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Erin E Washburn, Teresa N Sparks, Kristen A Gosnell, Larry Rand, Juan M Gonzalez, Vickie A Feldstein
OBJECTIVE:  This article describes the natural history of stage I twin-twin transfusion syndrome (TTTS) including risk of progression to higher stage TTTS and pregnancy outcomes, and to identify risk factors for progression. STUDY DESIGN:  Retrospective cohort study of monochorionic diamniotic (MCDA) twin pregnancies from 2006 to 2016 with expectantly managed Quintero stage I TTTS. RESULTS:  A total of 30 MCDA twin pregnancies with expectantly managed stage I TTTS were identified...
February 8, 2018: American Journal of Perinatology
Guang-Zhi Ning, Shun-Li Kan, Ru-Sen Zhu, Shi-Qing Feng
OBJECTIVE: Mobi-C cervical disc arthroplasty (MCDA) has been regarded as an alternative to anterior cervical discectomy and fusion (ACDF). In this study, the effectiveness and safety between MCDA and ACDF for symptomatic cervical degenerative disc disease was evaluated. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials. Studies were included based on the eligibility criteria. Risk of bias assessment and quality of evidence assessment were performed...
March 7, 2018: World Neurosurgery
Cristina Mitric, Vincent Ponette
BACKGROUND: In twin pregnancies, elective cerclage placement based on obstetrical history or ultrasound findings has been shown to be ineffective and even harmful. There are currently no guidelines for the use of rescue cervical cerclage in twin pregnancies. CASE: The current report presents the case of a 33-year-old patient with monochorionic diamniotic twins (MCDA) found to have dilated cervix at 3.5cm with exposed membranes upon physical examination at 19 weeks and 3 days...
March 1, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Robert Anderson, Jenny Norrman, Pär-Erik Back, Tore Söderqvist, Lars Rosén
Decision support tools (DST) are often used in remediation projects to aid in the complex decision on how best to remediate a contaminated site. In recent years, the sustainable remediation concept has brought increased attention to the often-overlooked contradictory effects of site remediation, with a number of sustainability assessment tools now available. The aim of the present study is twofold: (1) to demonstrate how and when different assessment views affect the decision support outcome on remediation alternatives in a DST, and (2) to demonstrate the contribution of a full sustainability assessment...
February 20, 2018: Science of the Total Environment
Carlos Campillo-Artero, Jaume Puig-Junoy, Anthony J Culyer
No abstract text is available yet for this article.
February 21, 2018: Applied Health Economics and Health Policy
Keisuke Ishii, Seiji Wada, Mayumi Takano, Masahiko Nakata, Takeshi Murakoshi, Haruhiko Sago
INTRODUCTION: We aimed to clarify the survival rate without brain abnormalities (BA) after fetoscopic laser photoco-agulation (FLP) for monochorionic diamniotic twin gestations (MCDA) with selective intrauterine growth restriction (sIUGR) accompanied by abnormal umbilical artery (UA) Doppler waveforms and isolated oligohydramnios in the sIUGR twin. MATERIALS AND METHODS: This retrospective study included 52 cases that underwent FLP. The main outcome was survival rate without BA of the twins at age 28 days...
February 20, 2018: Fetal Diagnosis and Therapy
Yi Zhang, Linhuan Huang, Xuan Huang, Zhiming He, Shaobin Lin, Ye Wang, Lin Li, Yanmin Luo, Qun Fang
OBJECTIVE: To investigate the types of cardiovascular anomalies and the results of invasive prenatal diagnosis in twin fetuses. METHODS: A total of 298 fetuses in 149 twin pairs were enrolled, in which 1 or 2 fetuses of a twin pair had cardiovascular anomalies. Prenatal diagnosis was performed on 290 fetuses of 149 twin pairs, including 150 monochorionic diamniotic (MCDA) fetuses (79 pairs) and 140 dichorionic diamniotic (DCDA) fetuses (70 pairs). G-banding karyotyping and/or chromosomal microarray analysis (CMA) were performed...
