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Sample records for osnove medi titana

  1. MediMax Elektronik-Marktkette

    NASA Astrophysics Data System (ADS)

    Die Elektronikkette MediMax setzt auf Server Based Computing mit Windows Server 2003® und Thin Clients. Mit über 100 Filialen ist MediMax die erfolgreiche Fachmarktlinie der ElectronicPartner-Verbundgruppe in Deutschland. Die Zugehörigkeit zum Mutterverbund garantiert den Franchisenehmern der Elektronikkette eine schnelle Warenversorgung und günstige Einkaufskonditionen. Über 50.000 Artikel zahlreicher namhafter Markenhersteller und unterschiedlicher Preisklassen sind ständig abrufbar. Darüber hinaus profitieren die Filialen von einer zentralen Organisation und Betreuung ihrer IT. Von Düsseldorf aus administriert ein internes Supportteam die Arbeitsplätze aller Standorte und stellt außerdem die Warenwirtschaftslösung zur Verfügung. Dank der Umstellung auf eine moderne Server Based Computing-Umgebung sind Wartung und Support künftig so effizient wie nie zuvor.

  2. Targeting CD73 in the tumor microenvironment with MEDI9447

    PubMed Central

    Hay, Carl M.; Sult, Erin; Huang, Qihui; Mulgrew, Kathy; Fuhrmann, Stacy R.; McGlinchey, Kelly A.; Hammond, Scott A.; Rothstein, Raymond; Rios-Doria, Jonathan; Poon, Edmund; Holoweckyj, Nick; Durham, Nicholas M.; Leow, Ching Ching; Diedrich, Gundo; Damschroder, Melissa; Herbst, Ronald; Hollingsworth, Robert E.; Sachsenmeier, Kris F.

    2016-01-01

    ABSTRACT MEDI9447 is a human monoclonal antibody that is specific for the ectoenzyme CD73 and currently undergoing Phase I clinical trials. Here we show that MEDI9447 is a potent inhibitor of CD73 ectonucleotidase activity, with wide ranging immune regulatory consequences. MEDI9447 results in relief from adenosine monophosphate (AMP)-mediated lymphocyte suppression in vitro and inhibition of mouse syngeneic tumor growth in vivo. In contrast with other cancer immunotherapy agents such as checkpoint inhibitors or T-cell agonists, MEDI9447 drives changes in both myeloid and lymphoid infiltrating leukocyte populations within the tumor microenvironment of mouse models. Changes include significant alterations in a number of tumor micro-environmental subpopulations including increases in CD8+ effector cells and activated macrophages. Furthermore, these changes correlate directly with responder and non-responder subpopulations within animal studies using syngeneic tumors. Combination data showing additive activity between MEDI9447 and anti-PD-1 antibodies using human cells in vitro and mouse tumor models further demonstrate the potential value of relieving adenosine-mediated immunosuppression. Based on these data, a Phase I study to test the safety, tolerability, and clinical activity of MEDI9447 in cancer patients was initiated (NCT02503774). PMID:27622077

  3. Targeting CD73 in the tumor microenvironment with MEDI9447.

    PubMed

    Hay, Carl M; Sult, Erin; Huang, Qihui; Mulgrew, Kathy; Fuhrmann, Stacy R; McGlinchey, Kelly A; Hammond, Scott A; Rothstein, Raymond; Rios-Doria, Jonathan; Poon, Edmund; Holoweckyj, Nick; Durham, Nicholas M; Leow, Ching Ching; Diedrich, Gundo; Damschroder, Melissa; Herbst, Ronald; Hollingsworth, Robert E; Sachsenmeier, Kris F

    2016-08-01

    MEDI9447 is a human monoclonal antibody that is specific for the ectoenzyme CD73 and currently undergoing Phase I clinical trials. Here we show that MEDI9447 is a potent inhibitor of CD73 ectonucleotidase activity, with wide ranging immune regulatory consequences. MEDI9447 results in relief from adenosine monophosphate (AMP)-mediated lymphocyte suppression in vitro and inhibition of mouse syngeneic tumor growth in vivo. In contrast with other cancer immunotherapy agents such as checkpoint inhibitors or T-cell agonists, MEDI9447 drives changes in both myeloid and lymphoid infiltrating leukocyte populations within the tumor microenvironment of mouse models. Changes include significant alterations in a number of tumor micro-environmental subpopulations including increases in CD8(+) effector cells and activated macrophages. Furthermore, these changes correlate directly with responder and non-responder subpopulations within animal studies using syngeneic tumors. Combination data showing additive activity between MEDI9447 and anti-PD-1 antibodies using human cells in vitro and mouse tumor models further demonstrate the potential value of relieving adenosine-mediated immunosuppression. Based on these data, a Phase I study to test the safety, tolerability, and clinical activity of MEDI9447 in cancer patients was initiated (NCT02503774). PMID:27622077

  4. MediGuide-impact on catheter ablation techniques and workflow.

    PubMed

    Pillarisetti, Jayasree; Kanmanthareddy, Arun; Reddy, Yeruva Madhu; Lakkireddy, Dhanunjaya

    2014-09-01

    Since the introduction of percutaneous intervention in modern medical science, specifically cardiovascular medicine fluoroscopy has remained the gold standard for navigation inside the cardiac structures. As the complexity of the procedures continue to increase with advances in interventional electrophysiology, the procedural times and fluoroscopy times have proportionately increased and the risks of radiation exposure both to the patients as well as the operator continue to rise. 3D electroanatomic mapping systems have to some extent complemented fluoroscopic imaging in improving catheter navigation and forming a solid platform for exploring the electroanatomic details of the target substrate. The 3D mapping systems are still limited as they continue to be static representations of a dynamic heart without being completely integrated with fluoroscopy. The field needed a technological solution that could add a dynamic positioning system that can be successfully incorporated into fluoroscopic imaging as well as electroanatomic imaging modalities. MediGuide is one such innovative technology that exploits the geo-positioning system principles. It employs a transmitter mounted on the X-ray panel that emits an electromagnetic field within which sensor-equipped diagnostic and ablation catheters are tracked within prerecorded fluoroscopic images. MediGuide is also integrated with NavX mapping system and helps in developing better 3D images by field scaling-a process that reduces field distortions that occur from impedance mapping alone. In this review, we discuss about the principle of MediGuide technology, the catheter ablation techniques, and the workflow in the EP lab for different procedures. PMID:24928484

  5. PicSafe Medi: a clinical photography app review.

    PubMed

    Lo, Michelle Chin I; Brinkworth, Simon; Knights, Christina; Mackie, Ian

    2015-01-01

    Medical photographs are used in many clinical settings; however, there are significant risks associated with using the camera feature on mobile devices, namely, breaches of security. PicSafe Medi is an app that allows healthcare professionals to take clinical photographs using smart devices whilst addressing the concerns of patient confidentiality. We review the app to assess its functionality in a UK clinical setting, taking into account UK guidelines such as those offered by the General Medical Council, UK legislation, the Institute of Medical Illustrators and the Department of Health. PMID:26828558

  6. Mead Data Central's MEDIS: medical information access in full-text.

    PubMed

    Albright, R G

    1989-01-01

    Electronic information access is an imperative skill for the modern health professional. Mead Data Central's MEDIS overcomes the limitations of "abstract-only" information networks and provides rapid access to a large collection of full-text medical information. With its proprietary communications software, Mead can display citations in a paged format with on-screen highlighting (in "reverse video") of search terms as they appear in documents. Users can move through the electronic pages as easily as they would thumb through a journal or book. A practice section on MEDIS is billed only for connect charges for using, and a unique on-line tutorial, which, while not specific for MEDIS, introduces users to searching the Mead system. Training is available to subscribers in several major cities and training software is available. MEDIS is a unique resource to access medical literature in full-text quickly and efficiently. PMID:10303627

  7. Competing for Medi-Cal business: why hospitals did, and did not, get contracts.

    PubMed

    Brown, E R; Cousineau, M R; Price, W T

    1985-01-01

    Although we cannot yet judge the broad consequences of Medi-Cal selective contracting, we can assess the outcome of the contracting process and the role that competition and other factors played in that process. In this study of the qualitative and quantitative characteristics of hospitals in Los Angeles County that bid for Medi-Cal contracts, we analyzed the factors that were important determinants of whether or not hospitals received contracts. We found that hospital dependence on Medi-Cal inpatient revenues was most strongly associated with winning a contract and the presence of a teaching program next most strongly related. We discuss the relative importance of hospital need for a contract and the Medi-Cal special negotiator's desire to include certain hospitals in the program, and conclude with a discussion of our study's implications for competition and regulation methods in Medicaid cost containment strategies. PMID:2931367

  8. Pharmacological profile of MEDI-551, a novel anti-CD19 antibody, in human CD19 transgenic mice.

    PubMed

    Gallagher, Sandra; Turman, Sean; Yusuf, Isharat; Akhgar, Ahmad; Wu, Yuling; Roskos, Lorin K; Herbst, Ronald; Wang, Yue

    2016-07-01

    B cell depletion therapy is beneficial for patients with B cell malignancies and autoimmune diseases. CD19, a transmembrane protein, is expressed on a vast majority of normal and neoplastic B cells, making it a suitable target for monoclonal antibody (MAb) mediated immunotherapy. We have developed MEDI-551, an affinity optimized and afucosylated IgG1 MAb targeting human CD19 for B cell depletion. MEDI-551 is currently under investigation in multiple clinical trials. Because MEDI-551 does not cross react with rodent and non-human primate CD19, the pharmacological characteristics of the MAb were evaluated in human CD19 transgenic mice (hCD19 Tg). Here we show that MEDI-551 potently depletes tissue and circulating B cells in hCD19 Tg mice and is more efficacious than the anti-CD19 MAb with intact fucose. The length of B cell depletion depends on MEDI-551 dose; and, B cell recovery in the circulation follows stepwise phenotypic maturation. Furthermore, intravenous (IV) and subcutaneous (SC) administration of MEDI-551 results in comparable efficacy. Lastly, the combination of MEDI-551 with the anti-CD20 MAb, rituximab, further prolongs the duration of B cell depletion. In summary, the pharmacological profile of MEDI-551 presented in hCD19 Tg mice supports further testing of MEDI-551 in clinical trials involving B cell malignancies and autoimmune diseases. PMID:27163209

  9. MediAgent: a WWW-based scalable and self-learning medical search engine.

    PubMed Central

    Tay, J.; Ke, S.; Lun, K. C.

    1998-01-01

    Searching for medical information on the Internet can be tedious and frustrating due to the number of irrelevant entries returned from generic search engines. We have developed MediAgent, a scalable search engine that aims to deliver a web-based medical search solution which is focused, exhaustive and able to keep improving its databases. The software package can run off a single low-end system and be scaled into a client-server, distributed computing architecture for high-end needs. This scalable architecture boosts MediAgent's handling capacity to tens of millions of web pages. In addition to large volume handling, MediAgent is designed to be manageable. All subsystems are not only highly configurable, but also support remote, interactive management and monitoring by the system administrator. PMID:9929289

  10. MediBook: Combining Semantic Networks with Metadata for Learning Resources To Build a Web Based Learning System.

    ERIC Educational Resources Information Center

    Steinacker, Achim; Faatz, Andreas; Seeberg, Cornelia; Rimac, Ivica; Hormann, Stefan; El Saddik, Abdulmotaleb; Steinmetz, Ralf

    This paper gives an overview of MediBook, a joint project of the Medical Department of the University GieBen (Germany) and the Department of Electrical Engineering and Information Technology at Darmstadt University of Technology (Germany) funded by the Hessian Ministry for Science and Arts (HMWK). The basis of MediBook is a formal representation…

  11. Identification and Characterization of MEDI4736, an Antagonistic Anti-PD-L1 Monoclonal Antibody.

    PubMed

    Stewart, Ross; Morrow, Michelle; Hammond, Scott A; Mulgrew, Kathy; Marcus, Danielle; Poon, Edmund; Watkins, Amanda; Mullins, Stefanie; Chodorge, Matthieu; Andrews, John; Bannister, David; Dick, Emily; Crawford, Nicola; Parmentier, Julie; Alimzhanov, Marat; Babcook, John S; Foltz, Ian N; Buchanan, Andrew; Bedian, Vahe; Wilkinson, Robert W; McCourt, Matthew

    2015-09-01

    Programmed cell-death 1 ligand 1 (PD-L1) is a member of the B7/CD28 family of proteins that control T-cell activation. Many tumors can upregulate expression of PD-L1, inhibiting antitumor T-cell responses and avoiding immune surveillance and elimination. We have identified and characterized MEDI4736, a human IgG1 monoclonal antibody that binds with high affinity and specificity to PD-L1 and is uniquely engineered to prevent antibody-dependent cell-mediated cytotoxicity. In vitro assays demonstrate that MEDI4736 is a potent antagonist of PD-L1 function, blocking interaction with PD-1 and CD80 to overcome inhibition of primary human T-cell activation. In vivo MEDI4736 significantly inhibits the growth of human tumors in a novel xenograft model containing coimplanted human T cells. This activity is entirely dependent on the presence of transplanted T cells, supporting the immunological mechanism of action for MEDI4736. To further determine the utility of PD-L1 blockade, an anti-mouse PD-L1 antibody was investigated in immunocompetent mice. Here, anti-mouse PD-L1 significantly improved survival of mice implanted with CT26 colorectal cancer cells. The antitumor activity of anti-PD-L1 was enhanced by combination with oxaliplatin, which resulted in increased release of HMGB1 within CT26 tumors. Taken together, our results demonstrate that inhibition of PD-L1 function can have potent antitumor activity when used as monotherapy or in combination in preclinical models, and suggest it may be a promising therapeutic approach for the treatment of cancer. MEDI4736 is currently in several clinical trials both alone and in combination with other agents, including anti-CTLA-4, anti-PD-1, and inhibitors of IDO, MEK, BRAF, and EGFR. PMID:25943534

  12. Progress on the development of the MediWatch ambulatory blood pressure monitor and related devices.

    PubMed

    Ng, Kim-Gau; Ting, Choon-Meng; Yeo, Joon-Hock; Sim, Kwang-Wei; Peh, Wee-Leng; Chua, Ngak-Hwee; Chua, Ngak-Kwong; Kwong, Frank

    2004-06-01

    The MediWatch is a wrist-mounted noninvasive blood pressure monitor designed to capture the radial pulse waveform using arterial tonometry and yield blood pressure measurements when the waveform is calibrated. An early prototype of this monitor uses a pulse-sensing system with a cylindrical plunger to applanate the radial artery. This prototype was evaluated against simulated blood pressure generated by a pneumatic pressure-pulse generator. The simulation-based results show that the prototype gave accurate pressure measurements when the MediWatch waveforms were calibrated against the simulator's pressure, indicating that the pulse-sensing system was able to measure force accurately. The prototype was clinically evaluated against intra-arterial pressure on post-open heart surgery patients. The results show that, under stationary conditions, for short periods of time and when the MediWatch waveforms were calibrated against the intra-arterial pressure, the prototype gave measurements that satisfy some of the statistical criteria of the 1993 Association for the Advancement of Medical Instrumentation standard, the 1993 British Hypertension Society protocol and the 2002 European Society of Hypertension protocol. These clinical results indicate that, under the stated test conditions, the prototype was able to accurately track changes in the patients' systolic and diastolic pressures. The MediWatch is being developed into an ambulatory device that provides a macroscopic view of the patient's blood pressure through measurement at preprogrammed intervals over 24 h, as well as a microscopic view of the patient's pressure through the pulse waveform captured during each measurement cycle. The design features of the MediWatch are being adapted for other applications that require the arterial pulse waveform, calibrated beat-to-beat blood pressure or both. An improved MediWatch prototype has been developed that provides memory storage for measurement data and functions as an

  13. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

    PubMed Central

    Kohatsu, Neal D.; Paciotti, Brian M.; Byrne, Jennifer V.; Kizer, Kenneth W.

    2015-01-01

    Introduction Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation’s largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. Methods The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Results Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Conclusion Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services. PMID:26564012

  14. Preliminary evaluation of the tomographic performance of the mediSPECT small animal imaging system

    NASA Astrophysics Data System (ADS)

    Accorsi, Roberto; Curion, Assunta Simona; Frallicciardi, Paola; Lanza, Richard C.; Lauria, Adele; Mettivier, Giovanni; Montesi, Maria Cristina; Russo, Paolo

    2007-02-01

    We report on the tests of a prototype (MediSPECT) system developed at University & INFN Napoli, for Single Photon Emission Computed Tomography (SPECT) imaging on small animals with a small Field of View (FoV) and high spatial resolution. MediSPECT is a SPECT imaging system based on a 1-mm-thick CdTe pixel detector, bump-bonded to the Medipix2 CMOS readout circuit operating in single-photon counting. The CdTe detector has 256×256 square array of pixels arranged with a 55 μm pitch, for a sensitive area of 14×14 mm 2. In its present version, this system implements a single detector head, mounted on a rotating gantry. For preliminary testing and calibration of the acquisition equipment and image reconstruction algorithms, 90 projections of a γ-ray point source ( 109Cd) through a single pinhole (diameter 0.4 mm; radius of rotation about 2.5 cm; focal length about 4.5 cm) were acquired for 20 min each in a step-and-shoot mode. Capillaries, 800 μm in diameter, were arranged in a Y-shape to form a more complex phantom ( 125I, 1 mm pinhole diameter, 45 projections, each acquired for 25 min). Images were reconstructed with a custom algorithm implementing standard OS-EM with center of rotation correction and spatial resolution of 0.2 mm over a FoV of 2 mm was obtained.

  15. European Commission-supported development of targeted nanomedicines: did MediTrans make a difference?

    PubMed

    Storm, G; Aime, S

    2011-07-01

    Nanotechnology-inspired approaches to particle design and formulation, an improved understanding of (patho) physiological processes and biological barriers to drug targeting, as well as the limited input of new chemical entities in the 'pipeline' of pharmaceutical companies, suggest a bright future for targeted nanomedicines as pharmaceuticals. There is an increased consensus to the view that a major limitation hampering the entry of targeted delivery systems into the clinic is that new concepts and innovative research ideas within academia are not being developed and exploited in close collaboration with the pharmaceutical industry. Thus, an integrated 'bench-to-clinic' approach realized within a structural collaboration between industry and academia, will facilitate and promote the progression of targeted nanomedicines towards clinical application. The MediTrans project performed under the EU Framework Program 6, was designed to contribute to this ambition. The objectives of this collaborative initiative were: to apply nanotechnology for development of innovative targeted drug-delivery systems; to optimize targeted nanomedicines by using imaging guidance; to promote structural collaboration between industry and academia; and to forward targeted nanomedicines towards the clinic and the market. In this article, we will briefly address the research content, outcome and impact of the MediTrans project. PMID:22833900

  16. Rapid Assessment with Qualitative Telephone Interviews: Lessons from an Evaluation of California's Healthy Families Program & Medi-Cal for Children

    ERIC Educational Resources Information Center

    Sobo, Elisa J.; Simmes, Diana R.; Landsverk, John A.; Kurtin, Paul S.

    2003-01-01

    California's Healthy Families/Medi-Cal for Children (HF/MCC) program provides low- and no-cost health insurance to low-income children. In December 1999 and January 2000, 72 community-based organizations (CBOs) were contracted by California's Department of Health Services (DHS) to supply culturally appropriate HF/MCC outreach and enrollment…

  17. Análise da medição do raio solar em ultravioleta

    NASA Astrophysics Data System (ADS)

    Saraiva, A. C. V.; Giménez de Castro, C. G.; Costa, J. E. R.; Selhorst, C. L.; Simões, P. J. A.

    2003-08-01

    A medição acurada do raio solar em qualquer banda do espectro eletromagnético é de relevância na formulação e calibração de modelos da estrutura e atmosfera solar. Esses modelos atribuem emissão do contínuo do Sol calmo em microondas à mesma região da linha Ha do Hell. Apresentamos a medição do raio solar em UV com imagens do EIT (Extreme Ultraviolet Image Telescope) entre 1996 e 2002, no comprimento de onda 30,9 nm (Ha do Hell), que se forma na região de transição/cromosfera solar. A técnica utilizada para o cálculo do raio UV foi baseada na transformada Wavelet B3spline. Fizemos um banco de dados com 1 imagem por dia durante o período citado. Obtivemos como resultado o raio médio da ordem de 975.61" e uma diminuição do mesmo para o período citado variando em média -0,45" /ano. Comparamos estes dados com os valores obtidos pelo ROI (Radio Observatório de Itapetinga) em 22/48 GHz e Nobeyama Radio Heliograph em 17 GHz mostrando que os raios médios são muito próximos o que indica que a região de formação nessas freqüências é a mesma conforme os modelos. Comparamos os resultados também com outros índices de atividade solar.

