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1.
J Comput Assist Tomogr ; 44(1): 75-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31804241

RESUMO

Computed tomography perfusion (CTP) is increasingly used to determine treatment eligibility for acute ischemic stroke patients. Automated postprocessing of raw CTP data is routinely used, but it can fail. In reviewing 176 consecutive acute ischemic stroke patients, failures occurred in 20 patients (11%) during automated postprocessing by the RAPID software. Failures were caused by motion (n = 11, 73%), streak artifacts (n = 2, 13%), and poor contrast bolus arrival (n = 2, 13%). Stroke physicians should review CTP results with care before they are being integrated in their decision-making process.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Processamento Eletrônico de Dados/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão/métodos , Fatores de Risco , Sensibilidade e Especificidade , Software , Tomografia Computadorizada por Raios X
2.
Parasit Vectors ; 12(1): 456, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533795

RESUMO

BACKGROUND: As mosquitoes are one of the most harmful creatures in the world, recent high-frequency interceptions of invasive mosquito species have emphasized the need to enhance the biological security of the Zhejiang Province in China. As such, an integrated management system should be implemented to monitor the vectors of mosquito-borne diseases during data digitization and the processing of permanent E-forms and provide an online one-stop identification service. METHODS: This system is a semi-open network built on the latest Microsoft.NET Framework, Active Server Page.NET (ASP.NET) and Internet Information Services (IIS) for the Windows 2000 service as a basic infrastructure platform. This creates a physical separation between the data input as the back-page intranet and the online automated Lucid identification as the front-page internet through the digital interchange platform and security firewall. RESULTS: This system mainly comprises three core modules: automated statistical analysis of operational data, online vector identification and digital specimen storage management, in addition to accessory modules. The joint analysis of invasive and native data collected between 2011 and 2017 at 14 surveillance points in the Zhejiang Province, excluding Ningbo Port, provided insights into the geographical differences in species abundance and the dynamic nature of seasonal interception within the statistical analysis module. Most importantly, multi-access keys to mosquitoes based on Lucid software were loaded in the module for vector identification. Subscribers can utilize this procedure for the online identification of 2 subfamilies, 10 genera and 33 mosquitoes by selecting any typical morphological feature in the classification system that matches the current images at hand. CONCLUSIONS: Our report suggests that this system can enhance the ability to master the basic information on invasive mosquitoes and satisfy the increasing requirements for public health safety in the integrated management of vector-borne diseases.


Assuntos
Serviços de Informação/organização & administração , Controle de Mosquitos/métodos , Controle de Mosquitos/organização & administração , Mosquitos Vetores/crescimento & desenvolvimento , Animais , China , Processamento Eletrônico de Dados/métodos , Processamento Eletrônico de Dados/organização & administração
3.
BMC Infect Dis ; 19(Suppl 1): 786, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31526387

RESUMO

BACKGROUND: Although the use of technology viz. mobile phones, personalised digital assistants, smartphones, notebook and tablets to monitor health and health care (mHealth) is mushrooming, only small, localised studies have described their use as a data collection tool. This paper describes the complexity, functionality and feasibility of mHealth for large scale surveillance at national and sub-national levels in South Africa, a high HIV-prevalence setting. METHODS: In 2010, 2011-12 and 2012-13 three nationally representative surveys were conducted amongst infants attending 580 facilities across all 51 districts, within all nine provinces of South Africa, to monitor the effectiveness of the programme to prevent mother-to-child transmission of HIV (PMTCT). In all three surveys a technical protocol and iterative system for mobile data collection was developed. In 2012-13 the system included automated folders to store information about upcoming interviews. Paper questionnaires were used as a back-up, in case of mHealth failure. These included written instructions per question on limits, skips and compulsory questions. Data collectors were trained on both systems. RESULTS: In the 2010, 2011-12 and 2012-2013 surveys respectively, data from 10,554, 10,071, and 10,536 interviews, and approximately 186 variables per survey were successfully uploaded to 151 mobile phones collecting data from 580 health facilities in 51 districts, across all nine provinces of South Africa. A technician, costing approximately U$D20 000 p.a. was appointed to support field-based staff. Two percent of data were gathered using paper- questionnaires. The time needed for mHealth interviews was approximately 1,5 times less than the time needed for paper questionnaires 30-45 min versus approximately 120 min (including 60-70 min for the interview with an additional 45 min for data capture). In 2012-13, 1172 data errors were identified via the web-based console. There was a four-week delay in resolving data errors from paper-based surveys compared with a 3-day turnaround time following direct capture on mobile phones. CONCLUSION: Our experiences demonstrate the feasibility of using mHealth during large-scale national surveys, in the presence of a supportive data management team. mHealth systems reduced data collection time by almost 1.5 times, thus reduced data collector costs and time needed for data management.


