bluuebunny/crossref_metadata_2025_split huggingface dataset:
VP14 Cost Analysis For HD And Peritoneal Dialysis For ESRD In South Africa
Authors: Makhele Letlhogonolo , Matlala Moliehi , Sibanda Mncengeli , Martin Antony , Godman Brian 
Published: December 2019

IntroductionHemodialysis (HD) and peritoneal dialysis (PD) are commonly used to treat patients with end-stage renal disease (ESRD). However, their costs have grown considerably in recent years as the rates of non-communicable diseases including diabetes and hypertension have grown. This will adversely impact on national health budgets especially in low- and middle-income countries (LMICs). Currently, there is limited knowledge about the costs of ESRD and the different components within the public healthcare system in South Africa. Consequently, our objective was to examine the direct medical costs of both approaches from a public provider perspective to provide future guidance.MethodsA prospective observational study undertaken at a leading public hospital in South Africa based principally on patients’ notes and costs from nationally procured lists. A micro-costing approach was used to estimate health care costs among adult patients with ESRD who had received either HD and PD for at least 3 months.ResultsThe majority of patients (35 percent) were aged 40 to 50 years. Patients aged 29-39 years were mostly on HD (28 percent) while those between 51-59 years mostly on PD (29 percent), with HD typically managed in the private sector with limited facilities in the public sector. The average age of patients on HD and PD was 41 and 42 years respectively. Variable costs (USD 20, 488.79) were the highest cost component for PD patients with fixed costs the highest component for HD patients ((USD 16,231.45). The annual cost of HD (USD 31,993.12) was higher than PD (USD 25,282 per patient) but not statistically significant (p = 0.816). The overall burden if appreciably more patients with ESRD are managed appropriately within the public system (covering 80 percent of the population) would be considerable and become unaffordable.ConclusionsHD costs more than PD. These cost estimates are useful for carrying out future health economic analyses and for allocating greater resources to prevent progress to ESRD.
VP27 Countrywide Screening Of Cardiovascular Diseases Through Telemedicine
Authors: Galvan Pedro , Ortellado Jose , Rivas Ronald , Portillo Juan , Mazzoleni Julio , Hilario Enrique 
Published: December 2019

IntroductionThrough telemedicine, advantageous telediagnostic systems can be developed to improve the health care of populations that do not have access to specialists. However, evidence on how such innovation technology can enhance the countrywide electrocardiographic (EKG) screening to support a prevention program for cardiovascular diseases is limited. The usability of telemedicine to improve the countrywide detection of heart diseases according to the national cardiovascular disease prevention program in Paraguay was investigated.MethodsThis cross-sectional survey included adults (≥19 and ≤ 80 years) and children (≥1 and ≤ 18 years) with medical prescription. The study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute (IICS-UNA) to evaluate the utility of a telediagnostic net for detection and prevention program of cardiovascular disease in public health. For this purpose, the results obtained by the EKG telediagnosis net implemented in sixty countrywide public hospitals were analyzed and verified the adherence to the cardiovascular prevention program.ResultsA total of 246,217 remote EKG diagnoses were performed between January 2014 and August 2018. Of the total, 80.6 percent (198,494) corresponded to adults and 19.4 percent (47,723) to children. The adult diagnoses were mainly normal (66.3 percent), sinus bradycardia (11.2 percent), right bundle branch block (4.8 percent), left ventricular hypertrophy (4.7 percent), ventricles repolarization disorder (4.4 percent), sinus tachycardia (4,4 percent), ischemia (1.7 percent), atrial fibrillation (1.1 percent), left bundle branch block (0.7 percent), and unspecified arrhythmias (0.6 percent). The children's diagnoses were mainly normal (79.4 percent), sinus bradycardia (10.6 percent), sinus tachycardia (3,2 percent), unspecified arrhythmias (2.8 percent), right bundle branch block (1.9 percent), left ventricular hypertrophy (1.0 percent), left bundle branch block (0.4 percent), ventricles repolarization disorder (0.3 percent), and atrial fibrillation (0.2 percent). The mean adherence rate to the prevention program was 2.3 between 2014 and 2018 for each thousand diagnosis performed.ConclusionsThe results show that the telemedicine can enhance significantly the EKG screening to support a prevention program for cardiovascular diseases and health programs. However, before carrying out its systematic implementation, a contextualization with the regional epidemiological profile must be performed.
VP28 Building A Virtual Diagnosis Network Through A Telemedicine Platform
Authors: Galvan Pedro , Rivas Ronald , Grossling Benicio , Portillo Juan , Mazzoleni Julio , Hilario Enrique 
Published: December 2019

