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1.
Swiss Med Wkly ; 154: 3590, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38579308

RESUMEN

Palliative sedation is defined as the monitored use of medications intended to induce a state of decreased or absent awareness (unconsciousness) to relieve the burden of otherwise intractable suffering in a manner ethically acceptable to the patient, their family, and healthcare providers. In Switzerland, the prevalence of continuous deep sedation until death increased from 4.7% in 2001 to 17.5% of all deceased in 2013, depending on the research method used and on regional variations. Yet, these numbers may be overestimated due to a lack of understanding of the term "continuous deep sedation" by for example respondents of the questionnaire-based study. Inadequately trained and inexperienced healthcare professionals may incorrectly or inappropriately perform palliative sedation due to uncertainties regarding its definitions and practice. Therefore, the expert members of the Bigorio group and the authors of this manuscript believe that national recommendations should be published and made available to healthcare professionals to provide practical, terminological, and ethical guidance. The Bigorio group is the working group of the Swiss Palliative Care Society whose task is to publish clinical recommendations at a national level in Switzerland. These recommendations aim to provide guidance on the most critical questions and issues related to palliative sedation. The Swiss Society of Palliative Care (palliative.ch) mandated a writing board comprising four clinical experts (three physicians and one ethicist) and two national academic experts to revise the 2005 Bigorio guidelines. A first draft was created based on a narrative literature review, which was internally reviewed by five academic institutions (Lausanne, Geneva, Bern, Zürich, and Basel) and the heads of all working groups of the Swiss Society of Palliative Care before finalising the guidelines. The following themes are discussed regarding palliative sedation: (a) definitions and clinical aspects, (b) the decision-making process, (c) communication with patients and families, (d) patient monitoring, (e) pharmacological approaches, and (f) ethical and controversial issues. Palliative sedation must be practised with clinical and ethical accuracy and competence to avoid harm and ethically questionable use. Specialist palliative care teams should be consulted before initiating palliative sedation to avoid overlooking other potential treatment options for the patient's symptoms and suffering.


Asunto(s)
Sedación Profunda , Médicos , Cuidado Terminal , Humanos , Cuidados Paliativos/métodos , Incertidumbre , Personal de Salud , Comunicación , Sedación Profunda/métodos , Cuidado Terminal/métodos , Hipnóticos y Sedantes/uso terapéutico
2.
BMC Psychol ; 12(1): 187, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38581066

RESUMEN

BACKGROUND AND OBJECTIVE: The need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis. METHODS: This study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined. RESULTS: In the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively. CONCLUSION: The results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.


Asunto(s)
Diálisis Renal , Humanos , Psicometría , Reproducibilidad de los Resultados , Incertidumbre , Análisis Factorial
3.
Brief Bioinform ; 25(3)2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38581417

RESUMEN

Untargeted metabolomics based on liquid chromatography-mass spectrometry technology is quickly gaining widespread application, given its ability to depict the global metabolic pattern in biological samples. However, the data are noisy and plagued by the lack of clear identity of data features measured from samples. Multiple potential matchings exist between data features and known metabolites, while the truth can only be one-to-one matches. Some existing methods attempt to reduce the matching uncertainty, but are far from being able to remove the uncertainty for most features. The existence of the uncertainty causes major difficulty in downstream functional analysis. To address these issues, we develop a novel approach for Bayesian Analysis of Untargeted Metabolomics data (BAUM) to integrate previously separate tasks into a single framework, including matching uncertainty inference, metabolite selection and functional analysis. By incorporating the knowledge graph between variables and using relatively simple assumptions, BAUM can analyze datasets with small sample sizes. By allowing different confidence levels of feature-metabolite matching, the method is applicable to datasets in which feature identities are partially known. Simulation studies demonstrate that, compared with other existing methods, BAUM achieves better accuracy in selecting important metabolites that tend to be functionally consistent and assigning confidence scores to feature-metabolite matches. We analyze a COVID-19 metabolomics dataset and a mouse brain metabolomics dataset using BAUM. Even with a very small sample size of 16 mice per group, BAUM is robust and stable. It finds pathways that conform to existing knowledge, as well as novel pathways that are biologically plausible.


