Important Additional Benefit Research Articles

Co-Opetition and the Firm’s Information Environment

Some firms in the technology sector choose to cooperate with competitors (“co-opetition”) in standard setting organizations (SSOs). These SSOs create technology standards that facilitate rapid market penetration of new technologies such as Wi-Fi, Bluetooth, and 4G. Active participation in the standard setting process requires the exchange of proprietary information with competitors. Although the goal of such information sharing is to further a technology or a product market, firms potentially receive an additional benefit from access to competitor and industry information. We examine whether contributing to SSO committees enhances a firm’s information set and allows managers to better predict future sales. We find that the centrality of a firm’s location within the network of SSO collaborators is positively related to the accuracy of the firm’s sales forecasts. This relation is stronger when firms exchange more information with direct competitors and with larger firms, when forecasting is more difficult ex ante, and when firms forecast over longer horizons. Our findings show that collaborating with competitors in the product market provides an important additional benefit of improving the manager’s information set. This paper was accepted by David Simchi-Levi, accounting. Funding: This work was supported by the Wharton School, Institut Européen d’Administration des Affaires, the Institut Européen d’Administration des Affaires-Wharton Alliance, and the Mack Institute for Innovation Management. Supplemental Material: The data and online appendix are available at https://doi.org/10.1287/mnsc.2021.03152 .

A Multioctave 8 GHz$-$40 GHz Receiver for Radio Astronomy

Accurate measurement of angular positions on the sky requires a well-defined system of reference, something that in practice is realized by the International Celestial Reference Frame (ICRF) with observations of distant (typical redshift <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\sim$</tex-math></inline-formula> 1) Active Galactic Nuclei (AGN). At such great distances a subset of these objects exhibit as little as 10 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-$</tex-math></inline-formula> 50 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\mu$</tex-math></inline-formula> as/year observed parallax or proper motion, thus giving the frame excellent spatial and temporal stability. Until fairly recently the majority of AGN centered imaging was accomplished in the S (2.3 GHz) and X (8.4 GHz) radio frequency bands, however S-band observations for reasons such as sensitivity “plateauing”, increased source structure (jets), and radio frequency interference (RFI) have become less productive. Following spacecraft telemetry moves to higher frequencies and a desire to strengthen JPL's leadership in defining the next-generation of celestial reference frames has motivated the development of a “Quad-band” prototype receiver that operates in X, Ku, K, and Ka band in both right hand (RCP) and left hand (LCP) circular polarization. The goal of this receiver is to achieve less than a 20 % increase in noise over the Jansky Very Large Array (JVLA, NRAO) performance specification, which in such a wide bandwidth represents a revolutionary capability. To evaluate the various technical developments of the 8 GHz <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-$</tex-math></inline-formula> 40 GHz receiver the feedhorn optical beam was designed to interface to the US based Very Long Baseline Array (VLBA). The receiver's intermediate frequency (IF) spans 4 GHz <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-$</tex-math></inline-formula> 8 GHz, giving rise to up to eight 4 GHz IF channels for a fully populated instrument. This paper outlines the technical development of a 2 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$^{1}$</tex-math></inline-formula> / <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$_{2}$</tex-math></inline-formula> octave wide (8 GHz <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$-$</tex-math></inline-formula> 40 GHz) X-Ka band prototype receiver, fulfilling a need for super broadband technology within the VLBI network. An important additional benefit of the wideband receiver approach is its simplicity and low cost of operation.

Congenital Infections: Priorities and Possibilities for Resource-limited Settings.

Congenital Infections: Priorities and Possibilities for Resource-limited Settings.

