bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost and efficiency of myringotomy procedures in minor procedure rooms compared to operating rooms
Authors: Davidson Jacob , Ioanidis Khrystyna , Fantillo Vanessa , Paradis Josee , Strychowsky Julie 
Published: February 2019

ObjectivesMinor pediatric surgeries performed in the minor procedure room (MPR) may be more time efficient and less costly compared to those performed in the operating room (OR).Study DesignRetrospective review.MethodsThis was a retrospective study on cost and efficiency differences of bilateral myringotomy with tube insertions performed in the MPR versus the OR. Charts were reviewed from June 2015 to May 2017. Cost data was based on supply cost and case costing of medical personnel including nurses, aides, and anesthesia assistants.ResultsTwo hundred eighteen patients were included in the study. The median age was 2.7 years (range: 0.8–16.7), and there were no differences in gender between locations. One hundred twenty‐three patients had surgery in the MPR (56.4%), and 95 had surgery in the OR (43.6%). The median length of time in the procedure room was 11 minutes shorter for patients who underwent surgery in the MPR (12.0 minutes, range: 3.0–33.0) compared to patients in the OR (23.0 minutes, range: 11.0–52.0; P < .0001). Median hospital stay (2.0 hours vs. 4.3 hours; P < 0.0001) and median patient turnover time (6.0 minutes vs. 14.0 minutes; P < .0001) was shorter in the MPR compared to OR. The total overall cost of a myringotomy with tube insertion, including labor and supply cost, was $189.41 in the MPR compared to $468.56 in the OR, a difference of $279.15 per case.ConclusionBilateral myringotomy with tube insertions are more time and cost‐efficient when performed in the MPR. This study supports the need for increased availability of MPR time for appropriate surgeries.Level of Evidence3 Laryngoscope, 130:242–246, 2020
Surgical Aspects of Liver Transplantation and Domino Liver Transplantation in Maple Syrup Urine Disease: Analysis of 15 Donor‐Recipient Pairs
Authors: Herden Uta , Grabhorn Enke , Santer René , Li Jun , Nadalin Silvio , Rogiers Xavier , Scherer Marcus N. , Braun Felix , Beime Jan , Lenhartz Henning , Muntau Ania C. , Fischer Lutz 
Published: February 2019

Liver transplantation (LT) has been shown to be a feasible treatment in patients with severe forms of maple syrup urine disease (MSUD). Because of a sufficient extrahepatic enzyme activity in non‐MSUD individuals, the organ of MSUD patients can be used as a domino graft. We performed a retrospective data collection of all LTs for MSUD carried out at the University Medical Center Hamburg‐Eppendorf (2016‐2018). Moreover, data from all consecutive domino LTs of the MSUD grafts either transplanted at our institution or allocated to other transplant centers were analyzed. During the study period, 15 LTs in MSUD patients were performed (12 children, 3 adults; median age, 10.9 years; range, 0.3‐26.1 years). Biliary complications occurred in 20%, and 13.3% suffered from bleeding complications. No further surgical problems occurred. At present, all MSUD patients are alive with a well‐functioning liver graft and on an unrestricted diet. In total, 14 consecutive domino LTs were performed. No surgical complications requiring intervention occurred. One patient died because of HCC relapse, and all other patients are alive with good liver graft function. In conclusion, the use of MSUD livers as domino grafts is safe and allows application of LT in MSUD patients without net extraction of a liver graft from the limited donor pool.
Damage‐Associated Molecular Patterns Induce Inflammatory Injury During Machine Preservation of the Liver: Potential Targets to Enhance a Promising Technology
Authors: Scheuermann Uwe , Zhu Minghua , Song Mingqing , Yerxa John , Gao Qimeng , Davis Robert P. , Zhang Min , Parker William , Hartwig Matthew G. , Kwun Jean , Brennan Todd V. , Lee Jaewoo , Barbas Andrew S. 
Published: February 2019