Asunto(s)
Metabolómica , Ratones , Animales , Teorema de Bayes , Tamaño de la Muestra , Incertidumbre , Metabolómica/métodos , Simulación por Computador
4.
Sci Rep ; 14(1): 8064, 2024 04 05.
Artículo en Inglés | MEDLINE | ID: mdl-38580697

RESUMEN

The causal role of the cerebral hemispheres in positive and negative emotion processing remains uncertain. The Right Hemisphere Hypothesis proposes right hemispheric superiority for all emotions, while the Valence Hypothesis suggests the left/right hemisphere's primary involvement in positive/negative emotions, respectively. To address this, emotional video clips were presented during dorsolateral prefrontal cortex (DLPFC) electrical stimulation, incorporating a comparison of tDCS and high frequency tRNS stimulation techniques and manipulating perspective-taking (first-person vs third-person Point of View, POV). Four stimulation conditions were applied while participants were asked to rate emotional video valence: anodal/cathodal tDCS to the left/right DLPFC, reverse configuration (anodal/cathodal on the right/left DLPFC), bilateral hf-tRNS, and sham (control condition). Results revealed significant interactions between stimulation setup, emotional valence, and POV, implicating the DLPFC in emotions and perspective-taking. The right hemisphere played a crucial role in both positive and negative valence, supporting the Right Hemisphere Hypothesis. However, the complex interactions between the brain hemispheres and valence also supported the Valence Hypothesis. Both stimulation techniques (tDCS and tRNS) significantly modulated results. These findings support both hypotheses regarding hemispheric involvement in emotions, underscore the utility of video stimuli, and emphasize the importance of perspective-taking in this field, which is often overlooked.


Asunto(s)
Estimulación Transcraneal de Corriente Directa , Humanos , Estimulación Transcraneal de Corriente Directa/métodos , Corteza Prefrontal/fisiología , Emociones/fisiología , Corteza Prefontal Dorsolateral , Incertidumbre
5.
PLoS One ; 19(4): e0300517, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38574021

RESUMEN

OBJECTIVES: This study aims to qualitatively examine nurses' perception of uncertainty regarding suspected pain in people with dementia (PWD). DESIGN: The study utilized a qualitative descriptive design. PARTICIPANTS: The participants in this study were nurses with a minimum of six months of experience caring for PWD and currently working in a university hospital in Irbid, Jordan. Twenty-five participants were selected using convenience sampling from the selected hospital. RESULTS: Four major themes and 12 subthemes relating to nurses' perceptions of uncertainty regarding suspected pain in PWD emerged. The main themes were (a) the culture-bound nature of uncertainty regarding suspected pain in PWD, (b) dimensions of uncertainty regarding suspected pain in PWD, (c) indicators of uncertainty regarding suspected pain in PWD, and (d) assessment methods of uncertainty to suspected pain in PWD. Moreover, for each major theme, different subthemes were developed. CONCLUSIONS: It is crucial to address factors influencing -nurses' uncertainty regarding suspected pain in PWD to improve pain assessment and management in PWD. Additionally, the study identified five indicators of uncertainty: complicated decision-making, knowledge deficit, bias, intuition, and misconceptions. Effective assessment methods, such as semi-structured interviews and simulated assessments, should be employed to evaluate uncertainty accurately. By addressing these issues and utilizing appropriate assessment approaches, healthcare professionals can enhance pain management for individuals with dementia.


Asunto(s)
Demencia , Enfermeras y Enfermeros , Humanos , Incertidumbre , Demencia/complicaciones , Demencia/diagnóstico , Investigación Cualitativa , Dolor/diagnóstico , Percepción
6.
Sci Rep ; 14(1): 7635, 2024 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-38561391

RESUMEN

Extracting knowledge from hybrid data, comprising both categorical and numerical data, poses significant challenges due to the inherent difficulty in preserving information and practical meanings during the conversion process. To address this challenge, hybrid data processing methods, combining complementary rough sets, have emerged as a promising approach for handling uncertainty. However, selecting an appropriate model and effectively utilizing it in data mining requires a thorough qualitative and quantitative comparison of existing hybrid data processing models. This research aims to contribute to the analysis of hybrid data processing models based on neighborhood rough sets by investigating the inherent relationships among these models. We propose a generic neighborhood rough set-based hybrid model specifically designed for processing hybrid data, thereby enhancing the efficacy of the data mining process without resorting to discretization and avoiding information loss or practical meaning degradation in datasets. The proposed scheme dynamically adapts the threshold value for the neighborhood approximation space according to the characteristics of the given datasets, ensuring optimal performance without sacrificing accuracy. To evaluate the effectiveness of the proposed scheme, we develop a testbed tailored for Parkinson's patients, a domain where hybrid data processing is particularly relevant. The experimental results demonstrate that the proposed scheme consistently outperforms existing schemes in adaptively handling both numerical and categorical data, achieving an impressive accuracy of 95% on the Parkinson's dataset. Overall, this research contributes to advancing hybrid data processing techniques by providing a robust and adaptive solution that addresses the challenges associated with handling hybrid data, particularly in the context of Parkinson's disease analysis.