Assuntos
Telefone Celular , Processamento Eletrônico de Dados/métodos , Vigilância em Saúde Pública/métodos , Telemedicina/métodos , Cuidadores , Estudos Transversais , Assistência à Saúde , Teste em Amostras de Sangue Seco , Estudos de Viabilidade , Seguimentos , Instalações de Saúde , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mães , África do Sul , Inquéritos e Questionários , Telemedicina/economia
4.
Cyberpsychol Behav Soc Netw ; 22(8): 543-551, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31403855

RESUMO

The aim of this study was to evaluate the usage of a reminiscence app by people living with dementia and their family carers, by comparing event log data generated from app usage alongside the qualitative experience of the process. A cross-comparative analysis of electronic event logging data with qualitative interview data was conducted. Electronic event logging data were obtained for 28 participating dyads (n = 56) and the interview sample comprised 14 people living with dementia and 16 family carers (n = 30). A thematic analysis framework was used in the analysis of interview transcripts and the identification of recurrent themes. The cross-comparison of electronic event log data and qualitative data revealed 25 out of 28 dyads regularly engaged with a reminiscence app, with the analysis of usage patterns revealing four clusters classifying different levels of user engagement. The cross-comparison of data revealed that the nature of the relationship was a significant factor in ongoing user engagement. The comparative analysis of the electronic event logs as "ground truth" in combination with the qualitative lived experience can provide a deeper understanding on the usage of a reminiscence app for those living with dementia and their family carers. This work not only shows the benefits of using automated event log data mining but also shows its clear limitations without using complementary qualitative data analysis. As such, this work also provides key insights into using mixed methods for evaluating human-computer interaction technologies.


Assuntos
Cuidadores/psicologia , Demência/psicologia , Processamento Eletrônico de Dados/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Participação dos Interessados/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Pesquisa Qualitativa
5.
Surg Infect (Larchmt) ; 20(7): 541-545, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31460834

RESUMO

Background: Surgical site infection (SSI) continues to be a common and costly complication after surgery. The current commonly used definitions of SSI were devised more than two decades ago and do not take in to account more modern technology that could be used to make diagnosis more consistent and precise. Patient-generated health data (PGHD), including digital imaging, may be able to fulfill this objective. Methods: The published literature was examined to determine the current state of development in terms of using digital imaging as an aide to diagnose SSI. This information was used to devise possible methodology that could be used to integrate digital images to more objectively define SSI, as well as using these data for both surveillance activities and clinical management. Results: Digital imaging is a highly promising means to help define and diagnose SSI, particularly in remote settings. Multiple groups continue to actively study these emerging technologies, however, present methods remain based generally on subjective rather than objective observations. Although current images may be useful on a case-by-case basis, similar to physical examination information, integrating imaging in the definition of SSI to allow more automated diagnosis in the future will require complex image analysis combined with other available quantified data. Conclusions: Digital imaging technology, once adequately evolved, should become a cornerstone of the criteria for both the clinical and surveillance definitions of SSI.


Assuntos
Processamento Eletrônico de Dados/métodos , Monitoramento Epidemiológico , Processamento de Imagem Assistida por Computador/métodos , Dados de Saúde Gerados pelo Paciente/métodos , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Telemedicina/métodos , Processamento Eletrônico de Dados/tendências , Humanos , Processamento de Imagem Assistida por Computador/tendências , Dados de Saúde Gerados pelo Paciente/tendências , Telemedicina/tendências
6.
Surg Infect (Larchmt) ; 20(7): 566-570, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31429637

