Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.101
Filtrar
1.
BMJ Open ; 11(9): e049878, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475176

RESUMO

INTRODUCTION: Given the complex causal origins of many non-communicable diseases (NCDs), and the complex landscapes in which policies designed to tackle them are made and unfold, the need for systems thinking and complexity science (STCS) in developing effective policy solutions has been emphasised. While numerous methods informed by STCS have been applied to the policy process in NCD prevention, these applications have not been systematically catalogued. The aim of this scoping review is to identify existing applications of methods informed by STCS to the policy process for NCD prevention, documenting which domains of the policy process they have been applied to. METHODS AND ANALYSIS: A systematic scoping review methodology will be used. IDENTIFICATION: We will search Medline, SCOPUS, Embase and Web of Science using search terms combining STCS, NCD prevention and the policy process. All records published in English will be eligible for inclusion, regardless of study design. SELECTION: We will screen titles and abstracts and extract data according to published guidelines for scoping reviews. In order to determine the quality of the included studies, we will use the approach developed by Dixon-Woods et al, excluding studies identified as fatally flawed, and determining the credibility and contribution of included studies. SYNTHESIS: We will identify relevant studies, summarising key data from each study and mapping applications of methods informed by STCS to different parts of the policy process. Review findings will provide a useful reference for policy-makers, outlining which domains of the policy process different methods have been applied to. ETHICS AND DISSEMINATION: Formal ethical approval is not required, as the study does not involve primary data collection. The findings of this study will be disseminated through a peer-reviewed publication, presentations and summaries for key stakeholders.


Assuntos
Doenças não Transmissíveis , Atenção à Saúde , Humanos , Doenças não Transmissíveis/prevenção & controle , Políticas , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Análise de Sistemas
2.
Rev Med Suisse ; 17(749): 1506-1511, 2021 Sep 08.
Artigo em Francês | MEDLINE | ID: mdl-34495586

RESUMO

Diagnostic process is at the heart of medical practice. It allows the clinician faced to a medical problem to reach a diagnosis in order to implement a management plan. Sometimes perceived as a cognitive process taking place in the clinician's mind, the diagnostic process is collaborative involving the patient, the clinician, the health care system and its various stakeholders. Because of the difficulty in defining and identifying diagnostic errors, the magnitude of the problem remains difficult to determine. However, these errors are frequent, sometimes with serious consequences and often preventable. In this article, we provide an overview of current knowledge about diagnostic errors, emphasizing the importance of a systems approach to understanding them in their entirety.


Assuntos
Análise de Sistemas , Erros de Diagnóstico , Humanos
3.
Sci Total Environ ; 791: 148254, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34412387

RESUMO

Multifunctional crops can simultaneously contribute to multiple societal objectives. As a result, they represent an attractive means for improving rural livelihoods. Moringa oleifera is an example of a multifunctional crop that produces nutritious leaves with uses as food, fodder, and a biostimulant to enhance crop growth. It yields seeds containing a water purifying coagulant and oil with cosmetic uses and possible biofuel feedstock. Despite Moringa oleifera's (and other multifunctional crops') various Food-Energy-Water uses, optimizing the benefits of its multiple uses and livelihood improvements remains challenging. There is a need for holistic approaches capable of assessing the multifunctionality of agriculture and livelihood impacts. Therefore, this paper critically evaluates Moringa oleifera's Food-Energy-Water-Livelihood nexus applications to gain insight into the tradeoffs and synergies among its various applications using a systems thinking approach. A systems approach is proposed as a holistic thinking framework that can help navigate the complexity of a crop's multifunctionality. The "Success to the Successful" systems archetype was adopted to capture the competition between the need for leaf yields and seed yields. In areas where there is energy and water insecurity, Moringa oleifera seed production is recommended for its potential to coproduce oil, the water purifying coagulant, and a residue that can be applied as a fertilizer. In areas where food insecurity is an issue, focusing on leaf production would be beneficial due to its significance in augmenting food for human consumption, animal feed, and its use as a biostimulant to increase crop yields. A causal loop diagram was found to effectively map the interconnections among the various uses of Moringa oleifera and associated livelihood improvements. This framework provides stakeholders with a conceptual decision-making tool that can help maximize positive livelihood outcomes. This approach can also be applied for improved management of other multifunctional crops.