IntroductionAdvances in information and communication technology (ICT) and health technology have enhanced healthcare for many countries around the world. The challenge for low income setting countries is to build a telemedicine platform to enhance the community hospital diagnosis response capacity. Populations living in remote areas did not have access to specialist care and quality diagnostic services and thus depended on the low response capacity of their local health system. There were subsequent equity issues between urban and rural populations. In this context the virtual telediagnosis network should be directed towards developing better equity in the provision of services in remote locations without access to specialists. The usability of a telemedicine platform to enhance the virtual diagnosis network of community hospitals in rural areas of Paraguay was investigated.MethodsThis descriptive study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute (IICS-UNA) and the University of the Basque Country (UPV / EHU) to evaluate the utility of a telemedicine platform to enhance the virtual diagnosis network of community hospitals. For this purpose, the results obtained by the virtual telediagnosis network implemented in sixty public countryside community hospitals were analyzed.ResultsA total of 427,026 remote diagnoses were performed between January 2014 and October 2018 in sixty community hospitals. Of the total, 35.76 percent (152,703) corresponded to tomography studies, 62.55 percent (267,100) to electrocardiography (EKG), 1.68 percent (7,204) to electroencephalography (EEG) and 0.01 percent (19) to ultrasound. There were no significant differences between the remote and the face-to-face diagnosis. With the remote diagnosis a reduction of the cost was obtained, that supposes an important benefit for each citizen of the sixty communities.ConclusionsThe results show that the virtual diagnosis network based on a telemedicine platform can enhance significantly the community hospital diagnostic services, maximizing professional time and productivity, increasing access and equity, and reducing costs. However, before carrying out its countrywide implementation, a contextualization with the regional epidemiological profile must be performed.
VP75 Improving Access To Ultra-Orphan Medicines In NHS Scotland
Authors: Downes Noreen , Jones Jan , Lee Anne , Brown Ailsa , McGuire Pauline , Wright Helen 
Published: December 2019

IntroductionMedicines for very rare conditions present challenges for healthcare globally due to uncertain evidence and often extremely high costs. In 2014, SMC introduced an ultra-orphan framework placing less emphasis on the cost per quality adjusted life year (QALY). Despite this, many medicines continued to be not recommended. A new pathway aimed at improved patient access based on further evidence collection is now being implemented.MethodsThe development of the new pathway has involved collaboration with key stakeholders including patient groups, the pharmaceutical industry, and clinicians. Medicines that meet a new definition (based on four criteria including the prevalence of the condition treated) will be appraised by the SMC committee and a data collection plan will then be agreed with the pharmaceutical company.ResultsFrom April 2019, medicines validated as ultra-orphans will initially be appraised using the broader decision-making framework and the SMC committee will outline key uncertainties in the clinical effectiveness. The medicine will then be available for a period of at least three years while further data are gathered, potentially comprising ongoing clinical trials, registry data, and patient reported outcome measures. SMC will then re-assess the clinical and economic evidence to inform a final decision on routine use of the medicine in NHS Scotland.ConclusionsThe new pathway for ultra-orphan medicines will allow further evidence on their longer-term clinical benefits to be collected before a final decision on routine use. This approach reflects the current direction of travel in medicines regulation, by making medicines that address an unmet need available to patients at an earlier stage of development.
VP90 Which Matching Adjusted Indirect Comparison Method Is Best?
Authors: Alsop Jonathan , Pont Lawrence , Scott Martin 
Published: December 2019