RESUMO

Background: The implementation of health information technology interventions is at the forefront of most hospital institutional policy agendas. Despite the availability of numerous apps and mobile platforms focusing on specific areas in healthcare the widespread integration into clinical practice can be a complex process. Here we present guidelines and methodology that we have learned in the implementation process of new technology and an overview of some of the current barriers and enablers specific to implementation of post-surgical site surveillance technology. Methods: Analysis of the experience of successful information technology (IT) implementation in different healthcare systems reveals that, despite differences among patient groups, care providers, and hospitals, there are common barriers and enablers to implementation of health IT. Results: The process of implementation in organizations and among individuals can be most successful by identifying barriers and enablers within three key stakeholder groups: (1) patients; (2) care providers/clinicians; and (3) manager/administration within healthcare systems. This can be achieved by specific engagement and co-design processes establishing clear benefits, sufficient incentives, and adequate support for clinicians as well as payer-provider relationships, marketplace competition and privacy legislation. Conclusions: The successful implementation of such programs requires appropriate strategic planning to address the needs of three specific components: patients, care provider, and policymakers/healthcare management understanding and acceptance.


Assuntos
Processamento Eletrônico de Dados/métodos , Informática Médica/métodos , Dados de Saúde Gerados pelo Paciente , Telemedicina/métodos , Processamento Eletrônico de Dados/organização & administração , Guias como Assunto , Humanos , Informática Médica/organização & administração
7.
Surg Infect (Larchmt) ; 20(7): 535-540, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31429644

RESUMO

Background: As the use of patient-owned devices, including smartphones and tablets, to manage day-to-day activities grows, so does healthcare industry's interest to better leverage technology to engage patients. For surgical care, a unique opportunity exists to capture patient-generated health data (PGHD) including photographs. As part of a broader initiative to evaluate PGHD for surgical site infection (SSI) surveillance, we sought evidence regarding patient involvement and experience with PGHD for SSI monitoring and surveillance. Methods: Through a scoping review of the literature and semi-structured stakeholder interviews we gathered evidence on what is currently known about patient perspectives of and experiences with mobile health (mHealth) interventions for post-operative recovery. We presented findings to and discussed with the ASSIST PGHD Stakeholder Advisory Group (PSAG) to generate priorities for further examination. Results: Our scoping review yielded 34 studies that addressed post-discharge use of PGHD for monitoring and surveillance of SSI. Of these, 16 studies addressed at least one outcome regarding patient experience; the most commonly measured outcome was patient satisfaction. Only three studies reported on patient involvement in the development of PGHD tools and interventions. We conducted interviews (n = 24) representing a range of stakeholder perspectives. Interviewees stressed the importance of patient involvement in tool and program design, noting patient involvement ensures the "work" that patients do in their daily lives to manage their health and healthcare is recognized. Discussion of evidence with the ASSIST PSAG resulted in formal recommendations for direct involvement of patients and caregivers for future work. Conclusions: While mHealth initiatives to advance post-operative management offer the ability to improve patient engagement, work is needed to ensure the patient voice is reflected. Active engagement with patients and caregivers in the development of new technology, the design of new workflows, and the conduct of research and evaluation ensures that the patient experiences and values are incorporated.


Assuntos
Testes Diagnósticos de Rotina/métodos , Monitoramento Epidemiológico , Participação do Paciente/métodos , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Telemedicina/métodos , Processamento Eletrônico de Dados/métodos , Humanos , Dados de Saúde Gerados pelo Paciente
8.
Surg Infect (Larchmt) ; 20(7): 555-565, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31424335

RESUMO

Background: Emerging technologies such as smartphones and wearable sensors have enabled the paradigm shift to new patient-centered healthcare, together with recent mobile health (mHealth) app development. One such promising healthcare app is incision monitoring based on patient-taken incision images. In this review, challenges and potential solution strategies are investigated for surgical site infection (SSI) detection and evaluation using surgical site images taken at home. Methods: Potential image quality issues, feature extraction, and surgical site image analysis challenges are discussed. Recent image analysis and machine learning solutions are reviewed to extract meaningful representations as image markers for incision monitoring. Discussions on opportunities and challenges of applying these methods to derive accurate SSI prediction are provided. Conclusions: Interactive image acquisition as well as customized image analysis and machine learning methods for SSI monitoring will play critical roles in developing sustainable mHealth apps to achieve the expected outcomes of patient-taken incision images for effective out-of-clinic patient-centered healthcare with substantially reduced cost.