Assuntos
Moringa oleifera , Água , Animais , Produtos Agrícolas , Humanos , Sementes , Análise de Sistemas
4.
PLoS One ; 16(8): e0256363, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34407105

RESUMO

The most unexpected and toughest phenomenon that has occurred in recent times is the global COVID-19 pandemic. One of the first measures to prevent the spread of the disease was to close educational institutions. The students were forced to start a learning process through social networks and web platforms. In some countries, a return to face-to-face classes was established. However, weeks later, some of them had to return to virtual activities due to an upswing in the COVID-19 cases. In Mexico, classes have been held virtually, with face-to-face activities only re-established in two of the 32 states. In our state, Yucatan, scholarly activities are still virtual. In this work, the dispersion of COVID-19 at different academic establishments in Yucatan was simulated. Networks of Friendship, noncordial treatment, family ties and study groups were considered. Based on these networks, we evaluated the possibility of returning to school without inducing a rebound in the COVID-19 cases in the state. Agent-based simulations were used, with each student as an agent. Interaction rules were established based on international research regarding good practices in times of COVID-19. We used seven networks from different academic institutions, ranging from primary through college level. As a result, possible contagion curves were obtained for different scenarios, which leads to a discussion about the measures that would be relevant once a return to face-to-face classes is overseen. Simulations show that isolating students and reducing the number of students in the same classroom are good strategies and substantially reduce the possible contagiousness.


Assuntos
COVID-19/epidemiologia , Pandemias/prevenção & controle , Estudantes de Medicina/psicologia , COVID-19/prevenção & controle , Humanos , México/epidemiologia , Instituições Acadêmicas , Rede Social , Análise de Sistemas , Universidades
5.
BMC Health Serv Res ; 21(1): 843, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416882

RESUMO

BACKGROUND: Allocation of limited resources to improve quality, patient safety, and outcomes is a decision-making challenge health care leaders face every day. While much valuable health care management research has concentrated on administrative data analysis, this approach often falls short of providing actionable information essential for effective management of specific system implementations and complex systems. This comprehensive performance analysis of a hospital-wide system illustrates application of various analysis approaches to support understanding specific system behaviors and identify leverage points for improvement. The study focuses on performance of a hospital rescue system supporting early recognition and response to patient deterioration, which is essential to reduce preventable inpatient deaths. METHODS: Retrospective analysis of tertiary care hospital inpatient and rescue data was conducted using a systems analysis approach to characterize: patient demographics; rescue activation types and locations; temporal patterns of activation; and associations of patient factors, including complications, with post-rescue care disposition and outcomes. RESULTS: Increases in bedside consultations (20% per year) were found with increased rescue activations during periods of resource limitations and changes (e.g., shift changes, weekends). Cardiac arrest, respiratory failure, and sepsis complications present the highest risk for rescue and death. Distributions of incidence of rescue and death by day of patient stay may suggest opportunities for earlier recognition. CONCLUSIONS: Specific findings highlight the potential of using rescue-related risk and targeted resource deployment strategies to improve early detection of deterioration. The approach and methods applied can be used by other institutions to understand performance and allow rational incremental improvements to complex care delivery systems.


