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1.
Philos Trans R Soc Lond B Biol Sci ; 379(1912): 20220533, 2024 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-39230452

RESUMEN

The spatial availability of social resources is speculated to structure animal movement decisions, but the effects of social resources on animal movements are difficult to identify because social resources are rarely measured. Here, we assessed whether varying availability of a key social resource-access to receptive mates-produces predictable changes in movement decisions among bighorn sheep in Nevada, the United States. We compared the probability that males made long-distance 'foray' movements, a critical driver of connectivity, across three ecoregions with varying temporal duration of a socially mediated factor, breeding season. We used a hidden Markov model to identify foray events and then quantified the effects of social covariates on the probability of foray using a discrete choice model. We found that males engaged in forays at higher rates when the breeding season was short, suggesting that males were most responsive to the social resource when its existence was short lived. During the breeding season, males altered their response to social covariates, relative to the non-breeding season, though patterns varied, and age was associated with increased foray probability. Our results suggest that animals respond to the temporal availability of social resources when making the long-distance movements that drive connectivity. This article is part of the theme issue 'The spatial-social interface: a theoretical and empirical integration'.


Asunto(s)
Borrego Cimarrón , Animales , Borrego Cimarrón/fisiología , Masculino , Nevada , Conducta Social , Estaciones del Año , Femenino , Conducta Sexual Animal/fisiología , Dinámica Poblacional , Movimiento
2.
Ecol Evol ; 14(9): e11665, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39224155

RESUMEN

During spring, migratory birds are required to optimally balance energetic costs of migration across heterogeneous landscapes and weather conditions to survive and reproduce successfully. Therefore, an individual's migratory performance may influence reproductive outcomes. Given large-scale changes in land use, climate, and potential carry-over effects, understanding how individuals migrate in relation to breeding outcomes is critical to predicting how future scenarios may affect populations. We used GPS tracking devices on 56 Greater White-fronted Geese (Anser albifrons) during four spring migrations to examine whether migration characteristics influenced breeding propensity and breeding outcome. We found a strong longitudinal difference in arrival to the breeding areas (18 days earlier), pre-nesting duration (90.9% longer), and incubation initiation dates (9 days earlier) between western- and eastern-Arctic breeding regions, with contrasting effects on breeding outcomes, but no migration characteristic strongly influenced breeding outcome. We found that breeding region influenced whether an individual likely pursued a capital or income breeding strategy. Where individuals fell along the capital-income breeding continuum was influenced by longitude, revealing geographic effects of life-history strategy among conspecifics. Factors that govern breeding outcomes likely occur primarily upon arrival to breeding areas or are related to individual quality and previous breeding outcome, and may not be directly tied to migratory decision-making across broad scales.

3.
J Neurosci Methods ; 411: 110275, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39241968

RESUMEN

BACKGROUND: There is growing interest in understanding the dynamic functional connectivity (DFC) between distributed brain regions. However, it remains challenging to reliably estimate the temporal dynamics from resting-state functional magnetic resonance imaging (rs-fMRI) due to the limitations of current methods. NEW METHODS: We propose a new model called HDP-HSMM-BPCA for sparse DFC analysis of high-dimensional rs-fMRI data, which is a temporal extension of probabilistic principal component analysis using Bayesian nonparametric hidden semi-Markov model (HSMM). Specifically, we utilize a hierarchical Dirichlet process (HDP) prior to remove the parametric assumption of the HMM framework, overcoming the limitations of the standard HMM. An attractive superiority is its ability to automatically infer the state-specific latent space dimensionality within the Bayesian formulation. RESULTS: The experiment results of synthetic data show that our model outperforms the competitive models with relatively higher estimation accuracy. In addition, the proposed framework is applied to real rs-fMRI data to explore sparse DFC patterns. The findings indicate that there is a time-varying underlying structure and sparse DFC patterns in high-dimensional rs-fMRI data. COMPARISON WITH EXISTING METHODS: Compared with the existing DFC approaches based on HMM, our method overcomes the limitations of standard HMM. The observation model of HDP-HSMM-BPCA can discover the underlying temporal structure of rs-fMRI data. Furthermore, the relevant sparse DFC construction algorithm provides a scheme for estimating sparse DFC. CONCLUSION: We describe a new computational framework for sparse DFC analysis to discover the underlying temporal structure of rs-fMRI data, which will facilitate the study of brain functional connectivity.