Assuntos
Processamento Eletrônico de Dados/métodos , Processamento de Imagem Assistida por Computador/métodos , Dados de Saúde Gerados pelo Paciente , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Telemedicina/métodos , Processamento Eletrônico de Dados/tendências , Humanos , Processamento de Imagem Assistida por Computador/tendências , Telemedicina/tendências
9.
Stud Health Technol Inform ; 264: 1564-1565, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438233

RESUMO

ICD-10 (International Classification of Diseases 10th revision) is a classification code for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. This paper describes an automatic information retrieval approach to map free-text disease descriptions to ICD-10 codes. We use the Hospital Italiano de Buenos Aires (HIBA) terminology data mapped to ICD-10 codes as indexed data to find an appropriate ICD-10 code using search engine similarity metrics.


Assuntos
Armazenamento e Recuperação da Informação , Classificação Internacional de Doenças , Processamento Eletrônico de Dados , Ferramenta de Busca
10.
Yearb Med Inform ; 28(1): 65-68, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31419817

RESUMO

OBJECTIVES: To summarize the recent literature and research and present a selection of the best papers published in 2018 in the field of Health Information Management (HIM) and Health Informatics. METHODS: A systematic review of the literature was performed, with the help of a medical librarian, by the two editors of the HIM section of the International Medical Informatics Association (IMIA) Yearbook. In order to include papers that would address the special theme of the 2019 Yearbook on artificial intelligence (AI) as well as HIM, we searched bibliographic databases for HIM-related papers with an AI focus using both Medical Subject Headings (MeSH) descriptors and keywords in titles and abstracts. A shortlist of 15 candidate best papers was first selected by section editors before being peer-reviewed by independent external reviewers. RESULTS: While there were a significant number of manuscripts that addressed issues relevant to HIM, there were virtually none with MeSH headings indicating an HIM focus. Manuscripts that were considered related to the HIM field in terms of the practice of health information management as well as the profession included those that examined using machine learning and other AI approaches to identify protected health information in clinical text to aid with de-identification, automated coding approaches to translate free-text into standardized codes, and natural language processing approaches to extract clinical data to assist with populating cancer and other registries. CONCLUSIONS: The papers discussed in the HIM section reflect the special theme of the use of AI in healthcare on issues particularly relevant to the field of HIM. This synopsis discusses these papers and recommends that HIM practitioners be more involved in research and that researchers in AI and related areas recognize the applicability and relevance of their work to the field of HIM.


Assuntos
Gestão da Informação em Saúde , Informática Médica , Inteligência Artificial , Codificação Clínica/métodos , Mineração de Dados , Processamento Eletrônico de Dados , Humanos , Neoplasias , Sistema de Registros
11.
Surg Infect (Larchmt) ; 20(7): 581-583, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31343385

RESUMO

Background: The history of large-scale technological advances, such as the digital revolution in our era, suggests that core technologies yield wide benefits by serving as a method of invention, spawning new tools and techniques that surpass the performance of their predecessors. Methods: Digital platforms provide a method of invention in the health sector by enabling innovations in data collection, use, and sharing. Although wide adoption of computerized information technology in healthcare has produced mixed results, the advent of mobile health (mHealth) creates new opportunities for device-mediated advances in surgical and public health practice. Conclusion: Mobile solutions for collecting, using, and sharing patient-generated health data after surgery can yield important benefits for post-operative monitoring, whether the data are used to evaluate and manage individual patients or track infections and other outcomes in patient populations.


Assuntos
Coleta de Dados , Processamento Eletrônico de Dados/métodos , Monitoramento Epidemiológico , Informática Médica/métodos , Humanos , Telemedicina/métodos
12.
Surg Infect (Larchmt) ; 20(7): 527-529, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31335255

RESUMO

Background: The expert panel that conducted the Assessing Surgical Site Infection Surveillance Technologies (ASSIST) project elaborates on the key findings of the health technologies assessment (HTA) report in a series of articles addressing topics from workflow challenges to implementation strategies to new big data analytics tailored to incorporate serial patient-generated health data (PGHD). Conclusion: By reporting on the methodology, with an emphasis on stakeholder engagement, the ASSIST investigators provide the basis for a future deep dive into the next phase of PGHD integration into surgical site infection (SSI) surveillance.


