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Yaniv Zipori, Karen Reidy, T Gilchrist, Lex W Doyle, Mark P Umstad
BACKGROUND: Monochorionic diamniotic (MCDA) twin pregnancies are associated with adverse perinatal outcome. Intertwin discordances at the time of nuchal translucency (NT) screening may have a value in the prediction of fetal loss or twin-to-twin transfusion syndrome. We aimed to determine the ability of intertwin NT and crown rump length (CRL) discordances among MCDA twins to predict adverse outcomes. MATERIAL AND METHODS: All MCDA twins with a documented routine ultrasound at 11 to 13+6 weeks' gestation, and known pregnancy outcome between August 2003 and August 2012 were included...
October 21, 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Y Wang, Y Wei, P B Yuan, X J Wang, Y Y Zhao
Objective: To analyze the prognosis of surviving monochorionic co-twin after single intrauterine fetal demise (sIUFD). Methods: Retrospectively analyzed the twin pregnancy cases admitted in Peking University Third Hospital between Jan 2008 and Feb 2015. We recorded perinatal characteristics, neuroimage in co-twin, and followed up the neonatal outcome. Results: 47 cases were found, including 45 cases of monochorionic diamniotic (MCDA) and 2 cases of monochorionic monoamniotic (MCMA). Median gestational age at sIUFD was 27 weeks...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Georgi Iskrov, Tsonka Miteva-Katrandzhieva, Rumen Stefanov
BACKGROUND: Limited resources and expanding expectations push all countries and types of health systems to adopt new approaches in priority setting and resources allocation. Despite best efforts, it is difficult to reconcile all competing interests, and trade-offs are inevitable. This is why multi-criteria decision analysis (MCDA) has played a major role in recent uptake of value-based reimbursement. MCDA framework enables exploration of stakeholders' preferences, as well as explicit organization of broad range of criteria on which real-world decisions are made...
2016: Frontiers in Public Health
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR)...
October 12, 2016: Prenatal Diagnosis
M L Avila, L R Brandão, S Williams, M I Montoya, J Stinson, A Kiss, B M Feldman
BACKGROUND: Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis defined by the presence of characteristic signs and symptoms. We developed a discriminative and evaluative index for the assessment of upper and lower extremity (UE/LE) pediatric PTS. METHODS: The items to be included in the index were voted for by 26 pediatric thrombosis experts invited to participate in a Delphi survey. Subsequent item weighting was based on item importance elicited using multi-criteria decision analysis (MCDA); 122 health care providers and patients/parents participated in item weighting...
October 6, 2016: Journal of Thrombosis and Haemostasis: JTH
Hector Eduardo Castro Jaramillo, Mireille Goetghebeur, Ornella Moreno-Mattar
OBJECTIVES: In 2012, Colombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute (IETS), the disbandment of the Regulatory Commission for Health and the reassignment of reimbursement decision-making powers to the Ministry of Health and Social Protection (MoHSP). These dynamic changes provided the opportunity to test Multi-Criteria Decision Analysis (MCDA) for systematic and more transparent resource-allocation decision-making...
October 3, 2016: International Journal of Technology Assessment in Health Care
Jun Zheng, Christoph Egger, Judit Lienert
Wastewater infrastructure management is increasingly important because of urbanization, environmental pollutants, aging infrastructures, and climate change. We propose a scenario-based multi-criteria decision analysis (MCDA) framework to compare different infrastructure alternatives in terms of their sustainability. These range from the current centralized system to semi- and fully decentralized options. Various sources of uncertainty are considered, including external socio-economic uncertainty captured by future scenarios, uncertainty in predicting outcomes of alternatives, and incomplete preferences of stakeholders...
December 1, 2016: Journal of Environmental Management
Erin E Yost, John Stanek, Lyle D Burgoon
Despite growing concerns over the potential for hydraulic fracturing to impact drinking water resources, there are limited data available to identify chemicals used in hydraulic fracturing fluids that may pose public health concerns. In an effort to explore these potential hazards, a multi-criteria decision analysis (MCDA) framework was employed to analyze and rank selected subsets of these chemicals by integrating data on toxicity, frequency of use, and physicochemical properties that describe transport in water...
