8,046 results on '"Arthur, J. A."'
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2. Bringing Manufacturing Back to the US Requires Political Will, But Success Hinges on Training American Workers
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Batabyal, Amitrajeet A. and Gosnell, Arthur J.
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Taiwan Semiconductor Manufacturing Company Ltd. -- Training ,National security ,Semiconductor industry -- Training ,Integrated circuit fabrication ,Semiconductor industry ,Integrated circuit fabrication ,Business ,Military and naval science ,Transportation industry - Abstract
Supply chain disruptions during COVID-19 brought to light how interdependent nations are when it comes to manufacturing. The inability of the US to produce such needed goods as test kits [...]
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- 2023
3. Are Long-Term Changes in Mixed Layer Depth Influencing North Pacific Marine Heatwaves?
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Amaya, Dillon J., Alexander, Michael A., Capotondi, Antonietta, Deser, Clara, Karnauskas, Kristopher B., Miller, Arthur J., and Mantua, Nathan J.
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Hot weather -- Forecasts and trends ,Human beings -- Influence on nature ,Oceanic mixing -- Environmental aspects ,Market trend/market analysis ,Business ,Earth sciences - Abstract
The 2019 Northwest Pacific marine heatwave was amplified by natural, multidecadal shoaling of the ocean mixed layer; anthropogenic mixed layer shoaling will amplify marine heatwaves in the future. In boreal [...]
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- 2021
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4. Aerosol and Cloud Experiments in the Eastern North Atlantic (ACE-ENA)
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Eduardo Brito de Azevedo, Beat Schmid, Katia Lamer, Mark A. Miller, Yann Blanchard, Yang Wang, Ryan C. Moffet, Jian Wang, Joseph Hardin, Matt Wyant, Pavlos Kollias, Susanne Glienke, Yangang Liu, Virendra P. Ghate, Jason Tomlinson, Fan Mei, Alexander Laskin, Michael Jensen, Jae Min Yeom, Maria A. Zawadowicz, Chongai Kuang, J. Christine Chiu, Kaitlyn J. Suski, Daniel Veghte, Edward P. Luke, John E. Shilling, Arthur J. Sedlacek, David B. Mechem, Lexie Goldberger, Rodney J. Weber, Allison C. Aiken, Francesca Gallo, Xiquan Dong, Chunsong Lu, Neel Desai, Seong Soo Yum, Sinan Gao, Mikhail Pekour, Robert Wood, Xiaohong Liu, Scott E. Giangrande, Guangjie Zheng, Swarup China, Mariusz Starzec, Amy P. Sullivan, Alyssa Matthews, Raymond A. Shaw, Zhibo Zhang, and Daniel A. Knopf
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Atmospheric Science ,business.industry ,Environmental science ,Cloud computing ,Atmospheric sciences ,business ,Aerosol - Abstract
With their extensive coverage, marine low clouds greatly impact global climate. Presently, marine low clouds are poorly represented in global climate models, and the response of marine low clouds to changes in atmospheric greenhouse gases and aerosols remains the major source of uncertainty in climate simulations. The eastern North Atlantic (ENA) is a region of persistent but diverse subtropical marine boundary layer clouds, whose albedo and precipitation are highly susceptible to perturbations in aerosol properties. In addition, the ENA is periodically impacted by continental aerosols, making it an excellent location to study the cloud condensation nuclei (CCN) budget in a remote marine region periodically perturbed by anthropogenic emissions, and to investigate the impacts of long-range transport of aerosols on remote marine clouds. The Aerosol and Cloud Experiments in Eastern North Atlantic (ACE-ENA) campaign was motivated by the need of comprehensive in situ measurements for improving the understanding of marine boundary layer CCN budget, cloud and drizzle microphysics, and the impact of aerosol on marine low cloud and precipitation. The airborne deployments took place from 21 June to 20 July 2017 and from 15 January to 18 February 2018 in the Azores. The flights were designed to maximize the synergy between in situ airborne measurements and ongoing long-term observations at a ground site. Here we present measurements, observation strategy, meteorological conditions during the campaign, and preliminary findings. Finally, we discuss future analyses and modeling studies that improve the understanding and representation of marine boundary layer aerosols, clouds, precipitation, and the interactions among them.
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- 2022
5. Measurement of value in rotator cuff repair: patient-level value analysis for the 1-year episode of care
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Edward V. Craig, Alicia K. Harrison, Brian P. Cunningham, Arthur J. Only, Bandele Okelana, Kelsey L. Wise, Megan Reams, Jonathan P. Braman, and Harsh R. Parikh
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medicine.medical_specialty ,Episode of care ,business.industry ,Episode of Care ,General Medicine ,Rotator Cuff Injuries ,Arthroscopy ,Rotator Cuff ,Treatment Outcome ,medicine.anatomical_structure ,Orthopedic surgery ,Physical therapy ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,Rotator cuff ,Poor correlation ,Patient Care Delivery ,Supraspinatus tears ,business ,Orthopedic Procedures ,Value (mathematics) - Abstract
Background Rotator cuff repair (RCR) is one of the most common elective orthopedic procedures with predictable indications, technique, and outcomes. As a result, this surgery is an ideal choice for studying value. The purpose of this study was to utilize Patient-level value-analysis (PLVA) within the setting of RCR over the one-year episode-of-care. Methods Included patients (n=396) underwent RCR between 2009 and 2016 at a single outpatient orthopedic surgery center. The episode-of-care was defined as one-year following surgery. The Western Ontario Rotator Cuff (WORC) index was collected at both the initial preoperative baseline and the one-year postoperative mark. The total cost-of-care was determined using time-driven activity-based costing (TDABC). Both patient (PLVA) and provider-level value-analysis (pLVA) were performed. Results The average TDABC cost-of-care was derived at $5413.78 ± $727.41 [$5341.92, $5485.64]. At the patient-level, arthroscopic isolated supraspinatus tears yielded the highest value coefficient, 0.82 (ANOVA F-Test, p=0.01). There was a poor correlation between the change in one-year WORC score and the TDABC cost-of-care (r2=0.03). Provider-level value demonstrated significant variation between the 8 evaluated providers (p Conclusion RCR is one of the most common orthopedic procedures, yet the correlations between cost-of-care and patient outcomes is unknown. PLVA quantifies the ratio of functional improvement to the TDABC estimated cost-of-care at the patient-level. This is the first study to apply patient-level value analysis over the first-year episode-of-care. With healthcare transitioning towards value-based delivery, PLVA offers a quantitative tool to measure the value of individual patient care delivery over the entire episode-of-care.
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- 2022
6. Highly Versatile Broadband RF Photonic Fractional Hilbert Transformer Based on a Kerr Soliton Crystal Microcomb
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Mengxi Tan, Xingyuan Xu, Andreas Boes, Bill Corcoran, Jiayang Wu, Thach G. Nguyen, Sai T. Chu, Brent E. Little, Arthur J. Lowery, Roberto Morandotti, Arnan Mitchell, and David J. Moss
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Physics ,business.industry ,Physics::Optics ,Soliton (optics) ,Atomic and Molecular Physics, and Optics ,law.invention ,Band-pass filter ,law ,Broadband ,Phase response ,Baseband ,Optoelectronics ,Photonics ,business ,Transformer ,Free spectral range - Abstract
We demonstrate an RF photonic fractional Hilbert transformer based on an integrated Kerr micro-comb source featuring a record low free spectral range of 48.9 GHz, yielding 75 microcomb lines across the C-band. By programming and shaping the comb lines according to calculated tap weights, we demonstrate that the Hilbert transformer can achieve tunable bandwidths ranging from 1.2 to 15.3 GHz, switchable centre frequencies from baseband to 9.5 GHz, and arbitrary fractional orders. We experimentally characterize the RF amplitude and phase response of the tunable bandpass and lowpass Hilbert transformers with 90 and 45-degree phase shift. The experimental results show good agreement with theory, confirming the effectiveness of our approach as a powerful way to implement the standard as well as fractional Hilbert transformers with broad and switchable processing bandwidths and centre frequencies, together with high reconfigurability and greatly reduced size and complexity.
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- 2021
7. Outcomes of Kidney Donors With Impaired Fasting Glucose
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Arthur J. Matas, Sean A Hebert, Horacio E. Adrogue, Dina N. Murad, Hassan N. Ibrahim, Duc T. Nguyen, and Edward A. Graviss
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Blood Glucose ,medicine.medical_specialty ,Diabetes risk ,Gastroenterology ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Living Donors ,Risk of mortality ,medicine ,Humans ,Transplantation ,Kidney ,Proteinuria ,Proportional hazards model ,business.industry ,Fasting ,medicine.disease ,Impaired fasting glucose ,Kidney Transplantation ,Glucose ,medicine.anatomical_structure ,medicine.symptom ,business ,Glomerular Filtration Rate ,Kidney disease - Abstract
Many kidney donor candidates with impaired fasting glucose (IFG) and all candidates with diabetes are currently excluded from kidney donation, fearing the development of an accelerated course of diabetic kidney disease in the remaining kidney.We studied mortality, proteinuria, and end-stage kidney disease (ESKD) in 8280 donors who donated between 1963 and 2007 according to donation fasting plasma glucose (FPG):100 mg/dL (n = 6204), 100-125 mg/dL (n = 1826), and ≥126 mg/dL (n = 250).Donors with IFG and those with FPG ≥126 mg/dL were older, less likely to be non-Hispanic White, had a higher body mass index, and were more likely to be related to their recipient. After 15.7 ± 10.5 y from donation to study close, 4.4% died, 29.4% developed hypertension, 13.8% developed proteinuria, and 41 (0.5%) developed ESKD. In both the logistic and Cox models, IFG was associated with a higher diabetes risk (adjusted hazard ratio [aHR], 1.65; 95% confidence interval [CI], 1.18-2.30) and hypertension (aHR, 1.35; 95% CI, 1.10-1.65; P = 0.003 for both), but not higher risk of proteinuria or ESKD. The multivariable risk of mortality in donors with ≥126 mg/dL was higher than the 2 other groups, but risks of proteinuria, cardiovascular disease, and reduced estimated glomerular filtration rate were similar to those with FPG126 mg/dL. Three cases of ESKD developed in the 250 donors with FPG ≥126 mg/dL at 18.6 ± 10.3 y after donation (aHR, 5.36; 95% CI, 1.0-27.01; P = 0.04).Donors with IFG and the majority of donors with ≥126 mg/dL do well and perhaps should not be routinely excluded from donation.
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- 2021
8. Practice Patterns of Pediatric Total Body Irradiation Techniques: A Children's Oncology Group Survey
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Harish K. Malhotra, David S Followill, Iain MacEwan, John C. Breneman, Adam C. Olson, Thomas J. Fitzgerald, Fred K. Cheung, Mahesh Gopalakrishnan, Prema Rassiah, S Pillai, Karen J. Marcus, Greg Niyazov, Natia Esiashvili, Andrea Molineu, Arthur J. Olch, John A. Kalapurakal, Cheng-Chia Wu, Kenneth Ulin, Jacqueline Faught, Chia Ho Hua, Nataliya Kovalchuk, An Liu, and Jose Penagaricano
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Response rate (survey) ,Cancer Research ,medicine.medical_specialty ,Radiation ,Practice patterns ,business.industry ,medicine.medical_treatment ,Total body irradiation ,Credentialing ,Volumetric modulated arc therapy ,Tomotherapy ,Cog ,Oncology ,Surveys and Questionnaires ,Radiation Oncology ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radiotherapy, Intensity-Modulated ,Child ,Dose rate ,business ,Lung ,Whole-Body Irradiation - Abstract
Purpose The aim of this study was to examine current practice patterns in pediatric total body irradiation (TBI) techniques among COG member institutions. Methods and Materials Between November 2019 and February 2020, a questionnaire containing 52 questions related to the technical aspects of TBI was sent to medical physicists at 152 COG institutions. The questions were designed to obtain technical information on commonly used TBI treatment techniques. Another set of 9 questions related to the clinical management of patients undergoing TBI was sent to 152 COG member radiation oncologists at the same institutions. Results Twelve institutions were excluded because TBI was not performed in their institutions. A total of 88 physicists from 88 institutions (63% response rate) and 96 radiation oncologists from 96 institutions (69% response rate) responded. The anterior-posterior/posterior-anterior (AP/PA) technique was the most common technique reported (49 institutions [56%]); 44 institutions (50%) used the lateral technique, and 14 (16%) used volumetric modulated arc therapy or tomotherapy. Midplane dose rates of 6 to 15 cGy/min were most commonly used. The most common specification for lung dose was the midlung dose for both AP/PA techniques (71%) and lateral techniques (63%). Almost all physician responders agreed with the need to refine current TBI techniques, and 79% supported the investigation of new TBI techniques to further lower the lung dose. Conclusions There was no consistency in the practice patterns, methods for dose measurement, and reporting of TBI doses among COG institutions. The lack of standardization precludes meaningful correlation between TBI doses and clinical outcomes including disease control and normal tissue toxicity. The COG radiation oncology discipline is currently undertaking several steps to standardize the practice and dose reporting of pediatric TBI using detailed questionnaires and phantom-based credentialing for all COG centers.