Engineering maintenance decision-making with unsupported judgement under operational constraints

In operational engineering maintenance situations, limitations on time, resource or the information available often inhibit rigorous analysis on complex decision problems. Decision-makers who are compelled to act in such circumstances, may be informed by some level of analysis if available, or else may have to rely on their unsupported judgement. This paper presents three engineering risk decision-making case studies across a 20 year span from the rail, aerospace, and military aviation contexts, highlighting the fallibilities of using unsupported judgements in an unstructured manner. To help situate this type of decision situation, we provide a descriptive model of the decision space which extends an existing description from the discipline of decision analysis. Furthermore, to help make and describe the distinction between unsupported and supported thinking, we provide another descriptive model, this time drawing parallels with the distinction made between Type 1 and Type 2 reasoning. This model is an extension of the default-interventionist model from cognitive psychology.The paper concludes that there is a pressing need to provide some form of support to engineering decision-makers facing operational decisions under severe time pressure. While the ultimate aim must be to improve the quality of decision-making, improved transparency is an important additional benefit. Increased emphasis on decision justification and self-awareness are suggested as potential ways of improving this situation. A further contribution of this paper is to identify and strengthen linkages between safety science and two other relevant disciplines, decision analysis and psychology. Such linkages make it easier to communicate across traditional disciplinary boundaries and may provide opportunities for interdisciplinary learning or suggest future directions for collaborative research.

Manual lymphatic drainage with or without fluoroscopy guidance did not substantially improve the effect of decongestive lymphatic therapy in people with breast cancer-related lymphoedema (EFforT-BCRL trial): a multicentre randomised trial.

When added to decongestive lymphatic therapy (DLT), what is the effect of fluoroscopy-guided manual lymphatic drainage (MLD) versus traditional MLD or placebo MLD for the treatment of breast cancer-related lymphoedema (BCRL)? Multicentre, three-arm, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of assessors and participants. At five hospitals in Belgium, 194 participants with unilateral chronic BCRL were recruited. All participants received standard DLT (education, skin care, compression therapy and exercises). Participants were randomised to also receive fluoroscopy-guided MLD (n= 65), traditional MLD (n= 64) or placebo MLD (n= 65). Participants received 14 sessions of physiotherapy during the 3-week intensive phase and 17 sessions during the 6-month maintenance phase. Participants performed self-management on the other days. All outcomes were measured: at baseline; after the intensive phase; after 1, 3 and 6 months of maintenance phase; and after 6 months of follow-up. The primary outcomes were reduction in excess volume of the arm/hand and accumulation of excess volume at the shoulder/trunk, with the end of the intensive phase as the primary endpoint. Secondary outcomes included daily functioning, quality of life, erysipelas and satisfaction. Excess lymphoedema volume decreased after 3 weeks of intensive treatment in each group: 5.3 percentage points of percent excessive volume (representing a relative reduction of 23.3%) in the fluoroscopy-guided MLD group, 5.2% (relative reduction 20.9%) in the traditional MLD group and 5.4% (relative reduction 24.8%) in the placebo MLD group. The effect of fluoroscopy-guided MLD was very similar to traditional MLD (between-group difference 0.0 percentage points, 95% CI -2.0 to 2.1) and placebo MLD (-0.2 percentage points, 95% CI -2.1 to 1.8). Fluid accumulated at the shoulder/trunk in all groups. The average accumulation with fluoroscopy-guided MLD was negligibly less than with traditional MLD (-3.6 percentage points, 95% CI -6.4 to -0.8) and placebo MLD (-2.4 percentage points, 95% CI -5.2 to 0.4). The secondary outcomes also showed no clinically important between-group differences. In patients with chronic BCRL, MLD did not provide clinically important additional benefit when added to other components of DLT. NCT02609724.