  18. Phase I Dose-Escalation Study of MEDI-573, a Bispecific, Antiligand Monoclonal Antibody against IGFI and IGFII, in Patients with Advanced Solid Tumors

    PubMed Central

    Haluska, Paul; Menefee, Michael; Plimack, Elizabeth R.; Rosenberg, Jonathan; Northfelt, Donald; LaVallee, Theresa; Shi, Li; Yu, Xiang-Qing; Burke, Patricia; Huang, Jaiqi; Viner, Jaye; McDevitt, Jennifer; LoRusso, Patricia

    2015-01-01

    Purpose This phase I, multicenter, open-label, single-arm, dose-escalation, and dose-expansion study evaluated the safety, tolerability, and antitumor activity of MEDI-573 in adults with advanced solid tumors refractory to standard therapy or for which no standard therapy exists. Experimental Design Patients received MEDI-573 in 1 of 5 cohorts (0.5, 1.5, 5, 10, or 15 mg/kg) dosed weekly or 1 of 2 cohorts (30 or 45 mg/kg) dosed every 3 weeks. Primary end points included the MEDI-573 safety profile, maximum tolerated dose (MTD), and optimal biologic dose (OBD). Secondary end points included MEDI-573 pharmacokinetics (PK), pharmacodynamics, immunogenicity, and antitumor activity. Results In total, 43 patients (20 with urothelial cancer) received MEDI-573. No dose-limiting toxicities were identified, and only 1 patient experienced hyperglycemia related to treatment. Elevations in levels of insulin and/or growth hormone were not observed. Adverse events observed in >10% of patients included fatigue, anorexia, nausea, diarrhea, and anemia. PK evaluation demonstrated that levels of MEDI-573 increased with dose at all dose levels tested. At doses >5 mg/kg, circulating levels of insulin-like growth factor (IGF)-I and IGFII were fully suppressed. Of 39 patients evaluable for response, none experienced partial or complete response and 13 had stable disease as best response. Conclusions The MTD of MEDI-573 was not reached. The OBD was 5 mg/kg weekly or 30 or 45 mg/kg every 3 weeks. MEDI-573 showed preliminary antitumor activity in a heavily pretreated population and had a favorable tolerability profile, with no notable perturbations in metabolic homeostasis. PMID:25024259

  19. The CEA/CD3-Bispecific Antibody MEDI-565 (MT111) Binds a Nonlinear Epitope in the Full-Length but Not a Short Splice Variant of CEA

    PubMed Central

    Huang, Jiaqi; Brohawn, Philip; Morehouse, Chris; Lekstrom, Kristen; Baeuerle, Patrick A.; Wu, Herren; Yao, Yihong; Coats, Steven R.; Dall’Acqua, William; Damschroder, Melissa; Hammond, Scott A.

    2012-01-01

    MEDI-565 (also known as MT111) is a bispecific T-cell engager (BiTE®) antibody in development for the treatment of patients with cancers expressing carcinoembryonic antigen (CEA). MEDI-565 binds CEA on cancer cells and CD3 on T cells to induce T-cell mediated killing of cancer cells. To understand the molecular basis of human CEA recognition by MEDI-565 and how polymorphisms and spliced forms of CEA may affect MEDI-565 activity, we mapped the epitope of MEDI-565 on CEA using mutagenesis and homology modeling approaches. We found that MEDI-565 recognized a conformational epitope in the A2 domain comprised of amino acids 326–349 and 388–410, with critical residues F326, T328, N333, V388, G389, P390, E392, I408, and N410. Two non-synonymous single-nucleotide polymorphisms (SNPs) (rs10407503, rs7249230) were identified in the epitope region, but they are found at low homozygosity rates. Searching the National Center for Biotechnology Information GenBank® database, we further identified a single, previously uncharacterized mRNA splice variant of CEA that lacks a portion of the N-terminal domain, the A1 and B1 domains, and a large portion of the A2 domain. Real-time quantitative polymerase chain reaction analysis of multiple cancers showed widespread expression of full-length CEA in these tumors, with less frequent but concordant expression of the CEA splice variant. Because the epitope was largely absent from the CEA splice variant, MEDI-565 did not bind or mediate T-cell killing of cells solely expressing this form of CEA. In addition, the splice variant did not interfere with MEDI-565 binding or activity when co-expressed with full-length CEA. Thus MEDI-565 may broadly target CEA-positive tumors without regard for expression of the short splice variant of CEA. Together our data suggest that MEDI-565 activity will neither be impacted by SNPs nor by a splice variant of CEA. PMID:22574157

  20. MediSim: A Prototype VR System for Training Medical First Responders

    SciTech Connect

    Stansfield, S.; Shawver, D.; Sobel, A.

    1997-12-31

    This paper presents a prototype virtual reality (VR) system for training medical first responders. The initial application is to battlefield medicine and focuses on the training of medical corpsmen and other front-line personnel who might be called upon to provide emergency triage on the battlefield. The system is built upon Sandia`s multi-user, distributed VR platform and provides an interactive, immersive simulation capability. The user is represented by an Avatar and is able to manipulate his virtual instruments and carry out medical procedures. A dynamic casualty simulation provides realistic cues to the patient`s condition (e.g. changing blood pressure and pulse) and responds to the actions of the trainee (e.g. a change in the color of a patient`s skin may result from a check of the capillary refill rate). The current casualty simulation is of an injury resulting in a tension pneumothorax. This casualty model was developed by the University of Pennsylvania and integrated into the Sandia MediSim system.

  1. Prograf five milligrams versus Tacrolimus medis in healthy volunteers: a bioequivalence study.

    PubMed

    Masri, M; Rizk, S; Boujbel, L; Bellahirich, W; Baassoumi, D; Attia, M; Matha, V

    2013-01-01

    For FDA approval, bioequivalence of a generic version of Tacrolimus must be demonstrated in a randomized, two-treatments, two-periods, two-sequences, single-dose crossover study in healthy adult volunteers. Currently there are at least 3 differents generic equivalent for Tacrolimus, that are approved by the EMA and the FDA, with a USA market share of nearly 50%. However, the market share of generic immunosuppressive drugs in the Middle East region is still very low due to the reluctance of the physician to accept Tacrolimus generics, considered to be a narrow therapeutic window drug, that are approved using the standard bioequivalence criteria of 80% to 125%. Herein we present a bioequivalence study of a new Tacrolimus generic, Tacrolimus Medis 5 mg developed by Medis Tunisia batch number 12G3003 compared with Prograf® 5 mg batch number 7202 manufactured by Astellas Toyama Co., Ltd. Japan and HIKMA Pharmaceuticals, Amman-Jordan in healthy adult volunteers using the 90%-111% criteria recommended for drugs with narrow therapeutic window. The study was, balanced, randomized, two-treatments, two-periods, two-sequences, single dose, crossover, comparative oral bioavailability study in healthy adult human volunteers. The study was carried out in accordance with the Basic Principles defined in the U.S. 21 CFR Part 312.20, the principles enunciated in the Declaration of Helsinki (World Medical Association Declaration of Helsinki). Thirty six non-smoking healthy, as determined by medical history, volunteers, 18 years and older, were included. Following randomization using a computer software (pharma solution) the volunteers were given a single oral dose of 5 milligrams following a 12 hour fast with a wash out period of 7 days. Pharmacokinetics profile with blood levels at: 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12, and 24 hours were performed following each dose. Tacrolimus plasma level was determined using an HPLC validated method (Transmedical For Life S.A.R.L. Beirut

  2. The detection of single electrons using a Micromegas gas amplification and a MediPix2 CMOS pixel readout

    NASA Astrophysics Data System (ADS)

    Fornaini, A.; Campbell, M.; Chefdeville, M.; Colas, P.; Colijn, A. P.; van der Graaf, H.; Giomataris, Y.; Heijne, E. H. M.; Kluit, P.; Llopart, X.; Schmitz, J.; Timmermans, J.; Visschers, J. L.

    2005-07-01

    By placing a Micromegas gas gain grid on top of a CMOS pixel readout circuit (MediPix2), we developed a device which acts as a pixel-segmented direct anode in gas-filled detectors. With a He/Isobutane 80/20 mixture (capable of achieving gas gain factors up to 20×103) and employing a drift length of 15 mm, signals from radioactive sources and cosmic radiation were measured. Single primary electrons originating from the passage of cosmic muons through the gas volume were detected with an efficiency higher than 90%.

  3. Detection of single electrons by means of a Micromegas-covered MediPix2 pixel CMOS readout circuit

    NASA Astrophysics Data System (ADS)

    Campbell, M.; Chefdeville, M.; Colas, P.; Colijn, A. P.; Fornaini, A.; Giomataris, Y.; van der Graaf, H.; Heijne, E. H. M.; Kluit, P.; Llopart, X.; Schmitz, J.; Timmermans, J.; Visschers, J. L.

    2005-03-01

    A small drift chamber was read out by means of a MediPix2 readout chip as a direct anode. A Micromegas foil was placed 50 μm above the chip, and electron multiplication occurred in the gap. With a He/isobutane 80/20 mixture, gas multiplication factors up to tens of thousands were achieved, resulting in an efficiency for detecting single electrons of better than 90%. We recorded many frames containing 2D images with tracks from cosmic muons. Along these tracks, electron clusters were observed, as well as δ-rays.

  4. Safety profile and clinical activity of multiple subcutaneous doses of MEDI-528, a humanized anti-interleukin-9 monoclonal antibody, in two randomized phase 2a studies in subjects with asthma

    PubMed Central

    2011-01-01

    Background Interleukin-9 (IL-9)-targeted therapies may offer a novel approach for treating asthmatics. Two randomized placebo-controlled studies were conducted to assess the safety profile and potential efficacy of multiple subcutaneous doses of MEDI-528, a humanized anti-IL-9 monoclonal antibody, in asthmatics. Methods Study 1: adults (18-65 years) with mild asthma received MEDI-528 (0.3, 1, 3 mg/kg) or placebo subcutaneously twice weekly for 4 weeks. Study 2: adults (18-50 years) with stable, mild to moderate asthma and exercise-induced bronchoconstriction received 50 mg MEDI-528 or placebo subcutaneously twice weekly for 4 weeks. Adverse events (AEs), pharmacokinetics (PK), immunogenicity, asthma control (including asthma exacerbations), and exercise challenge test were evaluated in study 1, study 2, or both. Results In study 1 (N = 36), MEDI-528 showed linear serum PK; no anti-MEDI-528 antibodies were detected. Asthma control: 1/27 MEDI-528-treated subjects had 1 asthma exacerbation, and 2/9 placebo-treated subjects had a total of 4 asthma exacerbations (one considered a serious AE). In study 2, MEDI-528 (n = 7) elicited a trend in the reduction in mean maximum decrease in FEV1 post-exercise compared to placebo (n = 2) (-6.49% MEDI-528 vs -12.60% placebo; -1.40% vs -20.10%; -5.04% vs -15.20% at study days 28, 56, and 150, respectively). Study 2 was halted prematurely due to a serious AE in an asymptomatic MEDI-528-treated subject who had an abnormal brain magnetic resonance imaging that was found to be an artifact on further evaluation. Conclusions In these studies, MEDI-528 showed an acceptable safety profile and findings suggestive of clinical activity that support continued study in subjects with mild to moderate asthma. Trial registration ClinicalTrials (NCT): NCT00507130 and ClinicalTrials (NCT): NCT00590720 PMID:21356110

  5. Phase I trial of a monoclonal antibody specific for alphavbeta3 integrin (MEDI-522) in patients with advanced malignancies, including an assessment of effect on tumor perfusion.

    PubMed

    McNeel, Douglas G; Eickhoff, Jens; Lee, Fred T; King, David M; Alberti, Dona; Thomas, James P; Friedl, Andreas; Kolesar, Jill; Marnocha, Rebecca; Volkman, Jennifer; Zhang, Jianliang; Hammershaimb, Luz; Zwiebel, James A; Wilding, George

    2005-11-01

    At present, a variety of agents targeting tumor angiogenesis are under clinical investigation as new therapies for patients with cancer. Overexpression of the alpha(v)beta(3) integrin on tumor vasculature has been associated with an aggressive phenotype of several solid tumor types. Murine models have shown that antibodies targeting the alpha(v)beta(3) integrin can affect tumor vasculature and block tumor formation and metastasis. These findings suggest that antibodies directed at alpha(v)beta(3) could be investigated in the treatment of human malignancies. The current phase I dose escalation study evaluated the safety of MEDI-522, a monoclonal antibody specific for the alpha(v)beta(3) integrin, in patients with advanced malignancies. Twenty-five patients with a variety of metastatic solid tumors were treated with MEDI-522 on a weekly basis with doses ranging from 2 to 10 mg/kg/wk. Adverse events were assessed weekly; pharmacokinetic studies were done; and radiographic staging was done every 8 weeks. In addition, dynamic computed tomography imaging was done at baseline and at 8 weeks in patients with suitable target lesions amenable to analysis, to potentially identify the effect of MEDI-522 on tumor perfusion. Treatment was well tolerated, and a maximum tolerated dose was not identified by traditional dose-limiting toxicities. The major adverse events observed were grade 1 and 2 infusion-related reactions (fever, rigors, flushing, injection site reactions, and tachycardia), low-grade constitutional and gastrointestinal symptoms (fatigue, myalgias, and nausea), and asymptomatic hypophosphatemia. Dynamic computed tomography imaging suggested a possible effect on tumor perfusion with an increase in contrast mean transit time from baseline to the 8-week evaluation with increasing doses of MEDI-522. No complete or partial responses were observed. Three patients with metastatic renal cell cancer experienced prolonged stable disease (34 weeks, >1 and >2 years) on

  6. MediSPECT: Single photon emission computed tomography system for small field of view small animal imaging based on a CdTe hybrid pixel detector

    NASA Astrophysics Data System (ADS)

    Accorsi, R.; Autiero, M.; Celentano, L.; Chmeissani, M.; Cozzolino, R.; Curion, A. S.; Frallicciardi, P.; Laccetti, P.; Lanza, R. C.; Lauria, A.; Maiorino, M.; Marotta, M.; Mettivier, G.; Montesi, M. C.; Riccio, P.; Roberti, G.; Russo, P.

    2007-02-01

    We describe MediSPECT, a new scanner developed at University and INFN Napoli, for SPECT studies on small animals with a small field of view (FOV) and high spatial resolution. The CdTe pixel detector (a 256×256 matrix of 55 μm square pixels) operating in single photon counting for detection of gamma-rays with low and medium energy (e.g. 125I, 27-35 keV, 99mTc, 140 keV), is bump bonded to the Medipix2 readout chip. The FOV of the MediSPECT scanner with a coded aperture mask collimator ranges from 6.3 mm (system spatial resolution 110 μm at 27-35 keV) to 24.3 mm. With a 0.30 mm pinhole the FOV ranges from 2.4 to 29 mm (where the system spatial resolution is 1.0 mm at 27-35 keV and 2.0 mm at 140 keV). MediSPECT will be used for in vivo imaging of small organs or tissue structures in mouse, e.g., brain, thyroid, heart or tumor.

  7. Staphylococcus aureus Alpha-Toxin Is Conserved among Diverse Hospital Respiratory Isolates Collected from a Global Surveillance Study and Is Neutralized by Monoclonal Antibody MEDI4893.

    PubMed

    Tabor, David E; Yu, Li; Mok, Hoyin; Tkaczyk, Christine; Sellman, Bret R; Wu, Yuling; Oganesyan, Vaheh; Slidel, Tim; Jafri, Hasan; McCarthy, Michael; Bradford, Patricia; Esser, Mark T

    2016-09-01

    Staphylococcus aureus infections lead to an array of illnesses ranging from mild skin infections to serious diseases, such endocarditis, osteomyelitis, and pneumonia. Alpha-toxin (Hla) is a pore-forming toxin, encoded by the hla gene, that is thought to play a key role in S. aureus pathogenesis. A monoclonal antibody targeting Hla, MEDI4893, is in clinical development for the prevention of S. aureus ventilator-associated pneumonia (VAP). The presence of the hla gene and Hla protein in 994 respiratory isolates collected from patients in 34 countries in Asia, Europe, the United States, Latin America, the Middle East, Africa, and Australia was determined. Hla levels were correlated with the geographic location, age of the subject, and length of stay in the hospital. hla gene sequence analysis was performed, and mutations were mapped to the Hla crystal structure. S. aureus supernatants containing Hla variants were tested for susceptibility or resistance to MEDI4893. The hla gene was present and Hla was expressed in 99.0% and 83.2% of the isolates, respectively, regardless of geographic region, hospital locale, or age of the subject. More methicillin-susceptible than methicillin-resistant isolates expressed Hla (86.9% versus 78.8%; P = 0.0007), and S. aureus isolates from pediatric patients expressed the largest amounts of Hla. Fifty-seven different Hla subtypes were identified, and 91% of the isolates encoded an Hla subtype that was neutralized by MED4893. This study demonstrates that Hla is conserved in diverse S. aureus isolates from around the world and is an attractive target for prophylactic monoclonal antibody (MAb) or vaccine development. PMID:27324766

  8. Staphylococcus aureus Alpha-Toxin Is Conserved among Diverse Hospital Respiratory Isolates Collected from a Global Surveillance Study and Is Neutralized by Monoclonal Antibody MEDI4893

    PubMed Central

    Yu, Li; Mok, Hoyin; Tkaczyk, Christine; Sellman, Bret R.; Wu, Yuling; Oganesyan, Vaheh; Slidel, Tim; Jafri, Hasan; McCarthy, Michael; Bradford, Patricia; Esser, Mark T.

    2016-01-01

    Staphylococcus aureus infections lead to an array of illnesses ranging from mild skin infections to serious diseases, such endocarditis, osteomyelitis, and pneumonia. Alpha-toxin (Hla) is a pore-forming toxin, encoded by the hla gene, that is thought to play a key role in S. aureus pathogenesis. A monoclonal antibody targeting Hla, MEDI4893, is in clinical development for the prevention of S. aureus ventilator-associated pneumonia (VAP). The presence of the hla gene and Hla protein in 994 respiratory isolates collected from patients in 34 countries in Asia, Europe, the United States, Latin America, the Middle East, Africa, and Australia was determined. Hla levels were correlated with the geographic location, age of the subject, and length of stay in the hospital. hla gene sequence analysis was performed, and mutations were mapped to the Hla crystal structure. S. aureus supernatants containing Hla variants were tested for susceptibility or resistance to MEDI4893. The hla gene was present and Hla was expressed in 99.0% and 83.2% of the isolates, respectively, regardless of geographic region, hospital locale, or age of the subject. More methicillin-susceptible than methicillin-resistant isolates expressed Hla (86.9% versus 78.8%; P = 0.0007), and S. aureus isolates from pediatric patients expressed the largest amounts of Hla. Fifty-seven different Hla subtypes were identified, and 91% of the isolates encoded an Hla subtype that was neutralized by MED4893. This study demonstrates that Hla is conserved in diverse S. aureus isolates from around the world and is an attractive target for prophylactic monoclonal antibody (MAb) or vaccine development. PMID:27324766

  9. CDA Templates - Utilizing the MediCUBE.

    PubMed

    Burwitz, Martin; Benedict, Martin; Schlieter, Hannes

    2016-01-01

    The specification and customization of clinical document types are tasks that need a strong collaboration between domain experts and IT specialists. However, these collaborators are often faced with difficulties due to different interpretation of domain knowledge. Therefore, an adequate method for sharing domain knowledge about documents is necessary. Even though there are some tools that help to define medical document types, there is a lack of approaches that focus on the understandability of the specification for the domain experts. This paper proposes a modeling approach based on the Clinical Document Architecture to address this gap. PMID:27577429

  10. Medi-Port Pilot Randomized Controlled Trial

    ClinicalTrials.gov

    2016-04-25

    Actively Undergoing Cancer Treatment; 4-9 Years of Age; At Least 1 Month From Diagnosis; Able to Speak and Understand English; Presenting to Clinic for at Least a 2nd Subcutaneous Port Needle Insertion

  11. Chocolate in history: food, medicine, medi-food.

    PubMed

    Lippi, Donatella

    2013-05-01

    Throughout history, chocolate has been used to treat a wide variety of ailments, and in recent years, multiple studies have found that chocolate can have positive health effects, providing evidence to a centuries-long established use; this acknowledgement, however, did not have a straight course, having been involved in religious, medical and cultural controversies. Christian Europe, in fact, feared the exhilarating effects of new drinks, such as chocolate, coffee and tea. Therefore, these beverages would have been banished, had not doctors and scientists explained that they were good for the body. The scientific debate, which reached its peak in Florence in the 18th century, regarded the therapeutic effectiveness of the various chocolate components: it was necessary to know their properties first, in order to prepare the best cacao concoction for every patient. When Dietetics separated from Medicine, however, chocolate acquired the role of vehicle for easing the administration of bitter medicines, being associated to different health problems. The recent rediscovery of the beneficial use of cacao and chocolate focuses upon its value as supplemental nutrition. Building a bridge to the past may be helpful to detect the areas where the potential health benefits of chocolate are likely to be further explored. PMID:23673608

  12. Improving interMediAte Risk management. MARK study

    PubMed Central

    2011-01-01

    Background Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect. Trial Registration Clinical Trials.gov Identifier: NCT01428934 PMID:21992621

  13. Chocolate in History: Food, Medicine, Medi-Food

    PubMed Central

    Lippi, Donatella

    2013-01-01

    Throughout history, chocolate has been used to treat a wide variety of ailments, and in recent years, multiple studies have found that chocolate can have positive health effects, providing evidence to a centuries-long established use; this acknowledgement, however, did not have a straight course, having been involved in religious, medical and cultural controversies. Christian Europe, in fact, feared the exhilarating effects of new drinks, such as chocolate, coffee and tea. Therefore, these beverages would have been banished, had not doctors and scientists explained that they were good for the body. The scientific debate, which reached its peak in Florence in the 18th century, regarded the therapeutic effectiveness of the various chocolate components: it was necessary to know their properties first, in order to prepare the best cacao concoction for every patient. When Dietetics separated from Medicine, however, chocolate acquired the role of vehicle for easing the administration of bitter medicines, being associated to different health problems. The recent rediscovery of the beneficial use of cacao and chocolate focuses upon its value as supplemental nutrition. Building a bridge to the past may be helpful to detect the areas where the potential health benefits of chocolate are likely to be further explored. PMID:23673608

  14. MEDI4736 (Durvalumab) in Patients With Brain Metastasis From Epithelial-derived Tumors

    ClinicalTrials.gov

    2016-09-12

    Non-Small Cell Lung Cancer; Nonsmall Cell Lung Cancer; Breast Cancer; Cancer of Breast; Cancer of the Breast; Gastroesophageal Cancer; Pancreatic Cancer; Cancer of the Pancreas; Colorectal Cancer; Colorectal Carcinoma; Renal Cancer; Kidney Cancer; Cancer of the Kidney; Cancer of Kidney; Ovarian Cancer; Ovary Cancer; Cancer of the Ovary; Cancer of Ovary

  15. MediLink: a wearable telemedicine system for emergency and mobile applications.

    PubMed

    Koval, T; Dudziak, M

    1999-01-01

    The practical needs of the medical professional faced with critical care or emergency situations differ from those working in many environments where telemedicine and mobile computing have been introduced and tested. One constructive criticism of the telemedicine initiative has been to question what positive benefits are gained from videoconferencing, paperless transactions, and online access to patient record. With a goal of producing a positive answer to such questions an architecture for multipurpose mobile telemedicine applications has been developed. The core technology is based upon a wearable personal computer with a smart-card interface coupled with speech, pen, video input and wireless intranet connectivity. The TransPAC system with the MedLink software system is designed to provide an integrated solution for a broad range of health care functions where mobile and hands-free or limited-access systems are preferred or necessary and where the capabilities of other mobile devices are insufficient or inappropriate. Structured and noise-resistant speech-to-text interfacing plus the use of a web browser-like display, accessible through either a flatpanel, standard, or headset monitor, gives the beltpack TransPAC computer the functions of a complete desktop including PCMCIA card interfaces for internet connectivity and a secure smartcard with 16-bit microprocessor and upwards of 64K memory. The card acts to provide user access control for security, user custom configuration of applications and display and vocabulary, and memory to diminish the need for PC-server communications while in an active session. TransPAC is being implemented for EMT and ER staff usage. PMID:10747560

  16. 78 FR 6167 - Order of Suspension of Trading; In the Matter of Medis Technologies Ltd., Modern Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ...., Tamir Biotechnology, Inc., and Techmedia Advertising, Inc., January 25, 2013. It appears to the... concerning the securities of Tamir Biotechnology, Inc. because it has not filed any periodic reports...

