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complexity, decision making, systems

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https://www.readbyqxmd.com/read/28340600/an-evaluation-of-the-comparative-effectiveness-of-geriatrician-led-comprehensive-geriatric-assessment-for-improving-patient-and-healthcare-system-outcomes-for-older-adults-a-protocol-for-a-systematic-review-and-network-meta-analysis
#1
Charlene Soobiah, Caitlin Daly, Erik Blondal, Joycelyne Ewusie, Joanne Ho, Meghan J Elliott, Rossini Yue, Jayna Holroyd-Leduc, Barbara Liu, Sharon Marr, Jenny Basran, Andrea C Tricco, Jemila Hamid, Sharon E Straus
BACKGROUND: Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective...
March 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28336504/mhealth-for-clinical-decision-making-in-sub-saharan-africa-a-scoping-review
#2
Ibukun-Oluwa Omolade Adepoju, Bregje Joanna Antonia Albersen, Vincent De Brouwere, Jos van Roosmalen, Marjolein Zweekhorst
BACKGROUND: In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established...
March 23, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28333829/acute-traumatic-coagulopathy-the-elephant-in-a-room-of-blind-scientists
#3
Michael A Meledeo, Maryanne C Herzig, James A Bynum, Xiaowu Wu, Anand K Ramasubramanian, Daniel N Darlington, Kristin M Reddoch, Andrew P Cap
Acute traumatic coagulopathy (ATC) is the failure of coagulation homeostasis that can rapidly arise following traumatic injury, hemorrhage, and shock; it is associated with higher injury severity, coagulation abnormalities, and increased blood transfusions. ATC has historically been defined by a prolonged prothrombin time (PT), although newer, more informative measurements of hemostatic function have been employed to improve diagnosis and support clinical decision making. The underlying biochemical mechanisms of and best practice therapeutics for ATC remain under active investigation because of its significant correlation to poor outcomes...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325441/a-review-of-fuzzy-cognitive-maps-in-medicine-taxonomy-methods-and-applications
#4
REVIEW
Abdollah Amirkhani, Elpiniki I Papageorgiou, Akram Mohseni, Mohammad R Mosavi
BACKGROUND AND OBJECTIVE: A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28323337/treatment-pathway-of-bone-sarcoma-in-children-adolescents-and-young-adults
#5
REVIEW
Damon R Reed, Masanori Hayashi, Lars Wagner, Odion Binitie, Diana A Steppan, Andrew S Brohl, Eric T Shinohara, Julia A Bridge, David M Loeb, Scott C Borinstein, Michael S Isakoff
When pediatric, adolescent, and young adult patients present with a bone sarcoma, treatment decisions, especially after relapse, are complex and require a multidisciplinary approach. This review presents scenarios commonly encountered in the therapy of bone sarcomas with the goal of objectively presenting a consensus, multidisciplinary management approach. Little variation was found in the authors' group with respect to local control or systemic therapy. Clinical trials were universally prioritized in all settings...
March 21, 2017: Cancer
https://www.readbyqxmd.com/read/28320112/multiple-sclerosis-patients-understanding-and-preferences-for-risks-and-benefits-of-disease-modifying-drugs-a-systematic-review
#6
REVIEW
Gurpreet K Reen, Eli Silber, Dawn W Langdon
BACKGROUND: Multiple sclerosis (MS) patients are faced with complex risk-benefit profiles of disease-modifying drugs (DMDs) when making treatment decisions. For effective shared decision-making, MS patients should understand the risks and benefits of DMDs and make treatment decisions based on personal preferences. METHODS: This is an inclusive systematic review to primarily assess current understanding of MS patients for information about DMDs provided during the standard healthcare system...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28314191/robust-detection-and-segmentation-of-cell-nuclei-in-biomedical-images-based-on-a-computational-topology-framework
#7
Rodrigo Rojas-Moraleda, Wei Xiong, Niels Halama, Katja Breitkopf-Heinlein, Steven Dooley, Luis Salinas, Dieter W Heermann, Nektarios A Valous
The segmentation of cell nuclei is an important step towards the automated analysis of histological images. The presence of a large number of nuclei in whole-slide images necessitates methods that are computationally tractable in addition to being effective. In this work, a method is developed for the robust segmentation of cell nuclei in histological images based on the principles of persistent homology. More specifically, an abstract simplicial homology approach for image segmentation is established. Essentially, the approach deals with the persistence of disconnected sets in the image, thus identifying salient regions that express patterns of persistence...
