bluuebunny/crossref_metadata_2025_split huggingface dataset:
ECONOMIC ANALYSIS OF TREATMENT OF FUNCTIONAL DYSPEPSIA
Authors: García-Altés Anna , Jovell Esther 
Published: September 2019

Objectives: The objective of this study was to assess the quality of economic analysis studies published in the medical and economical literature assessing the clinical management of functional dyspepsia.Methods: Bibliographic search in the main biomedical databases, in articles from bibliographic references, health technology assessment reports, and in gray literature. A specific protocol with economic and clinical items was designed for the evaluation.Results: Overall, 18 of 162 studies met the inclusion criteria for the assessment. The compared treatment options were very diverse. The main methodologic deficiencies were in perspective of analysis, inclusion of indirect costs, and sources of clinical information.Conclusions: Specific checklists with clinical and economical items may help to better assess the quality of economic analysis in the field of functional dyspepsia. The methodologic rigor in the application of economic analysis techniques, as well as the use of appropriate clinical outcome measures, is essential to guarantee the reproducibility of the studies.
PANELISTS' VIEWS OF 68 NIH CONSENSUS CONFERENCE
Authors: Ferguson John H. , Sherman Charles R. 
Published: September 2019

Objectives: To analyze the response patterns and trends of 68 surveys of successive NIH consensus panels' views on the NIH consensus process.Methods: Each panel's responses were compared to an “average” panel's responses calculated by determining the mean response for each survey question across panels.Results: The results show a stable pattern of panelists' generally positive views. However, several conferences were judged very positively and some very negatively compared to the norm. Most negatively viewed conferences occurred early in the consensus program's history.Conclusions: The disparate perceptions are discussed and interpreted as reflecting favorable panels' views of recent changes in the NIH Consensus Development Program.
METHODOLOGISTS AND THEIR METHODS
Authors: Hopewell Sally , Clarke Mike 
Published: September 2019

Objectives: To assess the extent to which abstracts of methodological research, initially presented at meetings on systematic reviews, have gone on to be published as full articles.Methods: Full publication was assessed in three ways: a search was carried out of The Cochrane Library; a search was conducted using MEDLINE; and a questionnaire was sent to the contact author of each abstract.Results: Approximately half of the abstracts had not been, or were unlikely ever to be, published in full.Conclusions: The rate of full publication of abstracts related to the methodology of systematic reviews seems similar to that for randomized trials.
METHODS TO ESTIMATE AND ANALYZE MEDICAL CARE RESOURCE USE
Authors: Katz Patricia P. , Showstack Jonathan A. , Lake John R. , Brown, Jr. Robert S. , Dudley R. Adams , Colwell M. Esther , Wiesner Russell H. , Zetterman Rowen K. , Everhart James 
Published: September 2019

This paper describes a method to construct a standardized health care
resource use database. Billing and clinical data were analyzed for 916
patients who received liver transplantations at three medical centers over a
4-year period. Data were checked for completeness by assessing whether each
patient's bill included charges covering specified dates and for specific
services, and for accuracy by comparing a sample of bills to medical records.
Detailed services were matched to a standardized service list from one of the
centers, and a single price list was applied. For certain services, clinical
data were used to estimate service use or, if a match was not possible,
adjusted charges for the services were used. Twenty-three patients were
eliminated from the database because of incomplete resource use data. There
was very good correspondence between bills and medical records, except for
blood products. Direct matches to the standardized service list accounted for
69.3% of services overall; 9.4% of services could not be matched to the
standardized service list and were thus adjusted for center and/or time
period. Clinical data were used to estimate resource use for blood products,
operating room time, and medications; these estimations accounted for 21.3% of
services overall.A database can be constructed that allows comparison of standardized
resource use and avoids biases due to accounting, geographic, or temporal
factors. Clinical data are essential for the creation of such a database. The
methods described are particularly useful in studies of the cost-effectiveness
of medical technologies.
WHICH FACTORS DETERMINE THE USE OF DIAGNOSTIC IMAGING TECHNOLOGIES FOR
GASTROINTESTINAL COMPLAINTS IN GENERAL MEDICAL PRACTICE?
Authors: Busse Reinhard , Hoopmann Michael , Schwartz Friedrich Wilhelm 
Published: September 2019