  17. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study

    PubMed Central

    Mariolis, Anargiros; Foscolou, Alexandra; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2016-01-01

    To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of “good” health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders. PMID:27330843

  18. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study.

    PubMed

    Mariolis, Anargiros; Foscolou, Alexandra; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2016-05-01

    To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of "good" health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders. PMID:27330843

  19. A Phase III Study of Durvalumab (MEDI4736) With or Without Tremelimumab for Previously Treated Patients With Advanced NSCLC: Rationale and Protocol Design of the ARCTIC Study.

    PubMed

    Planchard, David; Yokoi, Takashi; McCleod, Michael J; Fischer, Jürgen R; Kim, Young-Chul; Ballas, Marc; Shi, Kelvin; Soria, Jean-Charles

    2016-05-01

    Anti-programmed cell death-1 and anti-programmed cell death ligand-1 (PD-L1) monotherapies have shown promising clinical activity in advanced, refractory non-small-cell lung cancer (NSCLC), but antitumor activity appears to be greater in patients with PD-L1(+) tumors compared with patients harboring PD-L1(-) tumors. Combining the anti-PD-L1 antibody durvalumab and the anti-cytotoxic T-lymphocyte antigen 4 antibody tremelimumab offers the potential for antitumor activity in patients with advanced NSCLC, regardless of PD-L1 tumor status. ARCTIC (NCT02352948) is a global, phase III, randomized, open-label multicenter study in patients with advanced NSCLC assessing the safety and clinical activity of durvalumab versus standard of care (SoC; erlotinib, gemcitabine, or vinorelbine) in patients with PD-L1(+) tumors (≥25% of tumor cells with membrane staining using VENTANA PD-L1 [SP263] CDx Assay) (Sub-study A) and the combination of durvalumab + tremelimumab or either agent as monotherapy versus SoC in patients with PD-L1(-) tumors (Sub-study B). Eligible patients are those with locally advanced or metastatic NSCLC (Stage IIIB/IV), without epidermal growth factor receptor tyrosine kinase activating mutations or anaplastic lymphoma kinase rearrangements, who have received at least 2 prior systemic regimens, including 1 platinum-based chemotherapy regimen. Co-primary endpoints are progression-free survival and overall survival. Secondary endpoints include the proportion of patients alive at 12 months, objective response rate, duration of response, progression-free survival at 6 and 12 months, safety and tolerability, pharmacokinetics, immunogenicity, and quality of life. The exploratory endpoints will assess potential biomarkers of treatment response. Recruitment started in January 2015 and is ongoing. PMID:27265743

  20. Successful aging, dietary habits and health status of elderly individuals: a k-dimensional approach within the multi-national MEDIS study.

    PubMed

    Tyrovolas, Stefanos; Haro, Josep Maria; Mariolis, Anargiros; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Tyrovola, Dimitra; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2014-12-01

    The definition and determinants of successful aging is still controversial. Although dietary habits have long been associated with aging, eating habits and behaviors have rarely been included in various proposed indices of successful aging. The aim of this work was to evaluate determinants of successful aging together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005-2011, 2663 elderly (aged 65-100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful aging index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful aging: psychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of aging. After adjusting for confounders, a 1/10-unit increase in the successful aging index was associated with 0.8 less annual visits to healthcare centers (95% CI -1.3 to-0.2). Stratified analysis by gender revealed heterogeneity of factors predicting successful aging. These findings suggest that successful aging is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful aging. PMID:25240688

  1. Anti-ICOS Monoclonal Antibody MEDI-570 in Treating Patients With Relapsed or Refractory Peripheral T-cell Lymphoma Follicular Variant or Angioimmunoblastic T-cell Lymphoma

    ClinicalTrials.gov

    2016-09-08

    Follicular Variant Peripheral T-Cell Lymphoma; Recurrent Angioimmunoblastic T-cell Lymphoma; Recurrent Mature T- and NK-Cell Non-Hodgkin Lymphoma; Refractory Angioimmunoblastic T-cell Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma

  2. Promethium-147 capacitor.

    PubMed

    Kavetskiy, A; Yakubova, G; Lin, Q; Chan, D; Yousaf, S M; Bower, K; Robertson, J D; Garnov, A; Meier, D

    2009-06-01

    Beta particle surface fluxes for tritium, Ni-63, Pm-147, and Sr-90 sources were calculated in this work. High current density was experimentally achieved from Pm-147 oxide in silica-titana glass. A 96 GBq (2.6 Ci) Pm-147 4pi-source with flux efficiency greater than 50% was used for constructing a direct charge capacitor with a polyimide coated collector and vacuum as electrical insulation. The capacitor connected to high resistance (TOmega) loads produced up to 35 kV. Overall conversion efficiency was over 10% (on optimal load). PMID:19328703

  3. Five-membered metallacycles of titanium and zirconium--attractive compounds for organometallic chemistry and catalysis.

    PubMed

    Rosenthal, Uwe; Burlakov, Vladimir V; Bach, Marc A; Beweries, Torsten

    2007-05-01

    In these days a renaissance of metallacycles as an increasingly important class of organometallic compounds for synthetic and catalytic applications is evident, making such very attractive for a plethora of investigations. Titanocene and zirconocene bis(trimethylsilyl)acetylene complexes, regarded as three-membered metallacycles (1-metallacyclopropenes), present a rich chemistry towards unsaturated molecules. By elimination of the alkyne these complexes form by reaction with unsaturated compounds five-membered titana- and zirconacycles, all of which are relevant to stoichiometric and catalytic C-C coupling and cleavage reactions of unsaturated molecules. PMID:17471397

  4. The SAATELLITE and EVADE Clinical Studies Within the COMBACTE Consortium: A Public-Private Collaborative Effort in Designing and Performing Clinical Trials for Novel Antibacterial Drugs to Prevent Nosocomial Pneumonia.

    PubMed

    François, Bruno; Chastre, Jean; Eggiman, Philippe; Laterre, Pierre-François; Torres, Antoni; Sanchez, Miguel; Esser, Mark T; Bishop, Brian; Bonten, Marc; Goosens, Herman; Jafri, Hasan S

    2016-08-15

    The Innovative Medicines Initiative-funded COMBACTE consortium fosters academic-industry partnership in pioneering studies to combat serious bacterial infections. We describe how this partnership is advancing the development of 2 monoclonal antibodies, MEDI4893 and MEDI3902, for the prevention of nosocomial pneumonia. PMID:27481953

  5. Assessing Indigent Health Care Needs and Use of County Health Services.

    ERIC Educational Resources Information Center

    Brown, E. Richard; Cousineau, Michael R.

    In 1982 California eliminated 250,000 "medically indigent adults" (MIAs) from the Medi-Cal program and transferred responsibility for their care to the counties, along with about 70% of what the state would have spent on their care had they remained in the Medi-Cal program. There is far greater variability among the counties in benefits,…

  6. Development and evaluation of an ensemble resource linking medications to their indications

    PubMed Central

    Wei, Wei-Qi; Cronin, Robert M; Xu, Hua; Lasko, Thomas A; Bastarache, Lisa; Denny, Joshua C

    2013-01-01

    Objective To create a computable MEDication Indication resource (MEDI) to support primary and secondary use of electronic medical records (EMRs). Materials and methods We processed four public medication resources, RxNorm, Side Effect Resource (SIDER) 2, MedlinePlus, and Wikipedia, to create MEDI. We applied natural language processing and ontology relationships to extract indications for prescribable, single-ingredient medication concepts and all ingredient concepts as defined by RxNorm. Indications were coded as Unified Medical Language System (UMLS) concepts and International Classification of Diseases, 9th edition (ICD9) codes. A total of 689 extracted indications were randomly selected for manual review for accuracy using dual-physician review. We identified a subset of medication–indication pairs that optimizes recall while maintaining high precision. Results MEDI contains 3112 medications and 63 343 medication–indication pairs. Wikipedia was the largest resource, with 2608 medications and 34 911 pairs. For each resource, estimated precision and recall, respectively, were 94% and 20% for RxNorm, 75% and 33% for MedlinePlus, 67% and 31% for SIDER 2, and 56% and 51% for Wikipedia. The MEDI high-precision subset (MEDI-HPS) includes indications found within either RxNorm or at least two of the three other resources. MEDI-HPS contains 13 304 unique indication pairs regarding 2136 medications. The mean±SD number of indications for each medication in MEDI-HPS is 6.22±6.09. The estimated precision of MEDI-HPS is 92%. Conclusions MEDI is a publicly available, computable resource that links medications with their indications as represented by concepts and billing codes. MEDI may benefit clinical EMR applications and reuse of EMR data for research. PMID:23576672

  7. Molecular basis for the antagonistic activity of an anti-CXCR4 antibody

    PubMed Central

    Peng, Li; Damschroder, Melissa M.; Cook, Kimberly E.; Wu, Herren; Dall'Acqua, William F.

    2016-01-01

    Antagonistic antibodies targeting the G-protein C-X-C chemokine receptor 4 (CXCR4) hold promising therapeutic potential in various diseases. We report for the first time the detailed mechanism of action at a molecular level of a potent anti-CXCR4 antagonistic antibody (MEDI3185). We characterized the MEDI3185 paratope using alanine scanning on all 6 complementary-determining regions (CDRs). We also mapped its epitope using CXCR4 mutagenesis to assess the relative importance of the CXCR4 N-terminal peptide, extracellular loops (ECL) and ligand-binding pocket. We show that the interaction between MEDI3185 and CXCR4 is mediated mostly by CDR3H in MEDI3185 and ECL2 in CXCR4. The MEDI3185 epitope comprises the entire ECL2 sequence, lacks any so-called ‘hot-spot’ and is remarkably resistant to mutations. The structure of MEDI3185 variable domains was modeled, and suggested a β-strand/β-strand interaction between MEDI3185 CDR3H and CXCR4 ECL2, resulting in direct steric hindrance with CXCR4 ligand SDF-1. These findings may have important implications for designing antibody therapies against CXCR4. PMID:26514996

  8. Relationship Of Mediterranean Diet And Caloric Intake To Phenoconversion In Huntington Disease

    PubMed Central

    Marder, Karen; Gu, Yian; Eberly, Shirley; Tanner, Caroline M.; Scarmeas, Nikolaos; Oakes, David; Shoulson, Ira

    2014-01-01

    Importance Adherence to Mediterranean-type diet (MeDi) may delay onset of Alzheimer's and Parkinson's disease. Whether adherence to MeDi affects time to phenoconversion in Huntington’s Disease (HD), a highly penetrant, single gene disorder, is unknown. Objective To determine if MeDi modifies the time to clinical onset of HD ('phenoconversion') in premanifest carriers participating in Prospective Huntington At Risk Observational Study (PHAROS), and to examine the effects of BMI and caloric intake on time to phenoconversion. Design A prospective cohort study. Setting 41 Huntington Study Group sites in the US and Canada. Participants 1001 participants were enrolled in PHAROS between July 1999 and January 2004, and were followed every 9 months until 2010. A total of 211 participants aged 26–57 with an expanded CAG repeat (≥37) were included in the current study. Exposure A semi-quantitative food frequency questionnaire (FFQ) was administered 33 months after baseline. We calculated daily gram intake for dairy, meat, fruit, vegetables, legumes, cereals, fish, monounsaturated and saturated fatty-acids, and alcohol, and constructed MeDi scores (0–9); higher scores indicate higher adherence. Demographics, medical history, BMI, and Unified Huntington's Disease Rating Scale (UHDRS) were collected. Main Outcome Measure Cox proportional hazards models to determine the association of MeDi and phenoconversion. Results Age, caloric intake, gender, education, and UHDRS motor scores did not differ among MeDi tertiles (0–3, 4–5, 6–9). The highest BMI was associated with lowest adherence to MeDi. 31 participants phenoconverted. In a model adjusted for age, CAG, and caloric intake, MeDi was not associated with phenoconversion (p for trend=0.14 for tertile of MeDi, and p=0.22 for continuous MeDi). When individual diet components of MeDi were analyzed, higher dairy consumption (hazard ratio 2.36; 1.0–5.57; p=0.051) and higher caloric intake (p=0.035) were associated with

  9. In-Situ Missions for the Exploration of Titan's Lakes

    NASA Technical Reports Server (NTRS)

    Elliott, John O.; Waite, J. Hunter

    2011-01-01

    The lakes of Titan represent an increasingly tantalizing target for future exploration. As Cassini continues to reveal more details the lakes appear to offer a particularly rich reservoir of knowledge that could provide insights to Titan's formation and evolution, as well as an ideal location to explore Titan's potential for pre-biotic chemistry. A recent study of Titan Lake Probe missions was undertaken as one of several dozen studies commissioned by the National Research Council (NRC) Planetary Decadal Survey to explore the technical readiness, feasibility and affordability of scientifically promising mission scenarios. This in-depth study focused on an in-situ examination of a hydrocarbon lake on the Saturnian moon Titan--a target that presents unique scientific opportunities as well as several unique engineering challenges (e.g., submersion systems and cryogenic sampling) to enable those measurements. Per direction from the NRC Planetary Decadal Survey Satellites Panel, and after an initial trade-space examination, study architectures focused on three possible New Frontiers-class missions and a more ambitious Flagship-class lander intended as the in-situ portion of a larger collaborative mission. Detailed point designs were developed to explore these four potential mission options, including consideration of flight system and mission designs, as well as operations on and under the lake's surface and scenarios for data return. In this paper we present an overview of the science objectives of the missions, the mission architecture and surface.

  10. Central venous catheters - ports

    MedlinePlus

    Central venous catheter - subcutaneous; Port-a-Cath; InfusaPort; PasPort; Subclavian port; Medi - port; Central venous line - port ... catheter is attached to a device called a port that will be under your skin. The port ...

  11. Fiberoptic Bronchoscopy

    MedlinePlus

    ... in the in- tensive care unit on a ventilator (respirator; breathing ma- chine) , you probably won’t ... medi- cines to keep you comfortable on the ventilator. If you are an outpatient or a non- ...

  12. Young citrus leaves decrease dispersal distance of Diaphorina citri Kuwayama (Hemiptera: Liviidae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To manage citrus Huanglongbing, understanding factors that affect dispersal behavior of Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae), is required to answer questions related to disease epidemiology and to improve management tactics. Currently, little is known about cues medi...

  13. TRANSMISSION OF ENTERIC DISEASE ASSOCIATED WITH WASTEWATER IRRIGATION: A PROSPECTIVE EPIDEMIOLOGICAL STUDY

    EPA Science Inventory

    We conducted a prospective epidemiological study of possible enteric disease transmission by aerosolized pathogens from sprinkler irrigation of partially treated wastewater in 20 kibbutzim (colllective agricultural settlements) in Isreal between March 1981 and February 1982. Medi...

  14. Adherence to a Mediterranean diet in Morocco and its correlates: cross-sectional analysis of a sample of the adult Moroccan population

    PubMed Central

    2012-01-01

    Background Dietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population. Methods The data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors. Results Mean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals. Conclusion MeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco. PMID:22578133

  15. Mediterranean diet and Alzheimer disease mortality

    PubMed Central

    Scarmeas, Nikolaos; Luchsinger, Jose A.; Mayeux, Richard; Stern, Yaakov

    2009-01-01

    Background We previously reported that the Mediterranean diet (MeDi) is related to lower risk for Alzheimer disease (AD). Whether MeDi is associated with subsequent AD course and outcomes has not been investigated. Objectives To examine the association between MeDi and mortality in patients with AD. Methods A total of 192 community-based individuals in New York who were diagnosed with AD were prospectively followed every 1.5 years. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of mortality in Cox models that were adjusted for period of recruitment, age, gender, ethnicity, education, APOE genotype, caloric intake, smoking, and body mass index. Results Eighty-five patients with AD (44%) died during the course of 4.4 (±3.6, 0.2 to 13.6) years of follow-up. In unadjusted models, higher adherence to MeDi was associated with lower mortality risk (for each additional MeDi point hazard ratio 0.79; 95% CI 0.69 to 0.91; p = 0.001). This result remained significant after controlling for all covariates (0.76; 0.65 to 0.89; p = 0.001). In adjusted models, as compared with AD patients at the lowest MeDi adherence fertile, those at the middle fertile had lower mortality risk (0.65; 0.38 to 1.09; 1.33 years’ longer survival), whereas subjects at the highest fertile had an even lower risk (0.27; 0.10 to 0.69; 3.91 years’ longer survival; p for trend = 0.003). Conclusion Adherence to the Mediterranean diet (MeDi) may affect not only risk for Alzheimer disease (AD) but also subsequent disease course: Higher adherence to the MeDi is associated with lower mortality in AD. The gradual reduction in mortality risk for higher MeDi adherence tertiles suggests a possible dose–response effect. PMID:17846408

  16. Association of Mediterranean diet with Mild Cognitive Impairment and Alzheimer’s disease: A Systematic Review and Meta-Analysis

    PubMed Central

    Singh, Balwinder; Parsaik, Ajay K.; Mielke, Michelle M.; Erwin, Patricia J.; Knopman, David S.; Petersen, Ronald C.; Roberts, Rosebud O.