IntroductionMatching adjusted indirect comparison (MAIC) methods are extremely useful when conducting ITCs, as they reduce baseline imbalances between studies, particularly upon patient characteristics that are confounded with treatment. The standard approach when conducting MAIC is that proposed by Signorovitch et al. (2010). However, there are newer, and potentially better, methods available.MethodsThree different MAIC methods (Signorovitch, Entropy Balancing, Polynomial Weighting) were compared using multiple phase 3 RCTs conducted in Diabetic Retinal Edema. The matching ability of each method was assessed, alongside its ability to avoid large weights (i.e. avoiding high leverage), and maximise effective same size (ESS). Each method's overall ease of use and impact upon estimates of treatment effectiveness were also evaluated.ResultsAll methods were able to precisely match the aggregate level data. However, the Entropy Balancing and Polynomial Weighting both outperformed the Signorovitch method in terms of having the lowest maximum weights. The Polynomial Weighting provided the highest ESS. The Entropy Balancing method was arguably the most challenging to implement, whilst the Signorovitch method the least. The Polynomial Weighting method appears to provide the greatest flexibility to the user.ConclusionsWhilst the Signorovitch method has become almost synonymous with MAIC, the Entropy Balancing and Polynomial Weighting methods offer potentially superior performance. In the absence of head-to-head trial data, these new MAIC approaches should provide less biased and more precise estimates of comparative effectiveness – ultimately leading to better decision making by regulators and payers.
VP92 Portable Robotic Exoskeleton Stride Management Assist (SMA®)
Authors: Sánchez-Gómez Luis María , Hijas-Gómez Ana Isabel , Polo-DeSantos Mar , Luengo-Matos Setefilla 
Published: December 2019

IntroductionThe Stride Management Assist (SMA®) device consist in a portable robotic exoskeleton designed for gait rehabilitation and training by repetition of walking patterns with automated regular gait cycles. Used for adult population with gait disorders of neurological or musculoskeletal origin that require rehabilitation. The objective of this work is to assess its efficacy and safety.MethodsThis technology was identified by the early Awareness and Alert System, “SINTESIS-new technologies” of AETS-ISCIII. An early assessment of the technology was conducted. The searched databases were: Pubmed, Embase, WOS, Tripdatabase, ClinicalTrials.org and Cochrane Library. Clinical studies using the device published in any language until 10 October 2018 were reviewed.ResultsWe found 3 abstracts to congresses and 6 clinical trials that evaluated the use of the device. Outcomes measures among studies included spatiotemporal gait parameters, energy expenditure, muscular activity and functional performance. Five studies consisted in proof-of-concept analysis; 3 studies evaluated the effect of gait training with SMA® compared with conventional therapy alone in individuals after stroke (2 studies) and Parkinson disease (1 study); and 1 before-and-after study assessed the effect of gait training with SMA® in elderly adults. During its use, improvements in spatiotemporal gait parameters were described in 4/5 studies, and 2/5 studies showed less energy expenditure versus 2/5 studies that found no differences. After gait training, 3/4 studies described greater improvements in gait parameters when associated its use. Only one clinical trial collected safety data reporting no adverse events.ConclusionsThe SMA® device allows to increase the efficiency and parameters of the march during its use. The assistance in the stride might have an impact on health by facilitating the recovery of the gait; however, further research is needed to determine the feasibility in the latter case since comparative studies with conventional therapy are limited.
Poststorm Thermospheric NO Overcooling?
Authors: Mikhailov Andrey V. , Perrone Loredana 
Published: December 2019