September 22, 2016: Science of the Total Environment
Oliver T Stirrup, Asma Khalil, Francesco D'Antonio, Baskaran Thilaganathan
INTRODUCTION: This study investigates patterns of intertwin size discordance in dichorionic diamniotic (DCDA) and monochorionic diamniotic (MCDA) twin pregnancies. MATERIAL AND METHODS: Ultrasound measurements of twin pregnancies, from 14 weeks to term, were collected by 9 hospitals over a 10-year period. This analysis considers the modelled and observed levels of discordance in abdominal circumference (AC) and estimated fetal weight (EFW) in relation to gestational age...
September 14, 2016: Fetal Diagnosis and Therapy
Rebecca McDonald, Ryan Hodges, Michelle Knight, Mark Teoh, Andrew Edwards, Peter Neil, Euan M Wallace, Philip DeKoninck
INTRODUCTION: Monochorionic-diamniotic (MCDA) twin pregnancies are high risk, due to twin-to-twin transfusion syndrome (TTTS), twin anaemia polycythaemia sequence (TAPS) and intrauterine growth restriction (IUGR). There is limited evidence to guide ultrasound surveillance protocols. Using a retrospective cohort, we aimed to provide insight into the optimal interval of ultrasound surveillance. METHODS: Retrospective cohort of women with MCDA pregnancies who received antenatal care at Monash Medical Centre (January 2011-October 2014)...
August 25, 2016: Fetal Diagnosis and Therapy
Hiroshi Kawamura, Keisuke Ishii, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To evaluate the incidence of twin-twin transfusion syndrome (TTTS) and the perinatal outcome at 28 days of age in monochorionic diamniotic (MCDA) pregnancies complicated with isolated polyhydramnios (I-Poly) and isolated oligohydramnios (I-Oligo) diagnosed < 26 weeks of gestation. METHODS: This was a retrospective study of women with MCDA pregnancies diagnosed with I-Poly or I-Oligo before 26 weeks of gestation over a period of six years. The incidence of subsequent TTTS and neonatal outcome in terms of intact survival (IS) at 28 days of age were evaluated...
August 24, 2016: Journal of Obstetrics and Gynaecology Research
Mathilde C Paul, Flavie L Goutard, Floriane Roulleau, Davun Holl, Weerapong Thanapongtharm, François L Roger, Annelise Tran
The Highly Pathogenic Avian Influenza H5N1 (HPAI) virus is now considered endemic in several Asian countries. In Cambodia, the virus has been circulating in the poultry population since 2004, with a dramatic effect on farmers' livelihoods and public health. In Thailand, surveillance and control are still important to prevent any new H5N1 incursion. Risk mapping can contribute effectively to disease surveillance and control systems, but is a very challenging task in the absence of reliable disease data. In this work, we used spatial multicriteria decision analysis (MCDA) to produce risk maps for HPAI H5N1 in poultry...
2016: Scientific Reports
Eli M Miloslavsky, Ray P Naden, Johannes W J Bijlsma, Paul A Brogan, E Sherwood Brown, Paul Brunetta, Frank Buttgereit, Hyon K Choi, Jean-Francois DiCaire, Jeffrey M Gelfand, Liam G Heaney, Liz Lightstone, Na Lu, Dedee F Murrell, Michelle Petri, James T Rosenbaum, Kenneth S Saag, Murray B Urowitz, Kevin L Winthrop, John H Stone
OBJECTIVES: To develop a Glucocorticoid Toxicity Index (GTI) to assess glucocorticoid (GC)-related morbidity and GC-sparing ability of other therapies. METHODS: Nineteen experts on GC use and outcome measures from 11 subspecialties participated. Ten experts were from the USA; nine from Canada, Europe or Australia. Group consensus methods and multicriteria decision analysis (MCDA) were used. A Composite GTI and Specific List comprise the overall GTI. The Composite GTI reflects toxicity likely to change during a clinical trial...
