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Emily M Ko, Laura J Havrilesky, Ronald D Alvarez, Oliver Zivanovic, Leslie R Boyd, Elizabeth L Jewell, Patrick F Timmins, Randall S Gibb, Anuja Jhingran, David E Cohn, Sean C Dowdy, Matthew A Powell, Eva Chalas, Yongmei Huang, Jill Rathbun, Jason D Wright
Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer...
March 12, 2018: Gynecologic Oncology
Jason D Wright, Laura J Havrilesky, David E Cohn, Yongmei Huang, Jill Rathbun, Laurel W Rice, Carol L Brown, Ronald D Alvarez, Emily M Ko
OBJECTIVE: To design an endometrial cancer (EC) alternative payment (ECAP) model focused on surgical management of EC, as well as identify drivers of cost in order to develop opportunities for cost-savings while maintaining quality of care. METHODS: National practice patterns and reimbursements were compared between private payers (MarketScan data, years 2009-13) and public payers (Medicare, year 2014) of EC patients who underwent hysterectomy. An episode of care for EC included the hysterectomy, stratified by surgical approach (laparotomy versus robotic versus laparoscopy), and in- and outpatient reimbursements from 30days preoperatively to 60days postoperatively...
February 26, 2018: Gynecologic Oncology
Razieh Alemi, Masoud Motassadi Zarandy, Mohammad Taghi Joghataei, Ali Eftekharian, Mohammad Reza Zarrindast, Nasim Vousooghi
INTRODUCTION: Sensory neural hearing loss could lead to some structural and physiological changes in the auditory pathways, such as alteration in the expression of neurotrophins. These factors, especially Brain-Derived Neurotrophic Factor (BDNF), play an important role in synaptic functions and experience-related plasticity. Restoring cochlear function after hearing loss is possible through cochlear implantation (CI). Evaluation of the blood concentration changes of neurotrophins as prerequisites of plasticity could help scientists to determine the prognosis of CI as in the candidacy procedure or enhancing prosthesis function by adding the exact needed amount of BDNF to the electrode array...
February 2018: International Journal of Pediatric Otorhinolaryngology
Shaoxiong Zhang, Ming Li, Hongxia Wang, Weili Cheng, Weiwei Lei, Yiming Liu, Wei Liang
Mg-9Al-1Si-1SiC composites with various initial microstructures prior to equal channel angular pressing (ECAP) were obtained by different pre-treatments (without and with homogenization treatment), and the resultant grain size, second phase and tensile properties of ECAPed composites were reported. The ECAPed composite with homogenization treatment (HT) exhibited finer grain size, higher fraction of dynamically recrystallized (DRXed) grains, weaker texture intensity, as well as the presence of dynamic precipitated Mg17Al12 phase compared to that without HT...
January 15, 2018: Materials
Joshua Cody Page, Matthew D Cox, Blake Hollowoa, Juliana Bonilla-Velez, Aaron Trinidade, John L Dornhoffer
OBJECTIVE: No consensus guidelines exist regarding intraoperative testing during cochlear implantation and wide variation in practice habits exists. The objective of this observational study was to survey otologists/neurotologists to understand practice habits and overall opinion of usefulness of intraoperative testing. STUDY DESIGN: Cross-sectional survey. SETTING: A web-based survey was sent to 194 practicing Otologists/Neurotologists. MAIN OUTCOME MEASURES: Questions included practice setting and experience, habits with respect to electrodes used, intraoperative testing modalities used, overall opinion of intraoperative testing, and practice habits in various scenarios...
January 16, 2018: Otology & Neurotology
Hao Zhang, Ling Yang, Wanjian Ding, Yingying Ma
The accepted catalytic mechanism of alkaline phosphatases was established on the hypothesis that Mg-coordinated water is a readily available hydroxide ion that functions as a general base and accepts a proton from the Ser102 hydroxyl group. The roles of the two distinctive residues Asp153 and Lys328 in Escherichia coli alkaline phosphatase (ECAP), which distinguish it from the mammalian enzymes, are elusive. Based on the crystal structures of ECAP in the absence and presence of inorganic phosphate, we have investigated the activation of Ser102 for nucleophilic attack and the subsequent formation of a covalent phosphoseryl intermediate using hybrid density functional theory (DFT) with the B3LYP functional...