Assuntos
Processamento Eletrônico de Dados , Monitoramento Epidemiológico , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Dados de Saúde Gerados pelo Paciente , Período Pós-Operatório , Infecção da Ferida Cirúrgica/diagnóstico , Humanos
13.
Comput Methods Programs Biomed ; 177: 31-38, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31319958

RESUMO

BACKGROUND AND OBJECTIVE: Monitoring of changes in respiratory rate provides information on a patient's psychophysical state. This paper presents a respiratory rate detection method based on analysis of signals from a fiber Bragg grating (FBG)-based sensor. METHODS: The detection method is based on a system of software blocks that identify notches in the signal waveforms, determine their parameters, and then transmit them to the classifier, which decides which of them are the characteristic waves of the respiratory cycle. The classifier of respiratory waves was developed by means of machine learning methods and using the training data obtained from 10 volunteers (7 males, 3 females, age: 41.1 ±â€¯8.28 years, weight: 73.6 ±â€¯15.25 kg, height 173.5 ±â€¯6.43 cm), who were lying in the tube of a 3-Tesla magnetic resonance imaging (MRI) scanner. RESULTS: In the verification study, aimed at assessing the performance of the method for detecting respiratory rate, 15 subjects (14 males, 1 female, age: 20.2 ±â€¯3.00 years, weight: 75.47 ± 10.58 kg, height 179.13 ± 6.27 cm) were involved. Clinically satisfactory results of respiratory rate detection were obtained: root mean square error of 1.48 rpm and the limits of agreement at -2.73 rpm and 3.04 rpm. The results indicate a high efficiency of the classifier, i.e., sensitivity: 96.50 ± 3.44%, precision: 95.42 ± 2.84%, and accuracy: 92.99 ± 3.37%. CONCLUSION: The all-dielectric sensor acquires the respiration curve and the proposed scheme of computation enables for extracting respiratory rate automatically and continuously. This scheme based on machine learning procedures will be integrated into a system to facilitate non-invasive continuous monitoring of MRI patients.


Assuntos
Aprendizado de Máquina , Imagem por Ressonância Magnética , Monitorização Fisiológica/métodos , Taxa Respiratória , Adulto , Algoritmos , Análise Discriminante , Processamento Eletrônico de Dados , Desenho de Equipamento , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
14.
Chaos ; 29(6): 063108, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31266314

RESUMO

We report that a genetic two-step activation cascade processes diverse flavors of information, e.g., synergy, redundancy, and unique information. Our computations measuring reduction in Shannon entropies and reduction in variances produce differently behaving absolute magnitudes of these informational flavors. We find that similarity can be brought in if these terms are evaluated in fractions with respect to corresponding total information. Each of the input signal and final gene-product is found to generate common or redundant information fractions (mostly) to predict each other, whereas they also complement one another to harness synergistic information fraction, predicting the intermediate biochemical species. For an optimally growing signal to maintain fixed steady-state abundance of activated downstream gene-products, the interaction information fractions for this cascade module shift from net-redundancy to information-independence.


Assuntos
Processamento Eletrônico de Dados , Aptidão Genética , Transcrição Genética , Células HeLa , Humanos , Cadeias de Markov , Análise Multivariada , Razão Sinal-Ruído
15.
S Afr Med J ; 109(7): 468-470, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31266570

RESUMO

Genomic research has been identified in South Africa (SA) as important in developing a strong bio-economy that has the potential to improve human health, drive job creation and offer potential solutions to the disease burden harboured by low- and middle-income countries. Central to the success of genomic research is the wide sharing of biological samples and data, but the true value of data can only be unlocked if there are laws and policies in place that foster the legal and ethical sharing of genomic data. The introduction and entry into force of SA's Protection of Personal Information Act (POPIA) No. 4 of 2013 is to be welcomed, but the wording of POPIA as it pertains to consent for the processing of personal information for research purposes has sparked a debate about the legal status of broad consent. We argue that a purposive interpretation of the legislation would permit broad consent for the processing of personal information for research. Although there are ongoing debates surrounding the ethical use of broad consent in Africa, the objective of this article is not to engage with the ethics of broad consent itself, but rather to focus on the legal status of broad consent for genomic data sharing under POPIA.