4.
Hum Brain Mapp ; 45(13): e70018, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39230193

RESUMEN

The characterisation of resting-state networks (RSNs) using neuroimaging techniques has significantly contributed to our understanding of the organisation of brain activity. Prior work has demonstrated the electrophysiological basis of RSNs and their dynamic nature, revealing transient activations of brain networks with millisecond timescales. While previous research has confirmed the comparability of RSNs identified by electroencephalography (EEG) to those identified by magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI), most studies have utilised static analysis techniques, ignoring the dynamic nature of brain activity. Often, these studies use high-density EEG systems, which limit their applicability in clinical settings. Addressing these gaps, our research studies RSNs using medium-density EEG systems (61 sensors), comparing both static and dynamic brain network features to those obtained from a high-density MEG system (306 sensors). We assess the qualitative and quantitative comparability of EEG-derived RSNs to those from MEG, including their ability to capture age-related effects, and explore the reproducibility of dynamic RSNs within and across the modalities. Our findings suggest that both MEG and EEG offer comparable static and dynamic network descriptions, albeit with MEG offering some increased sensitivity and reproducibility. Such RSNs and their comparability across the two modalities remained consistent qualitatively but not quantitatively when the data were reconstructed without subject-specific structural MRI images.


Asunto(s)
Electroencefalografía , Magnetoencefalografía , Red Nerviosa , Humanos , Magnetoencefalografía/métodos , Electroencefalografía/métodos , Adulto , Red Nerviosa/fisiología , Red Nerviosa/diagnóstico por imagen , Masculino , Femenino , Adulto Joven , Persona de Mediana Edad , Imagen por Resonancia Magnética/métodos , Anciano , Conectoma/métodos , Adolescente , Encéfalo/fisiología , Encéfalo/diagnóstico por imagen , Descanso/fisiología
5.
Front Public Health ; 12: 1438945, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39139662

RESUMEN

Background: Point-of-care Testing (POCT) glycosylated hemoglobin (HbA1c) is a convenient, cheap, effective and accessible screening method for type 2 diabetes in rural areas and community settings that is widely used in the European region and Japan, but not yet widespread in China. The study is the first to evaluate the cost-effectiveness of POCT HbA1c, fasting capillary glucose (FCG), and venous blood HbA1c to screen for type 2 diabetes in urban and rural areas of China, and to identify the best socio-economically beneficial screening strategy. Methods: Based on urban and rural areas in China, economic models for type 2 diabetes screening were constructed from a social perspective. The subjects of this study were adults aged 18-80 years with undiagnosed type 2 diabetes. Three screening strategies were established for venous blood HbA1c, FCG and POCT HbA1c, and cost-effectiveness analysis was performed by Markov models. One-way sensitivity analysis and probabilistic sensitivity analysis were performed on all parameters of the model to verify the stability of the results. Results: Compared with FCG, POCT HbA1c was cost-effective with an incremental cost-utility ratio (ICUR) of $500.06/quality-adjusted life year (QALY) in urban areas and an ICUR of $185.10/QALY in rural areas, within the willingness-to-pay threshold (WTP = $37,653). POCT HbA1c was cost-effective with lower cost and higher utility compared with venous blood HbA1c in both urban and rural areas. In the comparison of venous blood HbA1c and FCG, venous blood HbA1c was cost-effective (ICUR = $20,833/QALY) in urban areas but not in rural areas (ICUR = $41,858/QALY). Sensitivity analyses showed that the results of the study were stable and credible. Conclusions: POCT HbA1c was cost-effective for type 2 diabetes screening in both urban and rural areas of China, which could be considered for future clinical practice in China. Factors such as geographic location, local financial situation and resident compliance needed to be considered when making the choice of venous blood HbA1c or FCG.


