National Trends in Utilization and 1-Year Outcomes with Transplantation of HCV-Viremic Kidneys

BackgroundRecent pilot trials have demonstrated the safety of transplanting HCV-viremic kidneys into HCV-seronegative recipients. However, it remains unclear if allograft function is impacted by donor HCV-viremia or recipient HCV-serostatus.MethodsWe used national United States registry data to examine trends in HCV-viremic kidney use between 4/1/2015 and 3/31/2019. We applied advanced matching methods to compare eGFR for similar kidneys transplanted into highly similar recipients of kidney transplants.ResultsOver time, HCV-seronegative recipients received a rising proportion of HCV-viremic kidneys. During the first quarter of 2019, 200 HCV-viremic kidneys were transplanted into HCV-seronegative recipients, versus 69 into HCV-seropositive recipients, while 105 HCV-viremic kidneys were discarded. The probability of HCV-viremic kidney discard has declined over time. Kidney transplant candidates willing to accept a HCV-seropositive kidney increased from 2936 to 16,809 from during this time period. When transplanted into HCV-seronegative recipients, HCV-viremic kidneys matched to HCV-non-viremic kidneys on predictors of organ quality, except HCV, had similar 1-year eGFR (66.3 versus 67.1 ml/min per 1.73 m2, P=0.86). This was despite the much worse kidney donor profile index scores assigned to the HCV-viremic kidneys. Recipient HCV-serostatus was not associated with a clinically meaningful difference in 1-year eGFR (66.5 versus 71.1 ml/min per 1.73 m2, P=0.056) after transplantation of HCV-viremic kidneys.ConclusionsBy 2019, HCV-seronegative patients received the majority of kidneys transplanted from HCV-viremic donors. Widely used organ quality scores underestimated the quality of HCV-viremic kidneys based on 1-year allograft function. Recipient HCV-serostatus was also not associated with worse short-term allograft function using HCV-viremic kidneys.

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The Development and Sustainability of School-Based Parent Networks in Low-Income Latinx Communities: A Mixed-Methods Investigation

American Educational Research Journal ◽

10.3102/0002831220916461 ◽

2020 ◽

Vol 57 (6) ◽

pp. 2450-2484

Author(s):

David E. Rangel ◽

Megan N. Shoji ◽

Adam Gamoran

Keyword(s):

Elementary School ◽

Mixed Methods ◽

Low Income ◽

Family Engagement ◽

Short Term ◽

Building Relationships ◽

School Based ◽

Quantitative Results ◽

Over Time

Research suggests that school-based parent networks have significant benefits for children’s education, yet scholars know very little about how such relationships form and develop over time. This study uses interview and survey data with elementary school parents in predominantly low-income Latinx communities to examine how parents meet one another; how deeper, more trusting relationships develop; and how the size and quality of parent networks change over time in the presence and absence of a family engagement program. Interview data suggest few and infrequent opportunities for parents to meet one another, which makes building relationships characterized by trust and shared expectations more difficult. The quantitative results show positive short-term effects of the program but differential effects over time.

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Spinal Fusion for Pediatric Spondylolisthesis: National Trends, Complications, and Short-Term Outcomes

Neurosurgery ◽

10.1093/neuros/nyx295 ◽

2017 ◽

Vol 82 (5) ◽

pp. 701-709 ◽

Cited By ~ 3

Author(s):

Kavelin Rumalla ◽

Chester K Yarbrough ◽

Andrew J Pugely ◽

Ian G Dorward

Keyword(s):