Objective: Even though gastrointestinal complaints are among the
most frequent reasons to contact general medical practioners, little is known
about the actual care of these patients, especially the use of diagnostic
imaging technologies.Methods: In a network of 57 family practitioners and 29 general
internists in Lower Saxony, Germany, 1,217 contacts with patients with
gastrointestinal diseases (16%, gastritis; 12%, gastroenteritis; 6%,
cholelithiasis; 5% each, ulcus ventriculi and duodeni, and 14%, no final
diagnosis) were documented. The effects of patient and physician/practice
side factors on the use of ultrasonography and radiography were modeled using
multivariate logistic regression.Results: For ultrasonography, diagnosis and ownership of an
ultrasound unit (odds ratio [OR] = 3.33) were highly significant
predictors (p < .0001), followed by unknown diagnosis at beginning
of contact (OR = 1.92; p = .0019), physician specialty (OR for
internists = 1.89; p = .0025), and severity (p = .0085). For
radiography, ownership of an ultrasound unit was the most significant factor
(OR = 0.34; p < .0001), followed by severity (p <
.0009), ownership of x-ray apparatus (OR = 2.56; p = .0025),
physician specialty (OR for internists = 1.98; p = .0358), and
unknown diagnosis at beginning of contact (OR = 1.79; p = .0451). Not
significant were age and sex of patient and diagnosis for radiography.Conclusions: Physicians use diagnostic imaging technologies for
patients with gastrointestinal complaints according to severity and knowledge
about the diagnosis, but ownership of technology is the most predictive
factor.
POPULATION-BASED AND OPPORTUNISTIC SCREENING AND ERADICATION OF
HELICOBACTER PYLORI
Authors: Mason James M. , Moayyedi Paul , Young Philip J. , Duffett Sara , Crocombe Will , Drummond Michael F. , Axon Anthony T. R. ,   For the Leeds H. pylori Study Group
Published: September 2019

Objectives: To examine whether screening and eradication of
Helicobacter pylori by population-based invitation or opportunistic
screening by general practitioners reduces costs to the National Health
Service (NHS) of treating dyspepsia.Methods: A limited dependent, variable, two-step regression
analysis was used to explore the baseline annual health care costs of
dyspepsia for men and women aged 40–49 enrolled in the Leeds H.
pylori screening and eradication trial.Results: Epidemiological and clinical questionnaires, general
practitioner notes, and 13C urea breath test results were available
for 4,754 individuals. After adjusting for covariates, H. pylori was
associated with a 6.7% increased probability of incurring
gastrointestinal-related NHS costs (p < .0001) in the population
aged 40-49. Additionally, H pylori increased average costs in those
who seek medical care (p = .001). In consequence, H. pylori
is associated with an average increased cost to the NHS of £0.30 per
year (95% CI: £0.17 to £0.45) per adult aged 40–49. In those
consulting for dyspepsia, the increased cost to the NHS was £1.04 per
year (95% CI: £0.42 to £1.75) per patient. The cost of population
screening and treatment would not be recovered in reduced dyspepsia costs in
the lifetime of those screened. Assuming laboratory-based serology screening
is used opportunistically in patients presenting with dyspepsia, it is
estimated that costs would be recouped in 18 years.Conclusions: This observational data set suggests that the costs
of screening and treatment in all individuals aged 40–49 or in those
presenting in primary care with dyspeptic symptoms are unlikely to be
attractive on the basis of cost savings alone.
HEALTH TECHNOLOGY ASSESSMENT AND POLICY DECISIONS ON HYPERBARIC OXYGEN
TREATMENT
Authors: Mitton Craig , Hailey David 
Published: September 2019