The effects of screening brief intervention referral to treatment (SBIRT) training on health professional trainees’ regard, attitudes, and beliefs toward patients who use substances

Background: Screening Brief Intervention Referral to Treatment (SBIRT) was developed as an integrated and comprehensive public health approach that includes early screening and intervention to address substance use in a variety of health care settings. Research suggests that SBIRT is effective in reducing substance use in individuals whose use places them at higher risk for negative health and social consequences. However, less is known about how training in SBIRT modifies attitudes, regard, and beliefs toward people who use substances. Methods: Participants included 461 students from a variety of healthcare related disciplines (physician assistant, nurse practitioner, pharmacy, psychiatry and psychology, and medical students). Participants were evaluated using a pre-post design to assess changes in regard, attitudes, and beliefs by completing the Short Alcohol and Alcohol Problems Perception Questionnaire, the Drug Problem Perception Questionnaire, the Medical Condition Regard Scale, and the Short Understanding of Substance Abuse Scale before and after a 7-hour SBIRT training program. We hypothesized that trainees would have more positive regard, attitudes, and beliefs toward people who use substances following training in SBIRT relative to a baseline assessment and that there would be between program differences. Results: Results were consistent with hypotheses and suggested that trainees had significantly more positive regard and changes in attitudes and beliefs toward working with patients who use substances following training in SBIRT. Results also suggested significant differences by training group at baseline and at 30-day follow up. Conclusions: Overall, the findings suggest that an important additional benefit of SBIRT is the impact it has on mitigating healthcare professional trainees’ negative regard and modifying attitudes and beliefs toward those who use substances.

Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release Syndrome.

Younger patients with COVID-19 may experience an exaggerated immune response to SARS-CoV-2 infection and develop cytokine release syndrome (CRS), which may be life threatening. There is no proven antiviral therapy for COVID-19 so far, but profound immunosuppression has recently been suggested as a treatment for COVID-19-associated CRS. We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). The rapid clinical and biochemical improvement following TCZ administration suggests that treatment with immunotherapy can be life-saving in selected patients with COVID-19-induced CRS.LEARNING POINTSCytokine release syndrome may cause sudden and potentially life-threatening clinical deterioration in COVID-19 pneumonia, particularly in younger patients.Immunosuppressive therapy may provide important additional therapeutic benefit in these patients.Tocilizumab, a specific IL-6 inhibitor, led to dramatic clinical improvement in a young patient with severe COVID-19-associated cytokine release syndrome.

The duration of chemoprophylaxis against malaria after treatment with artesunate-amodiaquine and artemether-lumefantrine and the effects of pfmdr1 86Y and pfcrt 76T: a meta-analysis of individual patient data

BackgroundThe majority of Plasmodium falciparum malaria cases in Africa are treated with the artemisinin combination therapies artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ), with amodiaquine being also widely used as part of seasonal malaria chemoprevention programs combined with sulfadoxine-pyrimethamine. While artemisinin derivatives have a short half-life, lumefantrine and amodiaquine may give rise to differing durations of post-treatment prophylaxis, an important additional benefit to patients in higher transmission areas.MethodsWe analyzed individual patient data from 8 clinical trials of AL versus AS-AQ in 12 sites in Africa (n = 4214 individuals). The time to PCR-confirmed reinfection after treatment was used to estimate the duration of post-treatment protection, accounting for variation in transmission intensity between settings using hidden semi-Markov models. Accelerated failure-time models were used to identify potential effects of covariates on the time to reinfection. The estimated duration of chemoprophylaxis was then used in a mathematical model of malaria transmission to determine the potential public health impact of each drug when used for first-line treatment.ResultsWe estimated a mean duration of post-treatment protection of 13.0 days (95% CI 10.7–15.7) for AL and 15.2 days (95% CI 12.8–18.4) for AS-AQ overall. However, the duration varied significantly between trial sites, from 8.7–18.6 days for AL and 10.2–18.7 days for AS-AQ. Significant predictors of time to reinfection in multivariable models were transmission intensity, age, drug, and parasite genotype. Where wild type pfmdr1 and pfcrt parasite genotypes predominated (<=20% 86Y and 76T mutants, respectively), AS-AQ provided ~ 2-fold longer protection than AL. Conversely, at a higher prevalence of 86Y and 76T mutant parasites (> 80%), AL provided up to 1.5-fold longer protection than AS-AQ. Our simulations found that these differences in the duration of protection could alter population-level clinical incidence of malaria by up to 14% in under-5-year-old children when the drugs were used as first-line treatments in areas with high, seasonal transmission.ConclusionChoosing a first-line treatment which provides optimal post-treatment prophylaxis given the local prevalence of resistance-associated markers could make a significant contribution to reducing malaria morbidity.

