Int J Drug Policy

Network modelling is a valuable tool for simulating hepatitis C virus (HCV) and HIV transmission among people who inject drugs (PWID) and assessing the potential impact of treatment and harm-reduction interventions. In this paper, we review literature on network simulation models, highlighting key structural considerations and questions that network models are well suited to address. We describe five approaches (Erd\uf6s-R\ue9nyi, Stochastic Block, Watts-Strogatz, Barab\ue1si-Albert, and Exponential Random Graph Model) used to model partnership formation with emphasis on the strengths of each approach in simulating different features of real-world PWID networks. We also review two important structural considerations when designing or interpreting results from a network simulation study: (1) dynamic vs. static network and (2) injection only vs. both injection and sexual networks. Dynamic network simulations allow partnerships to evolve and disintegrate over time, capturing corresponding shifts in individual and population-level risk behaviour; however, their high level of complexity and reliance on difficult-to-observe data has driven others to develop static network models. Incorporating both sexual and injection partnerships increases model complexity and data demands, but more accurately represents HIV transmission between PWID and their sexual partners who may not also use drugs. Network models add the greatest value when used to investigate how leveraging network structure can maximize the effectiveness of health interventions and optimize investments. For example, network models have shown that features of a given network and epidemic influence whether the greatest community benefit would be achieved by allocating hepatitis C or HIV treatment randomly, versus to those with the most partners. They have also demonstrated the potential for syringe services and "buddy sharing" programs to reduce disease transmission.U38 PS004644/PS/NCHHSTP CDC HHSUnited States/P30 DA040500/DA/NIDA NIH HHSUnited States/P30 AI042853/AI/NIAID NIH HHSUnited States/CC/CDC HHSUnited States/R01 DA046527/DA/NIDA NIH HHSUnited States/2022-01-05T00:00:00Z31740175PMC872979210782vault:4066

The role of stereotypical information on medical judgements for black and white patients

The new generation of direct-acting antivirals has improved dramatically the rates of cure for chronic hepatitis C. Yet, evidence shows that racial groups are deemed more often ineligible for hepatitis C treatment, despite no clinical evidence supporting differential treatment for Black and White patients. One possible explanation has to do with providers’ racial biases. This investigation sought to explore medical students’ racial stereotypes (Study 1, N = 171) and the role of stereotypical cues on perceptions of medical adherence of Black and White patients (Study 2, N = 208). In Study 1, we first sought to identify health-related aspects that are consistently associated with Blacks as part of a stereotype. In Study 2, we experimentally manipulated racial stereotypes identified in Study 1 by asking participants to read a clinical vignette depicting a patient (Black vs. White) and their medical history (cause of exposure to hepatitis C: unprotected sex vs. non-injectable drugs use). The results show that the impact of stereotypicality on patient perceived compliance varies as a function of medical students’ racial prejudice. Implications for further applied health inequalities research and for medical training are discussed.info:eu-repo/semantics/publishedVersio

Model-guided therapy for hepatocellular carcinoma: A role for information technology in predictive, preventive and personalized medicine

Predictive, preventive and personalized medicine (PPPM) may have the potential to eventually improve the nature of health care delivery. However, the tools required for a practical and comprehensive form of PPPM that is capable of handling the vast amounts of medical information that is currently available are currently lacking. This article reviews a rationale and method for combining and integrating diagnostic and therapeutic management with information technology (IT), in a manner that supports patients through their continuum of care. It is imperative that any program devised to explore and develop personalized health care delivery must be firmly rooted in clinically confirmed and accepted principles and technologies. Therefore, a use case, relating to hepatocellular carcinoma (HCC), was developed. The approach to the management of medical information we have taken is based on model theory and seeks to implement a form of model-guided therapy (MGT) that can be used as a decision support system in the treatment of patients with HCC. The IT structures to be utilized in MGT include a therapy imaging and model management system (TIMMS) and a digital patient model (DPM). The system that we propose will utilize patient modeling techniques to generate valid DPMs (which factor in age, physiologic condition, disease and co-morbidities, genetics, biomarkers and responses to previous treatments). We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient. An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists. The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM

A Neuro-Fussy Based Model for Diagnosis of Monkeypox Diseases

The largest vertebrate viruses known, infecting humans, and other vertebrates are poxviruses including cowpox, vaccinia, variola (smallpox), and monkeypox viruses. Monkeypox was limited to the rain forests of central and western Africa until 2003. A smallpox-like viral infection caused by a virus of zoonotic origin, monkeypox belongs to the genus Orthopoxvirus, family Poxviridae, and sub-family Chordopoxvirinae. Monkeypox has a clinical presentation like ordinary forms of smallpox, including flulike symptoms, fever, malaise, back pain, headache, and characteristic rash. In view of the eradication of smallpox, such symptoms in a monkepox endemic region should be carefully diagnosed. The problem in diagnosing monkeypox lies in the fact that it is clinically indistinguishable from other pox-like illnesses making virus differentiation difficult. In this paper, we present a neuro-fuzzy based model for early diagnosis of monkeypox virus with a differentiation from other pox families

Social Presence and Use of Internet-Delivered Interventions: A Multi-Method Approach