July 29, 2016: Annals of the Rheumatic Diseases
Stephan Bartke, Stanislav Martinát, Petr Klusáček, Lisa Pizzol, Filip Alexandrescu, Bohumil Frantál, Andrea Critto, Alex Zabeo
Prioritizing brownfields for redevelopment in real estate portfolios can contribute to more sustainable regeneration and land management. Owners of large real estate and brownfield portfolios are challenged to allocate their limited resources to the development of the most critical or promising sites, in terms of time and cost efficiency. Authorities worried about the negative impacts of brownfields - in particular in the case of potential contamination - on the environment and society also need to prioritize their resources to those brownfields that most urgently deserve attention and intervention...
July 21, 2016: Journal of Environmental Management
Yang Zhang, Jing Shen, Feng Ding, Yu Li, Li He
Atmospheric environment quality worsening is a substantial threat to public health worldwide, and in many places, air pollution due to the intensification of the human activity is increasing dramatically. However, no studies have been investigated the integration of vulnerability assessment and atmospheric environment driven by human impacts. The objective of this study was to identify and prioritize the undesirable environmental changes as an early warning system for environment managers and decision makers in term of human, atmospheric environment, and social economic elements...
November 15, 2016: Science of the Total Environment
Rebecca Fischbein, James Meeker, Julia R Saling, Michelle Chyatte, Lauren Nicholas
BACKGROUND: Twin-to-twin transfusion syndrome (TTTS) affects 10-20 % of monochorionic diamniotic (MCDA) births and accounts for 50 % of fetal loss in MCDA pregnancies. This exploratory qualitative study identified shared experiences, including potential emotional and psychosocial impacts, of this serious disease. METHODS: Forty-five publicly accessible, online stories posted by families who experienced TTTS were analyzed using grounded theory. RESULTS: Shared TTTS experiences included a common trajectory: early pregnancy experiences, diagnostic experiences, making decisions, interventions and variable outcomes...
2016: BMC Pregnancy and Childbirth
Omar Boutkhoum, Mohamed Hanine, Hicham Boukhriss, Tarik Agouti, Abdessadek Tikniouine
At present, environmental issues become real critical barriers for many supply chain corporations concerning the sustainability of their businesses. In this context, several studies have been proposed from both academia and industry trying to develop new measurements related to green supply chain management (GSCM) practices to overcome these barriers, which will help create new environmental strategies, implementing those practices in their manufacturing processes. The objective of this study is to present the technical and analytical contribution that multi-criteria decision making analysis (MCDA) can bring to environmental decision making problems, and especially to GSCM field...
2016: SpringerPlus
Mette Kjer Kaltoft, Jesper Bo Nielsen, Glenn Salkeld, Jack Dowie
An interactive decision support tool based on Multi-Criteria Decision Analysis (MCDA) can help health professionals integrate the principlist (principle-based) and casuist (case-based) approaches to ethical decision making in both their training and practice. MCDA can incorporate generic ethical principles as criteria; then draw on case-based reasoning as the basis for specifying, in the individual case, the available options, the ratings of each option on each criterion, and the relative weighting of the criteria...
2016: Studies in Health Technology and Informatics
Ruan Peng, Yi Zhou, Hong-Ning Xie, Ju Zheng, Ying-Jun Xie, Jian-Bo Yang
OBJECTIVE: To evaluate whether discrepant copy number variations (CNVs) contribute to the risk for discordant congenital anomalies in monochorionic diamniotic (MCDA) twins. METHODS: We conducted a parallel testing using both G-banding for standard karyotyping and chromosomal microarray analysis (CMA) with Affymetrix CytoScan HD array in MCDA twins with discordant malformations. RESULTS: During the study period, 193 MCDA twins with discordant malformations were detected and followed up...
August 2016: Prenatal Diagnosis
Zhaoguo Wang, Xishihui Du
Natural World Heritage Sites (NWHSs) are invaluable treasure due to the uniqueness of each site. Proper monitoring and management can guarantee their protection from multiple threats. In this study, geographic information system (GIS)-based multi-criteria decision analysis (GIS-MCDA) was used to assess criteria layers acquired from the data available in the literature. A conceptual model for determining the priority area for monitoring in Bogda, China, was created based on outstanding universal values (OUV) and expert knowledge...
July 2016: Environmental Monitoring and Assessment
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