Asunto(s)
Algoritmos , Enfermedad de Parkinson , Humanos , Minería de Datos/métodos , Incertidumbre
7.
J Exp Psychol Gen ; 153(4): 1139-1151, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38587935

RESUMEN

The calculation of statistical power has been taken up as a simple yet informative tool to assist in designing an experiment, particularly in justifying sample size. A difficulty with using power for this purpose is that the classical power formula does not incorporate sources of uncertainty (e.g., sampling variability) that can impact the computed power value, leading to a false sense of precision and confidence in design choices. We use simulations to demonstrate the consequences of adding two common sources of uncertainty to the calculation of power. Sampling variability in the estimated effect size (Cohen's d) can introduce a large amount of uncertainty (e.g., sometimes producing rather flat distributions) in power and sample-size determination. The addition of random fluctuations in the population effect size can cause values of its estimates to take on a sign opposite the population value, making calculated power values meaningless. These results suggest that calculated power values or use of such values to justify sample size add little to planning a study. As a result, researchers should put little confidence in power-based choices when planning future studies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Incertidumbre , Humanos , Tamaño de la Muestra
8.
J Exp Psychol Anim Learn Cogn ; 50(2): 77-98, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38587939

RESUMEN

Rescorla (2000, 2001) interpreted his compound test results to show that both common and individual error terms regulate associative change such that the element of a conditioned compound with the greater prediction error undergoes greater associative change than the one with the smaller prediction error. However, it has recently been suggested that uncertainty, not prediction error, is the primary determinant of associative change in people (Spicer et al., 2020, 2022). The current experiments use the compound test in a continuous outcome allergist task to assess the role of uncertainty in associative change, using two different manipulations of uncertainty: outcome uncertainty (where participants are uncertain of the level of the outcome on a particular trial) and causal uncertainty (where participants are uncertain of the contribution of the cue to the level of the outcome). We replicate Rescorla's compound test results in the case of both associative gains (Experiment 1) and associative losses (Experiment 3) and then provide evidence for greater change to more uncertain cues in the case of associative gains (Experiments 2 and 4), but not associative losses (Experiments 3 and 5). We discuss the findings in terms of the notion of theory protection advanced by Spicer et al., and other ways of thinking about the compound test procedure, such as that proposed by Holmes et al. (2019). (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Aprendizaje por Asociación , Señales (Psicología) , Humanos , Incertidumbre , Aprendizaje por Asociación/fisiología
9.
Musculoskeletal Care ; 22(2): e1879, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38563603

RESUMEN

BACKGROUND: Exercise therapy is a popular non-surgical treatment to help manage individuals with rotator cuff-related shoulder pain (RCRSP) and is recommended in all clinical practice guidelines. Due to modest effect sizes, low quality evidence, uncertainty relating to efficacy, and mechanism(s) of benefit, exercise as a therapeutic intervention has been the subject of increasing scrutiny. AIMS: The aim of this critical review is to lay out where the purported uncertainties of exercise for RCRSP exist by exploring the relevant quantitative and qualitative literature. We conclude by offering theoretical and practical considerations to help reduce the uncertainty of delivering exercise therapy in a clinical environment. RESULTS AND DISCUSSION: Uncertainty underpins much of the theory and practice of delivering exercise therapy for individuals with RCRSP. Nonetheless, exercise is an often-valued treatment by individuals with RCRSP, when provided within an appropriate clinical context. We encourage clinicians to use a shared decision-making paradigm and embrace a pluralistic model when prescribing therapeutic exercise. This may take the form of using exercise experiments to trial different exercise approaches, adjusting, and adapting the exercise type, load, and context based on the individual's symptom irritability, preferences, and goals. CONCLUSION: We contend that providing exercise therapy should remain a principal treatment option for helping individuals with RCRSP. Limitations notwithstanding, exercise therapy is relatively low cost, accessible, and often valued by individuals with RCRSP. The uncertainty surrounding exercise therapy requires ongoing research and emphasis could be directed towards investigating causal mechanisms to better understand how exercise may benefit an individual with RCRSP.


