Kooperativer Bibliotheksverbund

Berlin Brandenburg


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  • 1
    In: PLoS ONE, 2018, Vol.13(10)
    Description: Public hospital spending consumes a large share of government expenditure in many countries. The large cost variability observed between hospitals and also between patients in the same hospital has fueled the belief that consumption of a significant portion of this funding may result in no clinical benefit to patients, thus representing waste. Accurate identification of the main hospital cost drivers and relating them quantitatively to the observed cost variability is a necessary step towards identifying and reducing waste. This study identifies prime cost drivers in a typical, mid-sized Australian hospital and classifies them as sources of cost variability that are either warranted or not warranted—and therefore contributing to waste. An essential step is dimension reduction using Principal Component Analysis to pre-process the data by separating out the low value ‘noise’ from otherwise valuable information. Crucially, the study then adjusts for possible co-linearity of different cost drivers by the use of the sparse group lasso technique. This ensures reliability of the findings and represents a novel and powerful approach to analysing hospital costs. Our statistical model included 32 potential cost predictors with a sample size of over 50,000 hospital admissions. The proportion of cost variability potentially not clinically warranted was estimated at 33.7%. Given the financial footprint involved, once the findings are extrapolated nationwide, this estimation has far-reaching significance for health funding policy.
    Keywords: Research Article ; Medicine And Health Sciences ; Research And Analysis Methods ; Physical Sciences ; People And Places ; Medicine And Health Sciences ; Medicine And Health Sciences ; Research And Analysis Methods ; Physical Sciences ; Physical Sciences ; Physical Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Computer And Information Sciences
    E-ISSN: 1932-6203
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  • 2
    In: Transplantation, 1996, Vol.62(10), pp.1523-1525
    Description: The major problem in using fetal sheep pancreas as a transplantable source of insulin-producing cells to reverse diabetes is that β cells do not differentiate well. Glucotoxicity is a potential explanation for this because the blood glucose level of recipient mice is higher than that of fetal sheep (7 vs. 1.5 mM). To test the effect of approximating these fetal conditions blood glucose levels of recipient athymic mice were lowered for 4 weeks from 7.3±1.6 mM to a nadir of 3.7±1.7 mM by administration of insulin pellets. This resulted in a 2.7-fold increase in the percentage ofβ cells and a 5.9-fold increase in the number of glucagon-containingα cells. The increase in endocrine cells was probably due to improved formation from undifferentiated cells, but greater proliferation of the mature cells is also a possibility. The effect was transient with endocrine cell numbers diminishing once the effect of insulin administration ceased. It is concluded that while transplanted fetal sheep pancreas may not be suitable for reversal of diabetes, it is a useful model for studying how pancreatic endocrine cells develop.
    Keywords: Xenografts ; Pancreas ; Beta Cells ; Xenograft ; Blood Levels ; Athymic Mice ; Sheep ; Glucose ; Athymic Mice ; Blood Levels ; Glucose ; Sheep;
    ISSN: 0041-1337
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  • 3
    In: ANZ Journal of Surgery, November 2004, Vol.74(11), pp.1028-1030
    Description: The authors report as deep soft tissue solitary myofibroma in a 48 year old man situated in the C7/T1 intervertebral foramen. It presented with a C8 nerve root compression mimicking disc prolapse or osteophytic compression. Such a presentation has not been previously descried. The unexpected magnetic resonance imaging with T1 and T2 isointensity and no contrast enhancement is also presented. (non-author abstract)
    Keywords: Myofibroma ; Myofibromatosis ; Solitary
    ISSN: 1445-1433
    E-ISSN: 1445-2197
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  • 4
    In: Melanoma Research, 2018, Vol.28(1), pp.52-55
    Description: Vemurafenib, ipilimumab and dabrafenib were registered for the treatment of advanced skin melanoma pursuant to the results of randomized phase III clinical trials. Real-world data on survival time for patients treated with those drugs in daily clinical practice are so far limited. Patients with advanced skin melanoma treated under reimbursement programmes (drug programmes), for which they were qualified pursuant to uniform inclusion criteria in force in all oncology centres in Poland. Data were obtained from the electronic databases of the national payer (NFZ) responsible for the implementation and monitoring of reimbursement (drug) programmes. The analysis included all patients included for treatment with vemurafenib (since March of 2013), ipilimumab (since March of 2014) and dabrafenib (since July of 2015) until December 2016. The end date of the observation was set to 31 December 2016. The total survival analysis was performed using the Kaplan–Meier estimator. Until 31 December 2016, 759 patients were treated with vemurafenib, 370 with ipilimumab and 181 with dabrafenib. The overall survival (OS) median was 9.8 months for patients treated with vemurafenib (95% confidence interval: 8.8–10.6) and 6.9 months for patients treated with ipilimumab (95% confidence interval: 5.7–9.2). For patients treated with dabrafenib, the OS median was not reached because of an overly short observation period. The probability of surviving 12 months in the group of patients treated with vemurafenib was 40.5%, ipilimumab was 35.1% and dabrafenib was 60.7%. The probability of surviving 24 and 36 months in the group of patients treated with vemurafenib or ipilimumab amounted to, respectively, 20.1, 15.4 and 21, 18.8%. OS of patients with advanced melanoma treated in daily clinical practice may be comparable to the ones achieved in registration trials. The use of appropriate treatment inclusion criteria may affect the obtained OS.
    Keywords: Melanoma -- Research ; Melanoma -- Drug Therapy ; Dabrafenib -- Dosage And Administration ; Ipilimumab -- Dosage And Administration ; Vemurafenib -- Dosage And Administration;
    ISSN: 0960-8931
    E-ISSN: 14735636
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