Assuntos
Confidencialidade/legislação & jurisprudência , Pesquisa em Genética , Genômica , Disseminação de Informação/legislação & jurisprudência , Consentimento Livre e Esclarecido/legislação & jurisprudência , Processamento Eletrônico de Dados/legislação & jurisprudência , Privacidade Genética/legislação & jurisprudência , Humanos , África do Sul
16.
J Med Syst ; 43(8): 257, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31264006

RESUMO

Telemedicine research improves the connectivity of remote patients and doctors. Researchers are focused on data optimization and processing over a predefined channel of communication under a depictive low QoS. In this paper a consolidated representation of telemedicine infrastructure of modern topological arrangement is represented and validated. The infrastructure is aided with Multiple Objective Optimized Medical dataset (MooM) processing and a channel optimizing TelMED protocol designed exclusively for remote medicine dataset transmission and processing. The proposed infrastructure provides an application oriented approach towards Electronics health records (EHR) creation and updating over edge computation. The focus of this article is to achieve higher order of Quality of Service (QoS) and Quality of Data (QoD) compared to typical communication channels algorithms for processing of medical data sample. Typically the proposed technique results are achieved to discuss in MooM dataset processing and TelMED channel optimization sessions and a resulting improvement is discussed with a comparison of each MooM dataset in reverse processing towards server end of diagnosis and a consolidated QoS is retrieved for proposed infrastructure.


Assuntos
Conjuntos de Dados como Assunto , Processamento Eletrônico de Dados , Qualidade da Assistência à Saúde , Consulta Remota , Telemedicina , Tecnologia sem Fio , Processamento de Sinais Assistido por Computador
17.
PLoS Negl Trop Dis ; 13(7): e0007565, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31306425

RESUMO

Contact patterns strongly influence the dynamics of disease transmission in both human and non-human animal populations. Domestic dogs Canis familiaris are a social species and are a reservoir for several zoonotic infections, yet few studies have empirically determined contact patterns within dog populations. Using high-resolution proximity logging technology, we characterised the contact networks of free-ranging domestic dogs from two settlements (n = 108 dogs, covering >80% of the population in each settlement) in rural Chad. We used these data to simulate the transmission of an infection comparable to rabies and investigated the effects of including observed contact heterogeneities on epidemic outcomes. We found that dog contact networks displayed considerable heterogeneity, particularly in the duration of contacts and that the network had communities that were highly correlated with household membership. Simulations using observed contact networks had smaller epidemic sizes than those that assumed random mixing, demonstrating the unsuitability of homogenous mixing models in predicting epidemic outcomes. When contact heterogeneities were included in simulations, the network position of the individual initially infected had an important effect on epidemic outcomes. The risk of an epidemic occurring was best predicted by the initially infected individual's ranked degree, while epidemic size was best predicted by the individual's ranked eigenvector centrality. For dogs in one settlement, we found that ranked eigenvector centrality was correlated with range size. Our results demonstrate that observed heterogeneities in contacts are important for the prediction of epidemiological outcomes in free-ranging domestic dogs. We show that individuals presenting a higher risk for disease transmission can be identified by their network position and provide evidence that observable traits hold potential for informing targeted disease management strategies.


Assuntos
Doenças do Cão/epidemiologia , Doenças do Cão/transmissão , Modelos Biológicos , Raiva/epidemiologia , Raiva/transmissão , Adolescente , Adulto , Animais , Chade/epidemiologia , Criança , Coleta de Dados , Cães , Processamento Eletrônico de Dados , Epidemias , Feminino , Heterogeneidade Genética , Humanos , Masculino , Raiva/veterinária , Adulto Jovem
18.
Surg Infect (Larchmt) ; 20(7): 588-591, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31347988