Asunto(s)
Manguito de los Rotadores , Dolor de Hombro , Humanos , Dolor de Hombro/etiología , Dolor de Hombro/terapia , Incertidumbre , Terapia por Ejercicio/efectos adversos
10.
J R Soc Interface ; 21(213): 20230656, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38593843

RESUMEN

Peripheral arterial disease (PAD) and abdominal aortic aneurysms (AAAs) often coexist and pose significant risks of mortality, yet their mutual interactions remain largely unexplored. Here, we introduce a fluid mechanics model designed to simulate the haemodynamic impact of PAD on AAA-associated risk factors. Our focus lies on quantifying the uncertainty inherent in controlling the flow rates within PAD-affected vessels and predicting AAA risk factors derived from wall shear stress. We perform a sensitivity analysis on nine critical model parameters through simulations of three-dimensional blood flow within a comprehensive arterial geometry. Our results show effective control of the flow rates using two-element Windkessel models, although specific outlets need attention. Quantities of interest like endothelial cell activation potential (ECAP) and relative residence time are instructive for identifying high-risk regions, with ECAP showing greater reliability and adaptability. Our analysis reveals that the uncertainty in the quantities of interest is 187% of that of the input parameters. Notably, parameters governing the amplitude and frequency of the inlet velocity exert the strongest influence on the risk factors' variability and warrant precise determination. This study forms the foundation for patient-specific simulations involving PAD and AAAs which should ultimately improve patient outcomes and reduce associated mortality rates.


Asunto(s)
Aneurisma de la Aorta Abdominal , Enfermedad Arterial Periférica , Humanos , Reproducibilidad de los Resultados , Incertidumbre , Modelos Cardiovasculares , Hemodinámica , Estrés Mecánico
11.
Turk Psikiyatri Derg ; 35(1): 24-33, 2024.
Artículo en Inglés, Turco | MEDLINE | ID: mdl-38556934

RESUMEN

OBJECTIVE: In this study, we aimed to evaluate the relationship between fear of COVID-19, perceived threat of COVID-19, anxiety, cognitive control/flexibility, and intolerance to uncertainty. In addition, the mediating role of cognitive control/flexibility and intolerance to uncertainty were investigated. METHOD: 224 volunteers aged between 18-55 years were included in the study. Cognitive Control and Felxibility Scale, Intolerance of Uncertainty Scale, Fear of COVID-19 Scale, Perceived COVID-19 Threat Form and Beck Anxiety Scales were administered to all participants via an online environment. In this context, Pearson correlation, linear regression, and mediation analyzes were performed. RESULTS: There were significant relationships among Cognitive Control and Flexibility, Intolerance of Uncertainty, Beck Anxiety, fear of COVID-19, perceived COVID-19 threat (p<0,01). Linear regression analysis showed that the Beck Anxiety Scale, Intolerance of Uncertainty and Cognitive Control/ Flexibility Scale scores significantly predicted fear of COVID-19 and the perceived threat of COVID-19 (p<0,001). In addition, mediation analysis revealed that intolerance to uncertainty and cognitive control/flexibility are mediating factors between anxiety and the perceived threat of COVID-19 (p<0,01). CONCLUSION: There is a relationship between fear of COVID-19 and perception of threat, anxiety, intolerance of uncertainty, and cognitive control mechanisms. In accordance with these findings, psychosocial support and therapy programs can be created based on cognitive control/flexibility and intolerance of uncertainty in order to increase the mental health well-being of individuals.


