bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient- and Procedure-Specific Variables Driving Total Direct Costs of Outpatient Anterior Cruciate Ligament Reconstruction
Authors: Karns Michael R. , Jones Daniel L. , Todd Dane C. , Maak Travis G. , Aoki Stephen K. , Burks Robert T. , Yoo Minkyoung , Nelson Richard E. , Greis Patrick E. 
Published: August 2018

Background: Few studies have investigated the influence of patient-specific variables or procedure-specific factors on the overall cost of anterior cruciate ligament reconstruction (ACLR) in an ambulatory surgery setting. Purpose: To determine patient- and procedure-specific factors influencing the overall direct cost of outpatient arthroscopic ACLR utilizing a unique value-driven outcomes (VDO) tool. Study Design: Cohort study (economic and decision analysis); Level of evidence, 3. Methods: All ACLRs performed by 4 surgeons over 2 years were retrospectively reviewed. Cost data were derived from the VDO tool. Patient-specific variables included age, body mass index, comorbidities, American Society of Anesthesiologists (ASA) classification, smoking status, preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computerized Adaptive Testing (PF-CAT) score, and preoperative Single Assessment Numeric Evaluation (SANE) score. Procedure-specific variables included graft type, revision status, associated injuries and procedures, time from injury to ACLR, surgeon, and operating room (OR) time. Multivariate analysis determined patient- and procedure-related predictors of total direct costs. Results: There were 293 autograft reconstructions, 110 allograft reconstructions, and 31 hybrid reconstructions analyzed. Patient-specific factors did not significantly influence the ACLR cost. The mean OR time was shorter for allograft reconstruction ( P < .001). Predictors of an increased direct cost included the use of an allograft or hybrid graft (44.5% and 33.1% increase, respectively; P < .001), increased OR time (0.3% increase per minute; P < .001), surgeon 3 or 4 (9.1% or 5.9% increase, respectively; P < .001 or P = .001, respectively), and concomitant meniscus repair (24.4% increase; P < .001). Within the meniscus repair cohort, all-inside, root, and combined repairs correlated with a 15.5%, 31.4%, and 53.2% increased mean direct cost, respectively, compared with inside-out repairs ( P < .001). Conclusion: This study failed to identify modifiable patient-specific factors influencing direct costs of ACLR. Allografts and hybrid grafts were associated with an increased total direct cost. Meniscus repair independently predicted an increased direct cost, with all-inside, root, and combined repairs being costlier than inside-out repairs. The time-saving potential of all-inside meniscus repair was not realized in this study, making implant use a significant factor in the overall cost of ACLR with meniscus repair.
Myroides odoratimimus urinary tract infection in an immunocompromised patient: an emerging multidrug-resistant micro-organism
Authors: Lorenzin Giovanni , Piccinelli Giorgio , Carlassara Lucrezia , Scolari Francesco , Caccuri Francesca , Caruso Arnaldo , De Francesco Maria Antonia 
Published: August 2018

Abstract
Background
Myroides spp. are common environmental organisms and they can be isolated predominantly in water, soil, food and in sewage treatment plants. In the last two decades, an increasing number of infections such as urinary tract infections and skin and soft tissue infections, caused by these microorganisms has been reported. Selection of appropriate antibiotic therapy to treat the infections caused by Myroides spp. is difficult due to the production of a biofilm and the organism’s intrinsic resistance to many antibiotic classes.

Case presentation
We report the case of a 69-year-old immunocompromised patient who presented with repeated episodes of macroscopic haematuria, from Northern Italy.
A midstream urine sample cultured a Gram negative rod in significant amounts (> 105 colony-forming units (cfu)/mL), which was identified as Myroides odoratimimus. The patient was successfully treated with trimethoprim/sulfamethoxazole after antibiotic susceptibility testing confirmed its activity.