Objectives: To provide information to health authorities and
others on the effectiveness of hyperbaric oxygen treatment (HBOT) and the
impact on health services should an additional HBOT facility be established in
the provincial health care system.Methods: A literature review on the clinical use of HBOT was
conducted, drawing on MEDLINE, EMBASE, and HealthSTAR. For each of 13
conditions, the effectiveness of HBOT was assessed, with reference to a widely
used classification of level of evidence. Cost implications were considered
for each condition for which there was sufficient evidence of effectiveness.
The perspective was that of the payer.Results: Good evidence of effectiveness exists for HBOT for four
conditions and HBOT is established as the clinical standard of care for two
others. Available evidence did not support the routine use of HBOT for a
further seven indications. An additional 59–87 patients per year would
be eligible for HBOT if a second facility were established in the province.
Improvement in quality of life could be expected for 30–60 persons per
year. A new facility would result in identified additional annual expenditure
of $108,000. Capital costs could exceed $600,000.Conclusions: On the basis of the available evidence on benefits
and costs to routine health care, there did not seem to be a particularly
strong case for establishing a second HBOT center in the province. Following
the assessment, the health authority made a decision not to provide funding
for this additional service.
PROBABILISTIC SENSITIVITY ANALYSIS IN COST-EFFECTIVENESS
Authors: Whang William , Sisk Jane E. , Heitjan Daniel F. , Moskowitz Alan J. 
Published: September 2019

Objectives: We explore the policy implications of probabilistic
sensitivity analysis in cost-effectiveness analysis by applying simulation
methods to a decision model.Methods: We present the multiway sensitivity analysis results of a
study of the cost-effectiveness of vaccination against pneumococcal bacteremia
in the elderly. We then execute a probabilistic sensitivity analysis of the
cost-effectiveness ratio by specifying posterior distributions for the
uncertain parameters in our decision analysis model. In order to estimate
probability intervals, we rank the numerical values of the simulated
incremental cost-effectiveness ratios (ICERs) to take into account preferences
along the cost-effectiveness plane.Results: The 95% probability intervals for the ICER were generally
much narrower than the difference between the best case and worst case results
from a multiway sensitivity analysis. Although the multiway sensitivity
analysis had indicated that, in the worst case, vaccination in the 85 and
older age group was not acceptable from a policy standpoint, probabilistic
methods indicated that the cost-effectiveness of vaccination was below $50,000
per quality-adjusted life-year in greater than 92% of the simulations and
below $100,000 in greater than 95% of the simulations.Conclusions: Probabilistic methods can supplement multiway
sensitivity analyses to provide a more comprehensive picture of the
uncertainty associated with cost-effectiveness ratios and thereby inform
policy decisions.
UNCERTAINTY OF INCREMENTAL COST-EFFECTIVENESS RATIOS
Authors: Severens Johan L. , De Boo Theo M. , Konst Emmy M. 
Published: September 2019

Objective: To compare different methods to estimate the confidence
interval of the incremental cost-effectiveness ratio (ICER).Methods: The adequacy of Fieller intervals and three methods for
calculating bootstrap intervals are compared based on a simulation of 10,000
trials, using data from one trial.Results: Both Fieller and bootstrap methods lead to unsatisfactory
results when the difference in effectiveness is approximately zero. Where this
difference is significant, the four methods for calculating confidence
intervals for ICER do not give very different results, but Fieller's
interval performs best.Conclusions: Since Fieller's confidence limits are relatively
easy to compute compared with bootstrap simulations, we recommend using this
method.
Looting and Smuggling of Artifacts as a Strategy to Finance Terrorism Global Sanctions as a Disruptive and Preventive Tool
Authors: Schindler Hans-Jakob , Gautier Frederique 
Published: September 2019

Abstract:In recent years, the Islamic State in Iraq and the Levant (ISIL)1 as well as several Al-Qaida affiliates have used the systematic and large-scale looting of antiquities as one of their income streams. Due to the large-scale and organized looting activities of these groups, in particular, in Iraq and the Syrian Arab Republic, the United Nations Security Council (UNSC), following various reports and recommendations by the ISIL, Al-Qaida and Taliban Monitoring Team has adopted a range of measures, chiefly among them the landmark UNSC Resolution 2347 (2017) to counter this threat. These measures demand that both member states’ regulators as well as private sector stakeholders take specific action to ensure that the art and antiquity trading industry is capable of defending itself against the misuse of their services to finance terrorism. This article outlines the various challenges member states and private industry are facing in this regard and explains how the various new UNSC provisions, including the measures outlined in UNSC Resolution 2347 (2017), could be employed effectively to counter this threat.
Neuroprosthetic Speech: The Ethical Significance of Accuracy, Control and Pragmatics
Authors: RAINEY STEPHEN , MASLEN HANNAH , MÉGEVAND PIERRE , ARNAL LUC H. , FOURNERET ERIC , YVERT BLAISE 
Published: September 2019