Asunto(s)
COVID-19 , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , COVID-19/epidemiología , COVID-19/psicología , Incertidumbre , Pandemias , Ansiedad/psicología , Miedo/psicología , Cognición
12.
An. psicol ; 40(1): 31-37, Ene-Abri, 2024. tab, ilus
Artículo en Inglés | IBECS | ID: ibc-229024

RESUMEN

Background/Objective: The Dark Future Scale (DFS) is a self-report instrument which assesses the tendency to think about the future with anxiety, fear, and uncertainty. Although it has been applied in different populations, instrumental studies are scarce, and there is no validated Spanish version. The aim was therefore to develop a Spanish version of the scale (DFS-S) and to analyze its psychometric properties in a sample of young adults. Method: Participants were 1,019 individuals aged from 18 to 24 years. They completed the DFS-S and the IPIP-BFM-20. Validity evidence based on the internal structure, including measurement invariance across gender, as well as on relationships with personality traits was obtained. Reliability and gender differences in DFS-S scores were also examined. Results: Results supported a single-factor structure, χ2(5) = 10.79, CFI = .999, RMSEA = .034, SRMR = .016, that was invariant across gender. Reliability of test scores was satisfactory (ω = .92). In the correlation analysis, future anxiety showed a strong positive correlation with neuroticism (.42) and a moderate negative correlation with extraversion (-.25). Females scored higher than males on future anxiety. Conclusions: The DFS-S has satisfactory psychometric properties and it is an adequate tool for measuring future anxiety among young adults.(AU)


Antecedentes/Objetivo: La Dark Future Scale (DFS) evalúa la ten-dencia a pensar en el futuro con ansiedad, miedo e incertidumbre. Aunque ha sido usadaen diferentes poblaciones, los estudios instrumentales son es-casos y no hay una versión adaptada al español. El objetivo del estudio fue adaptarla al español (DFS-S) y analizar sus propiedades psicométricas en una muestra de adultos jóvenes. Método:Participaron 1.019 jóvenes entre 18 y 24 años. Completaron la DFS-S y el IPIP-BFM-20. Se analizan evidencias de validez basadas en la estructura interna, incluyendo la invarianza de me-dida según el género, y basadas en las relaciones con rasgos de personali-dad, así como análisis de la fiabilidad y de las diferencias de género. Resulta-dos:Los resultados apoyaron una estructura de un solo factor, χ2(5) = 10.79, CFI = .999, RMSEA = .034, SRMR = .016, con invarianza respecto al gé-nero, y con coeficiente de fiabilidad satisfactorio (ω= .92). Se encontró co-rrelación positiva fuerte entre ansiedad futura y neuroticismo (.42) y una correlación negativa moderada con extraversión (-.25). Las puntuaciones en ansiedad futura fueron mayores en las mujeres. Conclusiones:Los resultados muestran propiedades psicométricas satisfactorias delaDFS-S, siendo un instrumento adecuado para medir la ansiedad futura en adultos jóvenes.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Escala de Ansiedad ante Pruebas , Psicometría , Incertidumbre , Miedo , España , Salud Mental , Ansiedad , Psicología , Psicología Social
13.
Ambio ; 53(5): 664-677, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38441861

RESUMEN

In recent decades, there has been a growing number of studies exploring the historical dimensions of the interconnectedness of human societies and the environment. A core approach in this field is historical ecology. We analyzed 544 historical-ecological papers to assess patterns and trends in the field. We found a high degree of interdisciplinarity with a focus on local case studies, of periods of fewer than 500 years, analyzing archival sources through quantitative approaches. The proportion of papers containing management recommendations has increased over time. To make historical ecology globally relevant, more effort should be made to utilize studies across languages, borders and worldviews. We call for high standards regarding the use of social scientific methodologies. Lastly, we argue that fostering longer-term studies and assessing the real-life impact of policy recommendations emerging from historical ecology can help the discipline better contribute solutions to the challenges facing humanity in an uncertain future.


Asunto(s)
Ecología , Proyectos de Investigación , Humanos , Incertidumbre
14.
Trends Cogn Sci ; 28(4): 286-289, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38448356

RESUMEN

The social world is inherently uncertain. We present a computational framework for thinking about how increasingly popular online environments modulate the social uncertainty we experience, depending on the type of social inferences we make. This framework draws on Bayesian inference, which involves combining multiple informational sources to update our beliefs.