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- 2021
9. Development of machine learning model to detect fibrotic non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease
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Parikshit Bansal, Daniel Rozenbaum, Manik Aggarwal, Arthur J. McCullough, Agam Bansal, and Rajat Garg
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Adult ,Male ,medicine.medical_specialty ,Hepatology ,business.industry ,Fatty liver ,Gastroenterology ,Non alcoholic ,Disease ,Middle Aged ,medicine.disease ,Fibrosis ,Machine Learning ,Cross-Sectional Studies ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,medicine ,Humans ,Female ,In patient ,Steatohepatitis ,business - Published
- 2021
10. Lung Dose Measured on Postradioembolization 90Y PET/CT and Incidence of Radiation Pneumonitis
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Arthur J. A. T. Braat, Hugo W. A. M. de Jong, Rob van Rooij, Martina Stella, and Marnix G.E.H. Lam
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PET-CT ,Lung ,Side effect ,business.industry ,Incidence (epidemiology) ,medicine.disease ,medicine.anatomical_structure ,Radionuclide therapy ,Breathing ,Medicine ,Radiology, Nuclear Medicine and imaging ,Lung volumes ,business ,Nuclear medicine ,Progressive disease - Abstract
Radiation pneumonitis is a rare but possibly fatal side effect of Yttrium-90 (90Y) radioembolization. It may occur 1 to 6 months after therapy, in case a significant part of the 90Y microspheres shunt to the lungs. In current clinical practice, a predicted value of lung dose greater than 30Gy is considered a criterion to exclude patients from treatment. However, contrasting findings regarding the occurrence of radiation pneumonitis and lung dose were previously reported in literature. In this study, the relationship between the lung dose value and the eventual occurrence of radiation pneumonitis after 90Y radioembolization was investigated. Methods: A total of 317 90Y liver radioembolization procedures performed during an 8-years period (Feb.2012-Sep.2020) were retrospectively analyzed. Predicted lung mean dose using 99mTc-MAA planar scintigraphy (LMDMAA) acquired during the planning phase and left lung mean dose (LMDY-90) using the 90Y PET/CT acquired after the treatment were calculated. For the lung dose computation, it was chosen to use the left lung as representative lung volume, to compensate for the scatter from the liver moving in the cranial-caudal direction due to breathing and mainly affecting the right lung. Results: Two hundred and seventy-two patients underwent 90Y procedures, of which 63% performed with glass microspheres and 37% with resin microspheres. Median injected activity was 1974MBq (range: 242-9538MBq). Median LMDMAA was 3.5Gy (range: 0.2-89.0Gy). For 14 procedures LMDMAA was >30Gy. Median LMDY-90 was 1Gy (range: 0.0-22.1Gy). No patients had a LMDY-90 >30Gy. Of the three patients with a LMDY-90 >12Gy, two patients (LMDY-90 = 22.1Gy, LMDMAA = 89Gy and LMDY-90 = 17.7Gy, LMDMAA = 34.1Gy, respectively) developed radiation pneumonitis and consequently died. A third patient with a LMDY-90 equal to 18.4Gy (LMDMAA = 29.1Gy) died 2 months after treatment, before imaging evaluation, due to progressive disease. Conclusion: The occurrence of radiation pneumonitis as a consequence of lung shunt following 90Y radioembolization is rare (
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- 2021
11. Cardiovascular and Obstetric Delivery Complications in Pregnant Women With Valvular Heart Disease
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Erin D. Michos, Ari M. Cedars, Stefano Schena, Faisal Rahman, Arthur J. Vaught, Sammy Zakaria, Di Zhao, Jon R. Resar, Nicole R. Gavin, Allison G. Hays, Steven P. Schulman, and Anum S. Minhas
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Adult ,medicine.medical_specialty ,Peripartum cardiomyopathy ,Pregnancy Complications, Cardiovascular ,Heart Valve Diseases ,Article ,Preeclampsia ,Cohort Studies ,Young Adult ,Pregnancy ,Risk Factors ,Internal medicine ,Odds Ratio ,medicine ,Humans ,Adverse effect ,Eclampsia ,Obstetrics ,business.industry ,valvular heart disease ,medicine.disease ,Pulmonary edema ,Pulmonary hypertension ,Obstetric Labor Complications ,Hospitalization ,Logistic Models ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Women with valvular heart disease may be more likely to have adverse obstetric and cardiovascular complications during pregnancy. Most current recommendations focus on stenotic lesions with less guidance regarding regurgitant lesions. We aimed to compare adverse events at delivery for women with various stenotic and regurgitant valvular diseases. We used the 2016 to 2018 National Inpatient Sample data to compare demographics, comorbidities, and obstetric and cardiovascular complications during delivery hospitalizations. After adjusting for clinical and socioeconomic factors, logistic regression was performed to investigate associations between valvular disease and outcomes. Among >11.2 million deliveries, 20,349 were in women with valvular disease. Women with valvular disease were older, had longer length of stays, and higher costs associated with delivery. They had higher prevalence of underlying cardiovascular comorbidities compared with women without valvular disease (hypertension: 5.1 vs 0.25%; pulmonary hypertension: 7.0 vs
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- 2021
12. Promoting a pro-oxidant state in skeletal muscle: Potential dietary, environmental, and exercise interventions for enhancing endurance-training adaptations
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Arthur J. Cheng, Adam C. Jordan, and Christopher G.R. Perry
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medicine.medical_specialty ,Antioxidant ,medicine.medical_treatment ,medicine.disease_cause ,Biochemistry ,Antioxidants ,Interval training ,03 medical and health sciences ,0302 clinical medicine ,Endurance training ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Muscle, Skeletal ,030304 developmental biology ,0303 health sciences ,business.industry ,Vitamin E ,Pro-oxidant ,Adaptation, Physiological ,Endurance Training ,Endocrinology ,Mitochondrial biogenesis ,Reactive Oxygen Species ,business ,High-intensity interval training ,030217 neurology & neurosurgery ,Oxidative stress - Abstract
Accumulating evidence now shows that supplemental antioxidants including vitamin C, vitamin E and N-Acetylcysteine consumption can suppress adaptations to endurance-type exercise by attenuating reactive oxygen and nitrogen species (RONS) formation within skeletal muscle. This emerging evidence points to the importance of pro-oxidation as an important stimulus for endurance-training adaptations, including mitochondrial biogenesis, endogenous antioxidant production, insulin signalling, angiogenesis and growth factor signaling. Although sustained oxidative distress is associated with many chronic diseases, athletes have, on average, elevated levels of certain endogenous antioxidants to maintain redox homeostasis. As a result, trained athletes may have a better capacity to buffer oxidants during and after exercise, resulting in a reduced oxidative eustress stimulus for adaptations. Thus, higher levels of RONS input and exercise-induced oxidative stress may benefit athletes in the pursuit of continuous endurance training redox adaptations. This review addresses why athletes should be looking to enhance exercise-induced oxidative stress and how it can be accomplished. Methods covered include high-intensity interval training, hyperthermia and heat stress, dietary antioxidant restriction and modified antioxidant timing, dietary antioxidants and polyphenols as adjuncts to exercise, and vitamin C as a pro-oxidant.
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- 2021
13. Intermediate Renal Outcomes, Kidney Failure, and Mortality in Obese Kidney Donors
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Duc T. Nguyen, Arthur J. Matas, Horacio E. Adrogue, Hana Nguyen, Hassan N. Ibrahim, Sean A. Hebert, Dina N. Murad, and Edward A. Graviss
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medicine.medical_specialty ,Proteinuria ,business.industry ,Proportional hazards model ,Absolute risk reduction ,Renal function ,General Medicine ,medicine.disease ,Kidney Transplantation ,Obesity ,Clinical Research ,Nephrology ,Internal medicine ,Diabetes mellitus ,Living Donors ,medicine ,Humans ,Kidney Failure, Chronic ,medicine.symptom ,business ,Body mass index ,Kidney disease - Abstract
BACKGROUND: Obesity is associated with the two archetypal kidney disease risk factors: hypertension and diabetes. Concerns that the effects of diabetes and hypertension in obese kidney donors might be magnified in their remaining kidney have led to the exclusion of many obese candidates from kidney donation. METHODS: We compared mortality, diabetes, hypertension, proteinuria, reduced eGFR and its trajectory, and the development of kidney failure in 8583 kidney donors, according to body mass index (BMI). The study included 6822 individuals with a BMI of
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- 2021
14. Aqueous angiography in pre‐glaucomatous and glaucomatous ADAMTS10 ‐mutant canine eyes: A pilot study
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Jessica B Burn, Chris G Pirie, András M. Komáromy, Alex S. Huang, and Arthur J. Weber
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Indocyanine Green ,medicine.medical_specialty ,genetic structures ,Pulsatile flow ,Lumen (anatomy) ,Pilot Projects ,Article ,Aqueous Humor ,Recovery period ,chemistry.chemical_compound ,Dogs ,Optical coherence tomography ,Ophthalmology ,Computer software ,medicine ,Animals ,Dog Diseases ,Fluorescein Angiography ,Intraocular Pressure ,General Veterinary ,medicine.diagnostic_test ,business.industry ,Glaucoma ,eye diseases ,Sclera ,medicine.anatomical_structure ,chemistry ,Angiography ,sense organs ,business ,Indocyanine green ,Tomography, Optical Coherence - Abstract
Objective To evaluate intravenous scleral and intracameral aqueous angiography in normotensive (n = 4) and hypertensive glaucomatous (n = 6) ADAMTS10-mutant canine eyes. Animals studied Ten ADAMTS10-mutant dogs were used in this study. Procedures Dogs were sedated and one eye from each dog underwent scleral angiography following intravenous injection of 0.25% indocyanine green (ICG). After a 24-h recovery period, the same eye underwent aqueous angiography via intracameral administration of ICG. Imaging of identical scleral sectors from the same eye was performed using a Heidelberg Spectralis® Confocal Scanning Laser Ophthalmoscope. Intrascleral vessel depth and lumen diameters were measured using Heidelberg Spectralis® optical coherence tomography and computer software. Results Scleral angiography permitted visualization of vascular components associated with conventional aqueous humor outflow pathways with an average time from injection to fluorescence of 35.8 ± 10.6 s (mean ± SD). Two normotensive eyes (2/10;20%) demonstrated turbulent dye movement, while 4 hypertensive eyes (4/10;40%) exhibited laminar flow. Aqueous angiography demonstrated dye fluorescence within the post-trabecular conventional aqueous humor outflow pathways in all 10 eyes at 34.3 ± 11.0 s post-injection. Sectoral and dynamic outflow patterns were observed primarily within the superotemporal sector in nine eyes (9/10; 90%). Seven eyes (7/10; 70%) demonstrated pulsatile dye movement and five eyes (5/10; 50%) exhibited laminar flow. The degree of laminar movement of dye was greatest in hypertensive eyes. Vessel lumen diameters measured 133.85 ± 28.36 µm and 161.18 ± 6.02 µm in hypertensive and normotensive eyes, respectively. Conclusions Aqueous angiography allowed for visualization of fluorescent dye in the superotemporal sclera. Laminar flow and smaller lumen vessels were observed mainly in hypertensive eyes.
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- 2021
15. Integrated pest management of Tuta absoluta: practical implementations across different world regions
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Thierry Brévault, Ramzi Mansour, Fernando Cantor, Mateus R. Campos, Marc Kenis, Abid Ali, Lucia Zappalà, Hossein Madadi, Michele Ricupero, Yunus Bayram, Nicolas Desneux, Gerben J. Messelink, César Ramos, Fedai Erler, Samira A. Mohamed, Peng Han, Thibaud Martin, Raul Narciso C. Guedes, Antonio Biondi, Meritxell Pérez-Hedo, Khasan Ismoilov, Alberto Urbaneja, Khaled Abbes, Judit Arnó, Hao-tian Liu, Raf De Vis, M. Jamal Hajjar, María Gabriela Luna, Emmanouil Roditakis, Khalid Haddi, Robert S. Nofemela, Yi-Bo Zhang, François Verheggen, Fang-Hao Wan, Kouassi Arthur J. Konan, Coline C. Jaworski, Anne-Violette Lavoir, Anaïs Chailleux, P. R. Shashank, Abiola Oke, Andrew G. S. Cuthbertson, D. M. Firake, Ahmed Mazih, Su Wang, Ming-hui Wang, Javad Karimi, Producció Vegetal, and Protecció Vegetal Sostenible
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H01 - Protection des végétaux - Considérations générales ,Integrated pest management ,GTB Gewasgez. Bodem en Water ,Pheromone ,Biological pest control ,Gestion intégrée des ravageurs ,F06 Irrigation ,Botanical insecticides ,Pheromones ,Méthode de lutte ,U40 Surveying methods ,H20 Plant diseases ,F04 Fertilizing ,Resistant cultivars ,Lutte antiravageur ,Parasitoids ,biology ,Agroforestry ,Entomopathogenic nematodes ,food and beverages ,PE&RC ,Tuta absoluta ,Mass trapping ,Essential oils ,Biological control ,Soil fertilization ,Lutte biologique contre les ravageurs ,Irrigation ,Microbial pesticides ,Invasive alien species ,Plant resistance ,Crop health ,Traps ,business.industry ,Pest control ,P01 Nature conservation and land resources ,F07 Soil cultivation ,biology.organism_classification ,Gelechiidae ,H10 - Ravageurs des plantes ,Agronomic control-related research ,Predatory mirid bugs ,Entomopathogenic fungi ,Agriculture ,Gewasgezondheid ,Chemical control ,IPM ,PEST analysis ,business ,Agronomy and Crop Science - Abstract
The South American tomato pinworm, Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae), has invaded most Afro-Eurasian countries and is threatening worldwide tomato production. Various strategies have been developed and implemented to manage this pest. Here, we present a timely review on the up-to-date development and practical implementation of integrated pest management (IPM) programs for tomato crops across different world regions infested by T. absoluta. While insecticide resistance is a growing concern, biological control via releasing or conserving arthropod natural enemies and sex pheromone-based biotechnical control are the most successful management practices. Agronomic control-related research is an emerging area where the soil fertilization and/or irrigation, as well as breeding of resistant cultivars, has the potential to enhance IPM effectiveness. Grower survey responses in the native areas (i.e., South America), early-invaded areas (i.e., first report between 2006 and 2012) and newly invaded areas (i.e., first report after 2012) showed that the control programs evolved along with the areas and time since invasion. Growers in the early-invaded areas shifted more rapidly from chemical control to biological control compared to those from the native area. In all concerned regions, the pest control failure risk following chemical insecticide applications and the high cost associated with either biological or biotechnical control methods have been the greatest concerns for growers. The information gathered from the native and/or early-invaded areas may help achieve a more effective management in newly invaded areas. Lastly, researchers are expected to break the bottlenecks of some key issues that would enable lowering application cost of novel biorational alternative management options.