Conclusion
This case underlines the emergence of multidrug resistant Myroides spp. which are ubiquitous in the environment and it demands that clinicians should be more mindful about the role played by atypical pathogens, which may harbour or express multidrug resistant characteristics, in immunocompromised patients or where there is a failure of empiric antimicrobial therapy.
The Economic Consequences of not Treating Depression
Authors: Rupp Agnes 
Published: August 2018

Background. A conceptual framework Is described for a broad cost–benefit evaluation of improved financial access to treatment of untreated affective disorders.Method. The analysis provides an estimate of the value of resources needed to provide improved access to treatment, and it compares these resources to the value of resources the improved access to treatment might save.Results. The cost–benefit analyses based on recent cost of mental illness studies provide some evidence that appropriately treating people with untreated affective disorders is cost-beneficial.Conclusion. Patients, providers and buyers of health care should be further encouraged to pay more attention and to commit more financial resources to the treatment of affective disorders.
The Economics of Depression in Primary Care: Department of Health Initiatives
Authors: Lloyd Keith , Jenkins Rachel 
Published: August 2018

Background. Most mental illness is treated in primary and not secondary care settings, with depression and anxiety the commonest conditions encountered.Method. The paper describes on-going Department of Health initiatives to optimise the primary care of common mental illnesses such as depression.Discussion. Primary care attenders with depression are often higher consumers of general health care than non-depressed attenders. Further data will become available soon from these ongoing studies to inform the debate on the optimal use of available resources in primary care. There is a particular need to evaluate non-pharmacological interventions in primary care.
Health economics and cost implications of anxiety and other mental disorders in the United States
Authors: Rice Dorothy P. , Miller Leonard S. 
Published: August 2018

Background Mental disorders impose a multi-billion dollar burden on the economy each year; translating the burden into economic terms is important to facilitate formulating policies about the use of resources.Method For direct costs, data were obtained from national household interview and provider surveys; for morbidity costs, a timing model was used that measures the lifetime effect on current income of individuals with mental disorders, taking into account the timing of onset and the duration of these disorders, based on regression analysis of Epidemiologic Catchment Area study data.Results The total economic costs of mental disorders amounted to US$ 147.8 billion in 1990. Anxiety disorders are the most costly, amounting to $46.6 billion, or 31.5% of the total; schizophrenic disorders accounted for $32.5 billion, affective disorders for $30.4 billion, and other mental disorders for $38.4 billion.Conclusions Mental illnesses, especially anxiety disorders, are costly to society. Although anxiety disorders have a higher prevalence than affective disorders and schizophrenia, use of medical care services is lowest for anxiety disorders. Anxiety disorders appear to be under-recognised and untreated even though treatment interventions have been shown to be effective and can be delivered in a cost-efficient manner.
The Evidence for 20 mg a day of Fluoxetine as the Optimal Dose in the Treatment of Depression
Authors: Altamura A. C. , Montgomery S. A. , Wernicke J. F. 
Published: August 2018

Fluoxetine, a selective serotonin-uptake inhibitor, has been shown to be effective in the treatment of depression. A series of studies found fluoxetine to be more effective than placebo and to be associated with equivalent efficacy to standard reference tricyclic antidepressants (Stark & Hardison, 1985; Feighner & Cohn, 1985).The selection of a dosage regime for fluoxetine in these studies was based on the information gathered from open dose-ranging investigations. In these studies, treatment starts with one dose level, which is then increased as indicated in the protocol or until increased doses are not tolerated due to side-effects. One of the weaknesses in this method of choosing the likely standard dose of a new antidepressant lies in the inherent bias towards the selection of the higher dose levels. This is particularly true for drugs which are well tolerated.
First-episode schizophrenia with long duration of untreated psychosis: Pathways to care
Authors: Larsen Tor K. , Johannessen Jan Olav , Opjordsmoen Stein 
Published: August 2018

Background The early course of illness in first-episode schizophrenia was examined with special emphasis on the duration of untreated psychosis and pathways to care.Method The consecutively admitted individuals (n=34) were assessed on premorbid functioning, duration of untreated psychosis, global functioning, symptoms and social network. To clarify the obstacles for receiving earlier treatment, 17 case histories with long duration of untreated psychosis were intensively studied.Results The duration of untreated psychosis was on average very long (130 weeks), the median value was 54 weeks. The long duration of untreated psychosis group (> 54 weeks) had greater deterioration in the premorbid phase, a weaker social network and were more withdrawn than the short duration of untreated psychosis group (< 54 weeks). The main obstacles for receiving treatment were withdrawal and poor social network.Conclusions In order to identify people earlier, a system of detection must be mobile, easily accessible and attentive to early symptoms of psychosis. It seems to be important to educate the social network related to the individual about the importance of early treatment.
Early intervention, untreated psychosis and the course of early schizophrenia
Authors: Linszen Donald , Lenior Marie , de Haan Lieuwe , Dingemans Peter , Gersons Berthold 
Published: August 2018