Asunto(s)
Análisis Costo-Beneficio , Diabetes Mellitus Tipo 2 , Hemoglobina Glucada , Pruebas en el Punto de Atención , Población Rural , Población Urbana , Humanos , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/sangre , China , Hemoglobina Glucada/análisis , Persona de Mediana Edad , Adulto , Anciano , Pruebas en el Punto de Atención/economía , Femenino , Masculino , Población Rural/estadística & datos numéricos , Anciano de 80 o más Años , Tamizaje Masivo/economía , Adolescente , Adulto Joven , Glucemia/análisis , Análisis de Costo-Efectividad
6.
Vaccine X ; 19: 100514, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39108420

RESUMEN

Background: NVX-CoV2373 is one of the vaccines marketed for COVID-19 prevention in Japan. Information on its cost-effectiveness is important for making well-informed decisions on the future of Japan's COVID-19 vaccination programme from the public healthcare payer's perspective. The aim of this study was to evaluate the cost-effectiveness of NVX-CoV2373 vaccination in the elderly Japanese population. Methods: Two analysis populations that included elderly Japanese individuals (aged ≥ 65 years) were defined in this study: those who had not received a COVID-19 vaccine or had not completed a primary vaccination series (i.e., first two vaccinations) with an approved COVID-19 vaccine (analysis population 1), and those who had received two primary vaccinations with an approved COVID-19 vaccine (analysis population 2). A literature-informed Markov model for each analysis population was developed to evaluate the cost-effectiveness of vaccination with NVX-CoV2373 against no vaccination with NVX-CoV2373 from the public healthcare payer's perspective as a base-case analysis and from the societal perspective as a scenario analysis. Vaccine efficacy was estimated from a phase 3 study of NVX-CoV2373 (EudraCT number: 2020-004123-16). Cost-effectiveness was assessed using a willingness-to-pay threshold of Japanese yen (JPY) 5 million per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses were also performed. Results: For analysis population 1, NVX-CoV2373 primary and booster vaccinations would reduce costs by JPY 37,647 and prolong QALYs by 0.01601. Therefore, NVX-CoV2373 primary and booster vaccinations were considered to be dominant over no vaccination. For analysis population 2, an NVX-CoV2373 booster vaccination would increase costs by JPY 5010 and prolong QALYs by 0.00550, with the incremental cost-effectiveness ratio of JPY 910,566 per QALY gained. Conclusions: Our analyses suggest that a vaccination strategy with NVX-CoV2373 is cost-effective in the elderly population (aged ≥ 65 years) of Japan.

7.
Ecol Evol ; 14(8): e70092, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39108569

RESUMEN

In movement analysis, correlated random walk (CRW) models often use so-called turning angles, which are measured relative to the previous movement direction. To segregate between different movement modes, hidden Markov models (HMMs) describe movements as piecewise stationary CRWs in which the distributions of turning angles and step sizes depend on the underlying state. This typically allows for the segregation of movement modes that show different movement speeds. We show that in some cases, it may be interesting to investigate absolute angles, that is, biased random walks (BRWs) instead of turning angles. In particular, while discrimination between states in the turning angle setting can only rely on movement speed, models with absolute angles can be used to discriminate between sections of different movement directions. A preprocessing algorithm is provided that enables the analysis of absolute angles in the existing R package moveHMM. In a data set of movements of cell organelles, models using not the turning angle but the absolute angle could capture interesting additional properties. Goodness-of-fit was increased for HMMs with absolute angles, and HMMs with absolute angles tended to choose a higher number of states, suggesting the existence and relevance of prominent directional changes in the present data set. These results suggest that models with absolute angles can provide important information in the analysis of movement patterns if the existence and frequency of directional changes is of biological importance.