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- 2021
16. Praying by hand: meditations on reading with feeling in late medieval England
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Arthur J. Russell
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Cultural Studies ,Literature ,Philosophy ,History ,Literature and Literary Theory ,Feeling ,business.industry ,media_common.quotation_subject ,Reading (process) ,Art ,business ,media_common - Published
- 2021
17. Correlation of Glomerular Size With Donor–Recipient Factors and With Response to Injury
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Erika S. Helgeson, Joseph P. Grande, and Arthur J. Matas
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Graft Rejection ,medicine.medical_specialty ,Biopsy ,Urology ,Renal function ,Kidney ,Article ,Diabetes mellitus ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Transplantation ,medicine.diagnostic_test ,urogenital system ,business.industry ,Graft Survival ,Hazard ratio ,medicine.disease ,Kidney Transplantation ,Tissue Donors ,Confidence interval ,Cross-Sectional Studies ,medicine.anatomical_structure ,Cohort ,business ,Glomerular Filtration Rate - Abstract
BACKGROUND Glomerular size in renal allografts is impacted by donor-recipient factors and response to injury. In serial biopsies of patients with well-functioning grafts, increased glomerular size correlates with better survival. However, no previous study has addressed the association of glomerular size at the time of a for-cause biopsy and clinical/histopathologic markers of injury, or effect on long-term graft outcome. METHODS Two cohorts of kidney transplant recipients enrolled in the Deterioration of Kidney Allograft Function study were evaluated. The prospective cohort (PC, n = 581): patients undergoing first for-cause kidney biopsy 1.7 ± 1.4 (mean ± SD) y posttransplant; and the cross-sectional cohort (CSC, n = 446): patients developing new-onset renal function deterioration 7.7 ± 5.6 y posttransplant. Glomerular planar surface area and diameter were measured on all glomeruli containing a vascular pole. Kidney biopsy was read centrally in a blinded fashion according to the Banff criteria. RESULTS Glomerular area was significantly higher in the CSC than the PC; time from transplant to indication biopsy was associated with glomerular area in both cohorts (P values ≤ 0.001). Glomerular area was associated with indices of microvascular inflammation (glomerulitis, peritubular capillary infiltrates; P values ≤ 0.001) and segmental glomerulosclerosis (P value < 0.0001). In the CSC, higher glomerular area was associated with higher estimated glomerular filtration rate (P value ≤ 0.001) and increased graft survival after accounting for microvascular inflammation (adjusted hazard ratio = 0.967; 95% confidence interval: 0.948-0.986; hazard ratio in biopsies without evidence of diabetes or antibody mediated rejection = 0.919, 95% confidence interval: 0.856-0.987). CONCLUSIONS Glomerular size is associated with histopathologic features present at the time of indication biopsy and with increased graft survival in the CSC.
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- 2021
18. The Digital Footprint of Academic Plastic Surgeons
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Brooks J. Knighton, Catherine Rawes, Michael Ha, Yvonne M. Rasko, Ledibabari M. Ngaage, Mimi R. Borrelli, Wilmina N. Landford, and Arthur J. Nam
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medicine.medical_specialty ,Online presence management ,business.industry ,Family medicine ,Control (management) ,medicine ,Digital footprint ,Surgery ,Social media ,Odds ratio ,computer.software_genre ,business ,computer - Abstract
INTRODUCTION The digital age and global pandemic have transformed the way patients select their plastic surgeon. However, as more patients turn to online resources, there is little information on the digital presence of academic plastic surgeons. METHODS We identified all academic faculty from integrated and independent plastic surgery residency programs. Using a Google-based custom search, the top 10 search results for each surgeon were extracted and categorized as surgeon noncontrolled (eg, physician rating websites) or controlled (eg, social media, institutional, and research profiles). RESULTS Eight hundred four academic plastic surgeons were included. Most search results were surgeon-noncontrolled sites (57%, n = 4547). Being male (odds ratio [OR], 0.60, P = 0.0020) and holding a higher academic rank (OR = 0.61, P < 0.0001) significantly decreased the prevalence of physician rating websites, whereas career length was significantly associated with a greater number of rating websites (OR = 1.04, P < 0.0001). Surgeon-controlled websites were significantly influenced by academic rank and years in practice; higher academic rank was associated with more social media platforms (OR = 1.42, P = 0.0008), institutional webpages (OR = 1.57, P < 0.0001), and research profiles (OR = 1.62, P = 0.0008). Conversely, longer career duration was a predictor for fewer social media platforms (OR = 0.95, P < 0.0001) and institutional webpages (OR = 0.95, P < 0.0001). CONCLUSIONS Academic plastic surgeons do not hold control of the majority of their search results. However, digitally savvy plastic surgeons can focus attention by building on certain areas to optimize their digital footprint. This study can serve as a guide for academic plastic surgeons wishing to control their online presence.
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- 2021
19. Hepatocellular carcinoma in nonalcoholic fatty liver disease with or without cirrhosis: a population-based study
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Kanokporn Pinyopornpanish, Arthur J. McCullough, Mohannad Abou Saleh, Srinivasan Dasarathy, Emad Mansoor, Chaisiri Angkurawaranon, Kanokwan Pinyopornpanish, and George Khoudari
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Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,Disease ,RC799-869 ,Gastroenterology ,Non-alcoholic Fatty Liver Disease ,Liver neoplasms ,Diabetes mellitus ,Internal medicine ,Fatty liver ,Nonalcoholic fatty liver disease ,medicine ,Humans ,Aged ,business.industry ,Research ,Incidence ,General Medicine ,Hepatology ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,digestive system diseases ,Population based study ,Hepatocellular carcinoma ,Liver cirrhosis ,business - Abstract
Background There are limited data regarding the factors associated with hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) patients without cirrhosis. We sought to determine the prevalence and factors associated with HCC in NAFLD patients with or without cirrhosis. Methods Adults with NAFLD (June 2015 to May 2020) were identified using the electronic health record database (Explorys Inc, Cleveland, OH) from 26 major integrated US healthcare systems. The prevalence of HCC was calculated. Multivariable analyses adjusting for covariates were performed to evaluate the associated risk factors and the presence of HCC. Results A total of 392,800 NAFLD patients were identified. Among 1110 patients with HCC, 170 (15.3%) had no cirrhosis. The prevalence of HCC in non-cirrhotic and cirrhotic NAFLD patients was 4.6/10,000 persons (95% CI 3.9–5.3), and 374.4/10,000 persons (95% CI 350.9–398.8), respectively. Age > 65 years (adjusted OR; 3.37, 95% CI 2.47–4.59), ever had elevated alanine aminotransferase (2.69; 2.14–3.37), male gender (2.57; 1.88–3.49), smoker (1.75; 1.23–2.49), and diabetes (1.56; 1.15–2.11) were associated with HCC in non-cirrhotic NAFLD (all P 65 years, male gender, Hispanic race, elevated alanine aminotransferase, diabetes and smoker (all P Conclusions These data identified the major risk factors for the development of HCC in NAFLD patients. In the non-cirrhotics, older male patients with smoking history, diabetes and an elevated alanine aminotransferase had highest risk and may need increased judicious monitoring.
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- 2021
20. 3D Printing of Molecular Models
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Adam Gardner and Arthur J. Olson
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0301 basic medicine ,Cognitive science ,business.industry ,Computer science ,3D printing ,Context (language use) ,General Medicine ,Visualization ,Visual arts ,03 medical and health sciences ,030104 developmental biology ,Physical structure ,Orrery ,business - Abstract
Physical models have a long and important role in exploring and communicating scientific and medical concepts and structures. One of the earliest physical scientific visualizations was the orrery, a mechanical model of the solar system, which first appeared in Greece around 150 BC. Early anatomical models, such as those made from Papier-Mache were developed in the early 19th Century. The earliest molecular models were those produced in the mid 19th century by chemists (such as Hoffman and Kekule) to visualize the nature of chemical composition. These models brought abstract or unseen structures into the context of human experience.
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- 2022
21. Radial trend in murine annulus fibrosus fiber orientation is best explained by vertebral growth
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Ali Raza and Arthur J. Michalek
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business.industry ,Fiber orientation ,Annulus (oil well) ,Swelling pressure ,Intervertebral disc ,Anatomy ,Concentric ,medicine.anatomical_structure ,Inclination angle ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Fiber ,Anisotropy ,business - Abstract
The intervertebral disc (IVD) annulus fibrosus (AF) is composed of concentric lamellae with alternating right- and left-handed helically oriented collagen fiber bundles. This arrangement results in anisotropic material properties, which depend on local fiber orientations. Prior measurements of fiber inclination angles in human lumbar and bovine caudal IVDs found a significantly higher inclination angle in the inner AF than outer, though it is currently unknown if this pattern is conserved in smaller mammalian species. Additionally, the physical mechanism behind this pattern remains un-determined. In this study, AF fiber angles were measured histologically in murine caudal IVDs and compared to previously published values from bovine caudal IVDs. Fiber angles were also predicted using three theoretical models, including two based on adaptation to internal swelling pressure and one based on vertebral body growth. Fiber angle was found to significantly decrease from 49.5 ± 3.8° in the inner AF to 34.5 ± 6.6° in the outer AF. While steeper than in bovine discs at all locations, the trend with radial position was comparable between species. This trend was best fit by growth-based model and opposite of that predicted by the pressure vessel models. Trends in AF fiber orientation are conserved between mammalian species. Modeling results suggest that the AF tissue microstructure is more likely to be driven by adjacent vertebral body growth than adapted for optimal mechanical performance.
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- 2021
22. Interconception Care for Primary Care Providers: Consensus Recommendations on Preconception and Postpartum Management of Reproductive-Age Patients With Medical Comorbidities
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Anum S. Minhas, Garima Sharma, Srilakshmi Mitta, Graeme N. Smith, Sammy Zakaria, Xiaolei Chen, Stephanie M. Toth-Manikowski, Arthur J. Vaught, and S. Michelle Ogunwole
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Medicine (General) ,medicine.medical_specialty ,HDP, hypertensive disorder of pregnancy ,Peripartum cardiomyopathy ,MFM, maternal-fetal medicine ,ACE, angiotensin-converting enzyme ,BMI, body mass index ,Population ,SMFM, Society for Maternal-Fetal Medicine ,VTE, venous thromboembolism ,CVD, cardiovascular disease ,Preconception Care ,OB/GYN, obstetrician/gynecologist ,Special Article ,R5-920 ,Diabetes mellitus ,DM, diabetes mellitus ,Medicine ,Intensive care medicine ,education ,Pregnancy ,education.field_of_study ,HbA1c, hemoglobin A1c ,business.industry ,GDM, gestational diabetes mellitus ,CKD, chronic kidney disease ,NTD, neural tube defect ,medicine.disease ,Gestational diabetes ,ARB, angiotensin receptor blocker ,Mood disorders ,ACOG, American College of Obstetricians and Gynecologists ,business ,PCP, primary care provider ,PPCM, peripartum cardiomyopathy ,Kidney disease - Abstract
Severe maternal morbidity and mortality continue to increase in the United States, largely owing to chronic and newly diagnosed medical comorbidities. Interconception care, or care and management of medical conditions between pregnancies, can improve chronic disease control before, during, and after pregnancy. It is a crucial and time-sensitive intervention that can decrease maternal morbidity and mortality and improve overall health. Despite these potential benefits, interconception care has not been well implemented by the primary care community. Furthermore, there is a lack of guidelines for optimizing preconception chronic disease, risk stratifying postpartum chronic diseases, and recommending general collaborative management principles for reproductive-age patients in the period between pregnancies. As a result, many primary care providers, especially those without obstetric training, are unclear about their specific role in interconception care and may be unsure of effective methods for collaborating with obstetric care providers. In particular, internal medicine physicians, the largest group of primary care physicians, may lack sufficient clinical exposure to medical conditions in the obstetric population during their residency training and may feel uncomfortable in caring for these patients in their subsequent practice. The objective of this article is to review concepts around interconception care, focusing specifically on preconception care for patients with chronic medical conditions (eg, chronic hypertension, chronic diabetes mellitus, chronic kidney disease, venous thromboembolism, and obesity) and postpartum care for those with medically complicated pregnancies (eg, hypertensive disorders of pregnancy, gestational diabetes mellitus, excessive gestational weight gain, peripartum cardiomyopathy, and peripartum mood disorders). We also provide a pragmatic checklist for preconception and postpartum management.