The prevalence and clinical characteristics of pertussis-associated pneumonia among infants in Botswana

BackgroundThere are scant data on the prevalence and clinical course of pertussis disease among infants with pneumonia in low- and middle-income countries. While pertussis vaccination coverage is high (≥90%) among infants in Botswana, human immunodeficiency virus (HIV) infection affects nearly one-third of pregnancies.We aimed to evaluate the prevalence and clinical course of pertussis disease in a cohort of HIV-unexposed uninfected (HUU), HIV-exposed uninfected (HEU), and HIV-infected infants with pneumonia in Botswana.MethodsWe recruited children 1–23 months of age with clinical pneumonia at a tertiary care hospital in Gaborone, Botswana between April 2012 and June 2016. We obtained nasopharyngeal swab specimens at enrollment and tested these samples using a previously validated in-house real-time PCR assay that detects a unique sequence of the porin gene of Bordetella pertussis.ResultsB. pertussis was identified in 1/248 (0.4%) HUU, 3/110 (2.7%) HEU, and 0/33 (0.0%) HIV-infected children. All pertussis-associated pneumonia cases occurred in infants 1–5 months of age (prevalence, 1.0% [1/103] in HUU and 4.8% [3/62] in HEU infants). No HEU infants with pertussis-associated pneumonia were taking cotrimoxazole prophylaxis at the time of hospital presentation. One HUU infant with pertussis-associated pneumonia required intensive care unit admission for mechanical ventilation, but there were no deaths.ConclusionsThe prevalence of pertussis was low among infants and young children with pneumonia in Botswana. Although vaccination against pertussis in pregnancy is designed to prevent classical pertussis disease, reduction of pertussis-associated pneumonia might be an important additional benefit.

Corruption and Doing Business in Emerging Markets

Corruption is a serious international problem with many damaging effects particularly in emerging market countries. We investigated to what degree overregulation and inadequate legal institutions contributed to corruption of small and medium-sized enterprises (SME) in emerging markets. Unlike other studies, we used data from the World Bank?s Doing Business annual series which provides indicators of the regulatory and legal environments facing SME. We had three major research questions. (1) Which government obstacles to conducting business in the form of overregulation and inadequate legal institutions contribute most to corruption? (2) Which are more closely linked to corruption, excessive regulations or weak legal institutions? (3) Which of the components, from which the World Bank?s indicators are derived, have the largest impact on corruption? We regressed Transparency International?s Corruption Perception Index on the nine World Bank indicators and five control variables for 51 emerging market countries from 2007 to 2015. This study concludes that all five regulation indicators, but only one of four legal indicators, contributed to corruption. While past studies have linked regulation and corruption, our contribution was identifying specifically which of the World Bank?s measures of the regulatory and legal environment cause corruption. In addition, our results also corroborate those of previous studies regarding our five control variables. Policy wise the World Bank has long advocated reducing regulations to improve SME operating efficiency. Our results further support such a policy because of its important additional benefit of reducing corruption and its many toxic effects.