December 30, 2017: Journal of Biological Inorganic Chemistry: JBIC
Jan Dirk Biesheuvel, Jeroen J Briaire, Johan H M Frijns
OBJECTIVE: An amplitude growth function (AGF) shows the amplitude of an electrically evoked compound action potential (eCAP) as a function of the stimulation current. AGFs can be used to derive the eCAP threshold, which represents the minimum amount of current needed to elicit a measurable eCAP. eCAP thresholds have been widely used clinically to, for example, assist with sound processor programming. However, no eCAP precision has been included to date. The aim of this study was to investigate the precision of eCAP thresholds and determine whether they are precise enough for clinical use...
December 6, 2017: Ear and Hearing
Anna Morozova, Elijah Borodin, Vladimir Bratov, Sergey Zherebtsov, Andrey Belyakov, Rustam Kaibyshev
This paper investigates the microstructural evolution and grain refinement kinetics of a solution-treated Cu-0.1Cr-0.06Zr alloy during equal channel angular pressing (ECAP) at a temperature of 673 K via route BC . The microstructural change during plastic deformation was accompanied by the formation of the microband and an increase in the misorientations of strain-induced subboundaries. We argue that continuous dynamic recrystallization refined the initially coarse grains, and discuss the dynamic recrystallization kinetics in terms of grain/subgrain boundary triple junction evolution...
December 6, 2017: Materials
T A K Nguyen, Samuel Cavuscens, Maurizio Ranieri, Konrad Schwarz, Nils Guinand, Raymond van de Berg, Thomas van den Boogert, Floor Lucieer, Marc van Hoof, Jean-Philippe Guyot, Herman Kingma, Silvestro Micera, Angelica Perez Fornos
The peripheral vestibular system is critical for the execution of activities of daily life as it provides movement and orientation information to motor and sensory systems. Patients with bilateral vestibular hypofunction experience a significant decrease in quality of life and have currently no viable treatment option. Vestibular implants could eventually restore vestibular function. Most vestibular implant prototypes to date are modified cochlear implants to fast-track development. These use various objective measurements, such as the electrically evoked compound action potential (eCAP), to supplement behavioral information...
2017: Frontiers in Neuroscience
Sebastian Hoth, Philipp Spitzer, Mark Praetorius
BACKGROUND: Electrically evoked compound action potentials (ECAPs) of the auditory nerve are routinely recorded for testing the cochlear implant integrity and its functional connection to the auditory system. The response thresholds derived from ECAP recordings are widely used as a helpful guide in the fitting of the dynamic range of electric stimulation, although they may not always predict the behavioral thresholds of individuals well. Conventionally, this threshold is based on the identification of a minimum N peak and maximum P peak and linear extrapolation of the resulting amplitude growth function (AGF)...
November 22, 2017: Cochlear Implants International
Paul Ramchandani
No abstract text is available yet for this article.
December 2017: European Child & Adolescent Psychiatry
Sebastian Hoth, Oliver Christian Dziemba
: Auditory evoked potentials (AEP) are highly demanded during the whole process of equipping patients with cochlear implants (CI). They play an essential role in preoperative diagnostics, intraoperative testing, and postoperative monitoring of auditory performance and success. The versatility of AEP's is essentially enhanced by their property to be evokable by acoustic as well as electric stimuli. Thus, the electric responses of the auditory system following acoustic stimulation and recorded by the conventional surface technique as well as by transtympanic derivation from the promontory (Electrocochleography [ECochG]) are used for the quantitative determination of hearing loss and, additionally, electrically evoked compound actions potentials (ECAP) can be recorded with the intracochlear electrodes of the implant just adjacent to the stimulation electrode to check the functional integrity of the device and its coupling to the auditory system...
December 2017: Otology & Neurotology
M Smits, M Rutten, L Schepers, P Giesen
OBJECTIVE: There is a trend for General Practitioner Cooperatives (GPCs) to co-locate with emergency departments (EDs) of hospitals at Emergency Care Access Points (ECAPs), where the GPCs generally conduct triage and treat a large part of self-referrals who would have gone to the ED by themselves in the past. We have examined patient and care characteristics of self-referrals at ECAPs where triage was conducted by GPCs, also to determine the percentage of self-referrals being referred to the ED...
2017: Nederlands Tijdschrift Voor Geneeskunde
Martijn Hendrik Rutten, Marleen Smits, Yvonne Anthonia Sebastiana Peters, Willem Jan Jozef Assendelft, Gert Pieter Westert, Paul Hendrikus Josephus Giesen
Background: In the Netherlands, out-of-hours primary care is provided in general-practitioner-cooperatives (GPCs). These are increasingly located on site with emergency departments (ED), forming Emergency-Care-Access-Points (ECAP). A more efficient and economical organization of out-of-hours primary emergency care could be realized by increased collaboration at an ECAP. In this study, we compared the effects of different models with respect to access to (hospital) radiology by the GPC...