March 6, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28306625/visualization-of-the-retina-and-vitreous-during-vitreoretinal-surgery-new-technologies
#8
Sarah P Read, Jorge A Fortun
PURPOSE OF REVIEW: Visualization remains a critical factor in successful ocular surgery.Here we review new technology that has the potential to allow for safer and more efficient retinal surgery. RECENT FINDINGS: Vitreoretinal surgery poses unique visualization challenges such as the need for specialized optical systems and the delicate and microscopic features of retinal structures. Better retinal visualization allows for new approaches to increasingly complex retinal cases...
March 16, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28299667/runx3-and-cell-fate-decisions-in-pancreas-cancer
#9
Martin C Whittle, Sunil R Hingorani
The RUNX family transcription factors are critical regulators of development and frequently dysregulated in cancer. RUNX3, the least well characterized of the three family members, has been variously described as a tumor promoter or suppressor, sometimes with conflicting results and opinions in the same cancer and likely reflecting a complex role in oncogenesis. We recently identified RUNX3 expression as a crucial determinant of the predilection for pancreatic ductal adenocarcinoma (PDA) cells to proliferate locally or promulgate throughout the body...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28298877/applying-structural-systems-thinking-to-frame-perspectives-on-social-work-innovation
#10
Erin J Stringfellow
OBJECTIVE: Innovation will be key to the success of the Grand Challenges Initiative in social work. A structural systems framework based in system dynamics could be useful for considering how to advance innovation. METHOD: Diagrams using system dynamics conventions were developed to link common themes across concept papers written by social work faculty members and graduate students (N = 19). RESULTS: Transdisciplinary teams and ethical partnerships with communities and practitioners will be needed to responsibly develop high-quality innovative solutions...
March 2017: Research on Social Work Practice
https://www.readbyqxmd.com/read/28290273/from-the-ebm-pyramid-to-the-greek-temple-a-new-conceptual-approach-to-guidelines-as-implementation-tools-in-mental-health
#11
L Salvador-Carulla, S Lukersmith, W Sullivan
Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development...
April 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28289051/paediatric-early-warning-systems-for-detecting-and-responding-to-clinical-deterioration-in-children-a-systematic-review
#12
Veronica Lambert, Anne Matthews, Rachel MacDonell, John Fitzsimons
OBJECTIVE: To systematically review the available evidence on paediatric early warning systems (PEWS) for use in acute paediatric healthcare settings for the detection of, and timely response to, clinical deterioration in children. METHOD: The electronic databases PubMed, MEDLINE, CINAHL, EMBASE and Cochrane were searched systematically from inception up to August 2016. Eligible studies had to refer to PEWS, inclusive of rapid response systems and teams. Outcomes had to be specific to the identification of and/or response to clinical deterioration in children (including neonates) in paediatric hospital settings (including emergency departments)...
March 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28287315/near-infrared-spectroscopy-and-geostatistical-analysis-for-modeling-spatial-distribution-of-analytical-constituents-in-bulk-animal-by-product-protein-meals
#13
José A Adame-Siles, Tom Fearn, José E Guerrero-Ginel, Ana Garrido-Varo, Francisco Maroto-Molina, Dolores Pérez-Marín
Control and inspection operations within the context of safety and quality assessment of bulk foods and feeds are not only of particular importance, they are also demanding challenges, given the complexity of food/feed production systems and the variability of product properties. Existing methodologies have a variety of limitations, such as high costs of implementation per sample or shortcomings in early detection of potential threats for human/animal health or quality deviations. Therefore, new proposals are required for the analysis of raw materials in situ in a more efficient and cost-effective manner...
March 2017: Applied Spectroscopy
https://www.readbyqxmd.com/read/28280913/how-decision-support-systems-can-benefit-from-a-theory-of-change-approach
#14
Will Allen, Jennyffer Cruz, Bruce Warburton
Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake...