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- 2021
23. OCT Angiography for the Diagnosis of Glaucoma
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Arthur J. Sit, Hana L. Takusagawa, Sunita Radhakrishnan, Jullia A Rosdahl, Ambika Hoguet, Teresa C. Chen, Ying Han, and Darrell WuDunn
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medicine.medical_specialty ,genetic structures ,Nerve fiber layer ,Glaucoma ,Nerve fiber ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,medicine ,030304 developmental biology ,0303 health sciences ,Receiver operating characteristic ,business.industry ,Retinal ,medicine.disease ,eye diseases ,Ganglion ,Visual field ,medicine.anatomical_structure ,chemistry ,Inclusion and exclusion criteria ,030221 ophthalmology & optometry ,sense organs ,business - Abstract
Purpose To review the current published literature on the use of OCT angiography (OCTA) to help detect changes associated with the diagnosis of primary open-angle glaucoma. Methods Searches of the peer-reviewed literature were conducted in March 2018, June 2018, April 2019, December 2019, and June 2020 in the PubMed and Cochrane Library databases. Abstracts of 459 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 75 articles were selected and the panel methodologist rated them for strength of evidence. Three articles were rated level I and 57 articles were rated level II. The 15 level III articles were excluded. Results OCT angiography can detect decreased capillary vessel density within the peripapillary nerve fiber layer (level II) and macula (level I and II) in patients with suspected glaucoma, preperimetric glaucoma, and perimetric glaucoma. The degree of vessel density loss correlates significantly with glaucoma severity both overall and topographically (level II) as well as longitudinally (level I). For differentiating glaucomatous from healthy eyes, some studies found that peripapillary and macular vessel density measurements by OCTA show a diagnostic ability (area under the receiver operating characteristic curve) that is comparable with structural OCT retinal nerve fiber and ganglion cell thickness measurements, whereas other studies found that structural OCT measurements perform better. Choroidal or deep-layer microvasculature dropout as measured by OCTA is also associated with glaucoma damage (level I and II). Lower peripapillary and macular vessel density and choroidal microvasculature dropout are associated with faster rates of disease progression (level I and II). Conclusions Vessel density loss associated with glaucoma can be detected by OCTA. Peripapillary, macular, and choroidal vessel density parameters may complement visual field and structural OCT measurements in the diagnosis of glaucoma.
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- 2021
24. Factors influencing management of bilateral femur fractures: A multicenter retrospective cohort of early versus delayed definitive Fixation
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Jason Nadeau, Melissa Albersheim, Joseph T. Labrum, Reuben C. Lufrano, Robert V. O’Toole, Harsh R. Parikh, Danielle Ries de Chaffin, Patrick Davis, Ilexa R. Flagstad, Daniel Connelly, Hassan R. Mir, Barbara Steverson, Tegan Schmidt, Natasha M Simske, Shawn Feinstein, Arthur J. Only, David J. Hak, Lauren M. Tatman, Brian P. Cunningham, Paul S. Whiting, Jerald R. Westberg, Claude Sagi, Julie Titter, Andres Rodriguez-Buitrago, Jared Atchison, Erik A. Lund, Nichole Shaw, Andrew H. Schmidt, Alexander B. Siy, Heather A. Vallier, Emily Wagstrom, Austin Heare, Mary A. Breslin, Jesse C. Hahn, Cyril Mauffrey, William T. Obremskey, and Sandy Vang
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medicine.medical_specialty ,Femoral shaft ,03 medical and health sciences ,Injury Severity Score ,0302 clinical medicine ,Trauma Centers ,medicine ,Humans ,Femur ,In patient ,Statistical analysis ,Retrospective Studies ,General Environmental Science ,Fixation (histology) ,030222 orthopedics ,Multiple Trauma ,business.industry ,030208 emergency & critical care medicine ,Retrospective cohort study ,Evidence-based medicine ,Surgery ,General Earth and Planetary Sciences ,business ,Femoral Fractures - Abstract
The purpose of our study was to evaluate the factors that influence the timing of definitive fixation in the management of bilateral femoral shaft fractures and the outcomes for patients with these injuries.Patients with bilateral femur fractures treated between 1998 to 2019 at ten level-1 trauma centers were retrospectively reviewed. Patients were grouped into early or delayed fixation, which was defined as definitive fixation of both femurs within or greater than 24 hours from injury, respectively. Statistical analysis included reversed logistic odds regression to predict which variable(s) was most likely to determine timing to definitive fixation. The outcomes included age, sex, high-volume institution, ISS, GCS, admission lactate, and admission base deficit.Three hundred twenty-eight patients were included; 164 patients were included in the early fixation group and 164 patients in the delayed fixation group. Patients managed with delayed fixation had a higher Injury Severity Score (26.8 vs 22.4; p0.01), higher admission lactate (4.4 and 3.0; p0.01), and a lower Glasgow Coma Scale (10.7 vs 13; p0.01). High-volume institution was the most reliable influencer for time to definitive fixation, successfully determining 78.6% of patients, followed by admission lactate, 64.4%. When all variables were evaluated in conjunction, high-volume institution remained the strongest contributor (XIn this study, high-volume institution was the strongest predictor of timing to definitive fixation in patients with bilateral femur fractures. This study demonstrates an opportunity to create a standardized care pathway for patients with these injuries.Level III.
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- 2021
25. Management of Scalp Injuries
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Joshua Yoon, Arthur J. Nam, and Joseph Puthumana
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medicine.medical_specialty ,Reconstructive Surgeon ,Esthetics, Dental ,Malignancy ,Surgical Flaps ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,030223 otorhinolaryngology ,Scalp ,business.industry ,Postoperative radiation ,Local flap ,Soft tissue ,030206 dentistry ,Plastic Surgery Procedures ,medicine.disease ,Reconstruction method ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Oral Surgery ,business - Abstract
Soft tissue wounds in the scalp are a common occurrence after trauma or resection of a malignancy. The reconstructive surgeon should strive to use the simplest reconstructive technique while optimizing aesthetic outcomes. In general, large defects with infection, previous irradiation (or require postoperative radiation), or with calvarial defects usually require reconstruction with vascularized tissue (ie, microvascular free tissue transfer). Smaller defects greater than 3 cm that are not amenable to primary closure can be treated with local flap reconstruction. In all cases, the reconstruction method will need be tailored to the patient's health status, desires, and aesthetic considerations.
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- 2021
26. Bacterial arthritis of native joints can be successfully managed with needle arthroscopy
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John G. Kennedy, Nathaniel P. Mercer, Arthur J. Kievit, Gino M. M. J. Kerkhoffs, Tobias Stornebrink, Sjoerd A. S. Stufkens, Stein. J. Janssen, Graduate School, Orthopedic Surgery and Sports Medicine, APH - Personalized Medicine, APH - Quality of Care, AMS - Amsterdam Movement Sciences, AMS - Ageing & Vitality, and AMS - Sports
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Arthrotomy ,Orthopedic surgery ,medicine.medical_specialty ,Original Paper ,NanoScope ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Arthroscopy ,Spinal anesthesia ,Needle arthroscopy ,Emergency department ,Surgery ,Bacterial arthritis ,medicine ,Arthroscopic lavage ,Orthopedics and Sports Medicine ,General anaesthesia ,business ,RD701-811 - Abstract
PurposeTo assess the feasibility of needle arthroscopy for management of suspected bacterial arthritis in native joints.MethodsDuring a pilot period, patients presenting with symptoms suggestive of native joint bacterial arthritis were eligible for initial management with needle arthroscopy. Procedures were performed in the operating theatre or at the patient bedside in the emergency department or inpatient ward. As our primary outcome measure, it was assessed whether needle arthroscopic lavage resulted in a clear joint. In addition, the need for conversion to standard arthroscopy or arthrotomy, the need for conversion from local to general anaesthesia, complications and the need for additional surgical intervention at follow-up during admission were recorded.ResultsEleven joints in 10 patients (four males, age range 35 – 77) were managed with needle arthroscopy. Needle arthroscopic lavage resulted in a clear joint in all cases. Conversion to standard arthroscopy or arthrotomy was not needed. Seven procedures were performed at the patient bedside using local anaesthesia. These procedures were well tolerated and conversion to general or spinal anaesthesia was not required. There were no procedure complications. One patient received multiple needle arthroscopic lavages. No further surgical interventions beside the initial needle arthroscopic lavage were required for successful management in other cases.ConclusionsNeedle arthroscopy can be a feasible tool in the initial management of complaints suggestive for native joint bacterial arthritis, providing an effective, quick and well-tolerable intervention in the operating theatre or at the patient bedside, with the potential to relief health systems from need for scarce operating theatre time.
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- 2021
27. Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States
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Allison G. Hays, Pensee Wu, Martha Gulati, S. Michelle Ogunwole, Mamas A. Mamas, Anum S. Minhas, Arthur J. Vaught, Di Zhao, and Erin D. Michos
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Adult ,Gestational hypertension ,medicine.medical_specialty ,Pregnancy Complications, Cardiovascular ,Disease ,030204 cardiovascular system & hematology ,Article ,White People ,Preeclampsia ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Internal Medicine ,medicine ,Humans ,Maternal health ,030212 general & internal medicine ,reproductive and urinary physiology ,Eclampsia ,Obstetrics ,business.industry ,Hypertension, Pregnancy-Induced ,medicine.disease ,United States ,female genital diseases and pregnancy complications ,Black or African American ,Increased risk ,Socioeconomic Factors ,Heart failure ,Pregnancy induced ,Female ,business - Abstract
Women with pregnancy-induced hypertension, defined as gestational hypertension and preeclampsia/eclampsia, are at increased risk of long-term cardiovascular disease, but less is known about the spectrum of acute cardiovascular outcomes, especially across racial/ethnic groups. We evaluated the risk of cardiovascular events at delivery associated with gestational hypertension and preeclampsia/eclampsia, compared with no pregnancy-induced hypertension, overall and by race/ethnicity. We used the 2016 to 2018 National Inpatient Sample data.International Classification of Diseases,Tenth Revision, Clinical Modification codes identified delivery hospitalizations and clinical diagnoses. Using survey weights, cardiovascular events were examined using logistic regression by pregnancy-induced hypertension status, with subsequent stratification by race/ethnicity. Among 11 304 996 deliveries in 2016 to 2018, gestational hypertension occurred in 614 995 (5.4%) and preeclampsia in 593 516 (5.2%). Black women had higher odds for preeclampsia independent of underlying comorbidities (adjusted odds ratio, 1.45 [95% CI, 1.42–1.49]) and had the highest rates for several complications (peripartum cardiomyopathy, 506; heart failure, 660; acute renal failure, 953; and arrhythmias, 418 per 100 000 deliveries). After adjustment for socioeconomic factors and comorbidities, preeclampsia/eclampsia was associated with increased risk of cardiovascular events in women of all races/ethnicities. However, risk was highest among Asian/Pacific Islander women and lowest among Black women. In sum, while Black women were the most likely to experience preeclampsia, Asian/Pacific women were the most at risk for acute cardiovascular complications during delivery hospitalization.
