Science
https://www.readbyqxmd.com/read/28428202/precision-physiology-and-rescue-of-brain-ion-channel-disorders
#19
REVIEW
Jeffrey Noebels
Ion channel genes, originally implicated in inherited excitability disorders of muscle and heart, have captured a major role in the molecular diagnosis of central nervous system disease. Their arrival is heralded by neurologists confounded by a broad phenotypic spectrum of early-onset epilepsy, autism, and cognitive impairment with few effective treatments. As detection of rare structural variants in channel subunit proteins becomes routine, it is apparent that primary sequence alone cannot reliably predict clinical severity or pinpoint a therapeutic solution...
May 1, 2017: Journal of General Physiology
https://www.readbyqxmd.com/read/28428165/a-framework-for-the-study-of-complex-mhealth-interventions-in-diverse-cultural-settings
#20
Marion A Maar, Karen Yeates, Nancy Perkins, Lisa Boesch, Diane Hua-Stewart, Peter Liu, Jessica Sleeth, Sheldon W Tobe
BACKGROUND: To facilitate decision-making capacity between options of care under real-life service conditions, clinical trials must be pragmatic to evaluate mobile health (mHealth) interventions under the variable conditions of health care settings with a wide range of participants. The mHealth interventions require changes in the behavior of patients and providers, creating considerable complexity and ambiguity related to causal chains. Process evaluations of the implementation are necessary to shed light on the range of unanticipated effects an intervention may have, what the active ingredients in everyday practice are, how they exert their effect, and how these may vary among recipients or between sites...
April 20, 2017: JMIR MHealth and UHealth
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