Background Studies have proved that early intervention can delay psychotic relapses, and prevent psychosocial deterioration in people with schizophrenia and related disorders.Method Our study with young people with recent onset schizophrenia has shown that an intensive intervention programme had a beneficial effect on the occurrence of psychotic relapse and the course of psychotic syndromes. This effect lasted until the end of the 15-month intervention. No significant effect of the two different intervention conditions became apparent.Results The results of a follow-up study showed that this beneficial effect did not last. Fifteen per cent of the people had a psychotic relapse during the intervention, whereas 64% relapsed during follow-up.Conclusions These results show that referral to other mental health agencies after intervention is not sufficient and that more support is required to continue disease management, medication compliance and stress management.
Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder
Authors: Saxena S. , Brody A. L. , Schwartz J. M. , Baxter L. R. 
Published: August 2018

Background Neuroimaging studies provide strong evidence that the pathophysiology of obsessive-compulsive disorder (OCD) involves abnormal functioning along specific frontal-subcortical brain circuits.Method A literature search was carried out for all brain imaging studies of patients with OCD. We also reviewed the basic science literature on the functional neuroanatomy of cortico-basal ganglia circuits, and integrated this information with neuroimaging data in OCD to formulate a theoretical model of brain mediation of OCD symptoms and response to treatment.Results At least a subgroup of patients with OCD may have abnormal basal ganglia development. Functional neuroimaging studies indicate that OCD symptoms are associated with increased activity in orbitofrontal cortex, caudate nucleus, thalamus and anterior cingulate gyrus.Conclusions OCD symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits, perhaps due to an imbalance of tone between direct and indirect striatopallidal pathways. We present a model which describes how frontal-subcortical brain circuitry may mediate OCD symptomatology, and suggest a hypothesis for how successful treatments may ameliorate symptoms, via their effects on circuit activity.
Pharmacotherapy for obessive-compulsive disorder
Authors: Greist John H. , Jefferson James W. 
Published: August 2018

Background Pharmacotherapy for obsessive-compulsive disorder (OCD) was seldom beneficial before clomipramine, a potent selective serotonin reuptake inhibitor (SSRI), became available. Subsequent progress in pharmacotherapy for OCD has increased the possibility of effective treatment for most sufferers.Method Randomised controlled trials of pharmacotherapy for OCD were reviewed, as well as reports of beneficial pharmacotherapy found in open trials and case reports.Results SSRIs are well-tolerated by patients with OCD, even in large doses. Prose roto n erg i c augmentation is seldom helpful but antipsychotic augmentations seem beneficial for many OCD patients with comorbid tics.Conclusions Potent SSRIs are the pharmacotherapy of choice for OCD, with a more limited role reserved for monoamine oxidase inhibitors. If one SSRI is ineffective, others may be beneficial. Non-drug therapies are also important in OCD: behaviour therapy is frequently helpful but infrequently available and neurosurgery is sometimes helpful when all other treatments have failed.
Genome-Wide Association Study Reveals Distinct Genetic Susceptibility of Thyroid Nodules From Thyroid Cancer
Authors: Hwangbo Yul , Lee Eun Kyung , Son Ho-Young , Im Sun-Wha , Kwak Soo-Jung , Yoon Ji Won , Kim Min Joo , Kim Jeongseon , Choi Hoon Sung , Ryu Chang Hwan , Lee You Jin , Kim Jong-Il , Cho Nam H , Park Young Joo 
Published: August 2018

Abstract

Context
Thyroid nodules are very common, and 7% to 15% of them are diagnosed as thyroid cancer. However, the inherited genetic risk factors for thyroid nodules and their associations with thyroid cancer remain unknown.

Objective
To identify the genetic variants associated with susceptibility to thyroid nodules in comparison with thyroid cancer.

Design and Setting
We performed a three-stage genome-wide association study for thyroid nodules. The discovery stage involved a genome-wide scan of 811 subjects with thyroid nodules and 691 subjects with a normal thyroid from a population-based cohort. Replication studies were conducted in an additional 1981 cases and 3100 controls from the participants of a health checkup. We also performed expression quantitative trait loci analysis of public data.

Results
The most robust association was observed in TRPM3 (rs4745021) in the joint analysis (OR, 1.26; P = 6.12 × 10−8) and meta-analysis (OR, 1.28; P = 2.11 × 10−8). Signals at MBIP/NKX2-1 were replicated but did not reach genome-wide significance in the joint analysis (rs2415317, P = 4.62 × 10−5; rs944289, P = 8.68 × 10−5). The expression quantitative trait loci analysis showed that TRPM3 expression was associated with the rs4745021 genotype in thyroid tissues.