Asunto(s)
Incertidumbre , Humanos , Teorema de Bayes
15.
J Environ Manage ; 356: 120484, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38522276

RESUMEN

The large-scale application of hydrogen steelmaking technology is expected to substantially accelerate the decarbonization process of the iron and steel industry. However, hydrogen steelmaking projects are still in the experimental or demonstration stage, and scientific investment decision-making methods are urgently needed to support the large-scale development of the technology. When assessing the investment value, existing studies usually only consider the intrinsic project value under a specific pathway, while ignoring the option value under realistic multiple uncertainties in terms of technology, market, and policy, leading to an underestimation of the investment value. To address this issue, this study constructs a real options model to explore the optimal investment timing and revenue of the hydrogen steelmaking project, by taking into account multi-dimensional uncertainties stemming from price fluctuations in the steel market, the development of the carbon market, and technological advances. Additionally, the impacts of various subsidy policies on the investment strategy are also investigated. Least Squares Monte Carlo method is applied to overcome computational challenges posed by dynamic programming under multi-dimensional uncertainties. The results show that: (i) Investment is not recommended based on current crude steel price and hydrogen price. (ii) When the annual reduction rate of hydrogen price reaches 5%, the optimal investment timing would advance to 2036. (iii) On this basis, with the introduction of a 20% green hydrogen subsidy policy, the optimal investment timing would be further brought forward to 2033. The implementation of tax incentives would significantly increase the investment value. The investment value would surge from 170 million CNY to 262 million CNY as the tax rate decreases from 20% to zero. The findings could provide reasonable suggestions for investment decisions under realistic volatile environments, as well as scientific references for policy design, thus facilitating the large-scale and high-level development of hydrogen-based steelmaking technology.


Asunto(s)
Inversiones en Salud , Hierro , Incertidumbre , Acero , Industrias
16.
Sci Rep ; 14(1): 7221, 2024 03 27.
Artículo en Inglés | MEDLINE | ID: mdl-38538693

RESUMEN

Institutions have an enhanced ability to implement tailored mitigation measures during infectious disease outbreaks. However, macro-level predictive models are inefficient for guiding institutional decision-making due to uncertainty in local-level model input parameters. We present an institutional-level modeling toolkit used to inform prediction, resource procurement and allocation, and policy implementation at Clemson University throughout the Covid-19 pandemic. Through incorporating real-time estimation of disease surveillance and epidemiological measures based on institutional data, we argue this approach helps minimize uncertainties in input parameters presented in the broader literature and increases prediction accuracy. We demonstrate this through case studies at Clemson and other university settings during the Omicron BA.1 and BA.4/BA.5 variant surges. The input parameters of our toolkit are easily adaptable to other institutional settings during future health emergencies. This methodological approach has potential to improve public health response through increasing the capability of institutions to make data-informed decisions that better prioritize the health and safety of their communities while minimizing operational disruptions.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Pandemias/prevención & control , Brotes de Enfermedades/prevención & control , Salud Pública , Incertidumbre
17.
J Environ Manage ; 356: 120692, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38547828

RESUMEN

Accurate characterization of soil contaminant concentrations is often crucial for assessing risks to human and ecological health. However, fine-scale assessments of large tracts of land can be cost prohibitive due to the number of samples needed. One solution to this problem is to extrapolate sampling results from one area to another unsampled area. In the absence of a validated extrapolation methodology, regulatory agencies have employed policy-based techniques for large sites, but the likelihood of decision errors resulting from these extrapolations is largely unexplored. This study describes the results of a simulation study aimed at guiding environmental sampling for sites where extrapolation concepts are of interest. The objective of this study is to provide practical recommendations to regulatory agencies for extrapolating sampling results on large tracts of land while minimizing errors that are detrimental to human health. A variety of site investigation scenarios representative of environmental conditions and sampling schemes were tested using adaptive sampling when collecting discrete samples or applying incremental sampling methodology (ISM). These simulations address extrapolation uncertainty in cases where a Pilot Study might result in either false noncompliance or false compliance conclusions. A wide range of plausible scenarios were used that reflect the variety of heterogeneity seen at large sites. This simulation study demonstrates that ISM can be reliably applied in a Pilot Study for purposes of extrapolating the outcome to a large area site because it decreases the likelihood of false non-compliance errors while also providing reliable estimates of true compliance across unsampled areas. The results demonstrate how errors depend on the magnitude of the 95% upper confidence limit for the mean concentration (95UCL) relative to the applicable action level, and that error rates are highest when the 95UCL is within 10%-40% of the action level. The false compliance rate can be reduced to less than 5% when 30% or more of the site is characterized with ISM. False compliance error rates using ISM are insensitive to the fraction of the decision units (DUs) that are characterized with three replicates (with a minimum of 10 percent), so long as 95UCLs are calculated for the DUs with one replicate using the average coefficient of variation from the three replicate DUs.


