RESUMEN
Research on pandemics in institutional settings often assumes that all human interactions within a jail pose similar viral transmission risks. We developed an agent-based model (ABM) called Simulation Applications for Forecasting Effective Responses in Corrections (SAFER-C™) to simulate nine scenarios of possible interactions and virus transmission among incarcerated individuals and jail staff and tested this assumption. We found that resumption of high-contact activities has a greater impact on the number of infections, while out-of-cell group sizes and initial vaccination rates had lower impact. This work emphasizes the importance of understanding and modeling human interactions in confinement facilities, as well as understanding, responding to, and limiting the mechanism of viral transmission in jails. Insights from ABMs provide correctional administrators with realistic options for managing responses.
Asunto(s)
COVID-19 , Prisioneros , Humanos , Prisiones , Cárceles Locales , Análisis de SistemasRESUMEN
BACKGROUND: Washington, District of Columbia lowered severe acute respiratory syndrome coronavirus 2 transmission in its large jail while community incidence was still high. METHODS: Coordinated clinical and operational interventions brought new cases to near zero. RESULTS: Aggressive infection control and underlying jail architecture can promote correctional coronavirus disease 2019 management. CONCLUSIONS: More intensive monitoring could help confirm that in-house transmission is truly zero.
RESUMEN
The objective of this postal survey was to assess the services currently accessed by primary care trusts (PCTs) for patients with chronic heart failure. Of the 303 PCTs in England, 225 (74%) responded to the questionnaire. Natriuretic peptides were used by 61 (26%) PCTs, whereas direct access to echocardiography was available to 163 (72%) and heart failure clinics to 95 (42%). Heart failure services were led by a cardiologist in 138 (61%) main referring hospitals, an elderly care physician in 33 (15%), and other physicians in 50 (22%). In total, 138 (62%) PCTs had access to heart failure nurses and 40 (18%) used coronary heart disease nurses; in 13 (5%) PCTs, patients with heart failure were seen by practice nurses. This survey highlights the need for further research on the cost effectiveness of service models for diagnosing and managing heart failure. The evidence base behind heart failure nurses should support their wider availability. The question of who cares for patients with heart failure should be reflected more widely in specialist training programmes in both secondary and primary care.
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Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Atención Primaria de Salud/normas , Garantía de la Calidad de Atención de Salud , Actitud del Personal de Salud , Biomarcadores/sangre , Diagnóstico Diferencial , Ecocardiografía/estadística & datos numéricos , Inglaterra , Humanos , Péptidos Natriuréticos/sangre , Pautas de la Práctica en Medicina , Pronóstico , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
A method was developed to optimize simultaneous selection for a quantitative trait with a known QTL within a male and a female line to maximize crossbred performance from a two-way cross. Strategies to maximize cumulative discounted response in crossbred performance over ten generations were derived by optimizing weights in an index of a QTL and phenotype. Strategies were compared to selection on purebred phenotype. Extra responses were limited for QTL with additive and partial dominance effects, but substantial for QTL with over-dominance, for which optimal QTL selection resulted in differential selection in male and female lines to increase the frequency of heterozygotes and polygenic responses. For over-dominant QTL, maximization of crossbred performance one generation at a time resulted in similar responses as optimization across all generations and simultaneous optimal selection in a male and female line resulted in greater response than optimal selection within a single line without crossbreeding. Results show that strategic use of information on over-dominant QTL can enhance crossbred performance without crossbred testing.
Asunto(s)
Alelos , Bovinos/genética , Hibridación Genética , Endogamia , Carácter Cuantitativo Heredable , Selección Genética , Animales , Cruzamientos Genéticos , Femenino , Frecuencia de los Genes , Genes Dominantes , Genética de Población , Masculino , Repeticiones de Microsatélite , Modelos Genéticos , FenotipoRESUMEN
A mathematical approach to optimize selection on multiple quantitative trait loci (QTL) and an estimate of residual polygenic effects was applied to selection on two linked or unlinked additive QTL. Strategies to maximize total or cumulative discounted response over ten generations were compared to standard QTL selection on the sum of breeding values for the QTL and an estimated breeding value for polygenes, and to phenotypic selection. Optimal selection resulted in greater response to selection than standard QTL or phenotypic selection. Tight linkage between the QTL (recombination rate 0.05) resulted in a slightly lower response for standard QTL and phenotypic selection but in a greater response for optimal selection. Optimal selection capitalized on linkage by emphasizing selection on favorable haplotypes. When the objective was to maximize total response after ten generations and QTL were unlinked, optimal selection increased QTL frequencies to fixation in a near linear manner. When starting frequencies were equal for the two QTL, equal emphasis was given to each QTL, regardless of the difference in effects of the QTL and regardless of the linkage, but the emphasis given to each of the two QTL was not additive. These results demonstrate the ability of optimal selection to capitalize on information on the complex genetic basis of quantitative traits that is forthcoming.
Asunto(s)
Ligamiento Genético/genética , Carácter Cuantitativo Heredable , Selección Genética , Animales , Cruzamiento/métodos , Bovinos , Femenino , Frecuencia de los Genes , Marcadores Genéticos , Genética de Población , Masculino , Modelos Genéticos , Modelos Teóricos , Herencia Multifactorial , FenotipoRESUMEN
A mathematical approach was developed to model and optimize selection on multiple known quantitative trait loci (QTL) and polygenic estimated breeding values in order to maximize a weighted sum of responses to selection over multiple generations. The model allows for linkage between QTL with multiple alleles and arbitrary genetic effects, including dominance, epistasis, and gametic imprinting. Gametic phase disequilibrium between the QTL and between the QTL and polygenes is modeled but polygenic variance is assumed constant. Breeding programs with discrete generations, differential selection of males and females and random mating of selected parents are modeled. Polygenic EBV obtained from best linear unbiased prediction models can be accommodated. The problem was formulated as a multiple-stage optimal control problem and an iterative approach was developed for its solution. The method can be used to develop and evaluate optimal strategies for selection on multiple QTL for a wide range of situations and genetic models.