RESUMO

Background: Patients increasingly use mobile devices to send text messages and photographic data to surgeons. There is potential to harness this patient-generated health data (PGHD) for clinical and public health surveillance of surgical site infection (SSI). Leveraging PGHD collected via remote monitoring in the post-operative period has the potential to produce important benefits for patients, surgeons, care teams, and infection surveillance and prevention. Methods: We conducted a health technology assessment (HTA), drawing heavily on stakeholder engagement to better understand current and potential uses of PGHD in post-operative care. Stakeholder engagement activities included assembling an advisory board composed of stakeholder experts, interviewing key informants, and seeking out stakeholder guidance to synthesize evidence from interviews, literature review, and technical app review in order to develop recommendations on the use of PGHD in SSI surveillance. Results: We conducted a review of the published literature, a technical/market scan of available apps for capturing post-operative PGHD, and two rounds of key informant interviews with stakeholders. In addition, we held a day-long workshop to solicit stakeholder feedback on initial findings of the project and to guide additional work. These activities culminated in an HTA report that provides guidance and recommendations on the use of PGHD in SSI surveillance, including practice, research, and public health surveillance, and identifies open issues on post-operative use of PGHD for which additional evidence and experience are needed to optimize application of those data for clinical and public health purposes. Conclusion: Stakeholders, individuals with direct experience, or interest in a given topic are critical to the HTA process. They provide insight to guide the work conducted, ensure that the topics addressed are relevant and important, and that products of the work are accessible and meaningful to the individuals who will be most impacted.


Assuntos
Monitoramento Epidemiológico , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Dados de Saúde Gerados pelo Paciente , Participação do Paciente/métodos , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Processamento Eletrônico de Dados , Humanos , Período Pós-Operatório , Participação dos Interessados
20.
Rev. bioét. derecho ; (46): 117-131, jul. 2019.
Artigo em Português | IBECS | ID: ibc-184855

RESUMO

O surgimento de novos softwares baseados em tecnologia blockchainlançam novas perguntas ao novo RGPD, criticado por ter sido criado tendo apenas em vista realidades virtuais centralizadas de controlo de dados. Apesar de quer o RGPD, quer o blockchaindesejarem objetivos comuns, como o aumento da transparência e da confiança na troca de dados online, a verdade é que em vários aspetos os desentendimentos entre ambos são reais: certas noções, como a de responsável pelo tratamento ou subcontratante, dificilmente se adequam; certos direitos, como o direito ao esquecimento ou à transferência de dados, correm o risco de perder conteúdo útil; ou mesmo certos princípios, como o da limitação de tratamento, dificilmente se compatibilizam com esta nova tecnología


La creación y el surgimiento de nuevos programas informáticos basados en la tecnología blockchain desafían el reciente GDPR con nuevas cuestiones, ya que se le critica tener en cuenta sólo las realidades virtuales basadas en el control centralizado de datos. A pesar de que tanto el RGDP como la blockchain comparten intereses comunes para aumentar la transparencia y la confianza en el intercambio de datos en línea, lo cierto es que, en varios aspectos, los malentendidos entre ambos son reales: algunas nociones como la de controlador o procesador de datos, son poco adecuadas; ciertos derechos, como el derecho al olvido o el derecho a la portabilidad de los datos corren el riesgo de perder su aplicación; o incluso ciertos principios, como la minimización de datos, son difícilmente compatibles con esta nueva tecnología


La creació i el sorgiment de nous programes informàtics basats en la tecnologia blockchain desafien el recent GDPR amb noves qüestions, ja que se li critica tenir en compte només les realitats virtuals basades en el control centralitzat de dades. A pesar que tant el RGDP com la blockchain comparteixen interessos comuns per a augmentar la transparència i la confiança en l'intercanvi de dades en línia, la veritat és que, en diversos aspectes, els malentesos entre tots dos són reals: algunes nocions com la de controlador o processador de dades, són poc adequades; certs drets, com el dret a l'oblit o el dret a la portabilitat de les dades corren el risc de perdre la seva aplicació; o fins i tot certs principis, com la minimització de dades, són difícilment compatibles amb aquesta nova tecnología


The creation and emergence of new software based on blockchain technology challenge the recent GDPR to new questions, as it is severely criticized for bearing in mind only virtual realities based on centralized data control. Despite both RGDP and blockchain share common interests in increasing transparency and confidence in online data exchange, the truth is that in several ways misunderstandings between the two are real: certain notions, such as data controller or processor, hardly adequate; certain rights, such as right to be forgotten or the right to data portability risk losing their enforcement; or even certain principles, such as data minimization, are hardly compatible with this new technology


Assuntos
Software/ética , Software/legislação & jurisprudência , Confidencialidade , Segurança Computacional/legislação & jurisprudência , Redes de Comunicação de Computadores , Redes de Comunicação de Computadores/legislação & jurisprudência , Curadoria de Dados/ética , Processamento Eletrônico de Dados/ética , Processamento Eletrônico de Dados/legislação & jurisprudência
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