8.
Trop Med Int Health ; 2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39095942

RESUMEN

Female genital schistosomiasis is a chronic gynaecological disease caused by the waterborne parasite Schistosoma (S.) haematobium. It affects an estimated 30-56 million girls and women globally, mostly in sub-Saharan Africa where it is endemic, and negatively impacts their sexual and reproductive life. Recent studies found evidence of an association between female genital schistosomiasis and increased prevalence of HIV and cervical precancer lesions. Despite the large population at risk, the burden and impact of female genital schistosomiasis are scarcely documented, resulting in neglect and insufficient resource allocation. There is currently no standardised method for individual or population-based female genital schistosomiasis screening and diagnosis which hinders accurate assessment of disease burden in endemic countries. To optimise financial allocations for female genital schistosomiasis screening, it is necessary to explore the cost-effectiveness of different strategies by combining cost and impact estimates. Yet, no economic evaluation has explored the value for money of alternative screening methods. This paper describes a novel application of health decision analytical modelling to evaluate the cost-effectiveness of different female genital schistosomiasis screening strategies across endemic settings. The model combines a decision tree for female genital schistosomiasis screening strategies, and a Markov model for the natural history of cervical cancer to estimate the cost per disability-adjusted life-years averted for different screening strategies, stratified by HIV status. It is a starting point for discussion and for supporting priority setting in a data-sparse environment.

9.
Front Public Health ; 12: 1425734, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39091529

RESUMEN

Background: Tislelizumab is the first PD-1 inhibitor in China to demonstrate superior efficacy in second-line or third-line treatment of patients with advanced or metastatic non-small-cell lung cancer (NSCLC). This study aimed to evaluate the cost-effectiveness of tislelizumab compared to docetaxel from a Chinese healthcare system perspective. Methods: A dynamic Markov model was developed to evaluate the cost-effectiveness of tislelizumab in comparison to docetaxel in second or third-line treatment. The efficacy data utilized in the model were derived from the RATIONALE-303 clinical trial, while cost and utility values were obtained from the drug data service platform and published studies. The primary outcomes of the model encompassed quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to validate the robustness of the base case analysis results. Results: The tislelizumab group demonstrated a cost increase of CNY 117,473 and a gain of 0.58 QALYs compared to the docetaxel group, resulting in an ICER value of CNY 202,927 per QALY gained. Conclusion: The administration of tislelizumab in patients with advanced or metastatic NSCLC not only extends the progression-free survival (PFS) and overall survival (OS). Moreover, this treatment demonstrates a favorable cost-effectiveness profile across the Chinese population.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Carcinoma de Pulmón de Células no Pequeñas , Análisis de Costo-Efectividad , Docetaxel , Neoplasias Pulmonares , Años de Vida Ajustados por Calidad de Vida , Femenino , Humanos , Masculino , Persona de Mediana Edad , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/economía , Antineoplásicos/economía , Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , China , Docetaxel/uso terapéutico , Docetaxel/economía , Neoplasias Pulmonares/tratamiento farmacológico , Cadenas de Markov
10.
J Transl Med ; 22(1): 763, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39143498

RESUMEN

BACKGROUD: Temporal lobe epilepsy (TLE) is associated with abnormal dynamic functional connectivity patterns, but the dynamic changes in brain activity at each time point remain unclear, as does the potential molecular mechanisms associated with the dynamic temporal characteristics of TLE. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI) was acquired for 84 TLE patients and 35 healthy controls (HCs). The data was then used to conduct HMM analysis on rs-fMRI data from TLE patients and an HC group in order to explore the intricate temporal dynamics of brain activity in TLE patients with cognitive impairment (TLE-CI). Additionally, we aim to examine the gene expression profiles associated with the dynamic modular characteristics in TLE patients using the Allen Human Brain Atlas (AHBA) database. RESULTS: Five HMM states were identified in this study. Compared with HCs, TLE and TLE-CI patients exhibited distinct changes in dynamics, including fractional occupancy, lifetimes, mean dwell time and switch rate. Furthermore, transition probability across HMM states were significantly different between TLE and TLE-CI patients (p < 0.05). The temporal reconfiguration of states in TLE and TLE-CI patients was associated with several brain networks (including the high-order default mode network (DMN), subcortical network (SCN), and cerebellum network (CN). Furthermore, a total of 1580 genes were revealed to be significantly associated with dynamic brain states of TLE, mainly enriched in neuronal signaling and synaptic function. CONCLUSIONS: This study provides new insights into characterizing dynamic neural activity in TLE. The brain network dynamics defined by HMM analysis may deepen our understanding of the neurobiological underpinnings of TLE and TLE-CI, indicating a linkage between neural configuration and gene expression in TLE.