PII: S1201-9712(18)33639-7

Sepsis is one of the most common severe infections and is associated with high morbidity and mortality. Several studies have underlined the importance of rapid initiation of adequate antimicrobial therapy. This is hampered by growing antimicrobial resistance and the long turnaround time of blood culture. Rapid and accurate diagnosis of the causing pathogen directly in blood together with its associated resistance genes would be highly valuable to improve survival. In this presentation an overview of important aspects of the direct detection of pathogens in blood including blood volume, method of isolation and detection, turnaround time and workflow is provided. Currently available commercial assays (SeptiFast, IRIDICA, T2 Sepsis Solution) are discussed as well as assays still in development. In addition, attention is given to specific patient populations as neonates, ICU patients and neutropenic patients. An important additional benefit of molecular detection could be the quantification of bacterial DNA. This bacterial DNA load can be used as a marker of severity of infection and for monitoring of treatment and will be illustrated with several examples. Despite the large number of studies investigating the molecular diagnosis of sepsis directly in blood, it is still not part of routine practice in many laboratories. Factors that are hampering its introduction in clinical practice (costs, suboptimal sensitivity, contamination and implementation) are presented in the last part of the presentation which includes future prospects.

Direct Observation of the Impurity Gettering Layers in Polysilicon-Based Passivating Contacts for Silicon Solar Cells

The formation of certain types of doped polysilicon passivating contacts for silicon solar cells is recently reported to generate very strong impurity gettering effects, revealing an important additional benefit of this passivating contact structure. This work investigates the underlying gettering mechanisms by directly monitoring the impurity redistribution during the contact formation and subsequent processes, via a combination of secondary ion mass spectrometry (SIMS), transmission electron microscopy (TEM), and minority carrier lifetime techniques. Microscopic features of the phosphorus and boron diffusion-doped polysilicon passivating contacts are also presented. Iron is used as a marker impurity in silicon to enable direct quantification of its concentration change in the bulk of the silicon wafers and in the surface layers that compose the contact structure. The results conclusively show that, for phosphorus-doped polysilicon passivating contacts, impurities are relocated from the silicon wafer bul...

Towards reproducible experimental studies for non-convex polyhedral shaped particles

The packing density and flat bottomed hopper discharge of non-convex polyhedral particles are investigated in a systematic experimental study. The motivation for this study is two-fold. Firstly, to establish an approach to deliver quality experimental particle packing data for non-convex polyhedral particles that can be used for characterization and validation purposes of discrete element codes. Secondly, to make the reproducibility of experimental setups as convenient and readily available as possible using affordable and accessible technology. The primary technology for this study is fused deposition modeling used to 3D print polylactic acid (PLA) particles using readily available 3D printer technology. A total of 8000 biodegradable particles were printed, 1000 white particles and 1000 black particles for each of the four particle types considered in this study. Reproducibility is one benefit of using fused deposition modeling to print particles, but an extremely important additional benefit is that specific particle properties can be explicitly controlled. As an example in this study the volume fraction of each particle can be controlled i.e. the effective particle density can be adjusted. In this study the particle volumes reduces drastically as the non-convexity is increased, however all printed white particles in this study have the same mass within 2% of each other.

Use of artificial intelligence to predict survival in pulmonary hypertension

BackgroundSurvival in pulmonary hypertension depends on right ventricular adaptation to pressure overload, but the three-dimensional (3D) patterns of function that are most discriminative of subsequent outcome are not known. The aim of this study was to compare the prognostic accuracy of artificial intelligence combined with 3D models of the right ventricle against conventional prognostic markers in predicting survival in patients with pulmonary hypertension. MethodsPatients with suspected pulmonary hypertension were prospectively enrolled and underwent cardiac MRI, right heart catheterisation, and 6-min walk testing, and received standard medical care and follow-up. From cardiac MRI, 3D right ventricular function models were developed and the patterns of function predictive of survival learnt by artificial intelligence. All-cause mortality prediction was compared between artificial intelligence and standard clinical markers using Cox proportional hazards. Findings256 patients had confirmed pulmonary hypertension, investigations within 3 months, and follow-up for a median of 4·0 years [IQR 2·0–5·7]. Artificial intelligence identified specific regional and directional patterns of function, which predicted survival and was a stronger predictor (median area under the curve 0·72, IQR 0·69–0·76; p<0·0001), better separator of high-risk and low-risk individuals by median survival time (median difference 4·1 years, IQR 3·6–4·6), and had a less variable threshold (5·2%, p<0·0001) than all other markers. Only artificial intelligence (hazard ratio 1·819, 95% CI 1·069–3·095; p=0·03) and 6-min walk testing (1·970, 1·171–3·314; p=0·01) were significant survival predictors when age and subtype of pulmonary hypertension were controlled for. Artificial intelligence identified separate patterns of dysfunction in pulmonary hypertension subtypes, which accurately predicted survival. InterpretationThe right ventricle in pulmonary hypertension demonstrates prognostic regional and directional adaptations that can be revealed by artificial intelligence methods, thereby improving risk-stratification and mechanistic insights. The variety of pulmonary hypertension subtypes and treatment regimens included might limit applicability to subgroups, but demonstrates efficacy across a spectrum of disease and treatment. Artificial intelligence methods could have important additional benefit in analysing complex cardiovascular datasets. FundingMedical Research Council UK, National Institute for Health Research Biomedical Research Centre, Imperial College Healthcare NHS Trust and Imperial College London, British Heart Foundation (project grant PG/12/27/29489, special grant SP/10/10/28431), Wellcome Trust GlaxoSmithKline Fellowship Grant.