Assuntos
Análise de Sistemas , Mortalidade Hospitalar , Humanos , Estudos Retrospectivos , Centros de Atenção Terciária , Atenção Terciária à Saúde
6.
Artigo em Inglês | MEDLINE | ID: mdl-34360504

RESUMO

Localized outbreaks of COVID-19 have been reported in sporting facilities. This study used the Agent-based Modeling (ABM) method to analyze the transmission rate of COVID-19 in different sporting models, sporting spaces per capita, and situations of gathering, which contributes to understanding how COVID-19 transmits in sports facilities. The simulation results show that the transmission rate of COVID-19 was higher under the Fixed Movement Route (FMR) than under the Unfixed Movement Route (UMR) in 10 different sporting spaces per capita (1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 m2) (p = 0.000). For both FMR and UMR, the larger the sporting space per capita, the lower the virus transmission rate. Additionally, when the sporting space per capita increases from 4 m2 to 5 m2, the virus transmission rate decreases most significantly (p = 0.000). In the FMR model with a per capita sporting space of 5 m2, minimizing gathering (no more than three people) could significantly slow down the transmission rate of the COVID-19 virus (p < 0.05). This study concluded that: (1) The UMR model is suggested in training facilities or playing grounds; (2) The sporting space should be non-overcrowding, and it is recommended that the sporting space per capita in the sporting grounds should not be less than 5 m2; (3) It is important to maintain safe social distancing and minimize gathering (no more than three people) when exercising.


Assuntos
COVID-19 , Simulação por Computador , Humanos , Distanciamento Físico , SARS-CoV-2 , Análise de Sistemas
7.
Sensors (Basel) ; 21(12)2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34201320

RESUMO

We considered scalable anonymous voting on the Ethereum blockchain. We identified three major bottlenecks in implementation: (1) division overflow in encryption of voting values for anonymity; (2) large time complexity in tallying, which limited scalability in the number of candidates and voters; and (3) tallying failure due to "no votes" from registered voters. Previous schemes failed at tallying if one (or more) registered voters did not send encrypted voting values. Algorithmic solutions and implementation details are provided. An experiment using Truffle and Remix running on a desktop PC was performed for evaluation. Our scheme shows great reduction in gas, which measures the computational burden of smart contracts to be executed on Ethereum. For instance, our scheme consumed 1/53 of the gas compared to a state-of-the-art solution for 60 voters. Time complexity analysis shows that our scheme is asymptotically superior to known solutions. In addition, we propose a solution to the tallying failure due to the "no vote" from registered voters.


Assuntos
Blockchain , Política , Análise de Sistemas
8.
PLoS Comput Biol ; 17(7): e1009146, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34252083

RESUMO

SARS-CoV-2 has spread across the world, causing high mortality and unprecedented restrictions on social and economic activity. Policymakers are assessing how best to navigate through the ongoing epidemic, with computational models being used to predict the spread of infection and assess the impact of public health measures. Here, we present OpenABM-Covid19: an agent-based simulation of the epidemic including detailed age-stratification and realistic social networks. By default the model is parameterised to UK demographics and calibrated to the UK epidemic, however, it can easily be re-parameterised for other countries. OpenABM-Covid19 can evaluate non-pharmaceutical interventions, including both manual and digital contact tracing, and vaccination programmes. It can simulate a population of 1 million people in seconds per day, allowing parameter sweeps and formal statistical model-based inference. The code is open-source and has been developed by teams both inside and outside academia, with an emphasis on formal testing, documentation, modularity and transparency. A key feature of OpenABM-Covid19 are its Python and R interfaces, which has allowed scientists and policymakers to simulate dynamic packages of interventions and help compare options to suppress the COVID-19 epidemic.


Assuntos
COVID-19/prevenção & controle , Busca de Comunicante , Análise de Sistemas , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/virologia , Teste para COVID-19 , Vacinas contra COVID-19/administração & dosagem , Surtos de Doenças , Humanos , Distanciamento Físico , Quarentena , SARS-CoV-2/isolamento & purificação
9.
Int J Mol Sci ; 22(12)2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34203972