March 9, 2017: Environmental Management
https://www.readbyqxmd.com/read/28280299/a-practical-guide-about-biosimilar-data-for-health-care-providers-treating-inflammatory-diseases
#15
REVIEW
Joseph Markenson, Daniel F Alvarez, Ira Jacobs, Carol Kirchhoff
To make informed decisions about the safety, efficacy, and clinical utility of a biosimilar, health care providers should understand the types and be able to analyze data generated from a biosimilar development program. This article reviews the biosimilar guidelines, the biosimilar development process to provide education and context about biosimilarity, and uses examples from infliximab biosimilars to review the terminology and potential types of analyses that may be used to compare potential biosimilars to the originator biologic...
2017: Biologics: Targets & Therapy
https://www.readbyqxmd.com/read/28273525/multisensory-integration-in-c-elegans
#16
REVIEW
D Dipon Ghosh, Michael N Nitabach, Yun Zhang, Gareth Harris
Multisensory integration is a neural process by which signals from two or more distinct sensory channels are simultaneously processed to form a more coherent representation of the environment. Multisensory integration, especially when combined with a survey of internal states, provides selective advantages for animals navigating complex environments. Despite appreciation of the importance of multisensory integration in behavior, the underlying molecular and cellular mechanisms remain poorly understood. Recent work looking at how Caenorhabditis elegans makes multisensory decisions has yielded mechanistic insights into how a relatively simple and well-defined nervous system employs circuit motifs of defined features, synaptic signals and extrasynaptic neurotransmission, as well as neuromodulators in processing and integrating multiple sensory inputs to generate flexible and adaptive behavioral outputs...
March 5, 2017: Current Opinion in Neurobiology
https://www.readbyqxmd.com/read/28269808/development-of-a-framework-for-resilience-measurement-suggestion-of-fuzzy-resilience-grade-rg-and-fuzzy-resilience-early-warning-grade-rewg
#17
Mohsen Omidvar, Adel Mazlomi, Fam Iraj Mohammad, Fereshteh Nirumand
BACKGROUND: Resilience engineering (RE) can be an alternative technique to the traditional risk assessment and management techniques, to predict and manage safety conditions of modern socio-technical organizations. While traditional risk management approaches are retrospective and highlight error calculation and computation of malfunction possibilities, resilience engineering seeks ways to improve capacity at all levels of organizations in order to build strong yet flexible processes...
February 28, 2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/28265245/passion-and-pacing-in-endurance-performance
#18
Lieke Schiphof-Godart, Florentina J Hettinga
Endurance sports are booming, with sports passionates of varying skills and expertise battering city streets and back roads on their weekly or daily exercise rounds. The investments required for performing in endurance exercise are nevertheless considerable, and passion for their sport might explain the efforts endurance athletes are willing to make. Passion may be defined as a strong motivational force and as such might be related to the neurophysiological basis underlying the drive to exercise. A complex relationship between the brain and other systems is responsible for athletes' exercise behavior and thus performance in sports...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28263408/cultural-competency-of-a-mobile-customized-patient-education-tool-for-improving-potential-kidney-transplant-recipients-knowledge-and-decision-making
#19
David A Axelrod, Crystal S Kynard-Amerson, David Wojciechowski, Marie Jacobs, Krista L Lentine, Mark Schnitzler, John D Peipert, Amy D Waterman
Patients considering renal transplantation face an increasingly complex array of choices as a result of the revised kidney transplant allocation system. Decision aids have been shown to improve patient decision making through the provision of detailed, relevant, individualized clinical data. A mobile iOS based application (app) including animated patient education and individualized risk adjusted outcomes following kidney transplants with varying donor characteristics and DSA waiting times was piloted in 2 large US transplant programs with a diverse group of renal transplant candidates (N=81)...
March 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28261208/t-cell-subpopulations-in-healthy-elderly-and-lung-cancer-patients-insights-from-cuban-studies
#20
REVIEW
Danay Saavedra, Beatriz Garcia, Agustin Lage
The senescence of the immune system and the risk of cancer increase with aging. Age itself entails changes in the immune system, which are related to a decrease in thymic output of naïve lymphocytes, an accumulation of chronic antigenic load, notably chronic viral infections such as cytomegalovirus (CMV), and replicative senescence of lymphocytes. These changes could eventually contribute to cancer risk and affect the response to cancer treatment. However, several confounding factors make it difficult to draw a picture of causal relationships...
2017: Frontiers in Immunology
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