Flexural cracking behavior of normal strength, high strength and high strength fiber concrete beams, using Digital Image Correlation technique

The paper presents the results of an experimental work on the flexural behavior of three types of concrete: normal strength concrete (NSC), high strength concrete (HSC) and high strength fiber concrete (HSFC) in terms of crack detection, crack development, crack width measurements and strain components, using the Digital Image Correlation (DIC) technique. The experimental results of the present work and from others published in the literature were used to assess the accuracy of the major codes provisions (Eurocode 2, ACI 318 and the BS8110 code) for the crack width predictions.The comparison between the classical measurement techniques and the DIC technique suggests that both of them are suitable for the analysis of the strain components (deformations) of structural members. The most important additional benefit of the DIC technique is that it allows the easy detection of the first crack with a high precision, measures the crack opening and follows the progressive cracking process until failure of reinforced concrete members. Furthermore, the experimental results show that the addition of steel fibers increases the load at first crack and amplifies the number of cracks which leads to a remarkable decrease in both the crack spacing and crack width as well as an improvement of the ductility. The flexural failure of the beam specimens also changes from a brittle concrete crushing at the compression zone to a ductile and smooth concrete compression failure.Moreover, the present study shows that, at service load, the code’s provision on crack width are conservative for beams containing steel fibers since predicting excessively higher values than the experimental ones; the overestimation exceeded 300% in some cases and none of the present major design codes takes into consideration the positive restraining effect of the fibers on the crack widening. The Rilem technical document appears to be the only one which takes account the positive effect of steel fibers on cracking, though still not accurate enough in predicting the crack width of fiber reinforced concrete. Based on the present experimental work and on data from the literature, a modification of the Rilem mathematical model is proposed with the aim of improving the crack width prediction of this challenging concrete material.

Nub Status - A 2014 Situation Analysis for Drugs: Oncology As Leading Therapeutic Area.

In the German hospital landscape NuB`s (Neue Untersuchungs- und Behandlungsmethoden) are essentially the precursor for cost-intensive drugs to be reimbursed within the G-DRG system. Hospitals can only start SHI negotiations for reimbursement once drugs have been given a NuB 1 status. The objective of this research was to provide an overview on the proportion of drugs (vs. Methods, medicinal products) and their respective indications, which submitted NuB applications for 2014. The German DRG database issued by the InEK (Institute for the Hospital Remuneration System) was used to analyse NuB subgroups sorted according to key therapeutic indications. In parallel, the number of NuB 1 status products that went through the AMNOG process was analysed. Out of 618 NuB submissions, only 133 (22%) were classified as drugs. In total, 114 (18%) of all NuB applications received a NuB 1 status, out of these 43 (38%) were drugs. The leading therapeutic area of the NuB 1 status drugs was oncology with 28 drugs (65%), followed by 5 ophthalmic products (12%). NuB 2 status was given to 465 (75%) procedures out of which 82 (18%) were drugs. The analysis reveals that, the success rate to receive the essential NuB 1 status is relatively low. Chances to receive a successfull NuB 1 status approval is one in three for drugs, however only one in six for other procedures. Out of the 43 drugs that were given NuB 1 status, already 24 (55%) passed through the AMNOG process and were given equal proportions from important additional benefit to no additional benefit. Drug applications are more likely than procedures to be given NuB 1 status and thereby initiate reimbursement negotiations with the SHI. The application quality and support by the scientific societies and treatment centres is essential to make a NuB application successful.