Abstract:Neuroprosthetic speech devices are an emerging technology that can offer the possibility of communication to those who are unable to speak. Patients with ‘locked in syndrome,’ aphasia, or other such pathologies can use covert speech—vividly imagining saying something without actual vocalization—to trigger neural controlled systems capable of synthesizing the speech they would have spoken, but for their impairment.We provide an analysis of the mechanisms and outputs involved in speech mediated by neuroprosthetic devices. This analysis provides a framework for accounting for the ethical significance of accuracy, control, and pragmatic dimensions of prosthesis-mediated speech. We first examine what it means for the output of the device to be accurate, drawing a distinction between technical accuracy on the one hand and semantic accuracy on the other. These are conceptual notions of accuracy.Both technical and semantic accuracy of the device will be necessary (but not yet sufficient) for the user to have sufficient control over the device. Sufficient control is an ethical consideration: we place high value on being able to express ourselves when we want and how we want. Sufficient control of a neural speech prosthesis requires that a speaker can reliably use their speech apparatus as they want to, and can expect their speech to authentically represent them. We draw a distinction between two relevant features which bear on the question of whether the user has sufficient control: voluntariness of the speech and the authenticity of the speech. These can come apart: the user might involuntarily produce an authentic output (perhaps revealing private thoughts) or might voluntarily produce an inauthentic output (e.g., when the output is not semantically accurate). Finally, we consider the role of the interlocutor in interpreting the content and purpose of the communication.These three ethical dimensions raise philosophical questions about the nature of speech, the level of control required for communicative accuracy, and the nature of ‘accuracy’ with respect to both natural and prosthesis-mediated speech.
Evaluation of cardiac function in fetuses of mothers with gestational diabetes
Authors: Mohsin Muhammad , Sadqani Saleem , Younus Kamran , Hoodbhoy Zahra , Ashiqali Salima , Atiq Mehnaz 
Published: September 2019

AbstractObjective:The purpose of this study was to assess fetal cardiac function in normal fetuses (control group) compared to those who are exposed to gestational diabetes mellitus using different echocardiographic measurements, and to explore the application of left atrial shortening fraction in determination of fetal diastolic function with gestational diabetes mellitus.Methods:A total of 50 women with gestational diabetes and 50 women with a healthy pregnancy were included in the study. Fetal echocardiography was performed and structural as well as functional fetal cardiac parameters were measured. Data were compared between with or without fetal myocardial hypertrophy and the control group.Results:In the study group, out of 50 fetuses of gestational diabetic mothers, 18 had myocardial hypertrophy and 32 had normal septal thickness. Gestational age at time of examination did not differ significantly between the control and gestational diabetes group (p = 0.55). Mitral E/A ratio was lower in gestational diabetes group as compared to the control (p < 0.001). Isovolumetric relaxation and contraction times and myocardial performance index were greater in fetuses of gestational diabetic mothers (p < 0.001). In fetuses of gestational diabetic mothers with myocardial hypertrophy, left atrial shortening fraction was lower as compared to those without myocardial hypertrophy and those of the control group (p < 0.001).Conclusions:The results of this study suggest that fetuses of gestational diabetic mothers have altered cardiac function even in the absence of septal hypertrophy, and that left atrial shortening fraction can be used as a reliable alternate parameter in the assessment of fetal diastolic function.
Late effects of radiofrequency ablation lesions resulting in a progressive mitral valve perforation in a 2-month-old infant
Authors: Wang Feng , Chen Gang , Wu Lin 
Published: September 2019

AbstractThere has been great concern with the use of radiofrequency ablation in infants since radiofrequency ablation lesions were shown to have a progressing nature in immature myocardium of animals. In this report, we present a 2-month-old infant with life-threatening medically refractory supraventricular tachycardia. Radiofrequency ablation successfully cured arrhythmia; however, late effects of radiofrequency ablation lesions resulted in a progressive mitral valve perforation requiring surgical repair.
Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein
Authors: Oliveira Edmundo C. , Moura Marco A. G. , Almeida José A. , Ribeiro Antonio L. P. , Nascimento Bruno R. 
Published: September 2019