Conclusions
To the best of our knowledge, we have performed the first genome-wide association study of thyroid nodules and identified a susceptibility locus associated with thyroid nodules, suggesting that thyroid nodules have a genetic predisposition distinct from that of thyroid cancer.
BMP- and neuropilin 1-mediated motor axon navigation relies on spastin alternative translation
Authors: Jardin Nicolas , Giudicelli François , Ten Martín Daniel , Vitrac Anaïs , De Gois Stéphanie , Allison Rachel , Houart Corinne , Reid Evan , Hazan Jamilé , Fassier Coralie 
Published: August 2018

ABSTRACT
Functional analyses of genes responsible for neurodegenerative disorders have unveiled crucial links between neurodegenerative processes and key developmental signalling pathways. Mutations in SPG4-encoding spastin cause hereditary spastic paraplegia (HSP). Spastin is involved in diverse cellular processes that couple microtubule severing to membrane remodelling. Two main spastin isoforms are synthesised from alternative translational start sites (M1 and M87). However, their specific roles in neuronal development and homeostasis remain largely unknown. To selectively unravel their neuronal function, we blocked spastin synthesis from each initiation codon during zebrafish development and performed rescue analyses. The knockdown of each isoform led to different motor neuron and locomotion defects, which were not rescued by the selective expression of the other isoform. Notably, both morphant neuronal phenotypes were observed in a CRISPR/Cas9 spastin mutant. We next showed that M1 spastin, together with HSP proteins atlastin 1 and NIPA1, drives motor axon targeting by repressing BMP signalling, whereas M87 spastin acts downstream of neuropilin 1 to control motor neuron migration. Our data therefore suggest that defective BMP and neuropilin 1 signalling may contribute to the motor phenotype in a vertebrate model of spastin depletion.
É bom fazer negócios no Brasil?
Authors: Oliveira Júnior Moacir de Miranda , Borini Felipe Mendes 
Published: August 2018

O Brasil tornou-se, a partir da década de 1990, um importante pólo de atração de investimento externo direto. Porém, para a maioria das grandes multinacionais aqui estabelecidas, o contexto de negócios é muito distante do ideal. As condições apresentadas pelo país limitam o desenvolvimento de inovações e restringem a geração de vantagens competitivas. Ambos, empresas e governo, devem estar preparados para enfrentar os desafios apresentados.
Labirinto high-tech
Authors: Petrini Maira 
Published: August 2018

Nos últimos anos, o crescimento dos negócios de informática foi acompanhado – e impulsionado – pela criação de dezenas de conceitos e centenas de aplicações. O resultado é que executivos e outros profissionais vêem-se às voltas com um verdadeiro labirinto de referências, alternativas e opções. Com isso, a dificuldade de fazer escolhas e realizar investimentosem TI é cada vez maior. Este artigo apresenta um “guia de sobrevivência” para o labirinto high-tech.
Afeto sob controle
Authors: Bendassolli Pedro Fernando 
Published: August 2018

O termo “inteligência emocional” ganhou espaço na mídia de negócios. Hoje ele é visto como uma melhor explicação para o desempenho do que o conceito tradicional de inteligência. Porém, ele não é um conceito neutro. Neste texto, o leitor verá que tal conceito não reflete apenas uma entrada do afeto no mundo dos negócios, mas uma nova maneira de controlar o desempenho humano que traz uma série de riscos que precisam ser identificados para um uso consciente do conceito.
Emoções perigosas
Authors: Campos Humberto Marcelo de 
Published: August 2018

A influência das empresas e seus líderes sobre o comportamento emocional de seus membros pode ser nociva e gerar sofrimento psíquico. O livro de Peter Frost mostra como identificar fatores que geram desgaste emocional e propõe medidas para combatê-lo.
PPP: unindo o público e o privado
Authors: Bonomi Cláudio Augusto , Malvessi Oscar 
Published: August 2018

Países como o Brasil precisam realizar grande esforço para fazer frente às lacunas de infra-estrutura que impedem o crescimento e a melhoria da qualidade de vida de seus habitantes. Por outro lado, sabe-se que, por pressões fiscais e orçamentárias, o governo não dispõe de recursos para investir. É preciso, portanto, captar recursos da iniciativa privada. A Parceria Público-Privada (PPP) apresenta-se como uma nova solução para a busca de alianças e para fazer frente a importantes desafios.
Resistir é preciso
Authors: Chu Rebeca Alves 
Published: August 2018