RESUMO

Opioid abuse has become a major public health crisis that affects millions of individuals across the globe. This widespread abuse of prescription opioids and dramatic increase in the availability of illicit opioids have created what is known as the opioid epidemic. Pregnant women are a particularly vulnerable group since they are prescribed for opioids such as morphine, buprenorphine, and methadone, all of which have been shown to cross the placenta and potentially impact the developing fetus. Limited information exists regarding the effect of oxycodone (oxy) on synaptic alterations. To fill this knowledge gap, we employed an integrated system approach to identify proteomic signatures and pathways impacted on mixed neuroglial cultures treated with oxy for 24 h. Differentially expressed proteins were mapped onto global canonical pathways using ingenuity pathway analysis (IPA), identifying enriched pathways associated with ephrin signaling, semaphorin signaling, synaptic long-term depression, endocannabinoid signaling, and opioid signaling. Further analysis by ClueGO identified that the dominant category of differentially expressed protein functions was associated with GDP binding. Since opioid receptors are G-protein coupled receptors (GPCRs), these data indicate that oxy exposure perturbs key pathways associated with synaptic function.


Assuntos
Neuroglia/metabolismo , Oxicodona/farmacologia , Proteoma/metabolismo , Análise de Sistemas , Animais , Morte Celular/efeitos dos fármacos , Células Cultivadas , Ontologia Genética , Neuroglia/efeitos dos fármacos , Proteômica , Ratos Sprague-Dawley
10.
Int J Mol Sci ; 22(14)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34299207

RESUMO

Different causative therapeutics for CF patients have been developed. There are still no mutation-specific therapeutics for some patients, especially those with rare CFTR mutations. For this purpose, high-throughput screens have been performed which result in various candidate compounds, with mostly unclear modes of action. In order to elucidate the mechanism of action for promising candidate substances and to be able to predict possible synergistic effects of substance combinations, we used a systems biology approach to create a model of the CFTR maturation pathway in cells in a standardized, human- and machine-readable format. It is composed of a core map, manually curated from small-scale experiments in human cells, and a coarse map including interactors identified in large-scale efforts. The manually curated core map includes 170 different molecular entities and 156 reactions from 221 publications. The coarse map encompasses 1384 unique proteins from four publications. The overlap between the two data sources amounts to 46 proteins. The CFTR Lifecycle Map can be used to support the identification of potential targets inside the cell and elucidate the mode of action for candidate substances. It thereby provides a backbone to structure available data as well as a tool to develop hypotheses regarding novel therapeutics.


Assuntos
Aminopiridinas/farmacologia , Benzodioxóis/farmacologia , Regulador de Condutância Transmembrana em Fibrose Cística/metabolismo , Fibrose Cística/tratamento farmacológico , Fibrose Cística/genética , Fibrose Cística/metabolismo , Fibrose Cística/patologia , Regulador de Condutância Transmembrana em Fibrose Cística/química , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Combinação de Medicamentos , Humanos , Mutação , Mapas de Interação de Proteínas , Análise de Sistemas
11.
PLoS Comput Biol ; 17(7): e1009149, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34310589

RESUMO

The COVID-19 pandemic has created an urgent need for models that can project epidemic trends, explore intervention scenarios, and estimate resource needs. Here we describe the methodology of Covasim (COVID-19 Agent-based Simulator), an open-source model developed to help address these questions. Covasim includes country-specific demographic information on age structure and population size; realistic transmission networks in different social layers, including households, schools, workplaces, long-term care facilities, and communities; age-specific disease outcomes; and intrahost viral dynamics, including viral-load-based transmissibility. Covasim also supports an extensive set of interventions, including non-pharmaceutical interventions, such as physical distancing and protective equipment; pharmaceutical interventions, including vaccination; and testing interventions, such as symptomatic and asymptomatic testing, isolation, contact tracing, and quarantine. These interventions can incorporate the effects of delays, loss-to-follow-up, micro-targeting, and other factors. Implemented in pure Python, Covasim has been designed with equal emphasis on performance, ease of use, and flexibility: realistic and highly customized scenarios can be run on a standard laptop in under a minute. In collaboration with local health agencies and policymakers, Covasim has already been applied to examine epidemic dynamics and inform policy decisions in more than a dozen countries in Africa, Asia-Pacific, Europe, and North America.