Machine preservation (MP) has emerged as a promising technology in liver transplantation, but the cellular processes occurring during MP have not been characterized. Recent studies have noted the presence of inflammatory molecules generated during MP. We hypothesized that there is a metabolism‐dependent accumulation of damage‐associated molecular patterns (DAMPs) and inflammatory cytokines during MP and that these molecules provoke inflammation in the graft. To stratify groups by metabolic rate, MP was performed on rat livers from standard donors at 3 different temperatures: room temperature (RT), subnormothermic (30°C), and normothermic (37°C). Static cold storage at 4°C was included as a reference group. Following a 4‐hour preservation period, graft reperfusion was performed ex vivo at 37°C (n = 6 for all groups). Levels of DAMPs and inflammatory cytokines were measured, and their biological activity was assessed by determining toll‐like receptor (TLR) stimulation, inflammatory gene expression, and activation of cell death pathways. There was a time‐dependent increase in levels of DAMPs during MP with high‐mobility group box 1 and extracellular DNA levels increasing for all groups (P < 0.05, 30 versus 240 minutes). Tumor necrosis factor α levels in the perfusate also increased during MP for all groups (P < 0.05, 30 minutes versus 240 minutes). Levels of inflammatory molecules correlated with increased activation of TLRs (TLR3, P = 0.02, normothermic machine preservation [MP37] versus machine preservation at room temperature [MPRT]; TLR9, P = 0.02, MP37 versus MPRT). Priming of the NLRP3 inflammasome and activation of cell death pathways were reduced in grafts preserved by MP at room temperature. In conclusion, inflammatory molecules produced during MP have a biological impact on the graft. Therapies to attenuate DAMP‐mediated inflammation during MP may further enhance this promising technology.
Let There Be Light: Targeted Photodynamic Therapy Using High Aspect Ratio Plant Viral Nanoparticles
Authors: Chariou Paul L. , Wang Lu , Desai Cian , Park Jooneon , Robbins Leanna K. , von Recum Horst A. , Ghiladi Reza A. , Steinmetz Nicole F. 
Published: February 2019

AbstractThe development of plant viral nanoparticles (VNP) loaded with different molecular versions of a photodynamic drug is described. Specifically, tobacco mosaic virus (TMV) and tobacco mild green mosaic virus (TMGMV) are developed as drug carriers that encapsulate the monocationic, dicationic, tricationic, and tetracationic versions of a porphyrin‐based photosensitizer drug (Zn‐Por). While TMV has been extensively explored for various nanotechnology applications, this is the first study investigating TMGMV for medical applications. Light‐activated cancer cell killing of Zn‐Por‐loaded VNPs is studied in vitro using melanoma and cervical cancer models. Native and nucleolin‐targeted VNP drug carriers are developed and their efficacy assessed. A fivefold increase in cancer cell killing is observed using nucleolin‐targeted TMV loaded with tricationic Zn‐Por and displaying the nucleolin‐specific F3 peptide.
EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease
Authors: Dafsari Haidar S. , Martinez‐Martin Pablo , Rizos Alexandra , Trost Maja , dos Santos Ghilardi Maria Gabriela , Reddy Prashanth , Sauerbier Anna , Petry‐Schmelzer Jan Niklas , Kramberger Milica , Borgemeester Robbert W. K. , Barbe Michael T. , Ashkan Keyoumars , Silverdale Monty , Evans Julian , Odin Per , Fonoff Erich Talamoni , Fink Gereon R. , Henriksen Tove , Ebersbach Georg , Pirtošek Zvezdan , Visser‐Vandewalle Veerle , Antonini Angelo , Timmermann Lars , Ray Chaudhuri K. ,   on behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non‐Motor Parkinson's Disease Study Group
Published: February 2019