Spinal Fusion ◽

Surgical Management ◽

Multivariable Analysis ◽

Bone Morphogenetic Protein 2 ◽

Teaching Hospitals ◽

Short Term ◽

Cross Sectional ◽

Spinal Fusions ◽

National Trends ◽

Over Time

AbstractBACKGROUNDCurrent surgical management guidelines for pediatric spondylolisthesis (PS) are reliant on data from single-center cohorts.OBJECTIVETo analyze national trends and predictors of short-term outcomes in spinal fusion surgery for PS by performing a retrospective cross-sectional analysis of the Kids’ Inpatient Database (KID).METHODSThe KID (sampled every 3 yr) was queried from 2003 to 2012 to identify all cases (age 5-17) of spinal fusion for PS (n = 2646). We analyzed trends in patient characteristics, surgical management, and short-term outcomes. Both univariate and multivariable analyses were utilized.RESULTSThe 2646 spinal fusions for PS included posterior-only fusions (86.8%, PSF), anterior lumbar interbody fusions (4.8%, ALIF), and combined anterior and posterior fusions (8.4%, APLF) procedures. The utilization of APLF decreased over time (9.9%-6.4%, P = .023), whereas the number of total spinal fusions and the proportion of PSF and ALIF procedures have not changed significantly. Uptrends in Medicaid insured individuals (1.2%-18.9%), recombinant human bone morphogenetic protein-2 insertion (8.8%-16.6%), decompression (34.7%-42.8%), and mean inflation-adjusted hospital costs ($21 855-$32 085) were identified (all P < .001). In multivariable analysis, Medicaid status (odds ratio [OR] = 1.93, P = .004), teaching hospitals (OR = 1.94, P = .01), decompression (OR = 1.78, P = .004), and the APLF procedure (OR = 2.47, P = .001) increased the likelihood of complication occurrence (all P < .001).CONCLUSIONThe addition of decompression during fusion and the APLF procedure were associated with more in-hospital complications, though this may have been indicative of greater surgical complexity. The utilization of the APLF procedure has decreased significantly, while costs associated with the treatment of PS have increased over time.

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Influence of the choice of insolation forcing on the results of a conceptual glacial cycle model

10.5194/cp-2021-119 ◽

2021 ◽

Author(s):

Gaëlle Leloup ◽

Didier Paillard

Keyword(s):

Frequency Shift ◽

Model Data ◽

Glacial Cycle ◽

Cycle Model ◽

Ice Volume ◽

Summer Insolation ◽

Time Period ◽

Insolation Forcing ◽

Over Time

Abstract. Over the Quaternary, the ice volume variations are “paced” by the astronomy. However, the precise way in which the astronomical parameters influence the glacial-interglacial cycles is not clear. The origin of the 100 kyr cycles over the last million year and of the switch from 40 kyr to 100 kyr cycles over the Mid Pleistocene Transition remain largely unexplained. By representing the climate system as oscillating between two states, glaciation and deglaciation, switching once a glaciation and a deglaciation thresholds are crossed, the main features of the ice volume record can be reproduced (Parrenin and Paillard, 2012). However, previous studies have only focused on the use of a single summer insolation as input. Here, we use a simple conceptual model to test and discuss the influence of the use of different summer insolation forcings, having different contributions from precession and obliquity, on the model results. We show that some features are robust. Specifically, to be able to reproduce the frequency shift over the Mid Pleistocene Transition, the deglaciation threshold needs to increase over time, independently of the summer insolation used as input. The quality of the model data agreement however depends on the chosen type of summer insolation and time period considered.

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DETERMINE THE IMPORTANT OF KIDNEY TRANSPLANTATION ITEMS IN SELECTED COUNTRIES AND IRAN (APPLICATION REGISTRY)

Medical Technologies Journal ◽

10.26415/2572-004x-vol1iss4p126-127 ◽

2017 ◽

Vol 1 (4) ◽

pp. 126-127

Author(s):

Majid Jangi ◽

Mahmoud Tara ◽

Kolsoum Deldar

Keyword(s):