Asunto(s)
Epilepsia del Lóbulo Temporal , Imagen por Resonancia Magnética , Cadenas de Markov , Humanos , Epilepsia del Lóbulo Temporal/genética , Epilepsia del Lóbulo Temporal/fisiopatología , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Masculino , Femenino , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Regulación de la Expresión Génica , Estudios de Casos y Controles , Adulto Joven , Persona de Mediana Edad , Descanso/fisiología , Red Nerviosa/fisiopatología , Red Nerviosa/diagnóstico por imagen
11.
Math Biosci Eng ; 21(7): 6608-6630, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39176411

RESUMEN

Feature representations with rich topic information can greatly improve the performance of story segmentation tasks. VAEGAN offers distinct advantages in feature learning by combining variational autoencoder (VAE) and generative adversarial network (GAN), which not only captures intricate data representations through VAE's probabilistic encoding and decoding mechanism but also enhances feature diversity and quality via GAN's adversarial training. To better learn topical domain representation, we used a topical classifier to supervise the training process of VAEGAN. Based on the learned feature, a segmentor splits the document into shorter ones with different topics. Hidden Markov model (HMM) is a popular approach for story segmentation, in which stories are viewed as instances of topics (hidden states). The number of states has to be set manually but it is often unknown in real scenarios. To solve this problem, we proposed an infinite HMM (IHMM) approach which utilized an HDP prior on transition matrices over countably infinite state spaces to automatically infer the state's number from the data. Given a running text, a Blocked Gibbis sampler labeled the states with topic classes. The position where the topic changes was a story boundary. Experimental results on the TDT2 corpus demonstrated that the proposed topical VAEGAN-IHMM approach was significantly better than the traditional HMM method in story segmentation tasks and achieved state-of-the-art performance.

12.
BMC Public Health ; 24(1): 2352, 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39210317

RESUMEN

BACKGROUND: Forecasting the intensity, source, and cost of informal care for older adults in China is essential to establish and enhance policy support systems for informal care within the context of East Asian traditional culture that emphasizes filial piety. This study aims to analyze the current situation and influencing factors for the informal care needs and predict the trends of informal care needs for older adults in China from 2020 to 2040. METHODS: Using the CHARLS database from 2015 to 2018, this study first combined a two-part model and a multinomial logit to analyze the influencing factors for the informal care needs of urban-rural older adults in China. Secondly, a multi-state Markov model was constructed to forecast the number of urban-rural older populations in each health state from 2020 to 2040. Finally, based on a microsimulation model, this study predicted the trends of informal care intensity, source, and cost for older adults in urban and rural areas from 2020 to 2040. RESULTS: In 2040, the size of the disabled older population in China will expand further. In rural areas, the total number of disabled people in 2040 (39.77 million) is 1.50 times higher than that in 2020; In urban areas, the total number of disabled people in 2040 (56.01 million) is 2.51 times higher than that in 2020. Compared with 2020, older adults population with mild, moderate and severe disability in 2040 would increase by 87.60%, 101.70%, and 115.08%, respectively. In 2040, the number of older adults receiving low-, medium-, and high-intensity care in China will be 38.60 million, 22.89 million, and 41.69 million, respectively, and older people will still rely on informal care provided by spouses and children (from spouses only: 39.26 million, from children only: 36.74 million, from spouses and children only: 16.79 million, other: 10.39 million). The total cost of informal care in 2040 will be 1,086.65 billion yuan, 2.22 times that of 2020 (490.31 billion yuan), which grows faster than the economic growth rate. CONCLUSION: From 2020 to 2040, the informal care needs of older people in rural areas will increase first and then decrease due to the demographic structure and rapid urbanization. In contrast, the informal care needs of older people in urban areas will continuously increase from 2020 to 2040, with the growth rate gradually slowing down. This study provides an evidence-based rationale for scientifically measuring the economic value of informal care and reasonably allocating care resources.