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- 2021
28. The feasibility of folate receptor alpha- and HER2-targeted intraoperative fluorescence-guided cytoreductive surgery in women with epithelial ovarian cancer: A systematic review
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Arthur J. A. T. Braat, Cornelis G. Gerestein, J.M. de Jong, Jacob P. Hoogendam, and Ronald P. Zweemer
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0301 basic medicine ,Folate Receptor Alpha ,Oncology ,medicine.medical_specialty ,Neoplasm, Residual ,Receptor, ErbB-2 ,Disease ,Carcinoma, Ovarian Epithelial ,Fluorescence ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Internal medicine ,False positive paradox ,Animals ,Humans ,Medicine ,False Positive Reactions ,Folate Receptor 1 ,Epithelial ovarian cancer ,Ovarian Neoplasms ,Relative survival ,business.industry ,Optical Imaging ,Ovary ,Obstetrics and Gynecology ,Cytoreduction Surgical Procedures ,Progression-Free Survival ,Molecular Imaging ,Disease Models, Animal ,030104 developmental biology ,Surgery, Computer-Assisted ,030220 oncology & carcinogenesis ,Feasibility Studies ,Lymph Node Excision ,Female ,Lymph Nodes ,Animal studies ,business ,Cytoreductive surgery - Abstract
Background Epithelial ovarian cancer (EOC) is often diagnosed late, with a 5-year relative survival of 30.2% for patients with metastatic disease. Residual disease following cytoreductive surgery is an important predictor for poor survival. EOC is characterized by diffuse peritoneal metastases and depositions of small size, challenging a complete resection. Targeted fluorescence imaging is a technique to enhance tumor visualization and can be performed intraoperatively. Folate receptor alpha (FRα) and human epidermal growth factor receptor 2 (HER2) are overexpressed in EOC in 80% and 20% of the cases, respectively, and have been previously studied as a target for intraoperative imaging. Objective To systematically review the literature on the feasibility of FRα and HER2 targeted fluorescence-guided cytoreductive surgery (FGCS) in women with EOC. Methods PubMed and Embase were searched for human and animal studies on FGCS targeting either HER2 or FRα in either women with EOC or animal models of EOC. Risk of bias and methodological quality were assessed with the SYRCLE and MINORS tool, respectively. Results All animal studies targeting either FRα or HER2 were able to detect tumor deposits using intraoperative fluorescence imaging. One animal study targeting HER2 compared conventional cytoreductive surgery (CCS) to FGCS and concluded that FGCS, either without or following CCS, resulted in statistically significant less residual disease compared to CCS alone. Human studies on FGCS showed an increased detection rate of tumor deposits. True positives ranged between 75%–77% and false positives between 10%–25%. Lymph nodes were the main source of false positive results. Sensitivity was 85.9%, though only reported by one human study. Conclusion FGCS targeting either HER2 or FRα appears to be feasible in both EOC animal models and patients with EOC. FGCS is a promising technique, but further research is warranted to validate these results and particularly study the survival benefit.
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- 2021
29. A Governance Framework to Integrate Longitudinal Clinical and Community Data in a Distributed Data Network: The Childhood Obesity Data Initiative
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Arthur J. Davidson, Emily McCormick Kraus, Thomas W Carton, Raymond J King, Dawn M Heisey-Grove, Matthew A Haemer, Matthew F. Daley, Jason P. Block, Alyson B. Goodman, Rachel Zucker, Kenneth A. Scott, Nedra Garrett, and Sara J Deakyne Davies
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Pediatric Obesity ,Knowledge management ,Colorado ,business.industry ,Health Policy ,Corporate governance ,Public Health, Environmental and Occupational Health ,Context (language use) ,distributed health data networks ,Memorandum of understanding ,community-based organizations ,public health surveillance ,Practice Full Report ,Documentation ,Data exchange ,Information system ,CoDi ,health IT ,record linkage ,Humans ,business ,Child ,Record linkage - Abstract
Context Integrating longitudinal data from community-based organizations (eg, physical activity programs) with electronic health record information can improve capacity for childhood obesity research. Objective A governance framework that protects individual privacy, accommodates organizational data stewardship requirements, and complies with laws and regulations was developed and implemented to support the harmonization of data from disparate clinical and community information systems. Participants and setting Through the Childhood Obesity Data Initiative (CODI), 5 Colorado-based organizations collaborated to expand an existing distributed health data network (DHDN) to include community-generated data and assemble longitudinal patient records for research. Design A governance work group expanded an existing DHDN governance infrastructure with CODI-specific data use and exchange policies and procedures that were codified in a governance plan and a delegated-authority, multiparty, reciprocal agreement. Results A CODI governance work group met from January 2019 to March 2020 to conceive an approach, develop documentation, and coordinate activities. Governance requirements were synthesized from the CODI use case, and a customized governance approach was constructed to address governance gaps in record linkage, a procedure to request data, and harmonizing community and clinical data. A Master Sharing and Use Agreement (MSUA) and Memorandum of Understanding were drafted and executed to support creation of linked longitudinal records of clinical- and community-derived childhood obesity data. Furthermore, a multiparty infrastructure protocol was approved by the local institutional review board (IRB) to expedite future CODI research by simplifying IRB research applications. Conclusion CODI implemented a clinical-community governance strategy that built trust between organizations and allowed efficient data exchange within a DHDN. A thorough discovery process allowed CODI stakeholders to assess governance capacity and reveal regulatory and organizational obstacles so that the governance infrastructure could effectively leverage existing knowledge and address challenges. The MSUA and complementary governance documents can inform similar efforts.
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- 2021
30. Outcomes of Kidney Allograft and Recipient Survival After Liver Transplantation by Induction Type in the United States
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John R. Lake, Scott Jackson, Nicholas Lim, Arthur J. Matas, and Samy Riad
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Graft Rejection ,medicine.medical_specialty ,medicine.medical_treatment ,Liver transplantation ,Kidney ,Gastroenterology ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Kidney transplantation ,Dialysis ,Transplantation ,Hepatology ,business.industry ,Graft Survival ,Immunosuppression ,Allografts ,medicine.disease ,Kidney Transplantation ,United States ,Tacrolimus ,Liver Transplantation ,surgical procedures, operative ,medicine.anatomical_structure ,Surgery ,business ,Immunosuppressive Agents - Abstract
There are several choices for induction immunosuppression in kidney-after-liver transplantation. We examined the impact of induction type on kidney graft and patient survival in kidney-after-liver recipients. We utilized the Scientific Registry of Transplant Recipients (SRTR) database and included patients transplanted between 1/1/2000 and 7/31/2017 to study kidney graft and patient outcomes of all kidney-after-liver transplant recipients in the United States. We only included those who were discharged on tacrolimus and mycophenolate with or without steroids and who had a negative crossmatch prior to kidney engraftment. We grouped recipients by kidney induction type into three groups: depletional (N=550), non-depletional (n=434), and no antibody induction (n=144). We studied patient and kidney allograft survival using Cox PH regression, with transplant center included as a random effect. Models were adjusted for liver induction regimen, recipient and donor age, gender, Human Leukocyte Antigen (HLA) mismatches, payor type, live-donor kidney transplant, dialysis status, time from liver engraftment, hepatitis C status, and the presence of diabetes mellitus at time of kidney transplant and transplant year. Six-month and one-year rejection rates did not differ between groups. In the multivariable models, as compared to no induction, neither depletional nor non-depletional induction was associated with improved recipient or graft survival. Depletional induction at the time of liver transplantation was associated with worse patient survival after kidney transplant [HR 1.71, 95%C.I. (1.09, 2.67), P 0.02]. Live-donor kidney transplantation was associated with a 48.1% improved graft survival [HR 0.52, 95%C.I. (0.33, 0.82), P 0.00]. In conclusion, in the settings of a negative crossmatch and maintenance with tacrolimus and mycophenolate, induction use was not associated with a patient or graft survival benefit in kidney after liver transplants.
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- 2021
31. Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett's esophagus: An Australian pilot study (with video)
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Dominic Staudenmann, Payal Saxena, Ellie Patricia Skacel, Arthur J. Kaffes, and Tatiana Tsoutsman
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Specialties of internal medicine ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Argon plasma coagulation ,medicine.disease ,RC31-1245 ,Term (time) ,RC581-951 ,Oncology ,Internal medicine ,Barrett's esophagus ,medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,argon plasma coagulation ,barrett esophagus ,surgical endoscopy ,business ,RC254-282 - Abstract
Background : : Five to ten percent of all patients undergoing radiofrequency ablation (RFA), which is the most established technique for Barrett's esophagus (BE) ablation-develop strictures. Hybrid-argon plasma coagulation (APC) combines APC with submucosal saline injection that was recently developed to tackle this problem. The aims of this pilot study were to evaluate the feasibility, tolerance, safety and long-term efficacy of hybrid-APC for the treatment of BE. Methods : : Patients with histological proven BE were selected for hybrid-APC. Prior to APC thermal ablation the mucosa was lifted using a submucosal high-pressure water jet injection system (Erbejet 2; Erbe, Tuebingen, Germany). Short-term (< 48 hours) and long-term (> 48 hours) safety were evaluated. Efficacy of ablation was measured at 3, 6, 12 and 24 months at follow-up endoscopy by evidence of macroscopically complete resolution of BE mucosa and/or histologically complete resolution of intestinal metaplasia (CRIM). Results : : Eleven patients were included in the study (average age, 68.2 years; male 72.7%). Eight patients (72.7%) were treatment naive, 9.1% (n = 1) had prior RFA and 18.2% (n = 2) had prior endoscopic mucosal resection. Two patients were excluded from the study. Nine patients (100%) had macroscopic remission and 88.9% (n = 8) had macroscopic remission and microscopic CRIM at 24 months after hybrid-APC ablation. No treatment-related stricture or other major complications were observed, 1 patient (11.1%) reported minor adverse effects. Conclusion : : In this prospective pilot study, hybrid-APC appears safe, feasible and effective after 24 months, which has not been evaluated so far. Further large, multi-centre trials are warranted to confirm the present results.
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- 2021
32. Long-Term Increases in Mental Disorder Diagnoses After Invasive Mechanical Ventilation for Severe Childhood Respiratory Disease: A Propensity Matched Observational Cohort Study*
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Jeffrey D. Edwards, Caleb Ing, Yewei Lu, Mark Olfson, May Hua, Caleb H. Miles, Arthur J. Smerling, Andrew S. Geneslaw, and Joshua Cappell
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medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Psychological intervention ,Critical Care and Intensive Care Medicine ,Article ,Cohort Studies ,medicine ,Humans ,Child ,Retrospective Studies ,Mechanical ventilation ,business.industry ,Mental Disorders ,Hazard ratio ,Respiratory disease ,Infant ,medicine.disease ,Respiration, Artificial ,Comorbidity ,Hospitalization ,Pediatrics, Perinatology and Child Health ,Cohort ,Emergency medicine ,Propensity score matching ,business ,Cohort study - Abstract
OBJECTIVES To evaluate neurodevelopmental and mental disorders after PICU hospitalization in children requiring invasive mechanical ventilation for severe respiratory illness. DESIGN Retrospective longitudinal observational cohort. SETTING Texas Medicaid Analytic eXtract data from 1999 to 2012. PATIENTS Texas Medicaid-enrolled children greater than or equal to 28 days old to less than 18 years old hospitalized for a primary respiratory illness, without major chronic conditions predictive of abnormal neurodevelopment. INTERVENTIONS We examined rates of International Classification of Diseases, 9th revision-coded mental disorder diagnoses and psychotropic medication use following discharge among children requiring invasive mechanical ventilation for severe respiratory illness, compared with general hospital patients propensity score matched on sociodemographic and clinical characteristics prior to admission. Children admitted to the PICU for respiratory illness not necessitating invasive mechanical ventilation were also compared with matched general hospital patients as a negative control exposure. MEASUREMENTS AND MAIN RESULTS Of 115,335 eligible children, 1,351 required invasive mechanical ventilation and were matched to 6,755 general hospital patients. Compared with general hospital patients, children requiring invasive mechanical ventilation had increased mental disorder diagnoses (hazard ratio, 1.43 [95% CI, 1.26-1.64]; p < 0.0001) and psychotropic medication use (hazard ratio, 1.67 [1.34-2.08]; p < 0.0001) following discharge. Seven-thousand seven-hundred eighty children admitted to the PICU without invasive mechanical ventilation were matched to 38,900 general hospital patients and had increased mental disorder diagnoses (hazard ratio, 1.08 [1.02-1.15]; p = 0.01) and psychotropic medication use (hazard ratio, 1.11 [1.00-1.22]; p = 0.049). CONCLUSIONS Children without major comorbidity requiring invasive mechanical ventilation for severe respiratory illness had a 43% higher incidence of subsequent mental disorder diagnoses and a 67% higher incidence of psychotropic medication use. Both increases were substantially higher than in PICU patients with respiratory illness not necessitating invasive mechanical ventilation. Invasive mechanical ventilation is a life-saving therapy, and its application is interwoven with underlying health, illness severity, and PICU management decisions. Further research is required to determine which factors related to invasive mechanical ventilation and severe respiratory illness are associated with abnormal neurodevelopment. Given the increased risk in these children, identification of strategies for prevention, neurodevelopmental surveillance, and intervention after discharge may be warranted.