United States ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Blood Type ◽

Hla Typing ◽

Kidney Donor ◽

Factors Affecting ◽

Comparative Review ◽

Transplant Candidates

Introduction: In many cases a kidney transplant is effective treatment for advanced chronic kidney disease and ESRD patients. There are multiple items to identify candidates for a kidney transplant. So one of the problems, considerable differences in factors, because of the vastness and the variety of factors affecting them.The purpose of this study is to provide a comparative analysis of kidney transplantation items in selected countries and Iran in order to choose the most important items that will be used in iran. Methods: The study was carried out in 2015 using a comparative review method in United States, Australia, Croatia and Iran. The countries have the largest number of kidney transplants on their continent in 2014. Items in two categories (Candidate’s items and Donor’s items) was gathered from last version guidelines and execute delphi rounds and focus group(feasibility) to choose the important criteria in 3 iran’s medical centers. Data analyzed by Excel 2015. Results: Total items of candidate was twenty that five items, including “duration of dialysis”, “blood type”, “previous transplant history”, “age“ and “HLA” were considered as items affecting transplant in all three countries. Iran just included two items (duration of dialysis and blood type). After Delphi rounds and accessibility study, sexteen items were remain to gathering in iran. Total items of donor was thirteen that three items, including “blood type”, “age“ and “HLA” were considered as items affecting transplant in all three countries. Iran just included 2 items (hepatit and blood type). After Delphi rounds and feasibility study, 11 items were remain to gathering in Iran. Croatia that adherence Euro guideline in kidney transplantation had maximum candidate’s items and United states has maximum donors items that involving in kidney transplantation Conclusion: Kidney transplantation items determine the amount of readiness kidney transplant candidates and the quality of the kidney donor. In iran this items did not intended to be the comparison candidates and just “duration of dialysis” was criterion. While in America, Europe and Australia the readiness of candidate and the quality of the kidney donor is based on the items scoring and matching. One of the deleted items as a result of feasibilty study in Iran was the HLA typing test. Due to the long time and high cost, there is no possibility of collecting it. projected is if Iran involved items in queues waiting for a transplant candidates, they will receive graft survival rate better than before.

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Learning Places from Views: Variation in Scene Processing as a Function of Experience and Navigational Ability

Journal of Cognitive Neuroscience ◽

10.1162/0898929052879987 ◽

2005 ◽

Vol 17 (1) ◽

pp. 73-83 ◽

Cited By ~ 94

Author(s):

Russell A. Epstein ◽

J. Stephen Higgins ◽

Sharon L. Thompson-Schill

Keyword(s):

Functional Magnetic Resonance ◽

Neural Basis ◽

Short Term ◽

Repetition Effects ◽

Parahippocampal Cortex ◽

Scene Processing ◽

Fmri Adaptation ◽

Over Time

Humans and animals use information obtained from different viewpoints to form representations of the spatial structure of the world. We used functional magnetic resonance imaging (fMRI) adaptation to investigate the neural basis of this learning process and to show how the concomitant representations vary across individuals as a function of navigational ability. In particular, we examined the effect of repeating viewpoint and/ or place information over both short (within-trial) and long (across-scan) intervals on the neural response in scene processing regions. Short-term fMRI adaptation effects in the parahippocampal cortex were initially highly viewpoint-specific but became less so over time. Long-term fMRI repetition effects included a significant viewpoint-invariant component. When individual differences in navigational ability were considered, a significant correlation between the strength of these effects and self-reported navigational competence was observed. In particular, good navigators encoded representations that differed between new and old views and new and old places, whereas bad navigators did not. These results suggest that cortical scene representations evolve over time to become more viewpoint-invariant and that the quality of these representations directly impacts navigational ability.

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Humans adapt to social diversity over time

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1818884116 ◽

2019 ◽

Vol 116 (25) ◽

pp. 12244-12249 ◽

Cited By ~ 14

Author(s):

Miguel R. Ramos ◽

Matthew R. Bennett ◽

Douglas S. Massey ◽

Miles Hewstone

Keyword(s):

Cognitive Processes ◽

Religious Diversity ◽

Intergroup Contact ◽

Short Term ◽

New Era ◽

Political Concern ◽

Diverse World ◽

Over Time

Humans have evolved cognitive processes favoring homogeneity, stability, and structure. These processes are, however, incompatible with a socially diverse world, raising wide academic and political concern about the future of modern societies. With data comprising 22 y of religious diversity worldwide, we show across multiple surveys that humans are inclined to react negatively to threats to homogeneity (i.e., changes in diversity are associated with lower self-reported quality of life, explained by a decrease in trust in others) in the short term. However, these negative outcomes are compensated in the long term by the beneficial influence of intergroup contact, which alleviates initial negative influences. This research advances knowledge that can foster peaceful coexistence in a new era defined by globalization and a socially diverse future.

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The Measuring Ammonia in Nature (MAN) network in the Netherlands

Biogeosciences ◽

10.5194/bg-12-5133-2015 ◽

2015 ◽

Vol 12 (16) ◽

pp. 5133-5142 ◽

Cited By ~ 18

Author(s):

D. E. Lolkema ◽

H. Noordijk ◽

A. P. Stolk ◽

R. Hoogerbrugge ◽

M. C. van Zanten ◽

...