AbstractA mechanism of the neutral gas density decrease at middle latitudes during the recovery storm phase is discussed. The recently proposed method to retrieve thermospheric parameters from ionospheric observations is used for the analysis of equinoctial, summer, and winter severe magnetic storms. CHAllenging Minisatellite Payload and Swarm neutral gas density observations are used for a comparison. It is shown that storm‐induced atomic oxygen variation is the controlling process. Well‐known F2‐layer storm morphology and the poststorm decrease of neutral gas density reflect the same storm‐induced variations of atomic oxygen abundance in the upper atmosphere. There is no need to attract a new “poststorm NO overcooling” concept to explain the decrease of neutral gas density.
Intraoperative assessment of skull base tumors using stimulated Raman scattering microscopy
Authors: Shin Kseniya S. , Francis Andrew T. , Hill Andrew H. , Laohajaratsang Mint , Cimino Patrick J. , Latimer Caitlin S. , Gonzalez-Cuyar Luis F. , Sekhar Laligam N. , Juric-Sekhar Gordana , Fu Dan 
Published: December 2019

AbstractIntraoperative consultations, used to guide tumor resection, can present histopathological findings that are challenging to interpret due to artefacts from tissue cryosectioning and conventional staining. Stimulated Raman histology (SRH), a label-free imaging technique for unprocessed biospecimens, has demonstrated promise in a limited subset of tumors. Here, we target unexplored skull base tumors using a fast simultaneous two-channel stimulated Raman scattering (SRS) imaging technique and a new pseudo-hematoxylin and eosin (H&E) recoloring methodology. To quantitatively evaluate the efficacy of our approach, we use modularized assessment of diagnostic accuracy beyond cancer/non-cancer determination and neuropathologist confidence for SRH images contrasted to H&E-stained frozen and formalin-fixed paraffin-embedded (FFPE) tissue sections. Our results reveal that SRH is effective for establishing a diagnosis using fresh tissue in most cases with 87% accuracy relative to H&E-stained FFPE sections. Further analysis of discrepant case interpretation suggests that pseudo-H&E recoloring underutilizes the rich chemical information offered by SRS imaging, and an improved diagnosis can be achieved if full SRS information is used. In summary, our findings show that pseudo-H&E recolored SRS images in combination with lipid and protein chemical information can maximize the use of SRS during intraoperative pathologic consultation with implications for tissue preservation and augmented diagnostic utility.
An inhibitor of apoptosis protein (EsIAP1) from Chinese mitten crab Eriocheir sinensis regulates apoptosis through inhibiting the activity of EsCaspase-3/7-1
Authors: Qu Chen , Sun Jiejie , Xu Qingsong , Lv Xiaojing , Yang Wen , Wang Feifei , Wang Ying , Yi Qilin , Jia Zhihao , Wang Lingling , Song Linsheng 
Published: December 2019

AbstractInhibitor of apoptosis proteins (IAPs) maintain the balance between cell proliferation and cell death by inhibiting caspase activities and mediating immune responses. In the present study, a homolog of IAP (designated as EsIAP1) was identified from Chinese mitten crab Eriocheir sinensis. EsIAP1 consisted of 451 amino acids containing two baculoviral IAP repeat (BIR) domains with the conserved Cx2 Cx6 Wx3 Dx5 Hx6 C motifs. EsIAP1 mRNA was expressed in various tissues and its expression level in hemocytes increased significantly (p < 0.01) at 12–48 h after lipopolysaccharide stimulation. In the hemocytes, EsIAP1 protein was mainly distributed in the cytoplasm. The hydrolytic activity of recombinant EsCaspase-3/7-1 against the substrate Ac-DEVD-pNA decreased after incubation with rEsIAP1. Moreover, rEsIAP1 could directly combine with rEsCaspase-3/7-1 in vitro. After EsIAP1 was interfered by dsRNA, the mRNA expression and the hydrolytic activity of EsCaspase-3/7-1 increased significantly, which was 2.26-fold (p < 0.05) and 1.71-fold (p < 0.05) compared to that in the dsGFP group, respectively. These results collectively demonstrated that EsIAP1 might play an important role in apoptosis pathway by regulating the activity of EsCaspase-3/7-1 in E. sinensis.
Dawn of a New Age Fissure Sealant? A Study Evaluating the Clinical Performance of Embrace WetBond and ART Sealants: Results from a Randomized Controlled Clinical Trial
Authors: Haricharan Praveen Bhoopathi , Barad Naveen , Patil Chetan R. , Voruganti Sreenivas , Mudrakola Durga Prasad , Turagam Neeraja 
Published: December 2019