Assuntos
COVID-19 , Modelos Biológicos , SARS-CoV-2 , Análise de Sistemas , Número Básico de Reprodução , COVID-19/etiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Teste para COVID-19 , Vacinas contra COVID-19 , Biologia Computacional , Simulação por Computador , Busca de Comunicante , Progressão da Doença , Desinfecção das Mãos , Interações entre Hospedeiro e Microrganismos , Humanos , Máscaras , Conceitos Matemáticos , Pandemias , Distanciamento Físico , Quarentena , Software
12.
PLoS One ; 16(7): e0253579, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34320025

RESUMO

The entire world has suffered a lot since the outbreak of the novel coronavirus (COVID-19) in 2019, so simulation models of COVID-19 dynamics are urgently needed to understand and control the pandemic better. Meanwhile, emotional contagion, the spread of vigilance or panic, serves as a negative feedback to the epidemic, but few existing models take it into consideration. In this study, we proposed an innovative multi-layer hybrid modelling and simulation approach to simulate disease transmission and emotional contagion together. In each layer, we used a hybrid simulation method combining agent-based modelling (ABM) with system dynamics modelling (SDM), keeping spatial heterogeneity while reducing computation costs. We designed a new emotion dynamics model IWAN (indifferent, worried, afraid and numb) to simulate emotional contagion inside a community during an epidemic. Our model was well fit to the data of China, the UK and the US during the COVID-19 pandemic. If there weren't emotional contagion, our experiments showed that the confirmed cases would increase rapidly, for instance, the total confirmed cases during simulation in Guangzhou, China would grow from 334 to 2096, which increased by 528%. We compared the calibrated emotional contagion parameters of different countries and found that the suppression effect of emotional contagion in China is relatively more visible than that in the US and the UK. Due to the experiment results, the proposed multi-layer network model with hybrid simulation is valid and can be applied to the quantitative analysis of the epidemic trends and the suppression effect of emotional contagion in different countries. Our model can be modified for further research to study other social factors and intervention policies in the COVID-19 pandemic or future epidemics.


Assuntos
Ansiedade/prevenção & controle , COVID-19/psicologia , Quarentena/psicologia , COVID-19/epidemiologia , COVID-19/transmissão , Simulação por Computador , Surtos de Doenças , Regulação Emocional , Emoções , Humanos , Modelos Estatísticos , Pandemias , Pânico , SARS-CoV-2/isolamento & purificação , Análise de Sistemas
13.
Matern Child Nutr ; 17 Suppl 1: e13228, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34241950

RESUMO

In all cultures, women and children are embedded in family systems that determine roles, relationships, patterns of communication and authority between family members. Especially in non-western societies, maternal and child nutrition practices are determined not only by the biological parents but also by other influential family members. Most maternal and child nutrition research and interventions do not consider the constellation of family roles and influence on women and children and continue to focus on the mother-child dyad and individual knowledge, attitudes and practices. There is growing agreement on the need to adopt an ecological framework to address public health issues, including those dealing with maternal and child nutrition. This special issue presents examples of research from a variety of settings that employed an ecological, family systems approach either to investigate maternal, child or adolescent nutrition issues or to design interventions that engaged various actors within family settings. These 11 articles contribute to a growing body of evidence supporting the relevance of a wider family systems perspective for nutrition research and interventions. Key themes across studies include the limitations of using a nuclear family model for research and intervention design, the need for formative research that comprehensively explores family systems, increasing recognition of the extensive involvement and support provided by grandmothers, and the importance of engaging men in culturally appropriate ways based on community dialogue and women's perspectives. Future maternal and child nutrition research and interventions can be strengthened by systems thinking that acknowledges that individuals are situated within family and community systems.


