Publications by authors named "Mittler J"

Article Synopsis
  • The Barcelona Clinic Liver Cancer (BCLC) staging system is crucial for treating hepatocellular carcinoma (HCC); recent updates allow for BCLC stage B patients to consider liver transplantation, while hepatectomy is now discouraged.
  • A systematic review analyzed 31 studies involving 3163 patients to compare survival rates, postoperative complications, and patient selection for liver resection versus transplantation in BCLC stage B patients.
  • Results showed that while resection had a 50-month survival and a 15-month recurrence-free period, data on transplantation was limited, with only one study reporting on it, indicating the need for more research in this area.
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Background: Therapeutic connections (TCs) between patients and care providers are important for achieving desired patient outcomes. For patients, TC is associated with greater health self-efficacy, better health status, mental health status, and higher satisfaction with providers.

Purpose: The aim of the study was to examine patients' descriptions of what signals to them they have a TC with their care provider.

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Preliminary work has shown that portal hypertension plays a key role for the prognosis in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Specifically, the presence of ascites appears to be a strong negative predictor for these patients. However, it remains unclear whether different ascites volumes influence prognosis.

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Therapeutic connections (TC) between patients and providers are foundational to patient-centered care, which is co-produced between patients and care providers. This necessitates that we understand what patients expect from TCs, the extent to which providers know what patients expect, and what providers expect. The purpose of this study was to examine nine TC dimensions and determine which are most important to patients, which dimensions providers believe are most important to patients, and which are most important to providers.

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Objective: To understand US hospitals' initial strategic responses to the federal price transparency rule that took effect January 2021.

Data Sources And Study Setting: Primary interview data collected from 12 not-for-profit hospital organizations in six US metropolitan markets. All but one organization were multihospital systems; the 12 organizations represent a total of 81 hospitals.

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Background: Patient-provider therapeutic connections (TCs) have been theorized to enhance patient outcomes as well as care provider job satisfaction and to reduce burnout. High-quality TCs may result in better matching of health care to patient needs, and thus, better care quality and patient outcomes. For care providers, work environments that enable high-quality TCs may make the work more motivating and facilitate resilience.

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Pathogens face a tradeoff with respect to virulence; while more virulent strains often have higher per-contact transmission rates, they are also more likely to kill their hosts earlier. Because virulence is a heritable trait, there is concern that a disease-modifying vaccine, which reduces the disease severity of an infected vaccinee without changing the underlying pathogen genotype, may result in the evolution of higher pathogen virulence. We explored the potential for such virulence evolution with a disease-modifying HIV-1 vaccine in an agent-based stochastic epidemic model of HIV in United States men who have sex with men (MSM).

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Introduction: The literature on liver transplantation (LT) for cirrhosis-associated hepatocellular carcinoma (cirr-HCC) in elderly patients (≥65 years of age) is scarce. The aim of this study was therefore to analyze the outcome after LT for cirr-HCC in elderly patients in our single-center experience.

Methods: All consecutive patients who underwent LT for cirr-HCC at our center were identified from our prospectively collected LT database and stratified into an elderly (≥65 years) and a younger (<65 years) cohort.

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Background: Kidneys from infants with anuric acute kidney injury (AKI) only rarely get accepted for transplantation despite encouraging data that such kidneys can have very good long-term outcome.

Methods: We report the transplantation of four kidney grafts from two pediatric donors (3 and 4 years) with anuric acute kidney injury as single kidneys into four adult recipients.

Results: All grafts gained function within 14 days posttransplantation, only one recipient needed dialysis after transplantation.

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Objectives: A combined digital droplet PCR (ddPCR)/pyrosequencing assay system was developed that demonstrated advantages applicable to multiple qualitative and quantitative molecular genetic diagnostic applications. Data for characterizing this combined approach for hematologic stem cell transplantation (HSCT) and allele quantification from graft-derived cell-free (cf) DNA in solid organ transplantation (SOT) is presented.

Methods: ddPCR and pyrosequencing assays targeting 32 SNPs/markers were established.

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Background: Microvascular invasion (MVI) can only be assessed on a full surgical specimen. We aimed at evaluating, whether the histology of the primary tumor is predictive of MVI in a hepatocellular carcinoma (HCC) recurrence.

Methods: Patients, who underwent liver resection or orthotopic liver transplantation (OLT) for recurrent HCC from January 2001 until June 2018 were eligible for this retrospective analysis.

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Background: Clinically significant portal hypertension (CSPH) has been identified as an important prognostic factor in patients with hepatocellular carcinoma (HCC) undergoing curative treatment. This study aimed to assess PH estimates as prognostic factors in patients with HCC treated with immunotherapy.