September 28, 2017: Family Practice
Emily R Spitzer, Michelle L Hughes
BACKGROUND: Contemporary cochlear implants (CIs) use cathodic-leading, symmetrical, biphasic current pulses, despite a growing body of evidence that suggests anodic-leading pulses may be more effective at stimulating the auditory system. However, since much of this research on humans has used pseudomonophasic pulses or biphasic pulses with unusually long interphase gaps, the effects of stimulus polarity are unclear for clinically relevant (i.e., symmetric biphasic) stimuli. PURPOSE: The purpose of this study was to examine the effects of stimulus polarity on basic characteristics of physiological spread-of-excitation (SOE) measures obtained with the electrically evoked compound action potential (ECAP) in CI recipients using clinically relevant stimuli...
October 2017: Journal of the American Academy of Audiology
Matthias Hey, Joachim Müller-Deile, Horst Hessel, Matthijs Killian
In this study we aim to resolve the contributions of facilitation and refractoriness at very short pulse intervals. Measurements of the refractory properties of the electrically evoked compound action potential (ECAP) of the auditory nerve in cochlear implant (CI) users at inter pulse intervals below 300 μs are influenced by facilitation and recovery effects. ECAPs were recorded using masker pulses with a wide range of current levels relative to the probe pulse levels, for three suprathreshold probe levels and pulse intervals from 13 to 200 μs...
September 11, 2017: Hearing Research
Johan J de Vos, Jan Dirk Biesheuvel, Jeroen J Briaire, Pieter S Boot, Margriet J van Gendt, Olaf M Dekkers, Marta Fiocco, Johan H M Frijns
OBJECTIVES: The electrically evoked compound action potential (eCAP) is widely used in the clinic as an objective measure to assess cochlear implant functionality. During the past decade, there has been increasing interest in applying eCAPs for fitting of cochlear implants. Several studies have shown that eCAP-based fitting can potentially replace time-consuming behavioral fitting procedures, especially in young children. However, a closer look to all available literature revealed that there is no clear consensus on the validity of this fitting procedure...
September 22, 2017: Ear and Hearing
Marc Russo, Michael J Cousins, Charles Brooker, Nathan Taylor, Tillman Boesel, Richard Sullivan, Lawrence Poree, Nastaran Hesam Shariati, Erin Hanson, John Parker
OBJECTIVES: Conventional spinal cord stimulation (SCS) delivers a fixed-input of energy into the dorsal column. Physiologic effects such as heartbeat, respiration, spinal cord movement, and history of stimulation can cause both the perceived intensity and recruitment of stimulation to increase or decrease, with clinical consequences. A new SCS system controls stimulation dose by measuring the recruitment of fibers in the dorsal column and by using the amplitude of the evoked compound action potentials (ECAPs) to maintain stimulation within an individualized therapeutic range...
September 18, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Lisa R Park, Holly F B Teagle, Kevin D Brown, Erika B Gagnon, Jennifer S Woodard, Craig A Buchman
OBJECTIVE: To identify differences in outcomes and map characteristics in pediatric bilateral cochlear implants with modiolar conforming and lateral wall arrays in opposite ears. STUDY DESIGN: Retrospective case series. SETTING: Tertiary care pediatric referral center. PATIENTS: Fourteen children who received a perimodiolar array in one ear and a slim straight array in the opposite ear in sequential surgeries. INTERVENTIONS: None...
October 2017: Otology & Neurotology
Joanna Kinga Ponińska, Bolesław Samoliński, Aneta Tomaszewska, Filip Raciborski, Piotr Samel-Kowalik, Artur Walkiewicz, Agnieszka Lipiec, Barbara Piekarska, Edyta Krzych-Fałta, Andrzej Namysłowski, Grażyna Kostrzewa, Andrzej Pawlik, Monika Jasek, Andrzej Wiśniewski, Piotr Kuśnierczyk, Sławomir Majewski, Rafał Płoski
The T allele of rs7927894 (at 11q13.5) was associated with atopic dermatitis and other allergic diseases. Our purpose was to replicate the association with allergic phenotypes and explore the role of rs7927894 in predisposing to persistent allergic rhinitis and atopic asthma. We also wanted to explore if other SNPs at 11q13.5 contributed to effect of rs7927894. We studied patients with atopic dermatitis (N = 270), atopic asthma (N = 486), persistent allergic rhinitis (N = 589) and controls matched for age, sex and region (N = 540, N = 372 and N = 1178, respectively)...
2017: PloS One
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