Reduction in Developmental Coordination Disorder with Neonatal Caffeine Therapy

To determine the effect of neonatal caffeine treatment on rates of developmental coordination disorder (DCD). Children in the Caffeine for Apnea of Prematurity trial were assessed for motor performance (Movement Assessment Battery for Children [MABC]), clinical signs of cerebral palsy, and Full-Scale IQ at 5 years of age by staff who were unaware of the children's treatment group. DCD was defined as MABC<5th percentile in children with a Full-Scale IQ>69 who did not have a diagnosis of cerebral palsy. There were 1433 children with known MABC corrected-age percentile as well as known Full-Scale IQ at 5 years and cerebral palsy status, of whom 735 had been randomly assigned to caffeine and 698 to placebo therapy. The rate of DCD was lower in those treated with caffeine (11.3%) than in the placebo group (15.2%) (OR adjusted for center and baseline covariates, 0.71, 95% CI, 0.52-0.97; P=.032). Neonatal caffeine therapy for apnea of prematurity reduces the rate of DCD at 5 years of age. As more children have DCD than have cerebral palsy, this is an important additional benefit from neonatal caffeine treatment.

Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial

Objective To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in primary care. The hypothesis was that more intensive intervention would result in a...

Detection of Sleep Disordered Breathing and Its Central/Obstructive Character Using Nasal Cannula and Finger Pulse Oximeter

To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHI(auto)) was calculated using both signals, and a respiratory disturbance index (RDI(auto)) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m(2)) were included in the analysis. AHI(manual) (19.4 ± 18.5 events/h) correlated highly significantly with AHI(auto) (19.9 ± 16.5 events/h) and RDI(auto) (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of -0.5 ± 6.6 and -1.0 ± 6.1 events/h. The automatic analysis of AHI(auto) and RDI(auto) detected sleep apnea (cutoff AHI(manual) ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of -4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.

Pretransplant serum phosphate levels and outcomes after kidney transplantation

The relation between serum phosphate control while on dialysis and kidney transplant outcomes is uncertain. Our study assessed the effect of pretransplant serum phosphate levels (PTxP) on kidney transplant outcomes. Hemodialysis patients included in the Dialysis Morbidity and Mortality Study of the US Renal Data System, undergoing kidney transplantation were studied (n=801). Delayed graft function (DGF) and graft failure as a function of PTxP, were assessed using multivariable logistic and Cox regression models. The within-quartile medians (interquartile range) of PTxP were 4.2 (3.7-4.5), 5.4 (5.1-5.7), 6.4 (6.1-6.8) and 8.5 (7.7-9.7) mg/dL. The adjusted odds ratio (OR) for DGF was significantly elevated for the fourth vs. first PTxP quartiles (OR=1.68; 95% confidence interval [95% CI], 1.05-2.71). Restricting the cohort to patients transplanted prior to the publication of the KDOQI bone metabolism and disease guidelines, PTxP measured within 1-year of transplant, or deceased donor recipients generally showed similar results. The adjusted hazard ratios for death-censored graft failure increased across PTxP quartiles (p for trend = 0.015). Higher PTxP is associated with an increased risk of adverse kidney allograft outcomes including DGF and death-censored graft failure. This suggests an important additional benefit of optimizing phosphate control in patients awaiting kidney transplantation while on dialysis.