A resistência a mudanças é comumente considerada a grande vilã dos processos de transformação organizacional. Muitas organizações chegam a promover verdadeira caça às bruxas, procurando eliminar os focos de resistências. Porém, segundo revelou uma pesquisa com executivos, a resistência também apresenta aspectos positivos, aspectos que, convenientemente tratados, podem ajudar a aperfeiçoar o processo de transformação.
Produtividade virtual? [entrevistados por Pedro Fernando Bendassolli]
Authors: Albertin Alberto Luiz , Barth Nelson Lerner 
Published: August 2018

A tecnologia de informação (TI) foi eleita como o grande impulsionador da produtividade de empresas, de setores industriais e até mesmo de países. Com ou sem evidências mais concretas, os tomadores de decisão investiram maciçamente em projetos de TI. Os resultados, como se sabe, são heterogêneos, variando de “revoluções” em termos de competitividade até fracassos absolutos. Em entrevista à RAE-executivo, Alberto Luiz Albertin e Nelson Lerner Barth, professores da FGV-EAESP, comentam verdades e lendas que cercam os investimentos em TI.
Miragem?
Authors: Guimarães Bruno Profeta 
Published: August 2018

Livro narra a história ímpar da recuperação de uma divisão de uma grande multinacional. No centro da virada, o uso maciço de rituais e de técnicas de liderança simbólica. Porém, transformar business em show business pode trazer riscos e conseqüências negativas para empresa e funcionários.
Roberto Giannetti da Fonseca [entrevistado por Françoise Terzian]
Authors: Fonseca Roberto Giannetti da 
Published: August 2018

Embora as exportações do Brasil estejam em alta, alguns fatores críticos presentes no ambiente econômico e institucional do país podem ser obstáculos sérios à nossa competitividade. Nesta entrevista, o diretor do Departamento de Relações Internacionais e Comércio Exterior da Fiesp, Roberto Giannetti da Fonseca, faz um balanço da situação atual do país no mercado internacional e identifica os dilemas que o governo e empresas devem enfrentar em defesa do crescimento.
A liderança aprendida
Authors: Vergara Sylvia Constant 
Published: August 2018

Os estudos sobre liderança não são convergentes sobre o que é liderança e como exercê-la. Ora a ênfase desses estudos é sobre a personalidade do líder, ora sobre o que ele faz, ora sobre as distintas combinações entre líder, liderados e situação. Este texto propõe uma compreensão sobre a liderança segundo a qual o líder deve responder a um ambiente de dilemas e contradições mediante a aquisição de competências sobre si mesmo, sobre seus liderados e sobre o contexto em que atua.
Trajetórias de vida e liderança
Authors: Tanure Betania , Duarte Roberto Gonzalez 
Published: August 2018

A influência que as experiências de vida exerce sobre líderes é uma questão intrigante. Na verdade, os líderes de hoje são pessoas cujas vivências passadas foram fundamentais para que se tornassem empreendedores ou executivos. Este artigo é resultado de uma pesquisa com presidentes executivos e presidentes empreendedores que buscou entender as origens da liderança e as formas de transmiti-la.
Indústria de empreendimentos
Authors: Rochman Ricardo Ratner 
Published: August 2018

A indústria de private equity e venture capital desempenha um papel de grande importância no financiamento de empreendedores e inovações no Brasil, podendo ser considerada responsável pelo rápido desenvolvimento de setores como Internet, tecnologia de informação e biotecnologia. O artigo descreve as características e história dessa indústria no país, as etapas envolvidas no processo de investimento e as dificuldades e tendências dessa indústria nos próximos anos.
Distribuindo os lucros
Authors: Eid Junior William , Motta Daniel Camarotto 
Published: August 2018

A distribuição das riquezas geradas por uma empresa aos seus acionistas é uma forma de geração de valor, pois diminui os riscos de os acionistas majoritários ou administradores utilizarem o caixa da empresa em benefício próprio. Existem hoje, na legislação, alguns mecanismos que podem ser utilizados pelas empresas para definir sua política de distribuição. O artigo apresenta esses mecanismos e as principais vantagens e desvantagens de cada um deles.