    2013-01-01

    Background/Objective To conduct a systematic review of all studies to determine whether there is an association between the Mediterranean diet (MeDi) and cognitive impairment. Methods We conducted a comprehensive search of the major databases and hand-searched proceedings of major neurology, psychiatry, and dementia conferences through November 2012. Prospective cohort studies examining the MeDi with longitudinal follow-up of at least 1 year and reporting cognitive outcomes (mild cognitive impairment [MCI] or Alzheimer’s disease [AD]) were included. The effect size was estimated as hazard-ratio (HR) with 95% confidence intervals (CIs) using the random-effects model. Heterogeneity was assessed using Cochran’s Q-test and I2-statistic. Results Out of the 664 studies screened, five studies met eligibility criteria. Higher adherence to the MeDi was associated with reduced risk of MCI and AD. The subjects in the highest MeDi tertile had 33% less risk (adjusted HR=0.67; 95% CI, 0.55–0.81; P<0.0001) of cognitive impairment (MCI or AD) as compared to the lowest MeDi score tertile. Among cognitively normal individuals, higher adherence to the MeDi was associated with a reduced risk of MCI (HR=0.73; 95% CI, 0.56–0.96; P=0.02) and AD (HR=0.64; 95% CI, 0.46–0.89; P=0.007). There was no significant heterogeneity in the analyses. Conclusions While the overall number of studies is small, pooled results suggest that a higher adherence to the MeDi is associated with a reduced risk of developing MCI and AD, and a reduced risk of progressing from MCI to AD. Further prospective-cohort studies with longer follow-up and randomized controlled trials are warranted to consolidate the evidence. PMID:24164735

  17. Long-Term Adherence to the Mediterranean Diet Is Associated with Overall Cognitive Status, but Not Cognitive Decline, in Women123

    PubMed Central

    Samieri, Cécilia; Okereke, Olivia I.; E. Devore, Elizabeth; Grodstein, Francine

    2013-01-01

    In this large-scale prospective epidemiological study, we examined associations of long-term adherence to the Mediterranean diet (MeDi) and subsequent cognitive function and decline. We included 16,058 women from the Nurses’ Health Study, aged ≥70 y, who underwent cognitive testing by telephone 4 times during 6 y, beginning in 1995–2001, and provided repeated information on diet between 1984 and the first cognitive exam. Primary outcomes were the Telephone Interview for Cognitive Status (TICS) and composite scores of verbal memory and global cognition. MeDi adherence was based on intakes of: vegetables, fruits, legumes, whole grains, nuts, fish, red and processed meats, moderate alcohol, and the ratio of monounsaturated:saturated fat. Long-term MeDi exposure was estimated by averaging all repeated measures of diet (>13 y, on average). In primary analyses of cognitive change, the MeDi was not associated with decline in global cognition or verbal memory. In a secondary approach examining cognitive status in older age, determined by averaging all 4 repeated measures of cognition, each higher quintile of long-term MeDi score was linearly associated with better multivariable-adjusted mean cognitive scores [differences in mean Z-scores between extreme quintiles of MeDi = 0.06 (95% CI: 0.01, 0.11); = 0.05 (95% CI: 0.01, 0.08); and = 0.06 (95% CI: 0.03, 0.10) standard units; P-trends = 0.004, 0.002, and <0.001 for TICS, global cognition, and verbal memory, respectively]. These associations were similar to those observed in women 1–1.5 y apart in age. In summary, long-term MeDi adherence was related to moderately better cognition but not with cognitive change in this very large cohort of older women. PMID:23365105

  18. Enrolling in Medicaid through the National School Lunch Program: outcome of a pilot project in California schools.

    PubMed

    Cousineau, Michael R; Wada, Eriko O; Hogan, Laura

    2007-01-01

    California has several health insurance programs for children. However, the system for enrolling into these programs is complex and difficult to manage for many families. Express Lane Eligibility is designed to streamline the Medicaid (called Medi-Cal in California) enrollment process by linking it to the National School Lunch Program. If a child is eligible for free lunch and the parents consent, the program provides two months of presumptive eligibility for Medi-Cal and a simplified application process for continuation in Medi-Cal. For those who are ineligible, it provides a referral to other programs. An evaluation of Express Lane shows that while many children were presumptively enrolled, nearly half of the applicants were already enrolled in Medi-Cal. Many Express Enrolled children failed to complete the full Medi-Cal enrollment process. Few were referred to the State Children's Health Insurance Program or county programs. Express Lane is less useful as a broad screening strategy, but can be one of many tools that communities use to enroll children in health insurance. PMID:17639647

  19. Structure and Function Analysis of an Antibody Recognizing All Influenza A Subtypes.

    PubMed

    Kallewaard, Nicole L; Corti, Davide; Collins, Patrick J; Neu, Ursula; McAuliffe, Josephine M; Benjamin, Ebony; Wachter-Rosati, Leslie; Palmer-Hill, Frances J; Yuan, Andy Q; Walker, Philip A; Vorlaender, Matthias K; Bianchi, Siro; Guarino, Barbara; De Marco, Anna; Vanzetta, Fabrizia; Agatic, Gloria; Foglierini, Mathilde; Pinna, Debora; Fernandez-Rodriguez, Blanca; Fruehwirth, Alexander; Silacci, Chiara; Ogrodowicz, Roksana W; Martin, Stephen R; Sallusto, Federica; Suzich, JoAnn A; Lanzavecchia, Antonio; Zhu, Qing; Gamblin, Steven J; Skehel, John J

    2016-07-28

    Influenza virus remains a threat because of its ability to evade vaccine-induced immune responses due to antigenic drift. Here, we describe the isolation, evolution, and structure of a broad-spectrum human monoclonal antibody (mAb), MEDI8852, effectively reacting with all influenza A hemagglutinin (HA) subtypes. MEDI8852 uses the heavy-chain VH6-1 gene and has higher potency and breadth when compared to other anti-stem antibodies. MEDI8852 is effective in mice and ferrets with a therapeutic window superior to that of oseltamivir. Crystallographic analysis of Fab alone or in complex with H5 or H7 HA proteins reveals that MEDI8852 binds through a coordinated movement of CDRs to a highly conserved epitope encompassing a hydrophobic groove in the fusion domain and a large portion of the fusion peptide, distinguishing it from other structurally characterized cross-reactive antibodies. The unprecedented breadth and potency of neutralization by MEDI8852 support its development as immunotherapy for influenza virus-infected humans. PMID:27453466

  20. Capitation in California—An Analysis of At-Risk Financing of Medicaid Services

    PubMed Central

    Halfon, Neal; Newacheck, Paul W.

    1986-01-01

    Recent legislative changes have fostered the growth of a highly competitive health care market in California. In addition to selective hospital contracting for Medicaid (Medi-Cal) services, the California Medical Assistance Commission is attempting to initiate pilot projects to capitate Medi-Cal beneficiaries in selected geographic areas throughout the state. Selective contracting with county capitated organized health systems is also underway in Santa Barbara County, with plans for other counties on the drawing boards. This paper describes these capitated programs as well as addressing problems that may arise in this transition from a fee-for-service to a capitated Medi-Cal system. Specifically considered are issues related to underutilization, quality of care, implementation, eligibility and effects on existing patterns of care. PMID:3532566

  1. Apparent Motion of the Sun, Shadows of Objects and Measurement of Time in the View of Seventh Grade Students of Middle School. (Breton Title: Movimento Aparente do Sol, Sombras dos Objetos e Medição do Tempo na Visão de Alunos do Sétimo Ano do Ensino Fundamental.) Movimiento Aparente del Sol, Sombras de los Objetos y Medición del Tiempo en la Visión de Estudiantes del Séptimo Grado del Ciclo Pirmario

    NASA Astrophysics Data System (ADS)

    Iria Machado, Daniel

    2013-07-01

    The apparent motion of the Sun on the celestial sphere and the behavior of the shadows of objects over time are observable phenomena in everyday life. However, students often do not have a proper understanding of such occurrences, and can even display misconceptions about them. Therefore, we performed a research in order to know students' notions about these subjects and to evaluate the contribution to their understanding brought about by an activity performed with an interactive sundial in an informal learning environment. We investigated the ideas of 43 students from the seventh grade of middle school by applying a test with open questions before and after an activity with an analemmatic sundial, conducted by a monitor. A significant proportion of students were initially unaware of most of the phenomena treated. The intervention performed helped the students to assimilate new concepts, providing the contact with new phenomena and to a lesser degree, the development of explanations about them, indicating an educational potential of this action. However, the contribution to the understanding of some of the ideas explored was small, pointing to the need to make additional observations, studies and discussions. O movimento aparente do Sol na esfera celeste e o comportamento das sombras dos objetos com o passar do tempo são fenômenos observáveis no dia a dia. No entanto, muitas vezes os estudantes não possuem uma compreensão adequada de tais ocorrências, podendo inclusive exibir concepções alternativas a seu respeito. Por isso, efetuou-se uma pesquisa com o intuito de conhecer as noções dos alunos sobre esses temas e avaliar a contribuição para seu entendimento propiciada por uma atividade feita com um relógio de Sol interativo, em um ambiente de ensino informal. Foram investigadas as ideias de 43 alunos do sétimo ano do Ensino Fundamental mediante a aplicação de um teste com questões abertas antes e depois de uma atividade com um relógio de Sol analemático, conduzida por um monitor. Uma proporção significativa de estudantes desconhecia inicialmente a maioria dos fenômenos tratados. A intervenção realizada colaborou para uma parte dos alunos assimilar novos conceitos, propiciando o contato com novos fenômenos e, em menor grau, a elaboração de explicações a respeito destes, indicando um potencial educativo dessa ação. Porém, a contribuição para o entendimento de algumas das ideias exploradas foi pequena, apontando para a necessidade de se fazer observações, estudos e discussões complementares. El movimiento aparente del Sol en la esfera celeste y el comportamiento de las sombras de los objetos a lo largo del tiempo son fenómenos observables en la vida cotidiana. Sin embargo, los estudiantes a menudo no tienen una adecuada comprensión de dichos problemas, e incluso pueden mostrar conceptos erróneos acerca de ellos. Por lo tanto, se realizó una investigación a fin de conocer las nociones de los estudiantes acerca de estas cuestiones y evaluar la contribución a su comprensión proporcionada por una actividad realizada con un reloj de Sol interactivo, en un entorno informal de aprendizaje. Se investigaron las ideas de 43 estudiantes del séptimo grado del ciclo primario mediante la aplicación de un test con preguntas abiertas antes y después de una actividad con un reloj de Sol analemático, dirigida por un monitor. Una proporción significativa de los estudiantes inicialmente desconocía la mayoría de los fenómenos tratados. La intervención realizada contribuyó para que los estudiantes asimilasen nuevos conceptos, proporcionando el contacto con nuevos fenómenos y, en menor medida, desarrollasen explicaciones acerca de estos, lo que indica un potencial educativo de esta acción. Sin embargo, la contribución a la comprensión de algunas de las ideas exploradas fue pequeña, lo que apunta a la necesidad de hacer observaciones, estudios y debates adicionales.

  2. Future Directions in Potato Variety Development

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Potato is often seen as a one-theme type of food. Its calorie-rich nature has become less appealing to a US consumer population that is less involved in physical labor than in previous times. The large percentage of the population that is battling being overweight also fears the potato due to medi...

  3. The effect of moderate alcohol consumption on biomarkers of inflammation and hemostatic factors in postmenopausal women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Inflammation and hemostasis contribute to the etiology of cardiovascular disease. We previously demonstrated that moderate alcohol consumption (1-2 drinks/day) may decrease risk for cardiovascular disease due to an improved the lipid profile. In addition to these beneficial changes, the alcohol medi...

  4. Growth of Piscirickettsia salmonis on Enriched Blood Agar

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Piscirickettsia salmonis is the etiologic agent of piscirickettsiosis, an economically significant disease of fish. Isolation of P. salmonis by culturing on fish cell lines has been the standard technique since the initial isolation of the organism. The ability to grow P. salmonis on artificial medi...

  5. Environmental conditions and reproductive health outcomes

    EPA Science Inventory

    Environmental exposures range across multiple domains to affect human health. In an effort to learn how environmental factors combine to contribute to health outcomes we constructed a multiple environmental domain index (MEDI) for use in health research. We used principal compone...

  6. RF-Medisys: a radio frequency identification-based electronic medical record system for improving medical information accessibility and services at point of care.

    PubMed

    Ting, Jacky S L; Tsang, Albert H C; Ip, Andrew W H; Ho, George T S

    2011-01-01

    This paper presents an innovative electronic medical records (EMR) system, RF-MediSys, which can perform medical information sharing and retrieval effectively and which is accessible via a 'smart' medical card. With such a system, medical diagnoses and treatment decisions can be significantly improved when compared with the conventional practice of using paper medical records systems. Furthermore, the entire healthcare delivery process, from registration to the dispensing or administration of medicines, can be visualised holistically to facilitate performance review. To examine the feasibility of implementing RF-MediSys and to determine its usefulness to users of the system, a survey was conducted within a multi-disciplinary medical service organisation that operates a network of medical clinics and paramedical service centres throughout Hong Kong Island, the Kowloon Peninsula and the New Territories. Questionnaires were distributed to 300 system users, including nurses, physicians and patients, to collect feedback on the operation and performance of RF-MediSys in comparison with conventional paper-based medical record systems. The response rate to the survey was 67%. Results showed a medium to high level of user satisfaction with the radiofrequency identification (RFID)-based EMR system. In particular, respondents provided high ratings on both 'user-friendliness' and 'system performance'. Findings of the survey highlight the potential of RF-MediSys as a tool to enhance quality of medical services and patient safety. PMID:21430306

  7. Clover Biotechnology Research at FAPRU

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Randy Dinkins (USDA-ARS-FAPRU) is conducting research to determine the utility of using the Medicago Affymetrix Genechip for use with red clover (Trifolium pretense). The Medicago Affymetrix Genechip contains approximately 51,000 probe sets that are derived from Medicago truncatula, 1,800 from Medi...

  8. Hydroxycinnamoyl-CoA:Malate Hydroxycinnamoyl Transferase is Crucial for 2-O-Caffeoyl-L-Malate Biosynthesis in Red Clover and Defines a New Pathway for Hydroxycinnamoyl-Malate Ester Biosynthesis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Red clover (Trifolium pratense L.) leaves accumulate several µmol of phaselic acid [2-O-caffeoyl-L-malate] per gram fresh weight. Post-harvest oxidation of such o-diphenols to o-quinones by endogenous polyphenol oxidases prevents breakdown of forage protein during storage. Forages like alfalfa (Medi...

  9. Injury among Stimulant-Treated Youth with ADHD

    ERIC Educational Resources Information Center

    Marcus, Steven C.; Wan, George J.; Zhang, Huabin F.; Olfson, Mark

    2008-01-01

    Objective: To assess risk factors for injury among children and adolescents treated with stimulants for ADHD. Method: An analysis was performed of pharmacy and service claims data from 2000-2003 California Medicaid (Medi-Cal) focusing on children and adolescents ages 6 to 17 years who initiated stimulant therapy for ADHD. Bivariate and…

  10. In vitro induction of polyploidy in Cercis glabra Pamp

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methods for in vitro induction of polyploid Cercis glabra Pamp. using oryzalin were developed and evaluated. Methods included treating shoot or callus cultures for different exposure durations with either an aqueous solution of 150 µM oryzalin or by inclusion of oryzalin into solidified culture medi...

  11. Extraction and HPLC- UV Analysis of C60, C70, and [6,6]-phenyl C61-butyric acid methyl ester in Synthetic and Natural Waters

    EPA Science Inventory

    Studies have shown that C60 fullerene can form stable colloidal suspensions in water that result in C60 aqueous concentrations many orders of magnitude above C60's aqueous solubility; however, quantitative methods for the analysis of C60 and other fullerenes in environmental medi...

  12. Systematics of the genus Streptomyces: will a phylogeny based on 16S ribosomal RNA genes yield taxonomic resolution or confusion?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Species of the bacterial genus Streptomyces are a predominant component of the microbial population of soil throughout the world, where they are thought to contribute to the degradation of complex organic materials and facilitate nutrient recycling. Streptomyces species produce a wide array of medi...

  13. CLINICAL TRIALS.GOV

    EPA Science Inventory

    ClinicalTrials.gov provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases and conditions. The U.S. National Institutes of Health (NIH), through its National Library of Medi...

  14. Multiple environmental contexts and preterm birth risks

    EPA Science Inventory

    Human health is affected by simultaneous exposure to numerous stressors and amenities, but research often focuses on single exposure models. To address this, a United States county-level Multiple Environmental Domain Index (MEDI) was constructed with data representing five envir...

  15. Ozone Induces a Proinflammatory Response in Primary Human Bronchial Epithelial Cells Through Mitogen-Activated Protein Kinase Activation Without Nuclear Factor-kB Activation

    EPA Science Inventory

    Ground-level ozone (O3) is a ubiquitous environmental air pollutant that is a potent inducer of airway inflammation and has been linked with both respiratory and cardiovascular morbidity and mortality. Some studies using transformed or immortalized cells have attributed O3-medi...

  16. Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (medi...

  17. Spray spectrum modifications through changes in airspeed to minimize drift

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Management of droplet size is one of the key components to minimizing spray drift, which can be accomplished in-flight by changing airspeed. Studies were conducted measuring spray droplet spectra parameters across airspeeds ranging from 100-140 mph (in 5 mph increments). In general the volume medi...

  18. Youth Emancipating from Foster Care in California: Findings Using Linked Administrative Data.

    ERIC Educational Resources Information Center

    Needell, Barbara; Cuccaro-Alamin, Stephanie; Brookhart, Alan; Jackman, William; Shlonsky, Aron

    This study examined characteristics of youth emancipated from child welfare (ECW) and probation (EPR) supervised foster care; receipt of mental health services for emancipating youth; births to emancipating females; deaths of youth who emancipated from foster care; receipt of Medi-Cal due to AFDC/TANF, SSI/disability, or medical indigence after…

  19. Utilization of high resolution computed tomography to visualize the three dimensional structure and function of plant vasculature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    High resolution x-ray computed tomography (HRCT) is a non-destructive diagnostic imaging technique with sub-micron resolution capability that is now being used to evaluate the structure and function of plant xylem network in three dimensions (3D). HRCT imaging is based on the same principles as medi...

  20. ULTRAVIOLET RADIATION-INDUCED NEOPLASTIC TRANSFORMATION OF NORMAL HUMAN CELLS, IN VITRO

    EPA Science Inventory

    Human foreskin cell cultures in schedules DNA synthesis (S phase) of the cell cycle were exposed to UV irradiation at a dose of 10 J.sq. m. in the presence of insulin. These treated cell populations, when selectively passaged in a high amino acid supplemented complete growth medi...

  1. WIC: A Door to Health Care for California's Children.

    ERIC Educational Resources Information Center

    Barillas, Roxana; Horner, Dawn

    About 1.5 million uninsured children in California are eligible for Medi-Cal or Healthy Families, the state's primary public health insurance programs for children. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides a natural entry point for reaching these eligible families. This briefing report was written for WIC…

  2. [Development of telepathology systems between different types of terminals based on the standard for image collaboration command protocol].

    PubMed

    Tofukuji, Ikuo; Nakagawa, Shuji; Suzuki, Akitoshi; Saito, Makoto; Hara, Shigeji; Tsuchihashi, Yasunari; Shiraishi, Taizo; Ooshiro, Mariko; Sawai, Takashi; Kaihara, Shigekoto

    2003-01-01

    In Japan telepathology systems have been developed in medical or pathological environment such as a shortage and an uneven distribution of pathologists. More than 100 telepathology terminals are working mainly for intraoperative quick diagnosis. They cannot communicate with different types each other. In March 2000 the Medical Information System Development Center(MEDIS-DC) successfully demonstrated the interconnection between different types of telepathology terminals based on the Standard for Image Collaboration Command Protocol (SICCP). Nikon, NTTdata and Olympus had joined the development. In February 2002 MEDIS-DC examined these systems for pathological consultations in the fields of Okinawa-Kyoto, Kyoto-Mie and Mie-Okinawa. These successful examinations let us know that telepathology systems need new observation methodologies for telecytology and teleconsultation in addition to the flow for intraoperative quick diagnosis, new GUI guidelines for telepathology terminal design and, education and support for users of their smooth operation. Outcomes of MEDIS-DC activities encourageed us to challenge the next generation telepathology. We found some new trends in telepathology or pathology informatics such as virtual slide technologies and the internet applications in US and Europe. In order to keep Japanese priority, MEDIS-DC telepathology comittee has started investigations to construct a strategy for development of Japanese next generation telepathology. PMID:12832859

  3. Pediatrician Participation in Medicaid—Findings of a Five-Year-Follow-up Study in California and Elsewhere

    PubMed Central

    Perloff, Janet Dale; Neckerman, Kathryn; Kletke, Phillip R.

    1986-01-01

    Medi-Cal—California's Medicaid program—underwent significant changes during the period 1978 through 1983. Most notable were the imposition of new copayments, reductions in physician reimbursement and selective contracting for hospital services. The state-funded medically indigent program was transferred to the counties and the state began to experiment with bulk purchasing of drugs and supplies, a lock-in for overutilizers and primary care case management. How have these changes affected primary care providers' participation in Medi-Cal? Surveys of California pediatricians in 1978 and 1983 suggest that while most continue to participate, the level of limited participation in Medi-Cal increased from 23% to 51%. Most pediatricians express discontent with the level of Medicaid payments and there is a growing sentiment that Medicaid regulations interfere with the provision of high quality medical care. Future Medi-Cal policy developments, such as contracting for physician services, should be structured in ways that maximize participation of primary care providers in the program. PMID:3538665

  4. First report of bacterial blight of crucifers caused by Pseudomonas cannabina pv. alisalensis in Minnesota on arugula (Eruca vesicaria subsp. sativa)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 2011, bacterial blight of arugula (Eruca vesicaria subsp. sativa; cv. Roquette) was observed in organically grown plants under overhead irrigation near Delano, MN. Approximately 80 to 100% of each planting was affected. Blue-green fluorescent pseudomonads were isolated consistently on King’s Medi...

  5. RAPID DETECTION OF OUTBREAK ESCHERICHIA COLI 0157 ADN SALMONELLA IN ALFALFA SPROUTS BY IMMUNOMAGNETIC CAPTURE AND TIME-RESOLVED FLUORESCENCE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Commercially available alfalfa seeds were inoculated with low levels (~ 4 CFU/g) of pathogenic bacteria. The inoculated seeds were then allowed to sprout in sterile tap water at 22 0C. After 48 hours, the irrigation water and sprouts were separately transferred to bovine heart infusion (BHI) medi...

  6. Discovery of chemicals that mediate mosquito host-seeking behavior

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Since 1942, the United States Department of Agriculture (USDA) has developed repellents and insecticides for the U.S. military. A small thrust of this research program has been focused on discovery of attractants for use as lures in commercial traps designed to attract and capture arthropods of medi...