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Avós , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Criança , Família , Feminino , Humanos , Masculino , Análise de Sistemas
14.
Artigo em Inglês | MEDLINE | ID: mdl-34206436

RESUMO

The COVID-19 pandemic has greatly influenced society in the past few years. Park accessibility and social distancing are considered important under the threat of a long-term epidemic. However, measures that can maintain park accessibility and diminish virus spreading synchronously have been seldom studied before, which may threaten public health in all major urban parks globally. This paper proposed a methodology based on an agent-based model to analyze capacities for parks by simulating park visitor behaviors when they all are social distancing. The model was derived from historical visitor data and realistic visitor behaviors in three park settings. Then, park capacities of varied contact conditions, different park policies, and layout adjustments were analyzed. First, congestions caused by social distancing without proper visitor control are found inside all parks. Second, 85 to 3972 square meters per person is predicted as a safe space in different parks. Third, the current results can be easily adjusted according to various concerns regarding infection distance and rate. Finally, it can be inferred that information provisions are more effective than space design adjustments and mandatory measures. The results can guide park managers and those who plan and design park settings. They are also helpful in improving knowledge of the mechanisms behind visitor behaviors. Moreover, these findings can be tested and verified in a variety of public spaces with many other contact-based illnesses.


Assuntos
COVID-19 , Parques Recreativos , Humanos , Pandemias , Distanciamento Físico , Recreação , SARS-CoV-2 , Análise de Sistemas
15.
Appl Ergon ; 97: 103495, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34298388

RESUMO

The United States is facing an unprecedented epidemic of opioid addiction and death due to opioid overdose. In an effort to improve patient knowledge and safe use about opioids, an Electronic Medication Complete Communication (EMC2) opioid strategy was developed targeting opioid naïve patients in the Emergency Department (ED). We conducted pre and post sociotechnical systems analyses to evaluate the variance between the process before the intervention and whether or not the process changed as expected with the new intervention. Results were analyzed using thematic qualitative analysis. Sociotechnical systems modeling illustrates the complexity of designing interventions for emergency medicine that affect multiple patients, providers, work systems, technologies, and processes. The post work systems model illustrates that several elements in the external ED environment can affect the effectiveness of the intervention. Sociotechnical systems analysis is an effective tool to illustrate the opportunities for designing health system interventions and evaluating the fidelity of such interventions.


Assuntos
Analgésicos Opioides , Medicina de Emergência , Serviço Hospitalar de Emergência , Humanos , Padrões de Prática Médica , Análise de Sistemas , Estados Unidos
16.
J Ambul Care Manage ; 44(4): 293-303, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34319924

RESUMO

COVID-19 necessitated significant care redesign, including new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. Opportunities also exist to harvest lessons from workflow innovations to benefit routine care. We describe a dedicated COVID-19 ambulatory unit for closing testing and follow-up loops characterized by standardized workflows and electronic communication, documentation, and order placement. More than 85% of follow-ups were completed within 24 hours, with no observed staff, nor patient infections associated with unit operations. Identified issues include role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns with phone screeners.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , COVID-19/terapia , Continuidade da Assistência ao Paciente/organização & administração , Pneumonia Viral/terapia , Unidades de Cuidados Respiratórios/organização & administração , Adulto , Idoso , Boston/epidemiologia , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Encaminhamento e Consulta/estatística & dados numéricos , SARS-CoV-2 , Análise de Sistemas , Fluxo de Trabalho
17.
Comput Biol Med ; 135: 104632, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34265554