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- 2021
33. Fully Covered Self-Expanding Metal Stent vs Multiple Plastic Stents to Treat Benign Biliary Strictures Secondary to Chronic Pancreatitis
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Armando Gabbrielli, Schalk Van der Merwe, Joyce Peetermans, Matthew Rousseau, D. Nageshwar Reddy, Vincent Lepilliez, Thierry Ponchon, André Roy, Andreas Püspöek, Jacques Devière, Andrea Tringali, Mohan Ramchandani, Marco J. Bruno, Barbara Tribl, Jan-Werner Poley, Wim Laleman, Werner Dolak, Sundeep Lakhtakia, Marianna Arvanitakis, Arthur J. Kaffes, Laura Bernardoni, Michael J. Bourke, Urban Arnelo, James Y.W. Lau, Horst Neuhaus, Guido Costamagna, and Gastroenterology & Hepatology
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0301 basic medicine ,biliary stenting ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Biliary Stenting ,law.invention ,chronic pancreatitis ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Self-expandable metallic stent ,Interquartile range ,law ,medicine ,randomized trial ,Endoscopic retrograde cholangiopancreatography ,Intention-to-treat analysis ,Hepatology ,medicine.diagnostic_test ,plastic stents ,business.industry ,Gastroenterology ,Stent ,medicine.disease ,self-expandable metallic stents ,Surgery ,030104 developmental biology ,Pancreatitis ,030211 gastroenterology & hepatology ,business - Abstract
BACKGROUND & AIMS: Benign biliary strictures (BBS) are complications of chronic pancreatitis (CP). Endotherapy using multiple plastic stents (MPS) or a fully covered self-expanding metal stent (FCSEMS) are acceptable treatment options for biliary obstructive symptoms in these patients. METHODS: Patients with symptomatic CP-associated BBS enrolled in a multicenter randomized noninferiority trial comparing 12-month treatment with MPS vs FCSEMS. Primary outcome was stricture resolution status at 24 months, defined as absence of restenting and 24-month serum alkaline phosphatase not exceeding twice the level at stenting completion. Secondary outcomes included crossover rate, numbers of endoscopic retrograde cholangiopancreatography (ERCPs) and stents, and stent- or procedure-related serious adverse events. RESULTS: Eighty-four patients were randomized to MPS and 80 to FCSEMS. Baseline technical success was 97.6% for MPS and 98.6% for FCSEMS. Eleven patients crossed over from MPS to FCSEMS, and 10 from FCSEMS to MPS. For MPS vs FCSEMS, respectively, stricture resolution status at 24 months was 77.1% (54/70) vs 75.8% (47/62) (P = .008 for noninferiority intention-to-treat analysis), mean number of ERCPs was 3.9 ± 1.3 vs 2.6 ± 1.3 (P < .001, intention-to-treat), and mean number of stents placed was 7.0 ± 4.4 vs 1.3 ± .6 (P < .001, as-treated). Serious adverse events occurred in 16 (19.0%) MPS and 19 (23.8%) FCSEMS patients (P = .568), including cholangitis/fever/jaundice (9 vs 7 patients respectively), abdominal pain (5 vs 5), cholecystitis (1 vs 3) and post-ERCP pancreatitis (0 vs 2). No stent- or procedure-related deaths occurred. CONCLUSIONS: Endotherapy of CP-associated BBS has similar efficacy and safety for 12-month treatment using MPS compared with a single FCSEMS, with FCSEMS requiring fewer ERCPs over 2 years. (ClinicalTrials.gov, Number: NCT01543256.). ispartof: GASTROENTEROLOGY vol:161 issue:1 pages:185-195 ispartof: location:United States status: published
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- 2021
34. Return to Preinjured Function Following Ankle Injury
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Patrick O. McKeon, Timothy L. Uhl, Aaron Sciascia, Jennifer R. Havens, and Arthur J. Nitz
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medicine.medical_specialty ,business.industry ,Rehabilitation ,Physical Therapy, Sports Therapy and Rehabilitation ,030229 sport sciences ,Function (mathematics) ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Ankle injury ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,business - Abstract
Athletic preinjury function is typically determined via subjective recall; however, obtaining preinjury function before injury occurs should be attempted in order to establish an individual baseline for postinjury comparison. The purpose of this study was to obtain preinjury baseline values for the Foot and Ankle Disability Index (FADI) and Foot and Ankle Disability Index sport version (FADISP), single-leg hop for distance, and Star Excursion Balance Test anterior reach and determine if athletes returned to those values following ankle injury. Out of 41 qualifying injuries, FADI/FADISP scores were significantly reduced at initial injury compared with baseline and all other time points (p p ≥ .98). Subjective and objective preinjury function can be reestablished by discharge from supervised treatment following low-grade ankle injury and maintained for at least 6 months following the cessation of treatment. However, testing metrics should be reviewed on an individual athlete basis, because group data may mask individual patient needs.
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- 2021
35. 911 EMS Activations by Pregnant Patients in Maryland (USA) during the COVID-19 Pandemic
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Torre Halscott, J. Lee Jenkins, Megan Hadley, Asa Margolis, Arthur J. Vaught, Matthew J. Levy, Timothy P. Chizmar, and Teferra Alemayehu
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Emergency Medical Services ,Coronavirus disease 2019 (COVID-19) ,Population ,Emergency Nursing ,pandemics ,maternal health ,Obstetric care ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Pandemic ,Emergency medical services ,Medicine ,Humans ,030212 general & internal medicine ,PUI, person under investigation (for COVID-19) ,MIEMSS, Maryland Institute for Emergency Medical Services Systems ,education ,CDC, Centers for Disease Control and Prevention ,Original Research ,COVID-19, coronavirus disease 2019 ,Retrospective Studies ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Population statistics ,Maryland ,business.industry ,pregnancy complications ,EMS, Emergency Medical Services ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,United States ,Emergency Medicine ,Female ,business ,Early phase ,Demography - Abstract
Introduction:In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, United States Emergency Medical Services (EMS) experienced a decrease in calls, and at the same time, an increase in out-of-hospital deaths. This finding led to a concern for the implications of potential delays in care for the obstetric population.Hypothesis/Problem:This study examines the impact of the pandemic on prehospital care amongst pregnant women.Methods:A retrospective observational study was conducted comparing obstetric-related EMS activations in Maryland (USA) during the pandemic (March 10-July 20, 2020) to a pre-pandemic period (March 10-July 20, 2019). Comparative analysis was used to analyze the difference in frequency and acuity of calls between the two periods.Results:There were fewer obstetric-related EMS encounters during the pandemic compared to the year prior (daily average during the pandemic 12.5 [SD = 3.8] versus 14.6 [SD = 4.1] pre-pandemic; P Conclusions:In this state-wide analysis of EMS calls in Maryland early in the pandemic, no significant differences existed in the utilization of EMS by pregnant women. Prehospital EMS activations amongst pregnant women in Maryland only decreased slightly without an increase in acuity. Of note, over-representation by African-American women compared to population statistics raises concern for broader systemic differences in access to obstetric care.
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- 2021
36. Initial Invasive or Conservative Strategy for Stable Coronary Disease
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Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C 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Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira 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Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, 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Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello Duarte, Tauqir Huk, Téodora Dutoiu, Terrance Chua, Terry Weyand, Thabitha Charles, Theodoros Kofidis, Theresa McCreary, Thierry Lefevre, Thippeekaa Arumairajah, Thitipong Tepsuwan, Thomas J Mulhearn, Thomas M Meyer, Thomas P Rocco, Thomas R Downes, Thomas Crain, Thomas Haldis, Thomas Mathew, Thomas Redick, Thounaojam Indira Devi, Thuraia Nageh, Tia Cauthren, Tiago Silva, Tiffany Little, Tijana Andric, Tina Harding, Titus Lau, Tiziana Formisano, Tiziano Moccetti, Tomasz Ciurus, Tomasz Mazurek, Tomasz Tarchalski, Toshiyuki Nagai, Tri Tran, Tricia Youn, Trish Tucker, Trudie Milner, Tuhina Bose, Tushar Kotecha, Udo Sechtem, Uma S Valeti, Umberto Cucchini, Umesh Badami, Upendra Kaul, V K Bahl, V S Narain, Valentina Casali, Valeria Godoy, Valerie Robesyn, Vamshi P Priya, Vandana Yadav, Vera McKinney, Veronica De Lenges, Veronica Tinnirello, Vicente Miro, Victor Navarro, Victoria Gumerova, Victoria Hernandez, Vidya Seeratan, Vijay Kumar, Vikentiy Y Kozulin, Viktoria Bulkley, Vilmar Veiga Jr, Vincent Setang, C P Vineeth, Virginai Pubull Nuñez, Virginia Fernández-Figares, Vitor Gomes, Viviana Gabriel, Viviane Dos Santos, Viviane Almeida, Vlad A Iliescu, Vladan Mudrenovic, Vladimir Dzavik, Vojislav L Giga, Walter Enrique Mogrovejo, Wan Xian Chan, Wanda C Marfori, Wanda Parker, Warangkana Mekara, Wassim Nona, Wayne Old, Wayne Pennachi, Weerachai Nawarawong, Wei Chen, Wei Su, Weibing Xing, Wei-Ren Lan, Wenda Crawford, Wendy L Stewart, Wendy Drewes, Wenhua Lin, William B Abernethy, William D Salerno, William F Fearon, William Vergoni, William Weintraub, Winnie C Sia, Wlodzimierz J Musial, Xacobe Flores-Ríos, Xavier Garcia-Moll Marimon, Xi Su, Xiang Ma, Xiangqiong Gu, Xiao Wang, Xiaomei Li, Xiaowei Yao, Xin Fu, Xin Su, Xin Zeng, Xinchun Yang, Xiuhong Li, Xuehua Fang, Xutong Wang, Yaming Geng, Yan Yan, Yanek Pépin-Dubois, Yanfu Wang, Yang Wang, Yanmeng Tian, Yaping Huang, Yechen Han, Yesenia Zambrano, Yi-Hsuan Yang, Ying Tung Sia, Yining Yang, Yitong Ma, Yolayfi Peralta, Yongjian Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits
- Subjects
Male ,Cardiac Catheterization ,Computed Tomography Angiography ,medicine.medical_treatment ,Myocardial Ischemia ,Coronary Disease ,Coronary Artery Disease ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Coronary Angiography ,ISCHEMIA Research Group ,law.invention ,Angina ,Coronary artery disease ,0302 clinical medicine ,Randomized controlled trial ,law ,Cardiovascular Disease ,Myocardial Revascularization ,030212 general & internal medicine ,Coronary Artery Bypass ,11 Medical and Health Sciences ,Cardiac catheterization ,General Medicine ,Middle Aged ,humanities ,Cardiovascular Diseases ,Cardiology ,Female ,Human ,medicine.medical_specialty ,Ischemia ,Article ,03 medical and health sciences ,Geriatric cardiology ,Percutaneous Coronary Intervention ,General & Internal Medicine ,Internal medicine ,medicine ,Humans ,Angina, Unstable ,Aged ,business.industry ,Coronary Artery Bypa ,Percutaneous coronary intervention ,Bayes Theorem ,medicine.disease ,Heart failure ,Quality of Life ,business - Abstract
BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
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- 2020
37. Improving Service Quality of Wealth Management Bank for High-Net-Worth Customers During COVID-19: A Fuzzy-DEMATEL Approach
- Author
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Arthur J. Lin, Sun-Weng Huang, Gwo-Hshiung Tzeng, and Hai-Yen Chang
- Subjects
High-net-worth individuals ,Finance ,Service quality ,business.industry ,media_common.quotation_subject ,Financial market ,Net worth ,COVID-19 ,Fuzzy linguistic scales ,Customer relationship management ,Wealth management ,Investment (macroeconomics) ,Article ,Theoretical Computer Science ,Computational Theory and Mathematics ,Artificial Intelligence ,Order (exchange) ,Fuzzy-DEMATEL ,Quality (business) ,business ,Software ,Financial services ,media_common - Abstract
The 2019–2020 COVID-19 pandemic has caused an economic turndown and high volatility in the global financial markets. Determining the factors that influence services to high-net-worth customers who typically have large investments in the financial markets is important for wealth management banks. This study constructs a hybrid approach by integrating the fuzzy logic and Decision-making Trial and Evaluation Laboratory (DEMATEL) methods to identify the most influential criteria affecting the performance of wealth management banks in Taiwan during the 2019–2020 COVID-19 pandemic. Surveys and interviews are designed using four dimensions (bank performance, service quality, customer relationship, and COVID-19) and 16 criteria for 10 banking executives using fuzzy linguistic scales, to obtain their expert opinions. The results show the order of influence as being service quality, customer relationships, bank performance, and COVID-19. The most important criteria are customized investment information (in-service quality), switching behavior (in-customer relationship), fee income (in-bank performance), and the number of confirmed cases in the top five countries affected by COVID-19. The managerial implication is that wealth management banks should focus on improving their service quality. Banks may strive to provide a wide range of customized investment information and increase customers’ usage of personalized financial products and services. The results of this study will benefit bank managers in serving high-net-worth individuals during the crisis period.