AbstractObjectiveReal‐life observational report of clinical efficacy of bilateral subthalamic stimulation (STN‐DBS), apomorphine (APO), and intrajejunal levodopa infusion (IJLI) on quality of life, motor, and nonmotor symptoms (NMS) in Parkinson's disease (PD).MethodsIn this prospective, multicenter, international, real‐life cohort observation study of 173 PD patients undergoing STN‐DBS (n = 101), IJLI (n = 33), or APO (n = 39) were followed‐up using PDQuestionnaire‐8, NMSScale (NMSS), Unified PD Rating Scale (UPDRS)‐III, UPDRS‐IV, and levodopa equivalent daily dose (LEDD) before and 6 months after intervention. Outcome changes were analyzed with Wilcoxon signed‐rank or paired t test when parametric tests were applicable. Multiple comparisons were corrected (multiple treatments/scales). Effect strengths were quantified with relative changes, effect size, and number needed to treat. Analyses were computed before and after propensity score matching, balancing demographic and clinical characteristics.ResultsIn all groups, PDQuestionnaire‐8, UPDRS‐IV, and NMSS total scores improved significantly at follow‐up. Levodopa equivalent daily dose was significantly reduced after STN‐DBS. Explorative NMSS domain analyses resulted in distinct profiles: STN‐DBS improved urinary/sexual functions, mood/cognition, sleep/fatigue, and the miscellaneous domain. IJLI improved the 3 latter domains and gastrointestinal symptoms. APO improved mood/cognition, perceptual problems/hallucinations, attention/memory, and the miscellaneous domain. Overall, STN‐DBS and IJLI seemed favorable for NMSS total score, and APO favorable for neuropsychological/neuropsychiatric NMS and PDQuestionnaire‐8 outcome.ConclusionsThis is the first comparison of quality of life, nonmotor. and motor outcomes in PD patients undergoing STN‐DBS, IJLI, and APO in a real‐life cohort. Distinct effect profiles were identified for each treatment option. Our results highlight the importance of holistic nonmotor and motor symptoms assessments to personalize treatment choices. © 2019 International Parkinson and Movement Disorder Society
Canadian genetic healthcare professionals’ attitudes towards discussing private pay options with patients
Authors: Di Gioacchino Vanessa , Langlois Sylvie , Elliott Alison M. 
Published: February 2019

AbstractBackgroundJust as there is inconsistency with respect to coverage of genomic testing with insurance carriers, there is interprovincial discrepancy in Canada. Consequently, the option of private pay (e.g., self pay) arises, which can lead to inequities in access, particularly when patients may not be aware of this option. There are currently no published data regarding how the Canadian genetics community handles discussions of private pay options with patients. The purpose of this study was to assess the attitudes of genetic healthcare professionals (GHPs: medical geneticists, genetic counselors, and genetic nurses) practicing in Canada toward these discussions.MethodsAn online survey was distributed to members of the Canadian College of Medical Geneticists and the Canadian Association of Genetic Counsellors to assess frequencies, rationale, and ethical considerations regarding these conversations. Quantitative data were analyzed using descriptive statistics.ResultsOf 144 respondents, 95% reported discussing private pay and 65% reported working in a clinic without a policy on this issue. There were geographic and practice‐specific differences. The most common circumstance for these discussions was when a test was clinically indicated (e.g., but funding was denied) followed by when the patient initiated the conversation. The most frequently discussed tests included: multi‐gene panels (73% of respondents), noninvasive prenatal testing (62%), and pre‐implantation genetic diagnosis (58%). Although 65% felt it was ethical to discuss private pay, 35% indicated it was “sometimes” ethical.ConclusionWith the increasing availability of genomic technologies, these findings inform how we practice and demonstrate the need for policy in this area.
Application of eye trackers for understanding mental disorders: Cases for schizophrenia and autism spectrum disorder
Authors: Shishido Emiko , Ogawa Shiori , Miyata Seiko , Yamamoto Maeri , Inada Toshiya , Ozaki Norio 
Published: February 2019

AbstractStudies of eye movement have become an essential tool of basic neuroscience research. Measures of eye movement have been applied to higher brain functions such as cognition, social behavior, and higher‐level decision‐making. With the development of eye trackers, a growing body of research has described eye movements in relation to mental disorders, reporting that the basic oculomotor properties of patients with mental disorders differ from those of healthy controls. Using discrimination analysis, several independent research groups have used eye movements to differentiate patients with schizophrenia from a mixed population of patients and controls. Recently, in addition to traditional oculomotor measures, several new techniques have been applied to measure and analyze eye movement data. One research group investigated eye movements in relation to the risk of autism spectrum disorder several years prior to the emergence of verbal‐behavioral abnormalities. Research on eye movement in humans in social communication is therefore considered important, but has not been well explored. Since eye movement patterns vary between patients with mental disorders and healthy controls, it is necessary to collect a large amount of eye movement data from various populations and age groups. The application of eye trackers in the clinical setting could contribute to the early treatment of mental disorders.
Repeated methamphetamine treatment increases spine density in the nucleus accumbens of serotonin transporter knockout mice
Authors: Kasahara Yoshiyuki , Sakakibara Yasufumi , Hiratsuka Takashi , Moriya Yuki , Lesch Klaus‐Peter , Hall F. Scott , Uhl George R. , Sora Ichiro 
Published: February 2019

