Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Resultados 1 - 20 de 29
Filtrar
1.
Nature ; 624(7992): 586-592, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38030732

RESUMEN

A long-standing expectation is that large, dense and cosmopolitan areas support socioeconomic mixing and exposure among diverse individuals1-6. Assessing this hypothesis has been difficult because previous measures of socioeconomic mixing have relied on static residential housing data rather than real-life exposures among people at work, in places of leisure and in home neighbourhoods7,8. Here we develop a measure of exposure segregation that captures the socioeconomic diversity of these everyday encounters. Using mobile phone mobility data to represent 1.6 billion real-world exposures among 9.6 million people in the United States, we measure exposure segregation across 382 metropolitan statistical areas (MSAs) and 2,829 counties. We find that exposure segregation is 67% higher in the ten largest MSAs than in small MSAs with fewer than 100,000 residents. This means that, contrary to expectations, residents of large cosmopolitan areas have less exposure to a socioeconomically diverse range of individuals. Second, we find that the increased socioeconomic segregation in large cities arises because they offer a greater choice of differentiated spaces targeted to specific socioeconomic groups. Third, we find that this segregation-increasing effect is countered when a city's hubs (such as shopping centres) are positioned to bridge diverse neighbourhoods and therefore attract people of all socioeconomic statuses. Our findings challenge a long-standing conjecture in human geography and highlight how urban design can both prevent and facilitate encounters among diverse individuals.


Asunto(s)
Ciudades , Análisis de Redes Sociales , Red Social , Factores Socioeconómicos , Población Urbana , Humanos , Teléfono Celular , Ciudades/estadística & datos numéricos , Vivienda/estadística & datos numéricos , Modelos Teóricos , Características de la Residencia/estadística & datos numéricos , Estados Unidos , Población Urbana/estadística & datos numéricos
2.
N Engl J Med ; 390(22): 2083-2097, 2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38767252

RESUMEN

BACKGROUND: Adjustment for race is discouraged in lung-function testing, but the implications of adopting race-neutral equations have not been comprehensively quantified. METHODS: We obtained longitudinal data from 369,077 participants in the National Health and Nutrition Examination Survey, U.K. Biobank, the Multi-Ethnic Study of Atherosclerosis, and the Organ Procurement and Transplantation Network. Using these data, we compared the race-based 2012 Global Lung Function Initiative (GLI-2012) equations with race-neutral equations introduced in 2022 (GLI-Global). Evaluated outcomes included national projections of clinical, occupational, and financial reclassifications; individual lung-allocation scores for transplantation priority; and concordance statistics (C statistics) for clinical prediction tasks. RESULTS: Among the 249 million persons in the United States between 6 and 79 years of age who are able to produce high-quality spirometric results, the use of GLI-Global equations may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, grading of chronic obstructive pulmonary disease for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; for example, classifications of nonobstructive ventilatory impairment may change dramatically, increasing 141% (95% confidence interval [CI], 113 to 169) among Black persons and decreasing 69% (95% CI, 63 to 74) among White persons. Annual disability payments may increase by more than $1 billion among Black veterans and decrease by $0.5 billion among White veterans. GLI-2012 and GLI-Global equations had similar discriminative accuracy with regard to respiratory symptoms, health care utilization, new-onset disease, death from any cause, death related to respiratory disease, and death among persons on a transplant waiting list, with differences in C statistics ranging from -0.008 to 0.011. CONCLUSIONS: The use of race-based and race-neutral equations generated similarly accurate predictions of respiratory outcomes but assigned different disease classifications, occupational eligibility, and disability compensation for millions of persons, with effects diverging according to race. (Funded by the National Heart Lung and Blood Institute and the National Institute of Environmental Health Sciences.).


Asunto(s)
Pruebas de Función Respiratoria , Insuficiencia Respiratoria , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/economía , Enfermedades Pulmonares/etnología , Enfermedades Pulmonares/terapia , Trasplante de Pulmón/estadística & datos numéricos , Encuestas Nutricionales/estadística & datos numéricos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/economía , Enfermedad Pulmonar Obstructiva Crónica/etnología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Grupos Raciales , Pruebas de Función Respiratoria/clasificación , Pruebas de Función Respiratoria/economía , Pruebas de Función Respiratoria/normas , Espirometría , Estados Unidos/epidemiología , Insuficiencia Respiratoria/diagnóstico , Insuficiencia Respiratoria/economía , Insuficiencia Respiratoria/etnología , Insuficiencia Respiratoria/terapia , Negro o Afroamericano/estadística & datos numéricos , Blanco/estadística & datos numéricos , Evaluación de la Discapacidad , Ayuda a Lisiados de Guerra/clasificación , Ayuda a Lisiados de Guerra/economía , Ayuda a Lisiados de Guerra/estadística & datos numéricos , Personas con Discapacidad/clasificación , Personas con Discapacidad/estadística & datos numéricos , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/economía , Enfermedades Profesionales/etnología , Financiación Gubernamental/economía , Financiación Gubernamental/estadística & datos numéricos
3.
Nature ; 589(7840): 82-87, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33171481