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- 2021
38. Cytokine Release Syndrome By T-cell–Redirecting Therapies: Can We Predict and Modulate Patient Risk?
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Arthur J Van De Vyver, Ken Wang, Antje-Christine Walz, Estelle Marrer-Berger, and Thorsten Lehr
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Cancer Research ,medicine.medical_specialty ,T-Lymphocytes ,medicine.medical_treatment ,T cell ,Patient risk ,MEDLINE ,Drug Development ,Cancer immunotherapy ,Intervention (counseling) ,Animals ,Humans ,Medicine ,Molecular Targeted Therapy ,Intensive care medicine ,Adverse effect ,Modalities ,business.industry ,medicine.disease ,Cytokine release syndrome ,Treatment Outcome ,medicine.anatomical_structure ,Gene Expression Regulation ,Oncology ,Cytokines ,Disease Susceptibility ,Cytokine Release Syndrome ,business ,Biomarkers - Abstract
T-cell–redirecting therapies are promising new therapeutic options in the field of cancer immunotherapy, but the development of these modalities is challenging. A commonly observed adverse event in patients treated with T-cell–redirecting therapies is cytokine release syndrome (CRS). Its clinical manifestation is a burden on patients, and continues to be a big hurdle in the clinical development of this class of therapeutics. We review different T-cell–redirecting therapies, discuss key factors related to cytokine release and potentially leading to CRS, and present clinical mitigation strategies applied for those modalities. We propose to dissect those risk factors into drug-target-disease–related factors and individual patient risk factors. Aiming to optimize the therapeutic intervention of these modalities, we illustrate how the knowledge on drug-target-disease–related factors, such as target expression, binding affinity, and target accessibility, can be leveraged in a model-based framework and highlight with case examples how modeling and simulation is applied to guide drug discovery and development. We draw attention to the current gaps in predicting the individual patient's risk towards a high-grade CRS, which requires further considerations of risk factors related, but not limited to, the patient's demographics, genetics, underlying pathologies, treatment history, and environmental exposures. The drug-target-disease–related factors together with the individual patient's risk factors can be regarded as the patient's propensity for developing CRS in response to therapy. As an outlook, we suggest implementing a risk scoring system combined with mechanistic modeling to enable the prediction of an individual patient's risk of CRS for a given therapeutic intervention.
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- 2021
39. VOLATILITY CONTAGION AMONG STOCK, CURRENCY, AND BULK SHIPPING MARKET DURING THE CHINA’S STOCK MARKET CRASH CRISIS
- Author
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Arthur J. Lin
- Subjects
Economics and Econometrics ,Stock market crash ,Currency ,Stock exchange ,Financial crisis ,Financial market ,Equity (finance) ,Renminbi ,Monetary economics ,Business ,Foreign exchange market - Abstract
Six financial markets were verified contagious to Shanghai Stock Exchange Composite (SSEC): domestic equity market (SSEC and China COSCO Shipping Co.), domestic currency market, international currency market, global shipping market, commodity future market and bulk shipping market (BDI) which regarded as a leading indicator of future economic growth instead of Li Keqiang index. This research analyzed intermarket contagion from March 14, 2008 to March 31, 2018. MIDAS-GARCH model was adopted to identify the spillover effect among the Shanghai Stock market and inter-market indices. The findings of this study were concluded as follows: (1) The commodity, global shipping market had significant volatility transmission to SSEC both before and after the crash crisis. (2) The volatility of domestic currency market was significantly contagious to SSEC only after the crash.
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- 2021
40. Criteria affecting Taiwan wealth management banks in serving high-net-worth individuals during COVID-19: a DEMATEL approach
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Hai-Yen Chang, Arthur J. Lin, Sun-Weng Huang, and Gwo-Hshiung Tzeng
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Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Commission ,Customer relationship management ,Wealth management ,N25 ,Decision-making trial and evaluation laboratory (DEMATEL) ,0502 economics and business ,High-net-worth individual ,Marketing ,Financial services ,business.industry ,Fee and commission income ,05 social sciences ,Net worth ,COVID-19 ,Asset under management (AUM) ,Original Article ,G21 ,050211 marketing ,Customer satisfaction ,G22 ,G01 ,business ,C44 ,050203 business & management ,Finance - Abstract
Wealth management services for high-net-worth individuals in Taiwan have grown rapidly over the last decade. This study used a decision-making trial and evaluation laboratory approach to identify the criteria affecting the performance of Taiwan wealth management banks during the coronavirus disease (COVID-19) period. This research surveyed 17 executives from Taiwanese banks using 13 criteria covering three dimensions: bank performance, professionalism, and customer relationship. The results indicated that customer relationship and professionalism have an influence on key performance. Customer involvement (in customer relationship), innovative products and services (in professionalism), and customer satisfaction (in key performance) are the most influential criteria. The results suggest that banks can attract and retain customers by increasing their uses of products and services, developing innovative products, and improving customer satisfaction despite the negative effect of COVID-19. The findings of this study benefit wealth management bank managers in sustaining fee and commission income from high-net-worth customers in the midst of adverse social and economic events.
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- 2021
41. Neuregulin-1 compensates for endothelial nitric oxide synthase deficiency
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Vincent F.M. Segers, Jhana O. Hendrickx, Hadis Shakeri, Jente R A Boen, Sofie De Moudt, Arthur J. A. Leloup, Pieter-Jan Guns, Griet Jacobs, Guido R.Y. De Meyer, and Gilles W. De Keulenaer
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medicine.medical_specialty ,Endothelial nitric oxide synthase ,biology ,Physiology ,business.industry ,Renal Hypertrophy ,medicine.disease ,biology.organism_classification ,Angiotensin II ,Muscle hypertrophy ,Endocrinology ,Fibrosis ,Enos ,Physiology (medical) ,Internal medicine ,mental disorders ,medicine ,biology.protein ,Secretion ,Human medicine ,Neuregulin 1 ,Cardiology and Cardiovascular Medicine ,business - Abstract
Endothelial cells (ECs) secrete different paracrine signals that modulate the function of adjacent cells; two examples of these paracrine signals are nitric oxide (NO) and neuregulin-1 (NRG1), a cardioprotective growth factor. Currently, it is undetermined whether one paracrine factor can compensate for the loss of another. Herein, we hypothesized that NRG1 can compensate for endothelial NO synthase (eNOS) deficiency. We characterized eNOS null and wild-type (WT) mice by cardiac ultrasound and histology and we determined circulating NRG1 levels. In a separate experiment, eight groups of mice were divided into four groups of eNOS null mice and WT mice; half of the mice received angiotensin II (ANG II) to induce a more severe phenotype. Mice were randomized to daily injections with NRG1 or vehicle for 28 days. eNOS deficiency increased NRG1 plasma levels, indicating that ECs increase their NRG1 expression when NO production is deleted. eNOS deficiency also increased blood pressure, lowered heart rate, induced cardiac fibrosis, and affected diastolic function. In eNOS null mice, ANG II administration not only increased cardiac fibrosis but also induced cardiac hypertrophy and renal fibrosis. NRG1 administration prevented cardiac and renal hypertrophy and fibrosis caused by ANG II infusion and eNOS deficiency. Moreover, Nrg1 expression in the myocardium is shown to be regulated by miR-134. This study indicates that administration of endothelium-derived NRG1 can compensate for eNOS deficiency in the heart and kidneys. NEW & NOTEWORTHY ECs compensate for eNOS deficiency by increasing the secretion of NRG1. NRG1 administration prevents cardiac and renal hypertrophy and fibrosis caused by ANG II infusion and eNOS deficiency. NRG1 expression is regulated by miR-134.
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- 2021
42. Blood culture quality assurance: what Australasian laboratories are measuring and opportunities for improvement
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Katherine Ryan, Arthur J. Morris, Debra Walker, Juliet Elvy, and Elizabeth Haremza
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0301 basic medicine ,medicine.medical_specialty ,Quality management ,Quality Assurance, Health Care ,medicine.diagnostic_test ,business.industry ,Australia ,Quality Improvement ,Pathology and Forensic Medicine ,03 medical and health sciences ,Clinical microbiology ,Biological safety ,030104 developmental biology ,0302 clinical medicine ,Blood Culture ,Surveys and Questionnaires ,030220 oncology & carcinogenesis ,Family medicine ,Humans ,Medicine ,Blood culture ,Laboratories ,business ,Quality assurance ,New Zealand - Abstract
Blood cultures are among the most important specimen types received and processed by the microbiology laboratory. Several publications list which variables should be measured to ensure quality. We undertook a qualitative structured questionnaire of Australian and New Zealand clinical microbiology laboratories to document current blood culture practices and to determine whether expected quality standards are being met. Questions included a wide range of pre-analytical, analytical, and post-analytical aspects of blood cultures from adults. The responses from 71 laboratories were analysed. Compliance was high for use of a biological safety cabinet (90%), incubating for 5 days (86%), and commenting on likely contaminants (85%). While Gram stains were reported within 2 hours during normal hours (93%), reporting was slower after hours (59%), p0.001. The volume of blood collected for a clinical episode was poorly monitored with only 11% (n=8) of laboratories regularly auditing the number of blood culture sets and 3% (n=2) monitoring adequacy of fill. Most laboratories received blood cultures from off-site with just 34% (n=21) meeting guidance for loading bottles onto the analyser within 4 hours. More laboratories met standards for loading bottles onto the analyser during working hours than after hours: 87% vs 56%, p0.001. Most laboratories did not monitor the contamination rate, 56% (n=40), and only 27% (n=19) knew their rate was below the guidance threshold of less than -3%. Considerable opportunities exist to improve quality assurance of blood culture practice in Australia and New Zealand, especially for the most critical aspect affecting culture sensitivity, the volume of blood collected.
- Published
- 2021
43. Netarsudil Improves Trabecular Outflow Facility in Patients with Primary Open Angle Glaucoma or Ocular Hypertension: A Phase 2 Study
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Arash Kazemi, Katy C. Liu, Theresa Heah, Hayley McKee, Divakar Gupta, Jae Lopez, Pratap Challa, Casey Kopczynski, and Arthur J. Sit
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Adult ,Male ,medicine.medical_specialty ,Intraocular pressure ,genetic structures ,Open angle glaucoma ,Phases of clinical research ,Ocular hypertension ,Administration, Ophthalmic ,Benzoates ,Aqueous Humor ,Tonometry, Ocular ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Trabecular Meshwork ,Ophthalmology ,medicine ,Humans ,Conjunctival hyperemia ,In patient ,Protein Kinase Inhibitors ,Intraocular Pressure ,Aged ,030304 developmental biology ,Morning ,rho-Associated Kinases ,0303 health sciences ,business.industry ,Middle Aged ,medicine.disease ,eye diseases ,beta-Alanine ,030221 ophthalmology & optometry ,Female ,Ocular Hypertension ,Outflow ,sense organs ,Ophthalmic Solutions ,business ,Glaucoma, Open-Angle - Abstract
PURPOSE Intraocular pressure (IOP) reduction is key to controlling primary open angle glaucoma (POAG). Pharmacotherapies for POAG or ocular hypertension (OHT) commonly lower IOP by increasing uveoscleral outflow or decreasing aqueous humor production. Netarsudil (Rhopressa), a Rho kinase inhibitor, reduces IOP by improving trabecular outflow facility, which is reduced in POAG. We investigated the effects of netarsudil on aqueous humor dynamics in patients with POAG or OHT. DESIGN Double-masked, randomized, vehicle-controlled, Phase 2 trial. METHODS Netarsudil 0.02% was instilled in 1 eye and vehicle into the contralateral eye of 20 patients once daily in the morning for 7 days. The primary endpoint was change in mean diurnal outflow facility on day 8 versus that on day 1 (baseline). Outflow facility was measured by using Schiotz tonography, IOP by pneumotonometry, and episcleral venous pressure (EVP) by automated venomanometry. RESULTS Eighteen patients (90%) completed the study. Mean diurnal outflow facility increased 0.039 versus 0.007 µL/min/mm Hg from baseline in the netarsudil- and the vehicle-treated groups, respectively (P < .001 vs. baseline for netarsudil), a treatment difference of 0.03 µL/min/mm Hg (P ≤ .001). Mean diurnal IOP change from baseline at day 8 was -4.52 mm Hg for netarsudil versus -0.98 mm Hg for vehicle, a treatment difference of -3.54 mm Hg (P < .0001). Mean diurnal EVP change from baseline was -0.79 mm Hg in the netarsudil-treated group versus 0.10 mm Hg for vehicle, a treatment difference of -0.89 mm Hg (P < .001). All patients reporting an adverse event reported conjunctival hyperemia of mild or moderate severity. CONCLUSIONS Netarsudil acts on the conventional outflow pathway, both proximal and distal, to significantly reduce IOP in POAG and OHT by improving trabecular outflow facility and decreasing EVP.
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- 2021
44. Statistical learning of blunt cerebrovascular injury risk factors using the elastic net
- Author
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Arthur J. Fountain, Maxwell E. Cooper, Jason W. Allen, Benjamin B. Risk, and Amanda S. Corey
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medicine.medical_specialty ,business.industry ,Vertebral artery ,Trauma center ,030208 emergency & critical care medicine ,Odds ratio ,medicine.disease ,Logistic regression ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Basilar skull fracture ,medicine.artery ,Emergency Medicine ,medicine ,Foramen ,Carotid canal ,Radiology, Nuclear Medicine and imaging ,Radiology ,Internal carotid artery ,business - Abstract
To compare logistic regression to elastic net for identifying and ranking clinical risk factors for blunt cerebrovascular injury (BCVI). Consecutive trauma patients undergoing screening CTA at a level 1 trauma center over a 2-year period. Each internal carotid artery (ICA) and vertebral artery (VA) was independently graded by 2 neuroradiologists using the Denver grading scale. Unadjusted odds ratios were calculated by univariate and adjusted odds ratios by multiple logistic regression with FDR correction. We applied logistic regression with the elastic net penalty and tenfold cross-validation. Total of 467 patients; 73 patients with BCVI. Maxillofacial fracture, basilar skull fracture, and GCS had significant unadjusted odds ratios (OR) for ICA injury and C-spine fracture, spinal ligamentous injury, and age for VA injury. Only transverse foramen fracture had significant adjusted OR for VA injury, with none for ICA injury, after FDR correction. Using elastic net, ICA injury variables included maxillofacial fracture, basilar skull fracture, GCS, and carotid canal fracture. For VA injury, these included cervical spine transverse foramen fracture, ligamentous injury, C1–C3 fractures, posterior element fracture, and vertebral body fracture. Elastic net statistical learning methods identified additional risk factors and outperformed multiple logistic regression for BCVI. Elastic net allows the study of a large number of variables, and is useful when covariates are correlated.