Keyword(s):

The Netherlands ◽

Nature Reserve ◽

Passive Samplers ◽

Active Sampling ◽

Model Calculations ◽

Trends Over Time ◽

National Trends ◽

The Cost ◽

Over Time

Abstract. Since 2005 the Measuring Ammonia in Nature (MAN) network monitors atmospheric ammonia concentrations in nature reserve areas in the Netherlands (http://man.rivm.nl). The main aim of the network is to monitor national trends, to assess regional deviations and to validate model calculations. Measurements are performed with commercial passive samplers, calibrated monthly against ammonia measurements of active sampling devices. The sampling is performed by an extensive group of local volunteers, which minimizes the cost and enables the use of local knowledge. We show the MAN network to be well capable of monitoring trends on national and local scales and providing data for more detailed local analyses. The quality of the network is such that trends over time for individual MAN areas can be detected on the order of 3 % per year for time series of 6–9 years.

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Improving the quality of care in health systems: towards better strategies

Israel Journal of Health Policy Research ◽

10.1186/s13584-021-00448-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Jennifer Dixon

Keyword(s):

Health Care ◽

Quality Of Care ◽

New Technologies ◽

Critical Mass ◽

National Level ◽

Short Term ◽

The Future ◽

Over Time

AbstractImproving the quality of health care across a nation is complex and hard. Countries often rely on multiple single national level programmes to make progress. But the key is to use a framework to develop a balanced overall strategy, and evaluate the main elements continuously and over time. Achieving that requires having a critical mass of leaders who collectively can see the bigger picture now, envision a roadmap for the future to chart an intelligent course, and course correct regularly. This is a long-term agenda requiring commitment, careful stewardship, different perspectives, trust, and the building of knowledge and experience over time. It is also almost completely at odds with much current policymaking which is short term, reactive and demands hard results. Many countries are making progress. But the rapid introduction of new types of care during the COVID 19 pandemic, such as online and digital, the use of new technologies which could soon revolutionalise the way care is delivered, experienced and evaluated, and the huge pressures on spending on health care in future mean we will have to do better. Achieving system-wide quality of care requires having a critical mass of leaders who collectively can see the bigger picture now, envision a roadmap for the future to chart a balanced intelligent course. For the Israeli health system, the recent IJHPR article by Dreiher et al. will help, but it will be important, in the future, to analyse how Israel measures up on the framework outlined above. This ideally would be supplemented with a survey of key leaders for their assessment, and both would be a regular (say 5 yearly) exercise and would help inform future strategies.

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Measuring the improving quality of outpatient care in medical oncology practices in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.66 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 66-66

Author(s):

Michael N. Neuss ◽

Jennifer Malin ◽

Stephanie Chan ◽

Pamela Kadlubek ◽

John L. Adams ◽

...

Keyword(s):

Clinical Information ◽

The United States ◽

Time Period ◽

Medical Oncologists ◽

The Mean ◽

Highly Correlated ◽

American Society ◽

Oncology Practice ◽

Over Time

66 Background: The American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) has provided a method for measurement of process based practice quality since 2006. We sought to determine whether QOPI participants show improvement in measured quality over time, and if change is demonstrated, those factors in either the measures or participants which are associated with change. Methods: 156 participant medical practice groups, which did not submit trainee data, participated in at least two collection rounds from 2006 through 2010, and reported on ≥30 patients per round from were included in analysis from a larger group of 306 participants from this time period. A database of these reports was used to evaluate trends in scoring among participants. A linear regression model, which controlled for varied initial performance, was used to estimate the effect of participation over time and evaluate participant and measure characteristics. Measures were aggregated into categories to evaluate which factors correlated with change. Results: Participants completed a mean of 5.71 (S.D. 1.84) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% C.I. 0.42 – 0.91) to 0.85 (95% C.I. 0.60 – 0.95). Overall odds ratio of improvement over time was 1.09 (p < 0.0001). The greatest improvement was seen in measures assessing newly introduced clinical information, where the mean scores improved from 0.05 (95% C.I. 0.01 – 0.17) to 0.69 (95% C.I. 0.33 – 0.91), (p ≤ 0.0001). Many measures showed no change over time. Conclusions: QOPI has gained widespread adoption and approximately 15% of U.S. medical oncologists participate. Participation over time is highly correlated with improvement in measured performance. Much of this improvement is the result of the adoption of newly introduced clinical information. Some measures show no change despite significant opportunity for improvement.

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