AbstractFemoral vein access is the first choice for percutaneous atrial septal defect closure, and when it cannot be used due to anatomic reasons, the alternative sites should be considered, frequently increasing the complexity of the procedure. Here we report the case of a 3-year-old boy, with situs inversus and dextrocardia, electively referred for percutaneous closure of an ostium secundum atrial septal defect. During the procedure, agenesis of the infra-hepatic segment of the inferior caval vein was diagnosed, and no double inferior caval vein or right superior caval vein were identified by ultrasound or angiography. Therefore, we opted to perform the procedure through the left internal jugular vein, with fluoroscopy and transesophageal echocardiographic guidance. Catheters were navigated through a hydrophilic guidewire, and a Stiff guidewire was positioned in the left ventricle for better support. An Amplatzer septa occluder 19 was successfully deployed without major difficulties and the patient was discharged after 24 hours in good clinical condition. Percutaneous atrial septal defect closure through alternative access sites, especially in the presence of situs inversus, may pose significant challenges to the interventional team. In this case, the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions.
A qualitative study to understand parent and physician perspectives about cow’s milk fat for children
Authors: Vanderhout Shelley M , Juando-Prats Clara , Birken Catherine S , Thorpe Kevin E , Maguire Jonathon L 
Published: September 2019

AbstractObjective:Consensus guidelines recommend that children consume reduced-fat (0·1–2 %) cow’s milk at age 2 years to reduce the risk of obesity. Behaviours and perspectives of parents and physicians about cow’s milk fat for children are unknown. Objectives were to: (i) understand what cow’s milk fat recommendations physicians provide to 2-year-old children; (ii) assess the acceptability of reduced-fat v. whole cow’s milk in children’s diets by parents and physicians; and (iii) explore attitudes and perceptions about cow’s milk fat for children.Design:Online questionnaires and individual interviews were conducted. Questionnaire data were analysed using descriptive statistics. Interview transcripts were analysed using a general inductive approach and thematic analysis.Setting:The TARGet Kids! practice-based research network in Toronto, Canada.Participants:Questionnaire respondents included fifty parents and fifteen physicians; individual interviews were conducted with with fourteen parents and twelve physicians.Results:Physicians provided various milk fat recommendations for 2-year-old children. Parents also provided different cow’s milks: eighteen (36 %) provided whole milk and twenty-nine (58 %) provided reduced-fat milk. Analysis of qualitative interviews revealed three themes: (i) healthy eating behaviours, (ii) trustworthy nutrition information and (iii) importance of dietary fat for children.Conclusions:Parents provide, and physicians recommend, a variety of cow’s milks for children and hold mixed interpretations of the role of cow’s milk fat in children’s diets. Clarity about its effect on child adiposity is needed to help make informed decisions about cow’s milk fat for children.
Carrier-Transport Study of Gallium Arsenide Hillock Defects
Authors: Xiao Chuanxiao , Jiang Chun-Sheng , Liu Jun , Norman Andrew , Moseley John , Schulte Kevin , Ptak Aaron J. , Gorman Brian , Al-Jassim Mowafak , Haegel Nancy M. , Moutinho Helio 
Published: September 2019

AbstractSingle-crystalline gallium arsenide (GaAs) grown by various techniques can exhibit hillock defects on the surface when sub-optimal growth conditions are employed. The defects act as nonradiative recombination centers and limit solar cell performance. In this paper, we applied near-field transport imaging to study hillock defects in a GaAs thin film. On the same defects, we also performed near-field cathodoluminescence, standard cathodoluminescence, electron-backscattered diffraction, transmission electron microscopy, and energy-dispersive X-ray spectrometry. We found that the luminescence intensity around the hillock area is two orders of magnitude lower than on the area without hillock defects in the millimeter region, and the excess carrier diffusion length is degraded by at least a factor of five with significant local variation. The optical and transport properties are affected over a significantly larger region than the observed topography and crystallographic and chemical compositions associated with the defect.