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- 2021
45. Rates of Diplopia in Ahmed FP7, Baerveldt 250, and 350 Glaucoma Patients Compared With Medical Controls
- Author
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Launia J. White, Feng Wang, Arthur J. Sit, Nouran Sabbagh, Khin P. Kilgore, Cheryl L. Khanna, Nicole C. Stern, Gavin W. Roddy, Sepideh Jamali, Elena Bitrian, and Brian G. Mohney
- Subjects
medicine.medical_specialty ,genetic structures ,Preoperative counseling ,Glaucoma ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Ophthalmology ,Diplopia ,Humans ,Medicine ,In patient ,Glaucoma Drainage Implants ,Strabismus ,Intraocular Pressure ,business.industry ,medicine.disease ,eye diseases ,Confidence interval ,Treatment Outcome ,Quality of Life ,030221 ophthalmology & optometry ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Precis Diplopia was present in ~20% of patients with Ahmed FP7 (FP7) or Baerveldt 350 (B350), compared with 5% to 6% in those with Baerveldt 250 (B250) or controls, suggesting risk of diplopia should be included in preoperative counseling. Purpose The purpose of this study was to examine the prevalence of diplopia and strabismus in patients with B250, B350, or FP7 glaucoma drainage devices (GDD). Materials and methods In this cohort study, glaucoma patients 18 years and above who had received, or would be receiving, a B250, B350, or FP7 GDD, and medically treated controls were consecutively enrolled from August 8, 2017, through July 31, 2019. The Diplopia Questionnaire was administered ≥30 days postoperatively, and upon enrollment to the controls. All diplopic patients underwent orthoptic measurements, which were reviewed by a strabismus specialist. Patients with GDDs in quadrants other than superotemporal, multiple GDDs, or scleral buckles were excluded. Bonferroni correction was applied for pairwise comparisons. Results Diplopia was reported in 23/129 (17.8%) GDD patients and 5/99 (5.1%) control patients (P=0.003): 8/35 (22.9%) FP7, 2/32 (6.3%) B250, and 13/62 (21.0%) B350, with significant differences between FP7 versus controls (P=0.014) and B350 versus controls (P=0.011). Diplopia was attributable to GDD in 2 FP7 (5.9%, 95% confidence interval: 0.7-19.2), 0 B250, and 4 B350 (6.5%, 95% confidence interval: 1.7-15.2) patients, without significant differences between the GDDs. Conclusions Patients with the larger (B350) or the higher profile plate (FP7) GDDs were more likely to experience diplopia than controls, and diplopia was attributable to the GDD in ~6% of patients with either a FP7 or a B350 GDD. Since diplopia can affect patients' quality of life, preoperative counseling for GDD surgery, particularly B350 and FP7, should include a discussion of the risk of diplopia.
- Published
- 2021
46. Analog Low-Latency Kramers-Kronig optical Single-Sideband Receiver
- Author
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Arthur J. Lowery and Timothy Feleppa
- Subjects
Signal processing ,business.industry ,Computer science ,02 engineering and technology ,Analog signal processing ,01 natural sciences ,Signal ,Atomic and Molecular Physics, and Optics ,Analog multiplier ,010309 optics ,020210 optoelectronics & photonics ,Modulation ,0103 physical sciences ,0202 electrical engineering, electronic engineering, information engineering ,Electronic engineering ,Compatible sideband transmission ,business ,Processing delay ,Digital signal processing - Abstract
Kramers-Kronig (KK) receivers have been shown to be able to cancel the signal-signal beat interference that occurs upon direct-photodetection in optical single-sideband systems, where the transmitted optical field is proportional to the modulation signal (Field-Modulated Direct-Detection systems). They can support complex modulation formats, and being single-sideband, electronic dispersion compensation, without the need for a coherent receiver. All current research has used digital-signal processing (DSP) to implement the KK algorithm. Radio-frequency KK receivers using analog processing were first introduced in the 1960's, and offer an alternative to DSP, particularly in their approximate form. Analog processing is inherently real-time and offers the lowest latency (processing delay). In this paper, we show that with minor changes, analog processing can also be used with signals from a photodetector. We have built an experimental receiver, using standard parts that have functionality that approximates to the desired algorithm. In particular, we show that a differential pair of bipolar transistors can approximate a square-root function, that the Hilbert transform can be approximated by an 8-tap transmission-line delay, and that a commercial analog multiplier chip can be used for a squaring and subtraction function. The system is demonstrated with 16-QAM at 500 Mbit/s with the photocurrent emulated in software and the KK algorithm performed in hardware. Finally, software band-limits the signal, down-converts it to form a constellation, and calculates symbol error rates. We show that the analog KK reduces the symbol error rate by at least a factor of ten, enabling low carrier-to-signal power ratios to be used with standard forward error correction. Much higher data rates could be supported using custom-designed microwave ASICs, which could be incorporated in packaged receivers. This would enable miniaturized receivers using standard DSP to work with dispersion-limited links. Interestingly, half the benefit could be gained by simply re-biasing the differential stage of a standard photoreceiver.
- Published
- 2021
47. Outcomes of Hypertensive Kidney Donors Using Current and Past Hypertension Definitions
- Author
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Edward A. Graviss, Horacio E. Adrogue, Hassan N. Ibrahim, Dina N. Murad, Sean A. Hebert, Duc T. Nguyen, Hana Nguyen, and Arthur J. Matas
- Subjects
medicine.medical_specialty ,Kidney ,Proteinuria ,business.industry ,030232 urology & nephrology ,Renal function ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Blood pressure ,Nephrology ,Internal medicine ,Cardiology ,medicine ,medicine.symptom ,business ,Kidney disease - Abstract
Introduction As many as 50% of U.S. transplant centers do not accept kidney donor candidates with hypertension, citing the link between hypertension, kidney disease, and cardiovascular disease (CVD). Methods We ascertained mortality, CVD, proteinuria, estimated glomerular filtration rate (eGFR) trajectory, reduced eGFR, and end-stage kidney disease (ESKD) in 904 hypertensive donors (blood pressure [BP] ≥140/90 mm Hg or receiving treatment) versus 7817 donors with BP Results Hypertensive donors were older, 58.1% were Conclusions Kidney donors with hypertension defined by past criteria do not appear to incur higher mortality, CVD, or ESKD. Donors with current definition of hypertension enjoyed similar renal outcomes but were more likely to develop CVD.
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- 2021
48. CT of Skull Base Fractures: Classification Systems, Complications, and Management
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David Dreizin, Osamu Sakai, Dheeraj Gandhi, Kathryn Champ, Arthur J. Nam, Robert E. Morales, Bizhan Aarabi, and David J. Eisenman
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Skull Base ,medicine.medical_specialty ,Cerebrospinal Fluid Leak ,Skull Fractures ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Physical examination ,Base (topology) ,Laboratory testing ,030218 nuclear medicine & medical imaging ,Fractures, Bone ,03 medical and health sciences ,Skull ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiology ,Tomography, X-Ray Computed ,business ,Retrospective Studies - Abstract
As advances in prehospital and early hospital care improve survival of the head-injured patient, radiologists are increasingly charged with understanding the myriad skull base fracture management implications conferred by CT. Successfully parlaying knowledge of skull base anatomy and fracture patterns into precise actionable clinical recommendations is a challenging task. The authors aim to provide a pragmatic overview of CT for skull base fractures within the broader context of diagnostic and treatment planning algorithms. Laterobasal, frontobasal, and posterior basal fracture patterns are emphasized. CT often plays a complementary, supportive, or confirmatory role in management of skull base fractures in conjunction with results of physical examination, laboratory testing, and neurosensory evaluation. CT provides prognostic information about short- and long-term risk of cerebrospinal fluid (CSF) leak, encephalocele, meningitis, facial nerve paralysis, hearing and vision loss, cholesteatoma, vascular injuries, and various cranial nerve palsies and syndromes. The radiologist should leverage understanding of specific strengths and limitations of CT to anticipate next steps in the skull base fracture management plan. Additional imaging is warranted to clarify ambiguity (particularly for potential sources of CSF leak); in other cases, clinical and CT criteria alone are sufficient to determine the need for intervention and the choice of surgical approach. The radiologist should be able to envision stepping into a multidisciplinary planning discussion and engaging neurotologists, neuro-ophthalmologists, neurosurgeons, neurointerventionalists, and facial reconstructive surgeons to help synthesize an optimal management plan after reviewing the skull base CT findings at hand.
- Published
- 2021
49. Holmium-166 Radioembolization
- Author
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Rutger C G Bruijnen, Arthur J. A. T. Braat, Bart de Keizer, Maarten L. J. Smits, and Marnix G.E.H. Lam
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medicine.medical_specialty ,business.industry ,Treatment outcome ,Personalized treatment ,Gastroenterology ,Individualized treatment ,030218 nuclear medicine & medical imaging ,Microsphere ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Surgery ,Medical physics ,Holmium 166 ,business - Abstract
Radioembolization is usually performed with microspheres containing yttrium-90 (90Y). Holmium-166 (166Ho)-microspheres were developed as an alternative new product for radioembolization. The unique characteristics of 166Ho-microspheres allow for improved imaging possibilities. They can be visualized and quantified, already at low numbers and activities, to predict treatment distribution using 166Ho-microspheres at scout quantity during pre-treatment simulation. The option to reliably predict the distribution of microspheres provides physicians control over the treatment, allowing them to select and treat patients with a personalized treatment plan. Safety and efficacy were established in several clinical studies. 166Ho-microspheres radioembolization aims to optimize individualized treatment planning in order to improve treatment outcomes.
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- 2021
50. Association of Patient Sex and Pregnancy Status With Naloxone Administration During Emergency Department Visits
- Author
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Lorraine Milio, Torre Halscott, Lauren A. Forbes, Joseph K. Canner, and Arthur J. Vaught
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Narcotic Antagonists ,Logistic regression ,Article ,Cohort Studies ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Pregnancy ,Naloxone ,medicine ,Humans ,030212 general & internal medicine ,Healthcare Disparities ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Retrospective cohort study ,Odds ratio ,Emergency department ,Middle Aged ,Opioid-Related Disorders ,United States ,Opioid ,Quartile ,Current Procedural Terminology ,Female ,Pregnant Women ,Emergency Service, Hospital ,business ,medicine.drug - Abstract
Objective To evaluate the association of sex and pregnancy status with rates of naloxone administration during opioid overdose-related emergency department (ED) visits by using the Nationwide Emergency Department Sample. Methods A retrospective cohort study was conducted using the Nationwide Emergency Department Sample 2016 and 2017 data sets. Eligible records included men and women, 15-49 years of age, with an opioid overdose-related ED visit; records for women were stratified by pregnancy status (International Classification of Diseases, Tenth Revision O codes). A multivariable logistic regression model was used to assess the primary outcome of naloxone administration (Current Procedural Terminology code: J2310). Secondary outcomes included subsequent admission and mortality. A subgroup analysis compared pregnant women who did receive naloxone compared with those who did not receive naloxone. Results Records from 443,714 men, 304,364 nonpregnant women, and 25,056 pregnant women were included. Nonpregnant women had lower odds for naloxone administration (1.70% vs 2.10%; adjusted odds ratio [aOR] 0.86 [95% CI 0.83-0.89]) and mortality (2.21% vs 2.99%; aOR 0.71 [95% CI 0.69-0.73]) but higher odds of subsequent admission (30.22% vs 27.18%; aOR 1.04 [95% CI 1.03-1.06]) compared with men. Pregnant women had lower odds for naloxone administration (0.27% vs 1.70%; aOR 0.16 [95% CI 0.13-0.21]) and mortality (0.41% vs 2.21%; aOR 0.28 [95% CI 0.23-0.35]) but higher odds of subsequent admission (40.50% vs 30.22%; aOR 2.04 [95% CI 2.00-2.10]) compared with nonpregnant women. Pregnant women who received naloxone had higher odds of mortality (14% vs 0.39%; aOR 6.30 [95% CI 2.11-18.78]) compared with pregnant women who did not receive naloxone. Pregnant women who did not receive naloxone were more likely to have Medicaid as their expected insurance payer, be in the lowest quartile of median household income for residence ZIP codes, and have a concurrent mental health diagnosis compared with pregnant women who did receive naloxone. Conclusion Reproductive-aged women who are nonpregnant and pregnant were less likely to receive naloxone during opioid overdose-related ED visits compared with reproductive-aged men. Naloxone administration for reproductive-aged women should be prioritized in the efforts to reduce opioid- and pregnancy-related morbidity and mortality in the United States.
- Published
- 2021
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