Methods: All patients with HCC treated with an immunotherapeutic agent in first or subsequent lines at our tertiary care center between 2016 and 2021 were included (n = 50).

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Article Synopsis
  • Policymakers face challenges in making decisions with limited information and conflicting predictions from different models, especially during crises like the COVID-19 pandemic.
  • A study brought together multiple modeling teams to assess reopening strategies in a mid-sized U.S. county, revealing consistent rankings for interventions despite variations in projection magnitudes.
  • The findings indicated that reopening workplaces could lead to a significant increase in infections, while restrictions could greatly reduce cumulative infections, highlighting the trade-offs between public health and economic activity with no optimal reopening strategy identified.
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Article Synopsis
  • - The study focuses on predicting the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) using data from over 4,900 patients, emphasizing the need for personalized assessment due to high recurrence rates.
  • - Researchers developed the RELAPSE score, which utilizes clinicopathological and radiological factors, validated through advanced statistical and machine learning methods, to enhance the accuracy of recurrence predictions in HCC patients post-LT.
  • - Key independent predictors of HCC recurrence identified include alpha-fetoprotein levels, tumor size, and vascular invasion, with a 5-year recurrence rate of 12.5% and a more robust predictive model achieved through machine learning techniques.
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Background: Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy, followed by intrahepatic cholangiocarcinoma (ICC). In addition, there is a mixed form for which only limited data are available. The aim of this study was to compare recurrence and survival of the mixed form within the cohorts of patients with HCC and ICC from a single center.

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Portal vein infiltration (PVI) is a typical complication of HCC. Once diagnosed, it leads to classification as BCLC C with an enormous impact on patient management, as systemic therapies are henceforth recommended. Our aim was to investigate whether radiomics analysis using imaging at initial diagnosis can predict the occurrence of PVI in the course of disease.

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Liver cirrhosis is the most common risk factor for the development of hepatocellular carcinoma (HCC). However, 10 to 15% of all HCC arise in a non-cirrhotic liver. Few reliable data exist on outcome after liver resection in a non-cirrhotic liver.

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Article Synopsis
  • Set-point viral load (SPVL) is found to correlate with the age of HIV acquisition, suggesting that older individuals may face a selection for more virulent strains due to decreasing risks of infection as they age.
  • The study utilized a model (EvoNetHIV) tailored for men who have sex with men (MSM) to simulate how various behavioral and clinical factors influence the relationship between age and SPVL.
  • Results indicated that while SPVL increases with age when not accounting for source partner SPVL, this effect diminishes significantly when it is included, highlighting behavioral factors like relationship duration and coital frequency as important influencers on SPVL outcomes.
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Background: Early tumor shrinkage (ETS) has been identified as a promising imaging biomarker for patients undergoing immunotherapy for several cancer entities. This study aimed to validate the potential of ETS as an imaging biomarker for patients undergoing immunotherapy for hepatocellular carcinoma (HCC).

Methods: We screened all patients with HCC that received immunotherapy as the first or subsequent line of treatment at our tertiary care center between 2016 and 2021.

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Introduction: The 13 C-methacetin breath test ( 13 C-MBT) is a dynamic method for assessing liver function. This proof-of-concept study aimed to investigate the association between 13 C-MBT values and outcomes in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE).

Methods: A total of 30 patients with HCC were prospectively recruited.

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: An association between immunotherapy and an increase in splenic volume (SV) has been described for various types of cancer. SV is also highly predictive of overall survival (OS) in patients with hepatocellular carcinoma (HCC). We evaluated SV and its changes with regard to their prognostic influence in patients with HCC undergoing immunotherapy.

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Background And Aims: In hereditary hemorrhagic telangiectasia (HHT), severe liver vascular malformations are associated with mutations in the Activin A Receptor-Like Type 1 ( ACVRL1 ) gene encoding ALK1, the receptor for bone morphogenetic protein (BMP) 9/BMP10, which regulates blood vessel development. Here, we established an HHT mouse model with exclusive liver involvement and adequate life expectancy to investigate ALK1 signaling in liver vessel formation and metabolic function.

Approach And Results: Liver sinusoidal endothelial cell (LSEC)-selective Cre deleter line, Stab2-iCreF3 , was crossed with Acvrl1 -floxed mice to generate LSEC-specific Acvrl1 -deficient mice ( Alk1HEC-KO ).

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Background: Long-term survival after liver transplantation (LT) for hepatocellular cancer (HCC) continues to increase along with the modification of inclusion criteria. This study aimed at identifying risk factors for 5- and 10-year overall and HCC-specific death after LT.

Methods: A total of 1,854 HCC transplant recipients from 10 European centers during the period 1987-2015 were analyzed.

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