Asunto(s)
Predicción , Población Rural , Población Urbana , Humanos , China , Anciano , Población Urbana/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Masculino , Femenino , Anciano de 80 o más Años , Persona de Mediana Edad , Necesidades y Demandas de Servicios de Salud/tendencias , Personas con Discapacidad/estadística & datos numéricos
13.
Life (Basel) ; 14(8)2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39202721

RESUMEN

Atherosclerosis, a leading cause of cardiovascular disease, necessitates advanced and innovative modeling techniques to better understand and predict plaque dynamics. The present work presents two distinct hypothetical models inspired by different research fields: the logistic map from chaos theory and Markov models from stochastic processes. The logistic map effectively models the nonlinear progression and sudden changes in plaque stability, reflecting the chaotic nature of atherosclerotic events. In contrast, Markov models, including traditional Markov chains, spatial Markov models, and Markov random fields, provide a probabilistic framework to assess plaque stability and transitions. Spatial Markov models, visualized through heatmaps, highlight the spatial distribution of transition probabilities, emphasizing local interactions and dependencies. Markov random fields incorporate complex spatial interactions, inspired by advances in physics and computational biology, but present challenges in parameter estimation and computational complexity. While these hypothetical models offer promising insights, they require rigorous validation with real-world data to confirm their accuracy and applicability. This study underscores the importance of interdisciplinary approaches in developing theoretical models for atherosclerotic plaques.

14.
Viruses ; 16(8)2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39205168

RESUMEN

Two vaccines against rotavirus diseases, Rotarix® and RotaTeq®, are being marketed in Spain; but rotavirus is not presently among the diseases covered by universal vaccination in Spain. The aim of this study was to assess the efficiency of extending Spain's current targeted rotavirus vaccination strategy including only preterm babies, to a policy of universal vaccination. A de novo cohort-based Markov model was built to evaluate the efficiency of three compared rotavirus vaccination strategies in Spain: targeted, universal, and no vaccination. Using Rotarix® or RotaTeq®, we compared the cost-utility of these strategies from both a societal perspective and Spanish National Health System (SNHS) perspective. The model represents the most important clinical events conceivably linked to rotavirus infection. Efficacy, effectiveness, safety, costs, and utilities were identified by systematic reviews. Incremental cost-utility ratio (ICUR) is EUR 23,638/QALY (Quality-Adjusted Life Year) for targeted vaccination with Rotarix® compared with no vaccination. The ICUR for the rest of the strategies evaluated are above EUR 30,000/QALY. The sensitivity analysis shows price as the only parameter that could make the universal vaccination strategy efficient. Considering a threshold of EUR 25,000/QALY, only targeted vaccination with Rotarix® would be efficient from societal perspective. Price drops of 36.9% for Rotarix® and 44.6% for RotaTeq® would make universal vaccination efficient.


Asunto(s)
Análisis Costo-Beneficio , Años de Vida Ajustados por Calidad de Vida , Infecciones por Rotavirus , Vacunas contra Rotavirus , Vacunación , Vacunas Atenuadas , Vacunas contra Rotavirus/economía , Vacunas contra Rotavirus/administración & dosificación , Vacunas contra Rotavirus/inmunología , España , Humanos , Infecciones por Rotavirus/prevención & control , Infecciones por Rotavirus/economía , Vacunación/economía , Vacunas Atenuadas/economía , Vacunas Atenuadas/administración & dosificación , Vacunas Atenuadas/inmunología , Lactante , Rotavirus/inmunología , Cadenas de Markov , Preescolar , Recién Nacido , Presupuestos
15.
Front Pharmacol ; 15: 1393559, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39206260