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic markedly changed human mobility patterns, necessitating epidemiological models that can capture the effects of these changes in mobility on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. Here we introduce a metapopulation susceptible-exposed-infectious-removed (SEIR) model that integrates fine-grained, dynamic mobility networks to simulate the spread of SARS-CoV-2 in ten of the largest US metropolitan areas. Our mobility networks are derived from mobile phone data and map the hourly movements of 98 million people from neighbourhoods (or census block groups) to points of interest such as restaurants and religious establishments, connecting 56,945 census block groups to 552,758 points of interest with 5.4 billion hourly edges. We show that by integrating these networks, a relatively simple SEIR model can accurately fit the real case trajectory, despite substantial changes in the behaviour of the population over time. Our model predicts that a small minority of 'superspreader' points of interest account for a large majority of the infections, and that restricting the maximum occupancy at each point of interest is more effective than uniformly reducing mobility. Our model also correctly predicts higher infection rates among disadvantaged racial and socioeconomic groups2-8 solely as the result of differences in mobility: we find that disadvantaged groups have not been able to reduce their mobility as sharply, and that the points of interest that they visit are more crowded and are therefore associated with higher risk. By capturing who is infected at which locations, our model supports detailed analyses that can inform more-effective and equitable policy responses to COVID-19.


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Simulación por Computador , Locomoción , Distanciamiento Físico , Grupos Raciales/estadística & datos numéricos , Factores Socioeconómicos , COVID-19/transmisión , Teléfono Celular/estadística & datos numéricos , Análisis de Datos , Humanos , Aplicaciones Móviles/estadística & datos numéricos , Religión , Restaurantes/organización & administración , Medición de Riesgo , Factores de Tiempo
4.
Proc Natl Acad Sci U S A ; 121(34): e2402267121, 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-39136986

RESUMEN

Despite ethical and historical arguments for removing race from clinical algorithms, the consequences of removal remain unclear. Here, we highlight a largely undiscussed consideration in this debate: varying data quality of input features across race groups. For example, family history of cancer is an essential predictor in cancer risk prediction algorithms but is less reliably documented for Black participants and may therefore be less predictive of cancer outcomes. Using data from the Southern Community Cohort Study, we assessed whether race adjustments could allow risk prediction models to capture varying data quality by race, focusing on colorectal cancer risk prediction. We analyzed 77,836 adults with no history of colorectal cancer at baseline. The predictive value of self-reported family history was greater for White participants than for Black participants. We compared two cancer risk prediction algorithms-a race-blind algorithm which included standard colorectal cancer risk factors but not race, and a race-adjusted algorithm which additionally included race. Relative to the race-blind algorithm, the race-adjusted algorithm improved predictive performance, as measured by goodness of fit in a likelihood ratio test (P-value: <0.001) and area under the receiving operating characteristic curve among Black participants (P-value: 0.006). Because the race-blind algorithm underpredicted risk for Black participants, the race-adjusted algorithm increased the fraction of Black participants among the predicted high-risk group, potentially increasing access to screening. More broadly, this study shows that race adjustments may be beneficial when the data quality of key predictors in clinical algorithms differs by race group.


Asunto(s)
Algoritmos , Neoplasias Colorrectales , Humanos , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/etnología , Neoplasias Colorrectales/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Exactitud de los Datos , Población Blanca/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Factores de Riesgo , Anciano , Adulto , Estudios de Cohortes , Grupos Raciales/estadística & datos numéricos , Medición de Riesgo/métodos
5.
JAMA ; 332(12): 989-1000, 2024 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-39073797

RESUMEN

Importance: Since 2013, the American College of Cardiology (ACC) and American Heart Association (AHA) have recommended the pooled cohort equations (PCEs) for estimating the 10-year risk of atherosclerotic cardiovascular disease (ASCVD). An AHA scientific advisory group recently developed the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations, which incorporated kidney measures, removed race as an input, and improved calibration in contemporary populations. PREVENT is known to produce ASCVD risk predictions that are lower than those produced by the PCEs, but the potential clinical implications have not been quantified. Objective: To estimate the number of US adults who would experience changes in risk categorization, treatment eligibility, or clinical outcomes when applying PREVENT equations to existing ACC and AHA guidelines. Design, Setting, and Participants: Nationally representative cross-sectional sample of 7765 US adults aged 30 to 79 years who participated in the National Health and Nutrition Examination Surveys of 2011 to March 2020, which had response rates ranging from 47% to 70%. Main Outcomes and Measures: Differences in predicted 10-year ASCVD risk, ACC and AHA risk categorization, eligibility for statin or antihypertensive therapy, and projected occurrences of myocardial infarction or stroke. Results: In a nationally representative sample of 7765 US adults aged 30 to 79 years (median age, 53 years; 51.3% women), it was estimated that using PREVENT equations would reclassify approximately half of US adults to lower ACC and AHA risk categories (53.0% [95% CI, 51.2%-54.8%]) and very few US adults to higher risk categories (0.41% [95% CI, 0.25%-0.62%]). The number of US adults receiving or recommended for preventive treatment would decrease by an estimated 14.3 million (95% CI, 12.6 million-15.9 million) for statin therapy and 2.62 million (95% CI, 2.02 million-3.21 million) for antihypertensive therapy. The study estimated that, over 10 years, these decreases in treatment eligibility could result in 107 000 additional occurrences of myocardial infarction or stroke. Eligibility changes would affect twice as many men as women and a greater proportion of Black adults than White adults. Conclusion and Relevance: By assigning lower ASCVD risk predictions, application of the PREVENT equations to existing treatment thresholds could reduce eligibility for statin and antihypertensive therapy among 15.8 million US adults.