February 19, 2018: Prenatal Diagnosis
Ole Rogeberg, Daniel Bergsvik, Lawrence D Phillips, Jan van Amsterdam, Niamh Eastwood, Graeme Henderson, Micheal Lynskey, Fiona Measham, Rhys Ponton, Steve Rolles, Anne Katrin Schlag, Polly Taylor, David Nutt
BACKGROUND: Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across multiple research disciplines making integrated judgements difficult. METHODS: Experts on drug harms, addiction, criminology and drug policy were invited to a decision conference to develop a multi-criterion decision analysis (MCDA) model for appraising alternative regulatory regimes...
February 16, 2018: International Journal on Drug Policy
Takashi Imamura, Hajime Maeda, Hidetoshi Kinoshita, Shogo Kin
When to deliver the monochorionic diamniotic (MCDA) twins with specific cord patterns? Although there is no clear evidence supporting an earlier delivery (before 36 weeks of gestation) in MCDA twins, an earlier delivery might prevent intrauterine death or neuromorbidity in MCDA twins with specific cord patterns.
February 2018: Clinical Case Reports
Nereo Vettoretto, Emanuela Foglia, Lucrezia Ferrario, Alberto Arezzo, Roberto Cirocchi, Gianfranco Cocorullo, Giuseppe Currò, Domenico Marchi, Giuseppe Portale, Chiara Gerardi, Umberto Nocco, Michele Tringali, Gabriele Anania, Micaela Piccoli, Gianfranco Silecchia, Mario Morino, Andrea Valeri, Emauele Lettieri
BACKGROUND: Three-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken from a full health technology assessment report on three-dimensional vision technology compared with standard two-dimensional laparoscopic systems. METHODS: A health technology assessment approach was implemented in order to investigate all the economic, social, ethical and organisational implications related to the adoption of the innovative three-dimensional view...
January 24, 2018: Surgical Endoscopy
Simen Vergote, Liesbeth Lewi, Willem Gheysen, Luc de Catte, Roland Devlieger, Jan Deprest
BACKGROUND: An improved survival and quality of life for neonatal survivors after fetoscopic laser therapy (FLC) for twin-twin transfusion syndrome (TTTS) has been reported. However, little is known about the medium-term maternal effects after FLC with respect to reproductive and gynecologic outcomes. OBJECTIVE: To document reproductive, obstetric, gynecologic and psychological outcomes in women who underwent FLC for TTTS. STUDY DESIGN: Monocentric controlled study on consecutive women who underwent FLC for TTTS between 2007 and 2013 at the University Hospitals Leuven (cases; n=198)...
January 12, 2018: American Journal of Obstetrics and Gynecology
Hiroko Konno, Takeshi Murakoshi, Akiko Yamashita, Mitsuru Matsushita
AIM: We evaluated risk factors for birthweight discordance in monochorionic diamniotic (MCDA) twin pregnancies without twin-twin transfusion syndrome (TTTS). METHODS: We investigated all MCDA twin placentas injected with colored dye at our institution between 2007 and 2015. We excluded pairs of twins with TTTS, fetal demise, or severe fetal malformation. All pairs of twins were assigned to the discordant group (birthweight discordance ≥ 25%) or the concordant group (birthweight discordance < 25%)...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
Afshin Khoshand, Ali Hasani Bafrani, Mohammad Zahedipour, Seyed Ahmad Mirbagheri, Majid Ehtehsami
Landfilling of municipal solid waste (MSW) is one of the serious environmental concerns as improper location of MSW landfill site can release the pollutants into the surrounding environment. The process of selecting MSW landfill site is a complicated decision making problem since it is subjected to simultaneous assessment of several environmental criteria, rules, and restrictions besides sociocultural and economic ones. The current study suggests a framework based on Multicriteria spatial decision support systems (MC-SDSS) to select landfill site...