Asunto(s)
Incertidumbre , Humanos , Proyectos Piloto
18.
Proc Natl Acad Sci U S A ; 121(14): e2316616121, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38551839

RESUMEN

Motivated by the implementation of a SARS-Cov-2 sewer surveillance system in Chile during the COVID-19 pandemic, we propose a set of mathematical and algorithmic tools that aim to identify the location of an outbreak under uncertainty in the network structure. Given an upper bound on the number of samples we can take on any given day, our framework allows us to detect an unknown infected node by adaptively sampling different network nodes on different days. Crucially, despite the uncertainty of the network, the method allows univocal detection of the infected node, albeit at an extra cost in time. This framework relies on a specific and well-chosen strategy that defines new nodes to test sequentially, with a heuristic that balances the granularity of the information obtained from the samples. We extensively tested our model in real and synthetic networks, showing that the uncertainty of the underlying graph only incurs a limited increase in the number of iterations, indicating that the methodology is applicable in practice.


Asunto(s)
COVID-19 , Pandemias , Humanos , Incertidumbre , COVID-19/epidemiología , Brotes de Enfermedades , SARS-CoV-2
19.
Patient Educ Couns ; 123: 108232, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38458091

RESUMEN

OBJECTIVE: Understand how physicians' uncertainty tolerance (UT) in clinical care relates to their personal characteristics, perceptions and practices regarding shared decision making (SDM). METHODS: As part of a trial of SDM training about colorectal cancer screening, primary care physicians (n = 67) completed measures of their uncertainty tolerance in medical practice (Anxiety subscale of the Physician's Reactions to Uncertainty Scale, PRUS-A), and their SDM self-efficacy (confidence in SDM skills). Patients (N = 466) completed measures of SDM (SDM Process scale) after a clinical visit. Bivariate regression analyses and multilevel regression analyses examined relationships. RESULTS: Higher UT was associated with greater physician age (p = .01) and years in practice (p = 0.015), but not sex or race. Higher UT was associated with greater SDM self-efficacy (p < 0.001), but not patient-reported SDM. CONCLUSION: Greater age and practice experience predict greater physician UT, suggesting that UT might be improved through training, while UT is associated with greater confidence in SDM, suggesting that improving UT might improve SDM. However, UT was unassociated with patient-reported SDM, raising the need for further studies of these relationships. PRACTICE IMPLICATIONS: Developing and implementing training interventions aimed at increasing physician UT may be a promising way to promote SDM in clinical care.


Asunto(s)
Toma de Decisiones Conjunta , Médicos de Atención Primaria , Humanos , Lactante , Incertidumbre , Toma de Decisiones , Participación del Paciente , Relaciones Médico-Paciente
20.
Environ Sci Pollut Res Int ; 31(16): 24014-24041, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38438639

RESUMEN

This study contributes significantly to the field by utilising the World Economic Policy Uncertainty (WEPU) Index, as devised by (Ahir in Nat Bureau Econ Res 2022), to scrutinise its impact on carbon dioxide emission reporting and performance. Employing the generalised method of moments (GMM) on a substantial dataset of 604 Fortune Global 500 firms spanning from 2005 to 2020, our analysis reveals crucial insights. The research elucidates the dual influence of WEPU Index: a positive correlation with carbon dioxide emission reporting and a negative correlation aimed at mitigating adverse effects and promoting sustainable practices, thereby enhancing firm trust. Moreover, the findings shed light on how companies in emission-intensive industries tend to ramp up carbon dioxide emission reporting, potentially to bolster investor confidence, particularly during high WEPU Index periods. Furthermore, this study uncovers a compelling association between high emitters and lowered carbon dioxide emission performance, stemming from political and social pressures to integrate environmental considerations. Notably, this pressure intensifies during periods of increased WEPU Index. The empirical results presented in this study carry immediate practical implications. Specifically, they offer valuable insights for regulatory bodies and industry associations, guiding the development of enhanced environmental and social reporting regulations and guidelines, particularly concerning carbon emission reporting and performance.


Asunto(s)
Allium , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Dióxido de Carbono , Incertidumbre , Industrias , Desarrollo Económico
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