Abstract
Objectives The main purpose of this article is to evaluate the clinical performance of atraumatic restorative treatment (ART) sealant versus Embrace WetBond sealant in terms of retention and fissure caries prevention among a section of school children in the southern Indian state of Karnataka (ClinicalTrials.gov NCT02716558).
Materials and Methods After obtaining consent from the parents and screening the children against the inclusion cum exclusion criteria, 90 school children whose mandibular first molars were caries free and with a well-defined pit and fissure system were recruited for this spilt mouth trial. The respective molars were allocated either to the ART sealant or the embrace group after the randomization process. The sealants were applied according to the manufacturer’s instructions and followed up at the end of 3rd, 6th, and 12th month, respectively. The outcome measures assessed were the retention and the caries preventive effects of the materials.
Results At the end of the 6th month, about one-fourth of the sealants in either group remained totally intact, without evidence of caries. No significant differences were seen between the sealants either in terms of retention or caries preventive benefits at the end of 12 months.
Statistical Analysis The chi-squared test was used to check differences in proportions. The significance value was set at <0.05. Kappa test was performed to assess the intraexaminer reproducibility with respect to retention and caries status.
Conclusion The moisture-tolerant resin sealant could not replicate the physical properties usually associated with conventional resin sealants. The usage of ART sealants was deemed to be less cumbersome in an outreach setting as observed in this trial.
Treatment of Severe Ulnar Instability of the MCP Joint Improves Function in LRTI Arthroplasty for Osteoarthritis of the Thumb CMC Joint
Authors: Wirth Johanna , Baur Eva-Maria 
Published: December 2019

Abstract
Background Comorbidity in the metacarpophalangeal joint (MCPj) of the thumb, i.e., hyperextension or ulnar collateral instability, could affect the outcome of arthroplasty in the thumb carpometacarpal joint (CMCj).
Objective In a retrospective study, we evaluated the effect of arthrodesis of the MCPj for thumbs with unstable MCPj and simultaneous ligament reconstruction tendon interposition (LRTI) arthroplasty for the CMCj in terms of strength, function, and patient satisfaction.
Patients and Methods A total of 69 thumbs treated with a LRTI arthroplasty of the CMCj were included. In 14 of those cases, an arthrodesis of the MCPj was performed as well. In 12 thumbs, both procedures were done simultaneously; in one case MCPj arthrodesis followed LRTI arthroplasty, whereas one patient already had MCPj arthrodesis at time of LRTI arthroplasty. Those 14 thumbs were compared with the control group of 55 thumbs who had only undergone LRTI. At a mean follow-up of 4 to 5 years (mean 54 [10–124] months) postoperative assessments included range of motion (ROM) of the CMC, MCP, and interphalangeal (IP) joint of the thumb, as well as any instability of the MCPj. Pinch and grip strength were examined, also the visual analogue scale (VAS), patient satisfaction, QuickDASH, PRWE-Thumb, and the Kapandji's Opposition Score. Radiologically, proximalization of the first metacarpal bone was measured. Student's t-test was used to determine significance, p < 0.05 was considered significant.
Results Additional arthrodesis of the MCPj provided no significant difference of function in thumbs that only had a hyperextension-instability. However, in thumbs with marked ulnar instability, stronger pinch-grip was obtained with arthrodesis, compared with only LRTI.
Conclusion In patients with advanced painful thumb CMCj osteoarthritis, we recommend (simultaneous) arthrodesis of the MCPj, to allow a stable thumb grip if there is additional marked ulnar collateral ligament instability.
Level of Evidence This is a Level III, retrospective comparative study.