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Laser-plasma direction for superior ablation regarding GaAs with mixed femtosecond and nanosecond impulses.
Results revealed that adding a fourth rater had a minimal impact on canonical babbling ratio assessment. Presence/absence of canonical babbling and size of consonant inventory showed a negligible impact on three out of four recordings, whereas the size of syllable inventory and presence/absence of canonical babbling was minimally affected in one recording by adding a fourth rater. In conclusion, adding a forth rater in assessment of pre-linguistic utterances in 12-month-old infants with naturalistic assessment in real time does not affect outcome classifications considerably. Thus, using three raters, as opposed to four, is recommended.Transportation cost is a barrier to HIV treatment, yet no studies have examined its association with contraceptive use among women living with HIV. We analyzed cross-sectional data from women attending three public healthcare facilities in Shinyanga, Tanzania where they initiated antiretroviral therapy for HIV infection in the previous 90 days; all facilities offered free contraception. Women self-reported current contraceptive use and the round-trip cost of transportation to the facility. Among 421 women aged 18-49, 86 (20.4%) were using any modern contraceptive method, of which half were using modern methods other than condoms. Women who paid more than 2,000 Tanzanian shillings for transportation had a significantly lower prevalence of any modern method use than women who paid nothing (9.1% vs. 21.3%; adjusted difference -12.9; 95% confidence interval -21.3, -4.4). A similar difference was observed for non-condom modern method use. We conclude that high transportation cost may impede contraceptive use even among women accessing HIV treatment.To identify the optimal cost-effective strategy for cervical cancer screening program in Thailand by comparing the different algorithms which based on the use of primary human papilloma virus (HPV) assay. We use a Microsoft Excel-based spreadsheet to calculate the accumulated cases of preinvasive and invasive cervical cancer and the budget impact of each screening program. The model was developed to determine the cost-effectiveness of 3 screening strategies pooled HPV test with reflex liquid-based cytology triage, HPV genotyping with reflex p16/ki67 dual stain cytology, and pooled HPV test with dual stain. The main outcomes were the total cost, incremental quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Adenosine Deaminase antagonist Strategy entailing primary HPV genotyping and reflex dual stain cytology is the least costly strategy (total cost US$37 893 407) and provides the similar QALY gained compared to pooled high-risk HPV testing with reflex dual stain (Average QALY 24.03). Pooled HPV test with reflex dual staining is more costly compared to strategy without reflex dual staining. The ICER was US$353.40 per QALY gained. One-way sensitivity analysis showed that the model is sensitive to the cost of dual stain and the cost of cancer treatment. Decreasing the incidence of cervical cancer case and increasing the QALYs can be successful by using dual stain cytology as the triage test for pooled HPV test or HPV genotyping. The result of our analysis favors the use of HPV genotyping with the reflex dual stain as it offers the most QALY at the lowest cost.Aim To analyze descriptors/definitions of meta-epidemiological studies as well as study design of articles that were self-described as meta-epidemiological studies. Methods We searched MEDLINE and Embase on 6 August 2019. We extracted definitions of meta-epidemiological studies, as well as study designs, statistics and units of analysis that were reported in studies self-labelled as meta-epidemiological studies. Results We included 175 information sources in the analysis. Definitions of meta-epidemiological studies varied and some studies used the term meta-epidemiological study to describe methodological research-on-research studies. Less than a half of the studies (n = 54; 42.9%) used the two-step meta-epidemiological approach in data analysis. Among studies self-labelled as meta-epidemiological, 9.4% reported registration in PROSPERO and 11% indicated they reported the study in line with PRISMA. Conclusion Research community would benefit from consensus about definition of meta-epidemiological study.Background - The optimal method to identify the arrhythmogenic substrate of scar-related VT is unknown. Sites of activation slowing during sinus rhythm (SR) often co-localize with the VT circuit. However, the utility and limitations of such approach for guiding ablation is unknown. Methods - We conducted a multicenter study in patients with infarct-related VT. The LV was mapped during activation from 3 directions SR (or atrial pacing), right ventricular (RV) and left ventricular (LV) pacing at 600 msec. Ablation was applied selectively to the cumulative area of slow activation, defined as the sum of all regions with activation times of ≥40 msec per 10mm. Hemodynamically tolerated VTs were mapped with activation or entrainment. The primary outcome was a composite of appropriate ICD therapies and cardiovascular death. Results - In 85 patients, the LV was mapped during activation from 2.4±0.6 directions. The direction of LV activation influenced the location and magnitude of activation slowing. The spatial overlap of activation slowing between SR and RV pacing was 84.2%±7.1%, between SR and LV pacing was 61.4%±8.8%, and between RV and LV pacing was 71.3%±9.6% (P less then 0.05 between all comparisons). Mapping during SR identified only 66.2%±8.2% of the entire area of activation slowing and 58% critical isthmus sites. Activation from other directions by RV and LV stimulation unmasked an additional 33% of slowly conducting zones and 25% critical isthmus sites. The area of maximal activation slowing often corresponded to the site where the wavefront first interacted with the infarct. During a follow-up period of 3.6 years, the primary endpoint occurred in 14/85 (16.5%) patients. Conclusions - The spatial distribution of activation slowing is dependent on the direction of LV activation with the area of maximal slowing corresponding to the site where the wavefront first interacts with the infarct. This data may have implications for VT substrate mapping strategies.
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