Objective Internet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to intervention websites once they are accessed is very low. This study tests whether and how social presence elements can increase website use. Methods A website about Hepatitis A, B, and C virus infections was used in a preparatory lab-based eye-tracking study assessing whether social presence elements attract participants\u27 attention, because this is a prerequisite for affecting website use. In the following field study, 482 participants representative of the Dutch population were randomized to either a website with or a website without social presence elements. Participants completed a questionnaire of validated measures regarding user perceptions immediately after exposure to the website. Server registrations were used to assess website use. Results Participants in the experimental condition focused on the social presence elements, both in terms of frequency (F(1, 98) = 40.34, p<.001) and duration (F(1, 88) = 39.99, p<.001), but did not differ in website use in comparison with the control condition; neither in terms of the number of pages visited (t(456) = 1.44, p = .15), nor in terms of time on the website (t(456) = 0.01, p = .99). Conclusions Adding social presence elements did not affect actual use of an intervention website within a public health context. Possible reasons are limited attention for these elements in comparison with the main text and the utilitarian value of intervention websites

ProCLAIM: an argument-based model for deliberating over safety critical actions

In this Thesis we present an argument-based model – ProCLAIM – intended to provide a setting for heterogeneous agents to deliberate on whether a proposed action is safe. That is, whether or not a proposed action is expected to cause some undesirable side effect that will justify not to undertake the proposed action. This is particularly relevant in safetycritical environments where the consequences ensuing from an inappropriate action may be catastrophic. For the practical realisation of the deliberations the model features a mediator agent with three main tasks: 1) guide the participating agents in what their valid argumentation moves are at each stage of the deliberation; 2) decide whether submitted arguments should be accepted on the basis of their relevance; and finally, 3) evaluate the accepted arguments in order to provide an assessment on whether the proposed action should or should not be undertaken, where the argument evaluation is based on domain consented knowledge (e.g guidelines and regulations), evidence and the decision makers’ expertise. To motivate ProCLAIM’s practical value and generality the model is applied in two scenarios: human organ transplantation and industrial wastewater. In the former scenario, ProCLAIM is used to facilitate the deliberation between two medical doctors on whether an available organ for transplantation is or is not suitable for a particular potential recipient (i.e. whether it is safe to transplant the organ). In the later scenario, a number of agents deliberate on whether an industrial discharge is environmentally safe.En esta tesis se presenta un modelo basado en la Argumentación –ProCLAIM– cuyo n es proporcionar un entorno para la deliberación sobre acciones críticas para la seguridad entre agentes heterogéneos. En particular, el propósito de la deliberación es decidir si los efectos secundario indeseables de una acción justi can no llevarla a cabo. Esto es particularmente relevante en entornos críticos para la seguridad, donde las consecuencias que se derivan de una acción inadecuada puede ser catastró cas. Para la realización práctica de las deliberaciones propuestas, el modelo cuenta con un agente mediador con tres tareas principales: 1) guiar a los agentes participantes indicando cuales son las líneas argumentación válidas en cada etapa de la deliberación; 2) decidir si los argumentos presentados deben ser aceptadas sobre la base de su relevancia y, por último, 3) evaluar los argumentos aceptados con el n de proporcionar una valoración sobre la seguridad de la acción propuesta. Esta valoración se basa en guías y regulaciones del dominio de aplicación, en evidencia y en la opinión de los expertos responsables de la decisión. Para motivar el valor práctico y la generalidad de ProCLAIM, este modelo se aplica en dos escenarios distintos: el trasplante de órganos y la gestión de aguas residuales. En el primer escenario el modelo se utiliza para facilitar la deliberación entre dos médicos sobre la viabilidad del transplante de un órgano para un receptor potencial (es decir, si el transplante es seguro). En el segundo escenario varios agentes deliberan sobre si los efectos de un vertido industrial con el propósito de minimizar su impacto medioambiental

A strategy for hepatitis diagnosis by using spherical q-linear Diophantine fuzzy Dombi aggregation information and the VIKOR method

Hepatitis is an infectious disease typified by inflammation in internal organ tissues, and it is caused by infection or inflammation of the liver. Hepatitis is often feared as a fatal illness, especially in developing countries, mostly due to contaminated water, poor sanitation, and risky blood transfusion practices. Although viruses are typically blamed, other potential causes of this kind of liver infection include autoimmune disorders, toxins, medicines, opioids, and alcohol. Viral hepatitis may be diagnosed using a variety of methods, including a physical exam, liver surgery (biopsy), imaging investigations like an ultrasound or CT scan, blood tests, a viral serology panel, a DNA test, and viral antibody testing. Our study proposes a new decision-support system for hepatitis diagnosis based on spherical q-linear Diophantine fuzzy sets (Sq-LDFS). Sq-LDFS form the generalized structure of all existing notions of fuzzy sets. Furthermore, a list of novel Einstein aggregation operators is developed under Sq-LDF information. Also, an improved VIKOR method is presented to address the uncertainty in analyzing the viral hepatitis categories demonstration. Interesting and useful properties of the proposed operators are given. The core of this research is the proposed algorithm based on the proposed Einstein aggregation operators and improved VIKOR approach to address uncertain information in decision support problems. Finally, a hepatitis diagnosis case study is examined to show how the suggested approach works in practice. Additionally, a comparison is provided to demonstrate the superiority and efficacy of the suggested decision technique