  7. Low temperature grown ZnO@TiO{sub 2} core shell nanorod arrays for dye sensitized solar cell application

    SciTech Connect

    Goh, Gregory Kia Liang; Le, Hong Quang; Huang, Tang Jiao; Hui, Benjamin Tan Tiong

    2014-06-01

    High aspect ratio ZnO nanorod arrays were synthesized on fluorine-doped tin oxide glasses via a low temperature solution method. By adjusting the growth condition and adding polyethylenimine, ZnO nanorod arrays with tunable length were successfully achieved. The ZnO@TiO{sub 2} core shells structures were realized by a fast growth method of immersion into a (NH{sub 4}){sub 2}·TiF{sub 6} solution. Transmission electron microscopy, X-ray Diffraction and energy dispersive X-ray measurements all confirmed the existence of a titania shell uniformly covering the ZnO nanorod's surface. Results of solar cell testing showed that addition of a TiO{sub 2} shell to the ZnO nanorod significantly increased short circuit current (from 4.2 to 5.2 mA/cm{sup 2}), open circuit voltage (from 0.6 V to 0.8 V) and fill factor (from 42.8% to 73.02%). The overall cell efficiency jumped from 1.1% for bare ZnO nanorod to 3.03% for a ZnO@TiO{sub 2} core shell structured solar cell with a 18–22 nm shell thickness, a nearly threefold increase. - Graphical abstract: The synthesis process of coating TiO{sub 2} shell onto ZnO nanorod core is shown schematically. A thin, uniform, and conformal shell had been grown on the surface of the ZnO core after immersing in the (NH{sub 4}){sub 2}·TiF{sub 6} solution for 5–15 min. - Highlights: • ZnO@TiO{sub 2} core shell nanorod has been grown on FTO substrate using low temperature solution method. • TEM, XRD, EDX results confirmed the existing of titana shell, uniformly covered rod's surface. • TiO{sub 2} shell suppressed recombination, demonstrated significant enhancement in cell's efficiency. • Core shell DSSC's efficiency achieved as high as 3.03%, 3 times higher than that of ZnO nanorods.

  8. Secure Grid Services for Cooperative Work in Medicine and Life Science

    NASA Astrophysics Data System (ADS)

    Weisbecker, Anette; Falkner, Jürgen

    MediGRID provides a grid infrastructure to solve challenging problems in medical and life sciences by enhancing the productivity and by enabling locationindependent, interdisciplinary collaboration. The usage of grid technology has enabled the development of new application and services for research in medical and life sciences. In order to enlarge the range of services and to get a broader range of users sustainable business models are needed. In Services@MediGRID methods for monitoring, accounting, and billing which fulfilled the high security demands within medicine and life sciences will be developed. Also different requirements of academic and industrial grid customers are considered in order to establish the sustainable business models for grid computing.

  9. Components of a Mediterranean diet and their impact on cognitive functions in aging

    PubMed Central

    Huhn, Sebastian; Kharabian Masouleh, Shahrzad; Stumvoll, Michael; Villringer, Arno; Witte, A. Veronica

    2015-01-01

    Background: Adhering to the Mediterranean diet (MeDi) is known to be beneficial with regard to many age-associated diseases including cardiovascular diseases and type 2 diabetes. Recent studies also suggest an impact on cognition and brain structure, and increasing effort is made to track effects down to single nutrients. Aims: We aimed to review whether two MeDi components, i.e., long-chain omega-3 fatty acids (LC-n3-FA) derived from sea-fish, and plant polyphenols including resveratrol (RSV), exert positive effects on brain health in aging. Content: We summarized health benefits associated with the MeDi and evaluated available studies on the effect of (1) fish-consumption and LC-n3-FA supplementation as well as (2) diet-derived or supplementary polyphenols such as RSV, on cognitive performance and brain structure in animal models and human studies. Also, we discussed possible underlying mechanisms. Conclusion: A majority of available studies suggest that consumption of LC-n3-FA with fish or fishoil-supplements exerts positive effects on brain health and cognition in older humans. However, more large-scale randomized controlled trials are needed to draw definite recommendations. Considering polyphenols and RSV, only few controlled studies are available to date, yet the evidence based on animal research and first interventional human trials is promising and warrants further investigation. In addition, the concept of food synergy within the MeDi encourages future trials that evaluate the impact of comprehensive lifestyle patterns to help maintaining cognitive functions into old age. PMID:26217224

  10. Targeting Alpha Toxin and ClfA with a Multimechanistic Monoclonal-Antibody-Based Approach for Prophylaxis of Serious Staphylococcus aureus Disease

    PubMed Central

    Tkaczyk, C.; Hamilton, M. M.; Sadowska, A.; Shi, Y.; Chang, C.S.; Chowdhury, P.; Buonapane, R.; Xiao, X.; Warrener, P.; Mediavilla, J.; Kreiswirth, B.; Suzich, J.; Stover, C. K.

    2016-01-01

    ABSTRACT Staphylococcus aureus produces numerous virulence factors, each contributing different mechanisms to bacterial pathogenesis in a spectrum of diseases. Alpha toxin (AT), a cytolytic pore-forming toxin, plays a key role in skin and soft tissue infections and pneumonia, and a human anti-AT monoclonal antibody (MAb), MEDI4893*, has been shown to reduce disease severity in dermonecrosis and pneumonia infection models. However, interstrain diversity and the complex pathogenesis of S. aureus bloodstream infections suggests that MEDI4893* alone may not provide adequate protection against S. aureus sepsis. Clumping factor A (ClfA), a fibrinogen binding protein, is an important virulence factor facilitating S. aureus bloodstream infections. Herein, we report on the identification of a high-affinity anti-ClfA MAb, 11H10, that inhibits ClfA binding to fibrinogen, prevents bacterial agglutination in human plasma, and promotes opsonophagocytic bacterial killing (OPK). 11H10 prophylaxis reduced disease severity in a mouse bacteremia model and was dependent on Fc effector function and OPK. Additionally, prophylaxis with 11H10 in combination with MEDI4893* provided enhanced strain coverage in this model and increased survival compared to that obtained with the individual MAbs. The MAb combination also reduced disease severity in murine dermonecrosis and pneumonia models, with activity similar to that of MEDI4893* alone. These results indicate that an MAb combination targeting multiple virulence factors provides benefit over a single MAb neutralizing one virulence mechanism by providing improved efficacy, broader strain coverage, and protection against multiple infection pathologies. PMID:27353753

  11. Enhanced Photoluminescence Properties of Carbon Dots by Doping with Europium.

    PubMed

    Chen, Yuan; Xu, Jiafu; Liu, Bitao; Li, Jiyun; Fang, Xiaomei; Xiong, Liqiong; Peng, Lingling; Han, Tao; Tu, Mingjing

    2016-04-01

    Europium (Eu) doped carbon dots (CDs) were synthesized via a rapid and simple microwave medi- ated method using polyethylene glycol (PEG) as a precursor, and characterized in detail. The results were that these as-prepared CDs showed a uniform and small particle size, and exhibit good pho- tostability and high photoluminescence quantum yields. Additionally, it also found that the doped Eu would change the fluorescence properties, which indicates potential applications in the field of biolabeling. PMID:27451699

  12. A great honor and a huge challenge for China: You-you TU getting the Nobel Prize in Physiology or Medicine.

    PubMed

    Yuan, Da; Yang, Xue; Guo, Jun-Chao

    2016-05-01

    Public excitement over the award of the 2015 Nobel Prize in Physiology or Medicine to the Chinese medical scientist You-you TU for the discovery of a herbal anti-malarial, may mislead the Chinese people into believing that traditional Chinese herbal medi-cine can be used to cure all disease without any ad-verse effects. The aim of this paper is to explain the advantages and disadvantages of herbal traditional Chinese medicine (TCM) objectively. PMID:27143269

  13. Anti-Alpha-Toxin Monoclonal Antibody and Antibiotic Combination Therapy Improves Disease Outcome and Accelerates Healing in a Staphylococcus aureus Dermonecrosis Model

    PubMed Central

    Hilliard, Jamese J.; Datta, Vivekananda; Tkaczyk, Christine; Hamilton, Melissa; Sadowska, Agnieszka; Jones-Nelson, Omari; O'Day, Terrence; Weiss, William J.; Szarka, Szabolcs; Nguyen, Vien; Prokai, Laszlo; Suzich, JoAnn; Stover, C. Kendall

    2014-01-01

    Alpha-toxin (AT) is a major virulence determinant in Staphylococcus aureus skin and soft tissue infection models. We previously demonstrated that prophylactic administration of 2A3, an AT-neutralizing monoclonal antibody (MAb), prevents S. aureus disease in a mouse dermonecrosis model by neutralizing AT-mediated tissue necrosis and immune evasion. In the present study, MEDI4893*, an affinity-optimized version of 2A3, was characterized for therapeutic activity in the dermonecrosis model as a single agent and in combination with two frontline antibiotics, vancomycin and linezolid. MEDI4893* postinfection therapy was found to exhibit a therapeutic treatment window similar to that for linezolid but longer than that for vancomycin. Additionally, when combined with either vancomycin or linezolid, MEDI4893* resulted in reduced tissue damage, increased neutrophil and macrophage infiltration and abscess formation, and accelerated healing relative to those with the antibiotic monotherapies. These data suggest that AT neutralization with a potent MAb holds promise for both prophylaxis and adjunctive therapy with antibiotics and may be a valuable addition to currently available options for the treatment of S. aureus skin and soft tissue infections. PMID:25348518

  14. Cosmetic effect of knee joint in a knee disarticulation prosthesis.

    PubMed

    de Laat, Fred A; van der Pluijm, Mark J; van Kuijk, Annette A; Geertzen, Jan H; Roorda, Leo D

    2014-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengthening and shortening were measured through an experimental setup using laser techniques. These measurements were made of 18 knee joints used in KD prostheses. Lengthening of the thigh varied between 23 and 92 mm, and shortening of the shank varied between 3 and 50 mm. The polycentric knees Medi KH6 and Medi KHF1 showed the least lengthening of the thigh, and the polycentric knees Teh Lin Prosthetic & Orthotic Co. Ltd Graph-Lite and Medi KP5 showed the least shortening of the shank. PMID:25856500

  15. LONG-TERM STABILITY OF THE LOCAL GROUND CONTROL NETWORK AT THE CO-LOCATION SITE OF MEDICINA

    NASA Astrophysics Data System (ADS)

    Abbondanza, C.; Sarti, P.; Legrand, J.

    2009-12-01

    ITRF combinations rely on the availability of accurate tie vectors linking reference points of space geodetic techniques. Co-located instruments are assumed to move consistently and no local relative motion is taken into account. Instabilities may degrade the quality of the co-location itself and perturb the result of ITRF combinations. This work aims to determine the stability of the local ground control network at Medicina (Italy) with independent surveying methods. The observatory hosts a co-location between a VLBI telescope and two GPS antennas, MEDI and MSEL. It is located in the Po Plain where thick layers of clays are the prevalent soil characteristics. Hence, provision of long term stability of geodetic monuments is a challenge and monitoring their stability is an issue. MEDI and the VLBI station regularly contribute to the determination of ITRF, while MSEL is part of the EUREF network. A set of five tie vectors observations linking the VLBI and MEDI reference points was acquired between 2001 and 2007. It is our main tool for performing local deformation analysis. Additionally, the GPS time series of MEDI and MSEL were used to cross check and confirm the local instability detected by terrestrial methods. To achieve a rigorous and reliable investigation of the local stability, multi-epoch terrestrial observations were homogeneously processed according to common parameterizations in a consistent reference frame. Similarly, continuous GPS observations from MEDI and MSEL were analysed according to the new EPN reprocessing strategy in order to monitor the short baseline between MEDI and MSEL; to spotlight any change in its length. Both approaches confirm differential motions at the site which can be related to monument instabilities originated by the particularly unfavourable local geological setting and the inapt design of the monuments foundation. The monuments move non homogeneously at rates reaching up to 1.6 mm/year, this value being comparable to intra

  16. EphA2 Targeted Chemotherapy Using an Antibody Drug Conjugate in Endometrial Carcinoma

    PubMed Central

    Lee, Jeong-Won; Stone, Rebecca L.; Lee, Sun Joo; Nam, Eun Ji; Roh, Ju-Won; Nick, Alpa M.; Han, Hee-Dong; Shahzad, Mian M.K.; Kim, Hye-Sun; Mangala, Lingegowda S.; Jennings, Nicholas B.; Mao, Shenlan; Gooya, John; Jackson, Dowdy; Coleman, Robert L.; Sood, Anil K.

    2013-01-01

    Purpose EphA2 overexpression is frequently observed in endometrial cancers, and is predictive of poor clinical outcome. Here, we utilize an antibody drug conjugate (MEDI-547) composed of a fully human monoclonal antibody against both human and murine EphA2 (1C1) and the tubulin polymerization inhibitor, monomethylauristatin F (MMAF). Experimental design EphA2 expression was examined in endometrial cancer cell lines by Western Blot. Specificity of MEDI-547 was examined by antibody degradation and internalization assays. Viability and apoptosis were investigated in endometrial cancer cell lines and orthotopic tumor models. Results EphA2 was expressed in the Hec-1A and Ishikawa cells, but was absent in the SPEC-2 cells. Antibody degradation and internalization assays showed that the antibody drug conjugate decreased EphA2 protein levels and was internalized in EphA2 positive cells (Hec-1A and Ishikawa). Moreover, in vitro cytotoxicity and apoptosis assays demonstrated that the antibody drug conjugate decreased viability and increased apoptosis of Hec-1A and Ishikawa cells. In vivo therapy experiments in mouse orthotopic models with this antibody drug conjugate resulted in 86 to 88% growth inhibition (P < 0.001) in the orthotopic Hec-1A and Ishikawa models compared to controls. Moreover, the mice treated with this antibody drug conjugate had a lower incidence of distant metastasis compared with controls. The anti-tumor effects of the therapy were related to decreased proliferation and increased apoptosis of tumor and associated endothelial cells. Conclusions The preclinical data for endometrial cancer treatment using MEDI-547 demonstrate substantial anti-tumor activity. PMID:20388851

  17. Medicaid and the Mainstream: Reassessment in the Context of the Taxpayer Revolt

    PubMed Central

    Myers, Beverlee A.; Leighton, Rigby

    1980-01-01

    California's Medicaid program—Medi-Cal—attempted to implement the ideal of mainstream medical care for the poor by giving program beneficiaries a “credit card” for use in the private health care marketplace. This exposed the program to the perverse economic incentives of the fee-for-service, costplus health care system, and contributed to a high rate of increase in program costs. Attempts to control costs have been equally perverse, resulting in low payment rates, the second-guessing of physician professional judgments, the probing of medical and fiscal records, and the use of computerized surveillance systems. Attempts to shift to the use of more efficient delivery systems have had small success. Attempts to attain cost containment through restructuring the Medi-Cal program have been rejected in the name of the mainstream ideal. Costs have continued to escalate, with annual increases as high as 20 percent in some years. Medi-Cal now costs $4 billion per year, the largest single program in California state government. The taxpayer revolt in California is creating a fiscal crisis that will force rethinking of the premises of publicly funded health care for the poor, and a restructuring of strategies for reaching that objective. In the short run, it appears that the issue may not be whether the indigent will have access to mainstream medical care, but whether they will have access to any medical care. In the longer run, the crisis should represent an opportunity for building a system of health care that can serve the financially disadvantaged at a cost tolerable to our society. PMID:6996334

  18. Automating Assessment of Lifestyle Counseling in Electronic Health Records

    PubMed Central

    Hazlehurst, Brian L.; Lawrence, Jean M.; Donahoo, William T.; Sherwood, Nancy E; Kurtz, Stephen E; Xu, Stan; Steiner, John F

    2015-01-01

    Background Numerous population-based surveys indicate that overweight and obese patients can benefit from lifestyle counseling during routine clinical care. Purpose To determine if natural language processing (NLP) could be applied to information in the electronic health record (EHR) to automatically assess delivery of counseling related to weight management in clinical health care encounters. Methods The MediClass system with NLP capabilities was used to identify weight management counseling in EHR encounter records. Knowledge for the NLP application was derived from the 5As framework for behavior counseling: Ask (evaluate weight and related disease), Advise at-risk patients to lose weight, Assess patients’ readiness to change behavior, Assist through discussion of weight loss methods and programs and Arrange follow-up efforts including referral. Using samples of EHR data in 1/1/2007-3/31/2011 period from two health systems, the accuracy of the MediClass processor for identifying these counseling elements was evaluated in post-partum visits of 600 women with gestational diabetes mellitus (GDM) compared to manual chart review as gold standard. Data were analyzed in 2013. Results Mean sensitivity and specificity for each of the 5As compared to the gold standard was at or above 85%, with the exception of sensitivity for Assist which was measured at 40% and 60% respectively for each of the two health systems. The automated method identified many valid cases of Assist not identified in the gold standard. Conclusions The MediClass processor has performance capability sufficiently similar to human abstractors to permit automated assessment of counseling for weight loss in post-partum encounter records. PMID:24745635

  19. Multielectron dissociative ionization of CH3I clusters under moderate intensity ps laser irradiation

    NASA Astrophysics Data System (ADS)

    Karras, G.; Kosmidis, C.

    2010-02-01

    The interaction of 35 ps laser pulses with methyl iodide clusters in the intensity region of 1012-3 × 1013 W/cm2 is studied at [lambda] = 266, 532 and 1064 nm by means of time-of-flight mass spectrometry. At [lambda] = 532 and 1064 nm the multielectron dissociative ionization (MEDI) of clusters results in highly charged atomic fragment (up to I7+) ion production of high kinetic energy. The explosion of the multiple charged cluster ions is found to be isotropic, while an asymmetric charge distribution prior to their fragmentation is observed. Moreover, negative ion formation is observed. The MEDI of clusters exhibits a dependence on laser polarization and the intensity thresholds for the observation of the fragment ions are determined for linear and circular laser polarization. These intensity thresholds are found to be about three orders of magnitude lower than those reported by experiments with 35 ps laser pulses on CH3I monomers. For the observed MEDI of (CH3I)n clusters a mechanism is proposed. According to this mechanism, the clusters are initially single ionized by multiphoton absorption and an internal electric field is created within the cluster, which distorts the potential barriers. This distortion increases the probability for electron tunneling even at relatively low laser intensities, giving thus rise to the formation of negatively charged moieties within the clusters, which prevent the cluster elongation and facile further the tunneling process. This procedure results in a higher distortion of the internal barriers and an increased ionization of the clusters, which, due to increased repulsive forces, finally fragment leading to multiple charged high kinetic energy fragment ion production.

  20. A comparison of capitated and fee-for-service Medicaid reimbursement methods on pregnancy outcomes.

    PubMed Central

    Oleske, D M; Branca, M L; Schmidt, J B; Ferguson, R; Linn, E S

    1998-01-01

    OBJECTIVE: To determine if the payment method influenced the likelihood of selected obstetrical process measures and pregnancy outcome indicators among Medicaid women. DATA SOURCE/STUDY SETTING: Data from the live birth certificates computer file for 1993 from the State of California. The computer files contain information about the demographic characteristics of the mother, her medical conditions prior to delivery, medical problems during labor and delivery, delivery method, newborn and maternal outcomes, and expected principal source of payment for prenatal care and for hospital delivery. STUDY DESIGN: The study sample consisted of singleton live births to women in the California Medi-Cal program residing in one of two counties in which a mixed-model managed care plan was the method of reimbursement or in one of three counties in which fee-for-service was the payment method. The study and control counties were matched in terms of geographic proximity and sociodemographics. PRINCIPAL FINDINGS: Among Medi-Cal women, the likelihood of low birth weight (LBW) was lower in the capitated payment group than in the fee-for-service payment group even when controlling for maternal and newborn characteristics and adequacy of prenatal care. There was no difference in either the adequacy of prenatal care, the cesarean birth rate, or the likelihood of adverse pregnancy outcomes other than LBW between the two payer groups. CONCLUSIONS: Results of this "natural experiment" suggest that enrollment of pregnant Medi-Cal beneficiaries in capitated healthcare services through a primary care case management system in a county-organized health system/health insuring organization can have a beneficial effect on low birth weight and provide care comparable to a fee-for-service system. PMID:9566177

  1. Developing e-Business Capabilities to Bridge the Knowledge Divide in Mediterranean Countries

    NASA Astrophysics Data System (ADS)

    Secundo, Giustina; Elia, Gianluca; Margherita, Alessandro; Passiante, Giuseppina

    This paper presents the results achieved in terms of e-business capabilities developed in an International Master framed within an Euro-Medi-terranean cooperation. In particular, an e-Business Design Laboratory is here described which has been set up for designing and implementing innovative solutions to bring digital and organizational innovation in traditional and new industries. The most significant highlights of the last two editions of the Master are also reported in terms of the human, social and structural capital being generated.