RESUMEN

Background: Pembrolizumab is a potentially valuable treatment. However, patients, doctors, and healthcare decision-makers are uncertain about its cost-effectiveness and an appropriate pricing for this new therapy. This study aims to appraise the cost-effectiveness of pembrolizumab as a first-line treatment for advanced biliary tract cancer (BTC) patients in China and the United States (US). Methods: A Markov model was constructed from the perspectives of healthcare systems in both China and the US for pharmacoeconomic evaluation. Patient baseline characteristics and key clinical data were sourced from the KEYNOTE-966 trial (ClinicalTrials.gov, NCT04003636). Costs and utilities were collected from drug cost websites and published literature. Cumulative costs (in USD), life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured and compared. Price simulations were conducted under given willingness-to-pay (WTP) thresholds to provide pricing scheme references. The model's robustness was analyzed through one-way sensitivity analysis and probabilistic sensitivity analysis. Results: Basic data analysis illustrates that pembrolizumab ($2662.41/100 mg) in combination with chemotherapy regimen was not cost-effective relative to chemotherapy regimens at the WTP threshold of $38,201.19 in China, and the additional cost relative to chemotherapy regimens was $77,114.94 (ICER $556,689.47/QALY) while increasing 0.14 QALYs. Pembrolizumab ($54.71/1 mg) also increased efficacy by 0.14 QALYs in the US, but remained also not cost-effective at the US WTP threshold of $229,044, and the total cost increased by $160,425.24 (ICER $1,109,462.92/QALY). Conclusion: Compared with chemotherapy, pembrolizumab plus chemotherapy reduces the disease of burden. However, at its current price, it may not be a cost-effective treatment for advanced BTC in both China and the US. This study can aid decision-makers in making optimal choices.

16.
Artículo en Inglés | MEDLINE | ID: mdl-39215475

RESUMEN

OBJECTIVES: Recently, the IMmotion151 trial evaluated the safety and efficacy of atezolizumab plus bevacizumab in metastatic renal cell carcinoma (mRCC) and found that this combination led to longer progression-free survival. However, no studies have evaluated the cost-effectiveness of atezolizumab plus bevacizumab. METHODS: We constructed a Markov model to evaluate the cost-effectiveness of atezolizumab plus bevacizumab, using costs and utilities from the published studies. We set the willingness-to-pay (WTP) threshold at $150,000. One-way and probabilistic sensitivity analyses were performed to ensure that our results were robust. We performed a threshold analysis to explore a more appropriate price for atezolizumab. RESULTS: Our results found that although atezolizumab plus bevacizumab provided more quality-adjusted life years (QALYs), its incremental cost-effectiveness ratio (ICER) was $1,640,532/QALY, well above the WTP threshold. One-way and probabilistic sensitivity analysis results confirmed the robust of this conclusion. Based on the threshold analysis, for atezolizumab plus bevacizumab to be cost-effective, the price of them would need to be reduced by 46.3% or more. CONCLUSIONS: From the perspective of US payers, atezolizumab plus bevacizumab is not cost-effective for mRCC patients. To make this combination cost-effective in the future, the price of atezolizumab and bevacizumab needs to be reduced.

17.
J Bioinform Comput Biol ; : 2450021, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39215524

RESUMEN

Sorting signals are crucial for the anchoring of proteins to the cell surface in archaea and bacteria. These proteins often feature distinct motifs at their C-terminus, cleaved by sortase or sortase-like enzymes. Gram-positive bacteria exhibit the LPXTGX consensus motif, cleaved by sortases, while Gram-negative bacteria employ exosortases recognizing motifs like PEP. Archaea utilize exosortase homologs known as archaeosortases for signal anchoring. Traditionally identification of such C-terminal sorting signals was performed with profile Hidden Markov Models (pHMMs). The Cell- Wall PREDiction (CW-PRED) method introduced for the first time a custom-made class HMM for proteins in Gram-positive bacteria that contain a cell wall sorting signal which begins with an LPXTG motif, followed by a hydrophobic domain and a tail of positively charged residues. Here we present a new and updated version of CW-PRED for predicting C-terminal sorting signals in Archaea, Gram-positive, and Gram-negative bacteria. We used a large training set and several model enhancements that improve motif identification in order to achieve better discrimination between C-terminal signals and other proteins. Cross-validation demonstrates CW-PRED's superiority in sensitivity and specificity compared to other methods. Application of the method in reference proteomes reveals a large number of potential surface proteins not previously identified. The method is available for academic use at http://195.251.108.230/apps.compgen.org/CW-PRED/ and as standalone software.