Asunto(s)
Antihipertensivos , Determinación de la Elegibilidad , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Infarto del Miocardio , Prevención Primaria , Accidente Cerebrovascular , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , American Heart Association , Antihipertensivos/administración & dosificación , Antihipertensivos/economía , Estudios Transversales , Determinación de la Elegibilidad/economía , Determinación de la Elegibilidad/normas , Determinación de la Elegibilidad/tendencias , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Inhibidores de Hidroximetilglutaril-CoA Reductasas/economía , Infarto del Miocardio/prevención & control , Infarto del Miocardio/epidemiología , Encuestas Nutricionales/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Medición de Riesgo/normas , Accidente Cerebrovascular/prevención & control , Accidente Cerebrovascular/epidemiología , Estados Unidos/epidemiología , Prevención Primaria/economía , Prevención Primaria/métodos , Prevención Primaria/normas
6.
N Engl J Med ; 390(2): 100-102, 2024 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-38198167
8.
Nat Methods ; 14(4): 414-416, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28263960

RESUMEN

We present single-cell interpretation via multikernel learning (SIMLR), an analytic framework and software which learns a similarity measure from single-cell RNA-seq data in order to perform dimension reduction, clustering and visualization. On seven published data sets, we benchmark SIMLR against state-of-the-art methods. We show that SIMLR is scalable and greatly enhances clustering performance while improving the visualization and interpretability of single-cell sequencing data.


Asunto(s)
Análisis de Secuencia de ARN/métodos , Análisis de la Célula Individual/métodos , Programas Informáticos , Algoritmos , Biología Computacional/métodos , Humanos , Neutrófilos/citología , Neutrófilos/fisiología
9.
Proteomics ; 18(2)2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29265724

RESUMEN

SIMLR (Single-cell Interpretation via Multi-kernel LeaRning), an open-source tool that implements a novel framework to learn a sample-to-sample similarity measure from expression data observed for heterogenous samples, is presented here. SIMLR can be effectively used to perform tasks such as dimension reduction, clustering, and visualization of heterogeneous populations of samples. SIMLR was benchmarked against state-of-the-art methods for these three tasks on several public datasets, showing it to be scalable and capable of greatly improving clustering performance, as well as providing valuable insights by making the data more interpretable via better a visualization. SIMLR is available on https://github.com/BatzoglouLabSU/SIMLRGitHub in both R and MATLAB implementations. Furthermore, it is also available as an R package on http://bioconductor.org.


Asunto(s)
Genómica/métodos , Aprendizaje Automático , Análisis de Secuencia de ARN/métodos , Análisis de la Célula Individual/métodos , Programas Informáticos , Algoritmos , Humanos
10.
Bioinformatics ; 33(14): i225-i233, 2017 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-28881977

RESUMEN

MOTIVATION: Chromatin immune-precipitation sequencing (ChIP-seq) experiments are commonly used to obtain genome-wide profiles of histone modifications associated with different types of functional genomic elements. However, the quality of histone ChIP-seq data is affected by many experimental parameters such as the amount of input DNA, antibody specificity, ChIP enrichment and sequencing depth. Making accurate inferences from chromatin profiling experiments that involve diverse experimental parameters is challenging. RESULTS: We introduce a convolutional denoising algorithm, Coda, that uses convolutional neural networks to learn a mapping from suboptimal to high-quality histone ChIP-seq data. This overcomes various sources of noise and variability, substantially enhancing and recovering signal when applied to low-quality chromatin profiling datasets across individuals, cell types and species. Our method has the potential to improve data quality at reduced costs. More broadly, this approach-using a high-dimensional discriminative model to encode a generative noise process-is generally applicable to other biological domains where it is easy to generate noisy data but difficult to analytically characterize the noise or underlying data distribution. AVAILABILITY AND IMPLEMENTATION: https://github.com/kundajelab/coda . CONTACT: akundaje@stanford.edu.


Asunto(s)
Inmunoprecipitación de Cromatina/métodos , Código de Histonas , Redes Neurales de la Computación , Programas Informáticos , Animales , Línea Celular , Epigenómica/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Humanos , Ratones , Análisis de Secuencia de ADN/métodos
SELECCIÓN DE REFERENCIAS
Detalles de la búsqueda