  2. Patterns of Antibacterial Use and Impact of Age, Race-Ethnicity, and Geographic Region on Antibacterial Use in an Outpatient Medicaid Cohort

    PubMed Central

    Gahbauer, Alice M.; Gonzales, Marco L.; Guglielmo, B. Joseph

    2014-01-01

    STUDY OBJECTIVES To describe patterns of outpatient antibacterial use among California Medicaid (Medi-Cal) fee-for-service system beneficiaries, and to investigate the influence of demographic factors—age, race-ethnicity, state county, and population density—on those patterns. DESIGN Retrospective analysis of administrative claims data. DATA SOURCE Medi-Cal fee-for-service system claims database. PATIENTS All outpatient Medi-Cal fee-for-service system beneficiaries enrolled between 2006 and 2011 who had at least one systemic antibacterial claim. MEASUREMENTS AND MAIN RESULTS Rates of antibacterial prescribing and the proportion of broad-spectrum antibacterial use were measured over the study period and among age, racial-ethnic and geographic (county) groups. Of the 10,018,066 systemic antibacterial claims selected for analysis, antibacterial prescribing rates decreased from 542 claims/1000 beneficiaries in 2006 to 461 claims/1000 beneficiaries in 2011 (r = –0.971, p = 0.0012; τ-b = –1.00, p = 0.009). Among age groups, children had the highest rate of use (605 claims/1000 beneficiaries, χ2 (2) = 320,000, p < 0.001); among racial-ethnic groups, Alaskan Natives and Native Americans had the highest rate of use (1086/1000 beneficiaries, χ2 (5) = 197,000, p < 0.001). Broad-spectrum antibacterial prescribing increased from 28.1% (95% confidence interval [CI] 28.1–28.2%) to 32.7% (95% CI 32.6–32.8%) over the study period. Senior age groups and Caucasians received the highest proportions of broad-spectrum agents (53.4% [95% CI 52.5–54.3%] and 36.6% [95% CI 36.6–36.7%], respectively). Population density was inversely related to both overall antibacterial use (ρ = –0.432, p = 0.0018) and broad-spectrum antibacterial prescribing (ρ = –0.359, p < 0.001). The rate of prescribing decreased over the study period for all antibacterial classes with the exception of macrolides and sulfonamides. Amoxicillin was the most frequently prescribed agent. CONCLUSION

  3. Mediterranean diet and leukocyte telomere length in a multi-ethnic elderly population.

    PubMed

    Gu, Yian; Honig, Lawrence S; Schupf, Nicole; Lee, Joseph H; Luchsinger, Jose A; Stern, Yaakov; Scarmeas, Nikolaos

    2015-01-01

    Leukocyte telomere length (LTL) is considered as the marker of biological aging and may be related to environmental factors. The current study aimed to examine the relation between Mediterranean-type diet and LTL. We used a cross-sectional study of 1743 multi-ethnic community residents of New York aged 65 years or older. Mediterranean-type diet (MeDi) was calculated from dietary information collected using a food frequency questionnaire. LTL was measured from leukocyte DNA using a real-time PCR method to measure T/S ratio, the ratio of telomere (T) to single-copy gene (S) sequence. Regression analysis showed that the MeDi score was not associated with LTL in the overall study population (β = 12.5; p = 0.32) after adjusting for age, sex, education, ethnicity, caloric intake, smoking, and physical and leisure activities. However, we found a significant association between MeDi and LTL among non-Hispanic whites (β = 48.3; p = 0.05), and the results held after excluding dementia subjects (β = 49.6; p = 0.05). We further found that, in the whole population, vegetable and cereal consumption above the sex-specific population median was associated with longer LTL (β = 89.1, p = 0.04) and shorter LTL (β = -93.5; p = 0.03), respectively. Among non-Hispanic whites, intake of meat or dairy below sex-specific population medians was associated with longer LTL (β = 154.7, p = 0.05; β = 240.5, p < 0.001, respectively). We found that higher adherence to a MeDi was associated with longer LTL among whites but not among African Americans and Hispanics. Additionally, a diet high in vegetables but low in cereal, meat, and dairy might be associated with longer LTL among healthy elderly. PMID:25750063

  4. Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

    NASA Technical Reports Server (NTRS)

    Taddeo, Terrance

    2012-01-01

    Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

  5. Creating virtual humans for simulation-based training and planning

    SciTech Connect

    Stansfield, S.; Sobel, A.

    1998-05-12

    Sandia National Laboratories has developed a distributed, high fidelity simulation system for training and planning small team Operations. The system provides an immersive environment populated by virtual objects and humans capable of displaying complex behaviors. The work has focused on developing the behaviors required to carry out complex tasks and decision making under stress. Central to this work are techniques for creating behaviors for virtual humans and for dynamically assigning behaviors to CGF to allow scenarios without fixed outcomes. Two prototype systems have been developed that illustrate these capabilities: MediSim, a trainer for battlefield medics and VRaptor, a system for planning, rehearsing and training assault operations.

  6. Simulated casualties and medics for emergency training.

    PubMed

    Chi, D M; Kokkevis, E; Ogunyemi, O; Bindiganavale, R; Hollick, M J; Clarke, J R; Webber, B L; Badler, N I

    1997-01-01

    The MediSim system extends virtual environment technology to allow medical personnel to interact with and train on simulated casualties. The casualty model employs a three-dimensional animated human body that displays appropriate physical and behavioral responses to injury and/or treatment. Medical corpsmen behaviors were developed to allow the actions of simulated medical personnel to conform to both military practice and medical protocols during patient assessment and stabilization. A trainee may initiate medic actions through a mouse and menu interface; a VR interface has also been created by Stansfield's research group at Sandia National Labs. PMID:10168943

  7. An integrated readout system for drift chambers: the application of monolithic CMOS pixel sensors as segmented direct anode

    NASA Astrophysics Data System (ADS)

    Campbell, M.; Heijne, E. H. M.; Llopart, X.; Chefdeville, M.; Colas, P.; Giomataris, Y.; Colijn, A. P.; Fornaini, A.; van der Graaf, H.; Kluit, P.; Timmermans, J.; Visschers, J. L.; Schmitz, J.

    2006-01-01

    A small TPC has been read out by means of a MediPix2 readout chip as direct anode. A Micromegas foil was placed 50 μm above the chip, and electron multiplication occurred in the gap. With a He/Isobutane 80/20 mixture, gas multiplication factors up to tens of thousands were achieved, resulting in an efficiency for detecting single electrons of better than 90%. We recorded many frames containing 2D images with tracks from cosmic muons. Along these tracks, electron clusters were observed, as well as δ-rays.

  8. Selective contracting in California: its effect on hospital finances.

    PubMed

    Mennemeyer, S T; Olinger, L

    1989-01-01

    In 1983, the State of California used a modified form of competitive bidding to select hospitals that would supply inpatient care for the Medi-Cal (Medicaid) program. Selective contracting halted a long history of hospital price inflation and won significant price concessions for the state. While the state might have used the bidding program to get the cheapest possible care from the worst possible providers, the evidence shows that it was used to secure price concessions from mainstream hospitals that provided accessible, good-quality care. Various administrative tools of admissions review were important adjuncts to both utilization control and quality assurance. PMID:2533171

  9. Two-thirds of California's seven million uninsured may obtain coverage under health care reform.

    PubMed

    Lavarreda, Shana Alex; Cabezas, Livier

    2011-02-01

    Almost 4.7 million nonelderly adults and children of the seven million Californians who were uninsured for all or part of 2009 will be eligible for insurance as a result of last year's health care reform legislation, according to new data from the 2009 California Health Interview Survey (CHIS 2009). Eligible Californians will obtain coverage either through Medi-Cal or through subsidies to purchase private health insurance in the new California Health Benefit Exchange (CHBE) starting in 2014. The CHBE will also be open to 1.2 million uninsured persons who do not qualify for subsidized premiums due to their income exceeding eligibility levels, but who will benefit from the new marketplace created through the Patient Protection and Affordable Care Act (PPACA). Just over one million uninsured persons do not qualify to participate in either the CHBE or in the Medi-Cal expansion due to their citizenship status. With seven million uninsured residents of California in 2009, the new insurance options made available by the PPACA could face challenges in enrolling these uninsured individuals. PMID:21365963

  10. Program Capacity to Eliminate Outcome Disparities in Addiction Health Services.

    PubMed

    Guerrero, Erick G; Aarons, Gregory A; Grella, Christine E; Garner, Bryan R; Cook, Benjamin; Vega, William A

    2016-01-01

    We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed. PMID:25450596

  11. Lessons Learned from Developing a Drug Evidence Base to Support Pharmacovigilance

    PubMed Central

    Smith, J.C.; Denny, J.C.; Chen, Q.; Nian, H.; Spickard III, A.; Rosenbloom, S. T.; Miller, R. A.

    2013-01-01

    Summary Objective This work identified challenges associated with extraction and representation of medication-related information from publicly available electronic sources. Methods We gained direct observational experience through creating and evaluating the Drug Evidence Base (DEB), a repository of drug indications and adverse effects (ADEs), and supplemented this through literature review. We extracted DEB content from the National Drug File Reference Terminology, from aggregated MEDLINE co-occurrence data, and from the National Library of Medicine’s DailyMed. To understand better the similarities, differences and problems with the content of DEB and the SIDER Side Effect Resource, and Vanderbilt’s MEDI Indication Resource, we carried out statistical evaluations and human expert reviews. Results While DEB, SIDER, and MEDI often agreed on medication indications and side effects, cross-system shortcomings limit their current utility. The drug information resources we evaluated frequently employed multiple, disparate vaguely related UMLS concepts to represent a single specific clinical drug indication or adverse effect. Thus, evaluations comparing drug-indication and drug-ADE coverage for such resources will encounter substantial numbers of false negative and false positive matches. Furthermore, our review found that many indication and ADE relationships are too complex – logically and temporally – to represent within existing systems. Conclusion To enhance applicability and utility, future drug information systems deriving indications and ADEs from public resources must represent clinical concepts uniformly and as precisely as possible. Future systems must also better represent the inherent complexity of indications and ADEs. PMID:24454585

  12. Dietary Factors and Cognitive Decline

    PubMed Central

    Smith, P.J.; Blumenthal, J.A.

    2015-01-01

    Cognitive decline is an increasingly important public health problem, with more than 100 million adults worldwide projected to develop dementia by 2050. Accordingly, there has been an increased interest in preventive strategies that diminish this risk. It has been recognized that lifestyle factors including dietary patterns, may be important in the prevention of cognitive decline and dementia in later life. Several dietary components have been examined, including antioxidants, fatty acids, and B vitamins. In addition, whole dietary eating plans, including the Mediterranean diet (MeDi), and the Dietary Approaches to Stop Hypertension (DASH) diet, with and without weight loss, have become areas of increasing interest. Although prospective epidemiological studies have observed that antioxidants, fatty acids, and B vitamins are associated with better cognitive functioning, randomized clinical trials have generally failed to confirm the value of any specific dietary component in improving neurocognition. Several randomized trials have examined the impact of changing ‘whole’ diets on cognitive outcomes. The MeDi and DASH diets offer promising preliminary results, but data are limited and more research in this area is needed. PMID:26900574

  13. A gene deletion that up-regulates viral gene expression yields an attenuated RSV vaccine with improved antibody responses in children.

    PubMed

    Karron, Ruth A; Luongo, Cindy; Thumar, Bhagvanji; Loehr, Karen M; Englund, Janet A; Collins, Peter L; Buchholz, Ursula J

    2015-11-01

    Respiratory syncytial virus (RSV) is the leading viral cause of severe pediatric respiratory illness, and a safe and effective vaccine for use in infancy and early childhood is needed. We previously showed that deletion of the coding sequence for the viral M2-2 protein (ΔM2-2) down-regulated viral RNA replication and up-regulated gene transcription and antigen synthesis, raising the possibility of development of an attenuated vaccine with enhanced immunogenicity. RSV MEDI ΔM2-2 was therefore evaluated as a live intranasal vaccine in adults, RSV-seropositive children, and RSV-seronegative children. When results in RSV-seronegative children were compared to those achieved with the previous leading live attenuated RSV candidate vaccine, vaccine virus shedding was significantly more restricted, yet the postvaccination RSV-neutralizing serum antibody achieved [geometric mean titer (GMT) = 1:97] was significantly greater. Surveillance during the subsequent RSV season showed that several seronegative RSV MEDI ΔM2-2 recipients had substantial antibody rises without reported illness, suggesting that the vaccine was protective yet primed for anamnestic responses to RSV. Rational design appears to have yielded a candidate RSV vaccine that is intrinsically superior at eliciting protective antibody in RSV-naïve children and highlights an approach for the development of live attenuated RSV vaccines. PMID:26537255

  14. Two Complementary Personal Medication Management Applications Developed on a Common Platform: Case Report

    PubMed Central

    Johnson, Kevin B; Siek, Katie A; Gordon, Jeffry S; Khan, Danish U; Haverhals, Leah M

    2011-01-01

    Background Adverse drug events are a major safety issue in ambulatory care. Improving medication self-management could reduce these adverse events. Researchers have developed medication applications for tethered personal health records (PHRs), but little has been reported about medication applications for interoperable PHRs. Objective Our objective was to develop two complementary personal health applications on a common PHR platform: one to assist children with complex health needs (MyMediHealth), and one to assist older adults in care transitions (Colorado Care Tablet). Methods The applications were developed using a user-centered design approach. The two applications shared a common PHR platform based on a service-oriented architecture. MyMediHealth employed Web and mobile phone user interfaces. Colorado Care Tablet employed a Web interface customized for a tablet PC. Results We created complementary medication management applications tailored to the needs of distinctly different user groups using common components. Challenges were addressed in multiple areas, including how to encode medication identities, how to incorporate knowledge bases for medication images and consumer health information, how to include supplementary dosing information, how to simplify user interfaces for older adults, and how to support mobile devices for children. Conclusions These prototypes demonstrate the utility of abstracting PHR data and services (the PHR platform) from applications that can be tailored to meet the needs of diverse patients. Based on the challenges we faced, we provide recommendations on the structure of publicly available knowledge resources and the use of mobile messaging systems for PHR applications. PMID:21749966

  15. Multi-electron dissociative ionization of clusters under picosecond and femtosecond laser irradiation: the case of alkyl-halide clusters.

    PubMed

    Karras, Gabriel; Kosmidis, Constantine

    2012-09-21

    The multi-electron dissociative ionization (MEDI) of alkyl-halide clusters induced by 35 ps (at 266, 532 and 1064 nm) and 20 fs (at 400 and 800 nm) laser pulses is reported. In most cases, the MEDI of clusters is observed at substantially lower laser intensities than those reported for the monomer molecules, while the fragment ions are released with higher kinetic energies. From the comparative analysis of the experimental data, is concluded that the increase of molecular chain and/or the presence of a lighter halogen (I, Br, Cl) in the molecular skeleton results in the increase of the laser intensity thresholds for the appearance of the singly and multiply charged fragment ions. As far as the angular distributions of the ejected ions are concerned, they are found to be dependent on the laser pulse duration. For the observed experimental data, a physical mechanism is proposed, based on the combined action of the laser and the electric field created within the clusters after their single ionization. PMID:22859215

  16. Inhibition of CD73 AMP hydrolysis by a therapeutic antibody with a dual, non-competitive mechanism of action.

    PubMed

    Geoghegan, James C; Diedrich, Gundo; Lu, Xiaojun; Rosenthal, Kim; Sachsenmeier, Kris F; Wu, Herren; Dall'Acqua, William F; Damschroder, Melissa M

    2016-01-01

    CD73 (ecto-5'-nucleotidase) has recently been established as a promising immuno-oncology target. Given its role in activating purinergic signaling pathways to elicit immune suppression, antagonizing CD73 (i.e., releasing the brake) offers a complimentary pathway to inducing anti-tumor immune responses. Here, we describe the mechanistic activity of a new clinical therapeutic, MEDI9447, a human monoclonal antibody that non-competitively inhibits CD73 activity. Epitope mapping, structural, and mechanistic studies revealed that MEDI9447 antagonizes CD73 through dual mechanisms of inter-CD73 dimer crosslinking and/or steric blocking that prevent CD73 from adopting a catalytically active conformation. To our knowledge, this is the first report of an antibody that inhibits an enzyme's function through 2 distinct modes of action. These results provide a finely mapped epitope that can be targeted for selective, potent, and non-competitive inhibition of CD73, as well as establish a strategy for inhibiting enzymes that function in both membrane-bound and soluble states. PMID:26854859

  17. Management of incontinence-associated dermatitis with a skin barrier protectant.

    PubMed

    Southgate, Geraldine; Bradbury, Sarah

    The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage. PMID:27172503

  18. The many faces of solitary and multiple erythema migrans.

    PubMed

    Eriksson, Pernilla; Schröder, Marika T; Niiranen, Kirsi; Nevanlinna, Antti; Panelius, Jaana; Ranki, Annamari

    2013-11-01

    Case definitions for European Lyme disease have been published. However, multiple erythema migrans may pose a diagnostic challenge. Therefore, we retrospectively reviewed the clinical and serological findings and response to therapy in a cohort of consecutive 54 patients with PCR-confirmed erythema migrans, referred to a university dermatology clinic. The proportion of patients with multiple erythema migrans lesions (usually 2 or 3) was almost equal (46%) to the proportion of patients with single erythema migrans lesions (54%). All patients, except for 2 multiple erythema migrans patients with a concomitant autoimmune disease, completely responded to treatment. In conclusion, multiple erythema migrans may be more common than anticipated, and since only 50% of the patients were seropositive when seeking medi-cal help, PCR testing of skin lesions is helpful to confirm the diagnosis in clinically atypical cases. PMID:23450303

  19. An integrated computerized triage system in the emergency department.

    PubMed

    Aronsky, Dominik; Jones, Ian; Raines, Bill; Hemphill, Robin; Mayberry, Scott R; Luther, Melissa A; Slusser, Ted

    2008-01-01

    Emergency department (ED) triage is a fast-paced process that prioritizes the allocation of limited health care resources to patients in greatest need. This paper describes the experiences with an integrated, computerized triage application. The system exchanges information with other information systems, including the ED patient tracking board, the longitudinal electronic medical record, the computerized provider order entry, and the medi-cation reconciliation application. The application includes decision support capabilities such as assessing the patients acuity level, age-dependent alerts for vital signs, and clinical reminders. The browser-based system utilizes the institutions controlled vocabulary, improves data completeness and quality, such as compliance with capturing required data elements and screening questions, initiates clinical processes, such as pneumococcal vaccination ordering, and reminders to start clinical pathways, issues alerts for clinical trial eligibility, and facilitates various reporting needs. The system has supported the triage documentation of >140,000 pediatric and adult patients. PMID:18999190

  20. Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

    PubMed Central

    Sommer, Philipp; Kircher, Simon; Rolf, Sascha; Richter, Sergio; Doering, Micha; Arya, Arash; Bollmann, Andreas; Hindricks, Gerhard

    2015-01-01

    A technological platform (MediGuide) has been recently introduced for non-fluoroscopic catheter tracking. In several studies, we have demonstrated that the application of this non-fluoroscopic catheter visualization system (NFCV) reduces fluoroscopy time and dose by 90-95% in a variety of electrophysiology (EP) procedures. This can be of relevance not only to the patients, but also to the nurses and physicians working in the EP lab. Furthermore, in a subset of indications such as supraventricular tachycardias, NFCV enables a fully non-fluoroscopic procedure and allows the lab staff to work without wearing lead aprons. With this protocol, we demonstrate that even complex procedures such as ablations of atrial fibrillation, that are typically associated with fluoroscopy times of >30 min in conventional settings, can safely be performed with a reduction of >90% in fluoroscopy exposure by the additional use of NFCV. PMID:26066541

  1. Davis signs return-to-work plan, three other bills.

    PubMed

    1999-10-29

    California Governor Gray Davis recently signed several pieces of legislation related to HIV and AIDS. A.B. 155 allows Medi-Cal recipients to return to work and maintain their benefits as long as they meet the Federal Medicaid definition of disability and pay monthly coverage premiums. Another bill protects local governments from prosecution if they distribute syringes in a needle-exchange program authorized by a declaration of emergency. Newly signed legislation also includes a ban on the disclosure of HIV-related medical records by insurers in workers compensation claims unless occupational exposure to HIV is involved. A fourth bill authorizes research on the safety and efficacy of marijuana when treating certain medical conditions. The 3-year research program, to be run by the University of California, gives top priority to patients with AIDS, cancer, seizures, or glaucoma. PMID:11367063

  2. PD-1/PD-L1 inhibitors.

    PubMed

    Sunshine, Joel; Taube, Janis M

    2015-08-01

    Tumors may adopt normal physiologic checkpoints for immunomodulation leading to an imbalance between tumor growth and host surveillance. Antibodies targeting the PD-1/PD-L1 checkpoint have shown dynamic and durable tumor regressions, suggesting a rebalancing of the host-tumor interaction. Nivolumab and pembrolizumab are the anti-PD-1 antibodies that are currently the furthest in clinical development, and anti-PD-L1 agents under investigation include MPDL3280A, MEDI4736, and BMS-936559. These agents have been used to treat advanced melanoma, non-small cell lung cancer, renal cell carcinoma, bladder cancer and Hodgkin lymphoma, amongst other tumor types. In this article, we review the updated response results for early clinical trials, note recent FDA actions regarding this class of agents, and summarize results across trials looking at PD-L1 status as a predictor of response to anti-PD-1/PD-L1. PMID:26047524

  3. [Method of traditional Chinese medicine formula design based on 3D-database pharmacophore search and patent retrieval].

    PubMed

    He, Yu-su; Sun, Zhi-yi; Zhang, Yan-ling

    2014-11-01

    By using the pharmacophore model of mineralocorticoid receptor antagonists as a starting point, the experiment stud- ies the method of traditional Chinese medicine formula design for anti-hypertensive. Pharmacophore models were generated by 3D-QSAR pharmacophore (Hypogen) program of the DS3.5, based on the training set composed of 33 mineralocorticoid receptor antagonists. The best pharmacophore model consisted of two Hydrogen-bond acceptors, three Hydrophobic and four excluded volumes. Its correlation coefficient of training set and test set, N, and CAI value were 0.9534, 0.6748, 2.878, and 1.119. According to the database screening, 1700 active compounds from 86 source plant were obtained. Because of lacking of available anti-hypertensive medi cation strategy in traditional theory, this article takes advantage of patent retrieval in world traditional medicine patent database, in order to design drug formula. Finally, two formulae was obtained for antihypertensive. PMID:25850277

  4. Society of Nuclear Medicine--57th annual meeting.

    PubMed

    Searle, Ben

    2010-08-01

    The 57th Annual Meeting of the Society of Nuclear Medicine, held in Salt Lake City, UT, USA, included topics covering new developments in imaging agents and radiopharmaceutical therapies in the field of nuclear medicine. This conference report highlights selected presentations related to imaging of the brain, the prediction of heart disease, and the detection and treatment of various cancers. Investigational drugs discussed include TF-2 plus [68Ga]IMP-288 and TF-2 plus [111In]IMP-288 (both Immunomedics Inc), [11C]PBR-170 (Royal Prince Alfred Hospital/Australian Nuclear Science & Technology Organization), [11C]LY-2795050 (Eli Lilly & Co), yttrium (90Y) clivatuzumab tetraxetan (Garden State Cancer Center/Immunomedics Inc), [18F]LMI-1195 (Lantheus Medical Imaging Inc), fluciclovine (18F) (GE Healthcare/Nihon Medi-Physics Co Ltd), [99mTc]MIP-1340 and [99mTc]MIP-1407 (both Molecular Insight Pharmaceuticals Inc). PMID:20721816

  5. [Advance in study on pharmacological effect of Eucommiae Folium].