AbstractAimRepeated psychostimulant drug treatment, including methamphetamine, in rodents readily produces behavioral sensitization, which reflects altered brain function caused by repeated drug exposure. Dendritic remodeling of medium spiny neurons in the nucleus accumbens is thought to be an essential mechanism underlying behavioral sensitization. We recently showed that chronic methamphetamine treatment did not produce behavioral sensitization in serotonin transporter knockout mice.MethodsIn this study, we report the spine density of medium spiny neurons in the nucleus accumbens after repeated methamphetamine injection to examine morphological alterations in serotonin transporter knockout mice.ResultsGolgi‐COX staining clearly showed that the spine density of medium spiny neurons in the nucleus accumbens increased following repeated methamphetamine treatment in both wild‐type and serotonin transporter knockout mice.ConclusionsOur results suggested that augmented serotonergic neurotransmission produced by serotonin transporter deletion prevents the development of behavioral sensitization in a manner that is independent of dendritic remodeling in the nucleus accumbens.
Multiregion human bladder cancer sequencing reveals tumour evolution, bladder cancer phenotypes and implications for targeted therapy
Authors: Heide Timon , Maurer Angela , Eipel Monika , Knoll Katrin , Geelvink Mirja , Veeck Juergen , Knuechel Ruth , van Essen Julius , Stoehr Robert , Hartmann Arndt , Altmueller Janine , Graham Trevor A , Gaisa Nadine T 
Published: February 2019

AbstractWe present an evolutionary analysis of the relative time of genetic events underlying tumorigenesis in human bladder cancers from 10 whole cystectomy specimens using multiregional whole‐exome sequencing. We timed bladder cancer drivers, mutational signatures, ploidy and copy number alterations, provided evidence for kataegis and correlated alterations with tumour areas and histological phenotypes. We found that: (1) heterogeneous tumour areas/phenotypes had distinct driver mutations, (2) papillary‐invasive tumours divided early into two parallel evolving branches and (3) parallel evolution of subclonal driver mutations occurred. APOBEC mutational signatures were found to be very early events, active in carcinoma in situ, and often remained a dominant source of mutations throughout tumour evolution. Genetic progression from carcinoma in situ followed driver mutations in NA13/FAT1, ZBTB7B or EP300/USP28/KMT2D. Our results point towards a more diverse mutational trajectory of bladder tumorigenesis and underpin the importance of timing of mutational processes and clonal architecture in bladder cancer as important aspects for successful prognostication and therapy. Copyright © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Cost‐effectiveness of early cancer surveillance for patients with Li–Fraumeni syndrome
Authors: Tak Casey R. , Biltaji Eman , Kohlmann Wendy , Maese Luke , Hainaut Pierre , Villani Anita , Malkin David , Sherwin Catherine M.T. , Brixner Diana I , Schiffman Joshua D. 
Published: February 2019

AbstractIntroductionPatients with germline TP53 pathogenic variants (Li–Fraumeni syndrome [LFS]) are at extremely high lifetime risk of developing cancer. Recent data suggest that tumor surveillance for patients with LFS may improve survival through early cancer detection. The objective of this study was to assess the cost‐effectiveness of a cancer surveillance strategy for patients with LFS compared with those whose tumors present clinically.MethodsA Markov decision analytic model was developed from a third‐party payer perspective to estimate cost‐effectiveness of routine cancer surveillance over a patient's lifetime. The model consisted of four possible health states: no cancer, cancer, post‐cancer survivorship, and death. Model outcomes were costs (2015 United States Dollars [USD]), effectiveness (life years [LY] gained), and incremental cost‐effectiveness ratio (ICER; change in cost/LY gained). One‐way sensitivity analyses and probabilistic sensitivity analyses examined parameter uncertainty.ResultsThe model showed a mean cost of $46 496 and $117 102 and yielded 23 and 27 LY for the nonsurveillance and surveillance strategies, respectively. The ICER for early cancer surveillance versus no surveillance was $17 125 per additional LY gained. At the commonly accepted willingness to pay threshold of $100 000/life‐year gained, surveillance had a 98% probability of being the most cost‐effective strategy for early cancer detection in this high‐risk population.ConclusionsPresymptomatic cancer surveillance is cost‐effective for patients with germline pathogenic variants in TP53. Lack of insurance coverage or reimbursement in this population may have significant consequences and leads to undetected cancers presenting in later stages of disease with worse clinical outcomes.
The utilization of prenatal microarray: A survey of current genetic counseling practices and barriers
Authors: Durham Leslie , Papanna Ramesha , Stevens Blair , Noblin Sarah , Rodriguez‐Buritica David , Hashmi S. Shahrukh , Krstic Nevena 
Published: February 2019