January 6, 2018: Environmental Science and Pollution Research International
Amanda Henry, Saranya Gopikrishna, Aditi Mahajan, Jennifer Alphonse, Neama Meriki, Alec W Welsh
AIMS: Assess clinical utility of the foetal Myocardial Performance Index (MPI) in evaluation and management of monochorionic, diamniotic twin (MCDA) pregnancies. METHODS: Prospective cohort of (a) initially uncomplicated MCDA (b) Complicated MCDA, including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and liquor and/or growth discordance (L/GD) not meeting TTTS or sIUGR criteria. TTTS and sIUGR were case-control matched...
January 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
Martijn Eikelboom, Alice do Carmo Precci Lopes, Claudio Mudadu Silva, Fábio de Ávila Rodrigues, Antônio José Vinha Zanuncio, José Cola Zanuncio
The Multi-Criteria Decision Analysis (MCDA) procedure was used to compare waste management options for kraft pulp mill sludge following its anaerobic digestion. Anaerobic digestion of sludge is advantageous because it produces biogas that may be used to generate electricity, heat and biofuels. However, adequate management of the digested sludge is essential. Landfill disposal is a non-sustainable waste management alternative. Kraft pulp mill digested sludge applied to land may pose risks to the environment and public health if the sludge has not been properly treated...
2018: PloS One
Erin E Washburn, Teresa N Sparks, Kristen A Gosnell, Larry Rand, Juan M Gonzalez, Vickie A Feldstein
OBJECTIVE:  The significance of polyhydramnios of one twin in the absence of oligohydramnios of the cotwin in monochorionic diamniotic (MCDA) twin pregnancies (polyhydramnios affecting a recipient-like twin [PART]) is unknown. Our aim is to assess the risk of progression to twin-twin transfusion syndrome (TTTS) with PART, progression to ≥ stage II TTTS, and neonatal survival. STUDY DESIGN:  This study was a retrospective cohort study of MCDA twin pregnancies with PART evaluated at a referral center from 2008 to 2015...
December 29, 2017: American Journal of Perinatology
Kevin Marsh, J Jaime Caro, Erica Zaiser, James Heywood, Alaa Hamed
OBJECTIVES: Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. METHODS: This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences...
January 2018: International Journal of Technology Assessment in Health Care
Surjeet Singh, N C Ghosh, Suman Gurjar, Gopal Krishan, Sumant Kumar, Preeti Berwal
Agriculture is a major sector in India which contributes around 14% of country's gross domestic product (GDP). Being an agriculture-based country, good quality of water for irrigation has been a prime requisite. Highly growing population and accelerated industrial development are causing anthropogenic pollution to both surface and groundwater on one side and geogenic contamination like arsenic, fluoride, high dissolved solids, sodicity, and iron in groundwater on other side. As a result, ensuring safe water quality for the irrigation has become a major challenge to both the central and state governments...
December 19, 2017: Environmental Monitoring and Assessment
Tommi Tervonen, Anastasia Ustyugova, Sumitra Sri Bhashyam, Gregory Y H Lip, Paolo Verdecchia, Ryan Kwan, Savion Gropper, Jutta Heinrich-Nols, Kevin Marsh
BACKGROUND: Decision on the most appropriate oral anticoagulation therapy for stroke prevention in patients with nonvalvular atrial fibrillation is difficult because multiple treatment options are available, and these vary in their clinical effects and relevant nonclinical characteristics. OBJECTIVES: To use a multicriteria decision analysis (MCDA) to compare the oral anticoagulants apixaban, dabigatran, edoxaban, rivaroxaban, and vitamin K antagonist (VKAs; specifically warfarin) in patients with nonvalvular atrial fibrillation...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Georgi Iskrov, Tsonka Miteva-Katrandzhieva, Rumen Stefanov
Innovative rare disease therapies and health technology assessment (HTA) share a lot of similarities. Both represent cases of interaction of epidemiology and health economics. Both are relatively new topics in public health practice. And both pose a lot of challenges to rare disease stakeholders who are currently looking for tools to support the timely access to innovative treatments while putting budget spending in order. This is why optimisation of assessment and appraisal of new rare disease therapies is a fundamental issue in rare disease health policy...
2017: Advances in Experimental Medicine and Biology
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