    PubMed

    Yuan, Tian-Yi; Fang, Lian-Hua; Lv, Yang; Du, Guan-Hu

    2013-03-01

    Eucommia ulmoides is a valuable traditional Chinese medicine, whose cortexes have long been used as medi cines. Due to the scarcity of its resources, people began using its leaves instead of cortexes in medicines. Eucommiae Folium and its leaves have many pharmacological effects and thereby being clinically applied as genuine traditional Chinese medicines. Modern pharmological studies have showed that Eucommiae Folium leaves have such effects as blood pressure reduction, blood lipid regulation, cardiovascular protection, anti-obesity, anti-inflammation, anti-virus, enhancement of immunologic function, resistance against senility and anti-fatigue. In clinic, Eucommiae Folium is mainly used to treat hypertention and obstetrical and gynecological disease. The essay summarizes the latest advance in domestic and foreign studie on pharmacological effeets and clinical applications of Eucommiae Folium leaves, and thus providing reference for studies on new drugs of Eucommiae Folium leave. PMID:23717951

  6. Performance analysis of a proposed tightly-coupled medical instrument network based on CAN protocol.

    PubMed

    Mujumdar, Shantanu; Thongpithoonrat, Pongnarin; Gurkan, D; McKneely, Paul K; Chapman, Frank M; Merchant, Fatima

    2010-01-01

    Advances in medical devices and health care has been phenomenal during the recent years. Although medical device manufacturers have been improving their instruments, network connection of these instruments still rely on proprietary technologies. Even if the interface has been provided by the manufacturer (e.g., RS-232, USB, or Ethernet coupled with a proprietary API), there is no widely-accepted uniform data model to access data of various bedside instruments. There is a need for a common standard which allows for internetworking with the medical devices from different manufacturers. ISO/IEEE 11073 (X73) is a standard attempting to unify the interfaces of all medical devices. X73 defines a client access mechanism that would be implemented into the communication controllers (residing between an instrument and the network) in order to access/network patient data. On the other hand, MediCAN™ technology suite has been demonstrated with various medical instruments to achieve interfacing and networking with a similar goal in its open standardization approach. However, it provides a more generic definition for medical data to achieve flexibility for networking and client access mechanisms. The instruments are in turn becoming more sophisticated; however, the operation of an instrument is still expected to be locally done by authorized medical personnel. Unfortunately, each medical instrument has its unique proprietary API (application programming interface - if any) to provide automated and electronic access to monitoring data. Integration of these APIs requires an agreement with the manufacturers towards realization of interoperable health care networking. As long as the interoperability of instruments with a network is not possible, ubiquitous access to patient status is limited only to manual entry based systems. This paper demonstrates an attempt to realize an interoperable medical instrument interface for networking using MediCAN technology suite as an open

  7. Physico-Chemical Research on the Sounding Rocket Maser 13

    NASA Astrophysics Data System (ADS)

    Lockowandt, Christian; Kemi, Stig; Abrahamsson, Mattias; Florin, Gunnar

    MASER is a sounding rocket platform for short-duration microgravity experiments, providing the scientific community with an excellent microgravity tool. The MASER programme has been running by SSC from 1987 and has up to 2012 provided twelve successful flights for microgravity missions with 6-7 minutes of microgravity, the g-level is normally below 1x10-5 g. The MASER 13 is planned to be launched in spring 2015 from Esrange Space Center in Northern Sweden. The rocket will carry four ESA financed experiment modules. The MASER 13 vehicle will be propelled by the 2-stage solid fuel VSB-30 rocket motor, which provided the 390 kg payload with an apogee of 260 km and 6 and a half minutes of microgravity. Swedish Space Corporation carries out the MASER missions for ESA and the program is also available for other customers. The payload comprise four different experiment modules of which three could be defined as physic-chemical research; XRMON-SOL, CDIC-3, MEDI. It also comprises the Maser Service Module and the recovery system. The Service Module provided real-time 5 Mbps down-link of compressed experiment digital video data from the on-board cameras, as well as high-speed housekeeping telemetry data. XRMON-SOL In this experiment the influence of gravity on the formation of an equiaxed microstructure will be investigated. Special attention will be put on the aspect of nucleation, segregation and impingement. The experiment scope is to melt and solidify an AlCu-alloy sample in microgravity. The solidification will be performed in an isothermal environment. The solidification process will be monitored and recorded with X-ray image during the whole flight, images will also be down-linked to ground for real-time monitoring and possible interaction. CDIC-3 The goal is to study in migrogravity the spatio-temporal dynamics of a chemical front travelling in a thin solution layer open to the air and specifically the respective role of Marangoni and density-related hydrodynamic

  8. Capitated risk-bearing managed care systems could improve end-of-life care.

    PubMed

    Lynn, J; Wilkinson, A; Cohn, F; Jones, S B

    1998-03-01

    Capitated or salaried managed care systems offer an important opportunity to provide high quality, cost-effective end-of-life care. However, capitated healthcare delivery systems have strong incentives to avoid patient populations in need of such care. Care currently provided at the end of life in fee-for-service practice is commonly deficient, with high rates of avoidable pain and other burdens. Only hospice offers a better track record, yet access to hospice is limited, and length of stay is short. Traditional staff- or group-model managed care plans, with their emphasis on prevention, patient education, cost efficiency, service coordination, and integrated provider networks, present a dynamic set of conditions and organizational structures that would support real change. Advantages derived from managed care systems providing quality end-of-life care include coordinated care across delivery sites, interdisciplinary teams, integrated services, and opportunities to develop innovative care programs, service arrays, utilization controls, and accountability for care standards. We propose a special comprehensive system of managed care, which we call MediCaring, for seriously ill persons nearing the end of life. MediCaring would encompass the best elements of palliative care within a managed care structure: comprehensive, supportive, community-based services that meet personal and medical needs, a focus on patient preferences, symptom management, family counseling, and support. Other programs, such as hospice, have shown that continuity and coordinated care, financed through a capitated payment and directed at a special population, are both feasible and effective. There are obstacles to improving care at the end of life. Managed care systems, like most of medical care, have largely ignored the terminally ill patient. Current financing arrangements make it financially undesirable for insurers to recruit or retain the very sick; very ill patients can be costly over a

  9. Characterization of Alpha-Toxin hla Gene Variants, Alpha-Toxin Expression Levels, and Levels of Antibody to Alpha-Toxin in Hemodialysis and Postsurgical Patients with Staphylococcus aureus Bacteremia

    PubMed Central

    Wu, Yuling; Tabor, David E.; Mok, Hoyin; Sellman, Bret R.; Jenkins, Amy; Yu, Li; Jafri, Hasan S.; Rude, Thomas H.; Ruffin, Felicia; Schell, Wiley A.; Park, Lawrence P.; Yan, Qin; Thaden, Joshua T.; Messina, Julia A.; Esser, Mark T.

    2014-01-01

    Alpha-toxin is a major Staphylococcus aureus virulence factor. This study evaluated potential relationships between in vitro alpha-toxin expression of S. aureus bloodstream isolates, anti-alpha-toxin antibody in serum of patients with S. aureus bacteremia (SAB), and clinical outcomes in 100 hemodialysis and 100 postsurgical SAB patients. Isolates underwent spa typing and hla sequencing. Serum anti-alpha-toxin IgG and neutralizing antibody levels were measured by using an enzyme-linked immunosorbent assay and a red blood cell (RBC)-based hemolysis neutralization assay. Neutralization of alpha-toxin by an anti-alpha-toxin monoclonal antibody (MAb MEDI4893) was tested in an RBC-based lysis assay. Most isolates encoded hla (197/200; 98.5%) and expressed alpha-toxin (173/200; 86.5%). In vitro alpha-toxin levels were inversely associated with survival (cure, 2.19 μg/ml, versus failure, 1.09 μg/ml; P < 0.01). Both neutralizing (hemodialysis, 1.26 IU/ml, versus postsurgical, 0.95; P < 0.05) and IgG (hemodialysis, 1.94 IU/ml, versus postsurgical, 1.27; P < 0.05) antibody levels were higher in the hemodialysis population. Antibody levels were also significantly higher in patients infected with alpha-toxin-expressing S. aureus isolates (P < 0.05). Levels of both neutralizing antibodies and IgG were similar among patients who were cured and those not cured (failures). Sequence analysis of hla revealed 12 distinct hla genotypes, and all genotypic variants were susceptible to a neutralizing monoclonal antibody in clinical development (MEDI4893). These data demonstrate that alpha-toxin is highly conserved in clinical S. aureus isolates. Higher in vitro alpha-toxin levels were associated with a positive clinical outcome. Although patients infected with alpha-toxin-producing S. aureus exhibited higher anti-alpha-toxin antibody levels, these levels were not associated with a better clinical outcome in this study. PMID:25392350

  10. The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

    PubMed Central

    Moon, Yeseon P.; Scarmeas, Nikolaos; Gu, Yian; Gardener, Hannah; Cheung, Ken; Wright, Clinton B.; Sacco, Ralph L.; Nickolas, Thomas L.; Elkind, Mitchell S.V.

    2014-01-01

    Background and objectives Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function. Design, setting, participants, & measurements This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR<60 ml/min per 1.73 m2using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline (≥2.5 ml/min per 1.73 m2 per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors. Results Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m2. Incident eGFR<60 ml/min per 1.73 m2 developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR<60 ml/min per 1.73 m2 (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98). Conclusions A Mediterranean diet was associated with a reduced incidence of eGFR<60 ml/min per 1.73 m2 and upper quartile of eGFR decline in a multiethnic cohort. PMID:25359387

  11. Linear dimensions and volumes of human lungs

    DOE PAGESBeta

    Hickman, David P.

    2012-03-30

    TOTAL LUNG Capacity is defined as “the inspiratory capacity plus the functional residual capacity; the volume of air contained in the lungs at the end of a maximal inspiration; also equals vital capacity plus residual volume” (from MediLexicon.com). Within the Results and Discussion section of their April 2012 Health Physics paper, Kramer et al. briefly noted that the lungs of their experimental subjects were “not fully inflated.” By definition and failure to obtain maximal inspiration, Kramer et. al. did not measure Total Lung Capacity (TLC). The TLC equation generated from this work will tend to underestimate TLC and does notmore » improve or update total lung capacity data provided by ICRP and others. Likewise, the five linear measurements performed by Kramer et. al. are only representative of the conditions of the measurement (i.e., not at-rest volume, but not fully inflated either). While there was significant work performed and the data are interesting, the data does not represent a maximal situation, a minimal situation, or an at-rest situation. Moreover, while interesting, the linear data generated by this study is limited by the conditions of the experiment and may not be fully comparative with other lung or inspiratory parameters, measures, or physical dimensions.« less

  12. US veterinary support to standardization of food and water safety and animal care and use within NATO.

    PubMed

    Burke, Ronald L; Mann, Kelly A; Richards, Steven; Stevenson, Timothy H

    2013-01-01

    NATO requires all standardization agreements and Al-lied Medical Publications to be reviewed at least once every 3 years to ensure they reflect current technologies and national military policies and procedures. This is particularly applicable with regard to veterinary medi-cine and food and water safety where advances in scientific knowledge and practices may result in documents quickly becoming obsolete. Such is the case with the 8 standardization agreements for which the FWSVS has responsibility; all are currently undergoing major revisions. With each revision, national representatives, including US veterinary and preventive medicine personnel, must review the documents to ensure there are no significant issues which would prevent ratification and implementation. This improves standardization and enhances interoperability between NATO partners to minimize duplication. This is accomplished by leveraging other national military capabilities, while maintaining confidence that the food, water, and veterinary support provided to their Warriors, support personnel, and animals in the field is safe and high in quality. Adherence to such standards is a major factor in maintaining the operational readiness of all alliance armed forces. PMID:23277450

  13. Protective Effect of Selenium-Based Medicines on Toxicity of Three Common Organophosphorus Compounds in Human Erythrocytes In Vitro

    PubMed Central

    Mostafalou, Sara; Navaei-Nigjeh, Mona; Baeeri, Maryam; Mohammadirad, Azadeh; Abdollahi, Mohammad

    2016-01-01

    Objective Organophosphorus (OP) compounds are used to control pests, however they can reach the food chain and enter the human body causing serious health problems by means of acetylcholinesterase (AChE) inhibition and oxidative stress (OS). Among the OPs, chlorpyrifos (CHP), malathion (MAL), and diazinon (DIA) are commonly used for commercial extermination purposes, in addition to veterinary practices, domestic, agricul- ture and public health applications. Two new recently registered medicines that contain selenium and other antioxidants, IMOD and angipars (ANG), have shown beneficial ef- fects for OS related disorders. This study examines the effect of selenium-based medi- cines on toxicity of three common OP compounds in erythrocytes. Materials and Methods In the present experimental study, we determined the ef- ficacy of IMOD and ANG on OS induced by three mentioned OP pesticides in human erythrocytes in vitro. After dose-response studies, AChE, lipid peroxidation (LPO), total antioxidant power (TAP) and total thiol molecules (TTM) were measured in eryth- rocytes after exposure to OPs alone and in combined treatment with IMOD or ANG. Results AChE activity, TAP and TTM reduced in erythrocytes exposed to CHP, MAL and DIA while they were restored in the presence of ANG and IMOD. ANG and IMOD reduced the OPs-induced elevation of LPO. Conclusion The present study shows the positive effects of IMOD and ANG in re- duction of OS and restoration of AChE inhibition induced by CHP, MAL and DIA in erythrocytes in vitro. PMID:26862533

  14. A new inventory for middle east dust source points.

    PubMed

    Moridnejad, Ali; Karimi, Neamat; Ariya, Parisa A

    2015-09-01

    We use the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on both Terra and Aqua satellites to present new high-resolution mapping of major atmospheric dust source points in the Middle East region on the basis of the improved version of the recently developed Middle East Dust Index (MEDI) applied to 70 dust storms, which occurred during the period between 2001 and 2012. Results indicate that 247 different source points have participated in dust storm generation in the Middle East region in which Iraq and Syria are the highest efficient sites for dust storm generation in this region, respectively. Using extracted indices for Deep Blue algorithm, identified dust sources were classified into three levels of intensity. The frequency of occurrence approach, the relationship between high atmospheric dust content and its number of occurrences, is also used to identify sensitive source points. High-intensity dust storms are mainly located west of Iraq and the border of Iraq and Syria. We will discuss the implications of our results in understanding the global dust cycle. PMID:26297415

  15. Do severity measures explain differences in length of hospital stay? The case of hip fracture.

    PubMed Central

    Shwartz, M; Iezzoni, L I; Ash, A S; Mackiernan, Y D

    1996-01-01

    OBJECTIVE: To examine whether judgments about hospital length of stay (LOS) vary depending on the measure used to adjust for severity differences. DATA SOURCES/STUDY SETTING: Data on admissions to 80 hospitals nationwide in the 1992 MedisGroups Comparative Database. STUDY DESIGN: For each of 14 severity measures, LOS was regressed on patient age/sex, DRG, and severity score. Regressions were performed on trimmed and untrimmed data. R-squared was used to evaluate model performance. For each severity measure for each hospital, we calculated the expected LOS and the z-score, a measure of the deviation of observed from expected LOS. We ranked hospitals by z-scores. DATA EXTRACTION: All patients admitted for initial surgical repair of a hip fracture, defined by DRG, diagnosis, and procedure codes. PRINCIPAL FINDINGS: The 5,664 patients had a mean (s.d.) LOS of 11.9 (8.9) days. Cross-validated R-squared values from the multivariable regressions (trimmed data) ranged from 0.041 (Comorbidity Index) to 0.165 (APR-DRGs). Using untrimmed data, observed average LOS for hospitals ranged from 7.6 to 23.9 days. The 14 severity measures showed excellent agreement in ranking hospitals based on z-scores. No severity measure explained the differences between hospitals with the shortest and longest LOS. CONCLUSIONS: Hospitals differed widely in their mean LOS for hip fracture patients, and severity adjustment did little to explain these differences. PMID:8885854

  16. Alveolar echinococcosis of the liver: percutaneous stent therapy in Budd-Chiari syndrome.

    PubMed Central

    Vogel, J; Görich, J; Kramme, E; Merkle, E; Sokiranski, R; Kern, P; Brambs, H J

    1996-01-01

    BACKGROUND AND AIMS: Infiltration of the hepatic veins in the alveolar echinococcosis can lead to the development of the Budd-Chiari syndrome. The medical and surgical treatment of this condition is generally unsatisfactory. The results of successful interventional treatment with percutaneous stent implantation in the hepatic veins are reported. METHODS: Using a transjugular approach, metal mesh stents (Boston Scientific, Medi-Tech Accuflex 8/60 mm) were placed in the median and left hepatic veins of a 53 year old woman. After the intervention, oral chemotherapy with albendazole (2 x 400 mg/day) was continued, but no anticoagulants were given. RESULTS: Stent placement was performed without complications. The clinical picture improved rapidly: normalisation of portal blood flow was confirmed by Doppler ultrasound and there was improvement of liver function, reduction of oesophageal varices, and disappearance of ascites. A follow-up examination at 15 months showed no evidence of stent occlusion. CONCLUSIONS: Treatment of portal hypertension in alveolar echinococcosis of the liver is problematic. In selected patients with portal hypertension secondary to hepatic vein stenoses but no cirrhosis, percutaneous stent placement in the hepatic veins represents a promising treatment alternative. Images Figure 1 Figure 2 PMID:9026484

  17. [Dextromethorphan abuse in adolescents: what can the pharmacists do?].

    PubMed

    Müller, Sandra; Jaffan, Linda; Kloiber, Edith; Läer, Stephanie

    2014-03-01

    In Germany, dextromethorphan (DXM) is used as OTC cough and cold medication. Overdose, however, can cause psychotropic side effects and is therefore abused among adolescents. To better control the drug by the pharmacist, a pilot was undertaken to monitor drug selling of DXM in German retail pharmacies. Over a 6-month period, pharmacies documented the request of DXM preparations. These data were compared to abuse cases of the German regulatory agency, the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), an analysis of the 2010 annual sales statistic from the IMS OTC and information about DXM products from drug abuse websites. Especially the young DXM buyers in German retail pharmacies showed characteristics similar to those people from the BfArM abuse data file: They were male and used the DXM product Hustenstiller-ratiopharm. Hustenstiller-ratiopharm has well-directed instructions for DXM abuse in the internet. However, the 2010 annual sales statistic from the IMS OTC report identified Wick MediNait as the product with highest sales numbers whereas Hustenstiller-ratiopharm" was of less importance indicating DXM abuse is limited to a small part of the DXM user population. PMID:24741849

  18. The economic value of contraception: a comparison of 15 methods.

    PubMed Central

    Trussell, J; Leveque, J A; Koenig, J D; London, R; Borden, S; Henneberry, J; LaGuardia, K D; Stewart, F; Wilson, T G; Wysocki, S

    1995-01-01

    OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods. Images FIGURE 1 FIGURE 2 PMID:7702112

  19. Application of the Nd:YAG laser to intracranial tumor operations

    NASA Astrophysics Data System (ADS)

    Kopera, Marek; Majchrzak, Henryk

    1996-03-01

    From January 1989 to December 1993, in the Neurosurgery Department of Mine Hospital in Sosnowiec, a Nd:YAG mediLas 4060 N (MBB) laser with the radiation wavelength of 1.064 micrometer was used for operation of 104 patients with intracranial neoplasm. Fifty-five patients were operated on without any use of the Nd:YAG laser. The coagulation capabilities of the Nd:YAG made it possible to achieve the hemostasis sooner and more certainly that brought an opportunity operate in a dry field. The shrinkage of a tumor, especially in the cases of meningioma and metastases, facilitated their preparation to a great extent. Removal of a lesion took place with negligible mechanical damage of the surrounding cerebral tissue. The Nd:YAG laser is particularly useful in the cases of well vascularized brain meningiomas; in this way larger tumors can be removed radically with milder postoperational course and good results of therapy were achieved significantly more frequently than in the control group. It was clearly demonstrated with significantly less frequent bouts of consciousness disturbance and pareses. The application of this Nd:YAG laser does not influence upon the postoperational course, the tumor regrowth and the number of persons with the expanding process recurrence in the glioma cases.

  20. Modern use of smartphone applications in the perioperative management in microsurgical breast reconstruction

    PubMed Central

    Rozen, Warren Matthew; Marsh, Daniel; Chow, Whitney T.H.; Vickers, Tobias; Khan, Lubna; Miller, George S.; Hunter-Smith, David J.; Ramakrishnan, Venkat V.

    2016-01-01

    Background Advances in mobile telecommunication, improved mobile internet and affordability have led to a significant increase in smartphone use within medicine. The capability of instant messaging, photography, videography, word processing, drawing and internet access allow significant potential in this small portable device. Smartphone use within medicine has grown tremendously worldwide given its affordability, improved internet and capabilities. Methods We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. Results The useful apps have been subdivided: (I) communication apps—multimedia messaging, WhatsApp, PicSafeMedi: allow efficient communication via text, picture and video messages leading to earlier assessment and definitive management of free flaps; (II) storage apps—Notability, Elogbook: electronic storage of patient notes and logbooks of case which can be shared with others if required; (III) educational apps—FlapApp, Touch Surgery, PubMed on tap: step by step guides to surgical procedures to aid learning and medical journal database; (IV) flap monitoring app—SilpaRamanitor: free flap monitoring app based on photographic analysis for earlier detection of compromised flaps. Conclusions There has been remarkable growth in smartphones use among surgeons. Apps are being developed for every conceivable use. The future will be in wearable smart devices that allow continuous monitoring with the potential to instigate change should deviations from the norm occur. The smart watch is the start of this digital revolution. PMID:27047783

  1. [Treatment of inflammatory bowel diseases].