18.
Med Image Anal ; 97: 103290, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39094462

RESUMEN

The brain exhibits intrinsic dynamics characterized by spontaneous spatiotemporal reorganization of neural activity or metastability, which is associated closely with functional integration and segregation. Compared to dynamic functional connectivity, state-dependent effective connectivity (i.e., dynamic effective connectivity) is more suitable for exploring the metastability as its ability to infer causalities between brain regions. However, methods for state-dependent effective connectivity are scarce and urgently needed. In this study, a novel data-driven computational framework, named NHSMM-MAR-sdNC integrating nonparametric hidden semi-Markov model combined with multivariate autoregressive model and state-dependent new causality, is proposed to investigate the state-dependent effective connectivity. The framework is not constrained by any biological assumptions. Furthermore, state number can be inferred from the observed data directly and the state duration distributions will be estimated explicitly rather than restricted by geometric form, which overcomes limitations of hidden Markov model. Experimental results of synthetic data show that the framework can identify the state number adaptively and the state-dependent causality networks accurately. The dynamics of state-related causality networks are also revealed by the new method on real-world resting-state fMRI data. Our method provides a new data-driven computational framework for identifying state-dependent effective connectivity, which will facilitate the identification and assessment of metastability and itinerant dynamics of the brain.


Asunto(s)
Encéfalo , Imagen por Resonancia Magnética , Humanos , Imagen por Resonancia Magnética/métodos , Encéfalo/diagnóstico por imagen , Algoritmos , Cadenas de Markov , Conectoma/métodos , Mapeo Encefálico/métodos , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/fisiología
19.
Lang Cogn Neurosci ; 39(5): 632-656, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39040138

RESUMEN

The sentences "More than half of the students passed the exam" and "Fewer than half of the students failed the exam" describe the same set of situations, and yet the former results in shorter reaction times in verification tasks. The two-step model explains this result by postulating that negative quantifiers contain hidden negation, which involves an extra processing stage. To test this theory, we applied a novel EEG analysis technique focused on detecting cognitive stages (HsMM-MVPA) to data from a picture-sentence verification task. We estimated the number of processing stages during reading and verification of quantified sentences (e.g. "Fewer than half of the dots are blue") that followed the presentation of pictures containing coloured geometric shapes. We did not find evidence for an extra step during the verification of sentences with fewer than half. We provide an alternative interpretation of our results in line with an expectation-based pragmatic account.

20.
Front Microbiol ; 15: 1437602, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39070267

RESUMEN

The fight against bacterial antibiotic resistance must be given critical attention to avert the current and emerging crisis of treating bacterial infections due to the inefficacy of clinically relevant antibiotics. Intrinsic genetic mutations and transferrable antibiotic resistance genes (ARGs) are at the core of the development of antibiotic resistance. However, traditional alignment methods for detecting ARGs have limitations. Artificial intelligence (AI) methods and approaches can potentially augment the detection of ARGs and identify antibiotic targets and antagonistic bactericidal and bacteriostatic molecules that are or can be developed as antibiotics. This review delves into the literature regarding the various AI methods and approaches for identifying and annotating ARGs, highlighting their potential and limitations. Specifically, we discuss methods for (1) direct identification and classification of ARGs from genome DNA sequences, (2) direct identification and classification from plasmid sequences, and (3) identification of putative ARGs from feature selection.

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