RESUMO

Obstructive sleep apnea (OSA) is a serious sleep disorder, which leads to changes in autonomic nerve function and increases the risk of cardiovascular disease. Heart rate variability (HRV) has been widely used as a non-invasive method for assessing the autonomic nervous system (ANS). We proposed the two-dimensional sample entropy of the coarse-grained Gramian angular summation field image (CgSampEn2D) index. It is a new index for HRV analysis based on the temporal dependency complexity. In this study, we used 60 electrocardiogram (ECG) records from the Apnea-ECG database of PhysioNet (20 healthy records and 40 OSA records). These records were divided into 5-min segments. Compared with the classical indices low-to-high frequency power ratio (LF/HF) and sample entropy (SampEn), CgSampEn2D utilizes the correlation information between different time intervals in the RR sequences and preserves the temporal dependency of the RR sequences, which improves the OSA detection performance significantly. The OSA screening accuracy of CgSampEn2D (93.3%) is higher than that of LF/HF (80.0%) and SampEn (73.3%). Additionally, CgSampEn2D has a significant association with the apnea-hypopnea index (AHI) (R = -0.740, p = 0). CgSampEn2D reflects the complexity of the OSA autonomic nerve more comprehensively and provides a novel idea for the screening of OSA disease.


Assuntos
Apneia Obstrutiva do Sono , Sistema Nervoso Autônomo , Frequência Cardíaca , Humanos , Polissonografia , Análise de Sistemas
18.
J Environ Manage ; 294: 112938, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34214943

RESUMO

The present study uses agent-based modeling (ABM) to examine the effectiveness of a nudge policy for improving recycling behavior. In our simulation, agents' recycling behavior is computed by components of the Theory of Planned Behaviour (i.e., attitudes, perceived behavioral control, social norms) and influenced by other agents as well as their surrounding (i.e., amount of waste in the area). The simulation, based on real data from a Taiwan community district, confirms realistic recycling trends and demonstrates the usefulness and reliability of ABM as a method to examine the effectiveness of waste management policies. An additional step in our simulation was to manipulate the amount of waste in the community to test the effect of a nudge policy based on social norms. Results showed that the policy increases recycling activity, but predominantly in low waste scenarios. This suggests that nudges, in the form of norm-based policies, can be an effective solution to enhancing people's recycling behavior under specific circumstances.


Assuntos
Reciclagem , Gerenciamento de Resíduos , Humanos , Políticas , Reprodutibilidade dos Testes , Análise de Sistemas , Taiwan
19.
Nat Commun ; 12(1): 3578, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34117230

RESUMO

Longitudinal multi-omics measurements are highly valuable in studying heterogeneity in health and disease phenotypes. For thousands of people, we have collected longitudinal multi-omics data. To analyze, interpret and visualize this extremely high-dimensional data, we use the Pareto Task Inference (ParTI) method. We find that the clinical labs data fall within a tetrahedron. We then use all other data types to characterize the four archetypes. We find that the tetrahedron comprises three wellness states, defining a wellness triangular plane, and one aberrant health state that captures aspects of commonality in movement away from wellness. We reveal the tradeoffs that shape the data and their hierarchy, and use longitudinal data to observe individual trajectories. We then demonstrate how the movement on the tetrahedron can be used for detecting unexpected trajectories, which might indicate transitions from health to disease and reveal abnormal conditions, even when all individual blood measurements are in the norm.


Assuntos
Fenótipo , Biologia de Sistemas , Doença , Feminino , Saúde , Humanos , Masculino , Metabolômica , Microbiota , Herança Multifatorial , Proteômica , Análise de Sistemas
20.
Acad Med ; 96(7S): S6-S8, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183595

RESUMO

The COVID-19 pandemic of 2020 exposed the reactive nature of the medical education community in response to a disruption that, at one time, may have seemed preposterous. In this article, the author reflected on the impact of an unpredictable plight on a system of medical education that (1) is continuous but doesn't function as a continuum and (2) requires adaptation but is steeped in a fixed mindset and structure that resists change. As a result, innovations which were previously considered impossible, such as time variable education and training, were forced into being. Inspired by the changes brought about by the pandemic, the ensuing decade is explored through a lens of possible futures to envision a path forward based on resilience rather than reactivity.


Assuntos
COVID-19 , Educação Baseada em Competências/organização & administração , Educação Médica/organização & administração , Modelos Educacionais , Inovação Organizacional , Educação Baseada em Competências/métodos , Criatividade , Educação Médica/métodos , Humanos , Resiliência Psicológica , Análise de Sistemas , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...