AbstractObjectiveWe evaluated what prenatal genetic counselor's (GCs) practices, attitudes, and barriers are in regards to prenatal microarray since the publication of the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal‐Fetal Medicine (SMFM) guidelines for microarray use.MethodsThis was a survey‐based cross‐sectional study of English‐speaking, board certified or eligible GCs who currently practice prenatal genetic counseling.ResultsOf 192 respondents, 183 (95%) have incorporated chromosome microarray (CMA) into clinical practice, with 64% believing that the benefits of CMA outweigh the harms and 52% agreeing that CMA should be offered to all women regardless of indication. Those who reported being experts/comfortable in their knowledge of CMA (85%) and familiar with current clinical guidelines (86%) were significantly more likely to offer CMA to patients undergoing invasive testing and patients with fetal anomalies. Patient‐specific concerns were the largest reported barrier (51%) when GCs do not offer CMA to patients.ConclusionOur study demonstrates GCs follow guidelines for CMA use when specific indications are involved, but further guidelines are needed regarding CMA use for other routine indications where utility of CMA is not clearly understood. On this basis, ACOG and SMFM should continue revising their guidelines as more information comes to light regarding utility of prenatal CMA for all indications, and organizations like the National Society of Genetic Counselors (NSGC) should consider publishing guidelines on prenatal CMA that are specialized to the GCs sphere of practice.
A systematic review of cancer caregiver interventions: Appraising the potential for implementation of evidence into practice
Authors: Ugalde Anna , Gaskin Cadeyrn J. , Rankin Nicole M. , Schofield Penelope , Boltong Anna , Aranda Sanchia , Chambers Suzanne , Krishnasamy Meinir , Livingston Patricia M. 
Published: February 2019

AbstractObjectivenformal caregivers provide substantial support for people living with cancer. Previous systematic reviews report on the efficacy of cancer caregiver interventions but not their potential to be implemented. The aim of this systematic review was to explore the potential for cancer caregiver interventions to be implemented into practice.MethodsWe searched three electronic databases to identify cancer caregiver interventions on 5 January 2018. We operationalised six implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and costs) into a tool to guide data extraction.ResultsThe search yielded 33 papers (27 papers from electronic databases and six papers from other sources) reporting on 26 studies that met review criteria. Fewer than half the studies (46%) contained evidence about the acceptability of interventions from caregivers' perspectives; only two studies (8%) included interventions developed with input from caregivers. Two studies (8%) addressed potential adoption of interventions, and no studies discussed intentions, agreement, or action to implement interventions into practice. All studies reported on intervention appropriateness by providing a rationale for the interventions. For feasibility, on average less than one‐third of caregivers who were eligible to be involved consented to participate. On fidelity, whether interventions were conducted as intended was reported in 62% of studies. Cost data were reported in terms of intervention delivery, requiring a median time commitment of staff of 180 minutes to be delivered.ConclusionsCaregiver intervention studies lack components of study design and reporting that could bridge the gap between research and practice. There is enormous potential for improvements in cancer caregiver intervention study design to plan for future implementation.
Output feedback regulation control for a class of cascade nonlinear systems by time‐varying Kalman observer
Authors: Wu Yuqiang , Yu Jiangbo , Zhang Zhongcai 
Published: February 2019

SummaryThe global output feedback regulation problem is studied for a class of cascade nonlinear systems. The considered system represents more general classes of nonlinear uncertain systems, including the integral input‐to‐state stable (iISS) unmodeled dynamics, the unknown control direction, the parameter uncertainty, and the external disturbance additively in the input channel. Technically, we explore the changing supply rate technique for the iISS system to deal the iISS unmodeled dynamics and apply the Nussbaum‐type gain into the control design to overcome the unknown control direction. Additionally, a dynamic extended state observer in the form of a time‐varying Kalman observer is novelly constructed to overcome the unmeasured state components in the nonlinear uncertainties. It is shown that the global regulation problem is well addressed by the proposed method, and its efficacy is demonstrated by a fan speed control system.