    PubMed

    Gomollón, Fernando

    2015-09-01

    In addition to immunosuppressive drugs and anti-TNF, there are a number of new options in the treatment of inflammatory bowel diseases. Vedolizumab has been approved by the FDA and EMA and has demonstrated utility both in the treatment of ulcerative colitis (UC) and Crohn's disease (CD), even in anti-TNF refractory patients. Other monoclonal antibodies with different targets such as PF-005447659 (antiMAd-CAM1), ustekinumab (anti-IL23/IL12) or MEDI2070 (anti-IL23) have shown promising results in distinct clinical scenarios. Mongersen (antisense oligonucleotide anti-Smad7) and oznimod (an SP-1 modulator) are new alternatives with proven efficacy in clinical trials in CD and UC, respectively. Some data suggest that faecal microbiota transplantation could be efficacious in individual patients, although controlled data do not show clear differences with placebo. Autologous stem-cell transplantation has shown long-term efficacy in "ultra-refractory" CD. The number of possible treatments is constantly increasing, and future research should focus both on the selection of the most appropriate treatment for any given patient and on comparative trials between options. PMID:26520192

  2. [Hypolipidemic and antihypertensive therapy in diabetic patients in the Czech Republic: notes on the VZP (General Health Insurance Company) Data].

    PubMed

    Šnejdrlová, Michaela; Češka, Richard; Janíčková-Žďárská, Denisa; Honěk, Petr; Dušek, Pavel; Pavlík, Tomáš; Kvapil, Milan

    2015-11-01

    Diabetes mellitus and in particular type 2 diabetes mellitus is one of the most important risk factors of cardiovascular disease. To influence cardiovascular risk there is enormous important not only positive influence of glycemia, but also the treatment of diabetic dyslipidemia and hypertension. The present work provides an analysis of lipid-lowering and antihypertensive therapy for all diabetics registered with General Health Insurance Company in the period 2010-2013. In this time 866,570 patients with diabetes mellitus registered with General Health Insurance Company were treated, the majority of them were diabetics independent on insulin. Approximately half of the patients were observed by dialectologists and half of them by the doctors of other specialization. Out of antihypertensive medi-cation, patients were most often treated by drugs that affect the renin-angiotensin system, as well as beta-blockers and diuretics. Prescription of the lipid-lowering therapy, especially prescription of statins, in accordance with the guidelines, is increasing, but remains insufficient (at 2013 43.6% diabetics treated by dialectologists and 51.3% diabetics treated by GP´s didn´t have lipid lowering therapy). Inadequate use of combination lipid-lowering therapy was recorded too, still represented mainly by combination of statin and fibrate, but in coming years we expect (based on the positive results of the subanalysis IMPROVE-IT study), an increase of combination therapy statin and ezetimibe. PMID:26652963

  3. Depression: Evolutionary New Neural Circuitries Are Still Adjusting for Cognition.

    PubMed

    Graczynska, Agata; Stefano, George B

    2015-01-01

    Depression can be both normal and abnormal, and the balance of its expression determines the behavioral outcome/diagnosis. It is a complex pathophysiology based on a heterogeneous syndrome whose etiology is diverse as well. Within the context of a central nervous system, the nervous system blueprint can be found in single cells (sensory, motor, and integrative processes). These consolidated functions provide for novel coping strategies for survival. The maintenance and evolvement of this system into a central nervous system is based on conserving these functions, including chemical messengers and functionality in having specific cells medi-ate these primordial functions. Additionally, this neural coping strategy provides advantages for DNA. Thus, with different neural cells at work, pathways/networks would evolve, producing more complex behaviors and become a very critical phenomenon for future advances. This evolvement has taken over 1 billion years to de-velop. In so doing, as with any new programming (e.g., cognition), errors will occur. Given the widespread qual-ities of depression, it is surmised that this abnormality, and other psychiatric disorders, may emerge due to in-herent neural weaknesses related to cognition being a recent evolutionary development. PMID:26420361

  4. [From freshmanship to the first "Staatsexamen"--increase of depression and decline in sense of coherence and mental quality of life in advanced medical students].

    PubMed

    Burger, Pascal H M; Tektas, Ozan Y; Paulsen, Friedrich; Scholz, Michael

    2014-08-01

    Psychiatric disorders (Burnout, depression, anxiety disorders) are common among medical students with a distinctly higher prevalence compared to the general public. Although medi-cal students show a normal health status at the beginning of their university study period, a deterioration of these aspects in higher semesters is evident and continues when they become residents. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters (1st-4th) before their first "Staatsexamen" with validated psychological questionnaires for depression, anxiety, quality of life and sense of coherence. Students in their 1st semester show normal values like the general public. During the 4 semesters a slow and continuous rise of depressive symptoms and anxiety was detected. Quality of life and sense of coherence constantly deteriorated. An increase of physical symptoms was not detected. In the 4th semester the number of depressive students had already doubled. The development of worsening psychological problems and resulting psychiatric disorders seems to be a continuous process, starting with the beginning of the medical studies and growing continuously during the preclinical semesters. Effect-ive strategies for coping with distress should be integrated in the medical curriculum at universities from the very first semester on. Relaxation techniques could thus be an opportunity. PMID:25105708

  5. Abortion debate continues: a look at laws, regulations, restrictions and funding.

    PubMed

    Smith, J A

    1980-06-01

    California's "Therapeutic Abortion Act" gives a physician the right to perform an abortion when certain conditions are met. The committee of the medical staff appointed to review requests for abortion may not approve one after the 20th week of pregnancy. Employers are prohibited from requiring various health professionals to participate directly in the procedure if the person has filed a written statement indicating a moral, ethical or religious basis for refusal to participate. The abortion debate continues regarding public funding. Until 1977 and the Hyde Amendment, elective abortion was covered under the Federal Medicaid program. In 1977 the Supreme Court ruled that states do not have to pay for poor women's abortions. In July 1978, the California Legislature adopted restrictions similar to those of the Hyde Amendment. These were challenged in CDRR v. Myers in the California Court of Appeal. That court upheld the legislature's restrictions. Pending appeal, cutoff of funds were postponed. California has continued to pay for elective abortions through its general Medi-Cal budget. Judge John Dooling in the U.S. District Court in New York ruled the Hyde Amendment unconstitutional. The ruling is currently being appealed in the Supreme Court. A decision is expected in June. PMID:6991059

  6. A challenge for public policy: the chronically ill elderly and nursing homes.

    PubMed

    Ricker-Smith, K L

    1982-11-01

    Data reported by skilled nursing facilities (SNFs) in an eight-county area in Northern California for 1977-78 indicate that the typical SNF resident was a impoverished female who was at least 75 years old. Her SNF stay was subsidized by MediCal, California's Medicaid program. She was in an urban, for-profit SNF for at least one year, during which time approximately one quarter of her co-residents died. She received about 2 hours of daily side-orderly-attendant care and almost 45 minutes of licensed nurse care. Although her most frequent contact was with aides-orderlies-attendants, a sustained relationship with the staff was not likely because of high employee turnover rate in the facility. This resident had a one-in-three chance of being in a SNF that had been cited (though the citation had not necessarily been upheld) for poor to life-threatening care. This information underscores the urgency of reorienting public policies so that they are based on the needs of the chronically ill elderly. Such a reorientation would I) ensure that people receive professional and paraprofessional services in the least restrictive environment; 2) preclude criticism of nursing homes for "warehousing" the elderly when there is actually little choice in the matter; and 3) enable the nation's elderly to live out their lives with sense of self-worth and dignity, and with the knowledge that they are valued members of society. PMID:6815387

  7. Spas unwrapped.

    PubMed

    Matheson-Shedrick, Kim

    2008-01-01

    From day and resort spas, to medical spas and integrated wellness centers, these havens for wellness are popping up everywhere--even in local hospitals. Whether seeking emotional balance, personal rejuvenation, or anti-aging therapies, there are no age or sex restrictions when it comes to the quest for wellness. Offering a wide variety of techniques and services, be they traditional or modern, from the East or from the West, spas meet the diverse needs of their clients. Spas come in many shapes, sizes, and focuses-from day spas where clients can get a single treatment to spa resorts and destination spas where they can stay for a week or more. There are also medi-spas that operate under the supervision of a medical doctor. A hybrid between a medical clinic and a day spa, they are the newest niche in cosmetic surgery. Along that same line, hospitals across the United States are beginning to add complementary and alternative medicine to their practices. Patients are being introduced to a new level of healthcare where massage, water therapies, reflexology, and even facials are par for the course. PMID:19146088

  8. Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas.

    PubMed

    Littleton, Heather L; Grills-Taquechel, Amie E; Axsom, Danny; Bye, Kimberly; Buck, Katherine S

    2012-11-01

    A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed. PMID:23795237

  9. Intrasite motions and monument instabilities at Medicina ITRF co-location site

    NASA Astrophysics Data System (ADS)

    Sarti, Pierguido; Abbondanza, Claudio; Legrand, Juliette; Bruyninx, Carine; Vittuari, Luca; Ray, Jim

    2013-03-01

    We process the total-station surveys performed at the ITRF co-location site Medicina (Northern Italy) over the decade (2001-2010) with the purpose of determining the extent of local intrasite motions and relating them to local geophysical processes, the geological setting and the design of the ground pillars. In addition, continuous observations acquired by two co-located GPS stations (MEDI and MSEL separated by ≈27 m) are analysed and their relative motion is cross-checked with the total-station results. The local ground control network extends over a small area (<100 × 100 m) but the results demonstrate significant anisotropic deformations with rates up to 1.6 mm a-1, primarily horizontal, a value comparable to intraplate tectonic deformations. The results derived from GPS and total-station observations are consistent and point to the presence of horizontal intrasite motions over very short distances possibly associated with varying environmental conditions in a very unfavourable local geological setting and unsuitable monument design, these latter being crucial aspects of the realization and maintenance of global permanent geodetic networks and the global terrestrial reference frame.

  10. Older adults challenged financially when adult children move home.

    PubMed

    Wallace, Steven P; Padilla-Frausto, D Imelda

    2014-02-01

    This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs. PMID:24804354

  11. Dual inhibition of Ang-2 and VEGF receptors normalizes tumor vasculature and prolongs survival in glioblastoma by altering macrophages

    PubMed Central

    Peterson, Teresa E.; Kirkpatrick, Nathaniel D.; Huang, Yuhui; Farrar, Christian T.; Marijt, Koen A.; Kloepper, Jonas; Datta, Meenal; Amoozgar, Zohreh; Seano, Giorgio; Jung, Keehoon; Kamoun, Walid S.; Vardam, Trupti; Snuderl, Matija; Goveia, Jermaine; Chatterjee, Sampurna; Batista, Ana; Muzikansky, Alona; Leow, Ching Ching; Xu, Lei; Batchelor, Tracy T.; Duda, Dan G.; Fukumura, Dai; Jain, Rakesh K.

    2016-01-01

    Glioblastomas (GBMs) rapidly become refractory to anti-VEGF therapies. We previously demonstrated that ectopic overexpression of angiopoietin-2 (Ang-2) compromises the benefits of anti-VEGF receptor (VEGFR) treatment in murine GBM models and that circulating Ang-2 levels in GBM patients rebound after an initial decrease following cediranib (a pan-VEGFR tyrosine kinase inhibitor) administration. Here we tested whether dual inhibition of VEGFR/Ang-2 could improve survival in two orthotopic models of GBM, Gl261 and U87. Dual therapy using cediranib and MEDI3617 (an anti–Ang-2–neutralizing antibody) improved survival over each therapy alone by delaying Gl261 growth and increasing U87 necrosis, effectively reducing viable tumor burden. Consistent with their vascular-modulating function, the dual therapies enhanced morphological normalization of vessels. Dual therapy also led to changes in tumor-associated macrophages (TAMs). Inhibition of TAM recruitment using an anti–colony-stimulating factor-1 antibody compromised the survival benefit of dual therapy. Thus, dual inhibition of VEGFR/Ang-2 prolongs survival in preclinical GBM models by reducing tumor burden, improving normalization, and altering TAMs. This approach may represent a potential therapeutic strategy to overcome the limitations of anti-VEGFR monotherapy in GBM patients by integrating the complementary effects of anti-Ang2 treatment on vessels and immune cells. PMID:27044097

  12. DICOM image communication in globus-based medical grids.

    PubMed

    Vossberg, Michal; Tolxdorff, Thomas; Krefting, Dagmar

    2008-03-01

    Grid computing, the collaboration of distributed resources across institutional borders, is an emerging technology to meet the rising demand on computing power and storage capacity in fields such as high-energy physics, climate modeling, or more recently, life sciences. A secure, reliable, and highly efficient data transport plays an integral role in such grid environments and even more so in medical grids. Unfortunately, many grid middleware distributions, such as the well-known Globus Toolkit, lack the integration of the world-wide medical image communication standard Digital Imaging and Communication in Medicine (DICOM). Currently, the DICOM protocol first needs to be converted to the file transfer protocol (FTP) that is offered by the grid middleware. This effectively reduces most of the advantages and security an integrated network of DICOM devices offers. In this paper, a solution is proposed that adapts the DICOM protocol to the Globus grid security infrastructure and utilizes routers to transparently route traffic to and from DICOM systems. Thus, all legacy DICOM devices can be seamlessly integrated into the grid without modifications. A prototype of the grid routers with the most important DICOM functionality has been developed and successfully tested in the MediGRID test bed, the German grid project for life sciences. PMID:18348944

  13. Suzanne F. Delbanco on the Leapfrog Group and employer purchasing power. Interview by Pamela K. Scarrow.

    PubMed

    Delbanco, Suzanne F

    2004-01-01

    Suzanne F. Delbanco, PhD MPH, is the first executive director of The Leapfrog Group, founded by the Business Roundtable. The Leapfrog Group's goal is to mobilize employer purchasing power to initiate breakthrough improvements in the safety, quality, and overall value of healthcare for American consumers. The group's growing consortium of more than 155 Fortune 500 companies and other large private and public healthcare purchasers provides health benefits to more than 34 million Americans; these companies spend more than 62 billion dollars on healthcare annually. Dr. Delbanco is a member of the National Committee for Quality Assurance Purchaser Advisory Council and a board member of Bridges to Excellence. Before joining The Leapfrog Group, she was a senior manager at the Pacific Business Group on Health (PBGH), where she worked on the quality team. Prior to joining PBGH, she worked on reproductive health policy and the changing healthcare marketplace initiative at the Henry J. Kaiser Family Foundation. She has also consulted on health insurance coverage in the temporary employment industry and on the first statewide survey in California of MediCal beneficiaries, and worked as a community Liaison for Kaiser Permanente during the establishment of one of California's first County Organized Health Systems. She holds a PhD in public policy from the Goldman School of Public PoLicy and a MPH from the School of Public Health at the University of California, Berkeley. PMID:15468651

  14. Linear dimensions and volumes of human lungs

    SciTech Connect

    Hickman, David P.

    2012-03-30

    TOTAL LUNG Capacity is defined as “the inspiratory capacity plus the functional residual capacity; the volume of air contained in the lungs at the end of a maximal inspiration; also equals vital capacity plus residual volume” (from MediLexicon.com). Within the Results and Discussion section of their April 2012 Health Physics paper, Kramer et al. briefly noted that the lungs of their experimental subjects were “not fully inflated.” By definition and failure to obtain maximal inspiration, Kramer et. al. did not measure Total Lung Capacity (TLC). The TLC equation generated from this work will tend to underestimate TLC and does not improve or update total lung capacity data provided by ICRP and others. Likewise, the five linear measurements performed by Kramer et. al. are only representative of the conditions of the measurement (i.e., not at-rest volume, but not fully inflated either). While there was significant work performed and the data are interesting, the data does not represent a maximal situation, a minimal situation, or an at-rest situation. Moreover, while interesting, the linear data generated by this study is limited by the conditions of the experiment and may not be fully comparative with other lung or inspiratory parameters, measures, or physical dimensions.

  15. Placebo-controlled study in neuromyelitis optica—Ethical and design considerations

    PubMed Central

    Cree, Bruce AC; Bennett, Jeffrey L; Sheehan, Mark; Cohen, Jeffrey; Hartung, Hans-Peter; Aktas, Orhan; Kim, Ho Jin; Paul, Friedemann; Pittock, Sean; Weinshenker, Brian; Wingerchuk, Dean; Fujihara, Kazuo; Cutter, Gary; Patra, Kaushik; Flor, Armando; Barron, Gerard; Madani, Soraya; Ratchford, John N; Katz, Eliezer

    2015-01-01

    Background: To date, no treatment for neuromyelitis optica (NMO) has been granted regulatory approval, and no controlled clinical studies have been reported. Objective: To design a placebo-controlled study in NMO that appropriately balances patient safety and clinical–scientific integrity. Methods: We assessed the “standard of care” for NMO to establish the ethical framework for a placebo-controlled trial. We implemented measures that balance the need for scientific robustness while mitigating the risks associated with a placebo-controlled study. The medical or scientific community, patient organizations, and regulatory authorities were engaged early in discussions on this placebo-controlled study, and their input contributed to the final study design. Results: The N-MOmentum study (NCT02200770) is a clinical trial that randomizes NMO patients to receive MEDI-551, a monoclonal antibody that depletes CD19+ B-cells, or placebo. The study design has received regulatory, ethical, clinical, and patient approval in over 100 clinical sites in more than 20 countries worldwide. Conclusion: The approach we took in the design of the N-MOmentum trial might serve as a roadmap for other rare severe diseases when there is no proven therapy and no established clinical development path. PMID:26666258

  16. The LHCb VELO upgrade

    NASA Astrophysics Data System (ADS)

    Dosil Suárez, Álvaro

    2016-07-01

    The upgrade of the LHCb experiment, planned for 2019, will transform the experiment to a trigger-less system reading out the full detector at 40 MHz event rate. All data reduction algorithms will be executed in a high-level software farm. The upgraded detector will run at luminosities of 2×1033 cm-2 s-1 and probe physics beyond the Standard Model in the heavy flavour sector with unprecedented precision. The Vertex Locator (VELO) is the silicon vertex detector surrounding the interaction region. The current detector will be replaced with a hybrid pixel system equipped with electronics capable of reading out at 40 MHz. The detector comprises silicon pixel sensors with 55×55 μm2 pitch, read out by the VeloPix ASIC, based on the TimePix/MediPix family. The hottest region will have pixel hit rates of 900 Mhits/s yielding a total data rate more than 3 Tbit/s for the upgraded VELO. The detector modules are located in a separate vacuum, separated from the beam vacuum by a thin custom made foil. The detector halves are retracted when the beams are injected and closed at stable beams, positioning the first sensitive pixel at 5.1 mm from the beams. The material budget will be minimised by the use of evaporative CO2 coolant circulating in microchannels within 400 μm thick silicon substrates.

  17. Flexible DAQ card for detector systems utilizing the CoaXPress communication standard

    NASA Astrophysics Data System (ADS)

    Neue, G.; Hejtmánek, M.; Marčišovský, M.; Voleš, P.

    2015-04-01

    This work concerns the design and construction of a flexible FPGA based data acquisition system aimed for particle detectors. The interface card as presented was designed for large area detectors with millions of individual readout channels. Flexibility was achieved by partitioning the design into multiple PCBs, creating a set of modular blocks, allowing the creation of a wide variety of configurations by simply stacking functional PCBs together. This way the user can easily toggle the polarity of the high voltage bias supply or switch the downstream interface from CoaXPress to PCIe or stream directly HDMI. We addressed the issues of data throughput, data buffering, bias voltage generation, trigger timing and fine tuning of the whole readout chain enabling a smooth data transmission. On the current prototype, we have wire-bonded a MediPix2 MXR quad and connected it to a XILINX FPGA. For the downstream interface, we implemented the CoaXPress communication protocol, which enables us to stream data at 3.125 Gbps to a standard PC.

  18. Networking and plug-and-play of bedside medical instruments.

    PubMed

    Thongpithoonrat, Pongnarin; McKneely, Paul K; Gumudavelli, Suman; Gurkan, D; Chapman, Frank M

    2008-01-01

    Medical device manufacturers continuously improve instruments with more capabilities at the point of care such as the bedside, operating room, intensive care unit, or emergency room. The instruments are in turn becoming more sophisticated; however, the operation of an instrument is still expected to be locally done by authorized medical personnel. The measurements from these instruments are stored using archaic methods such as a patient history record on a paper. The access to these records is cumbersome and not available unless the medical personnel is present at the point of care. Unfortunately, each medical instrument has its unique proprietary API (application programming interface - if any) to provide automated and electronic access to monitoring data. Integration of these APIs requires an agreement with the manufacturers towards realization of interoperable health care networking. As long as the interoperability of instruments with a network is not possible, ubiquitous access to patient status is limited only to manual entry based systems. Manual entry is being implemented to create electronic health records, HL7, and similar initiatives. However, they do not address a bottomup automation (i.e. from instrument and patient bed side up) to leverage the mature networking technologies in a health care setting. This paper demonstrates an attempt to realize an interoperable medical instrument interface for networking using MediCAN technology suite as an open standard. We will present the approach with a comparison study of a similar initiative led by ISO/IEEE 11073 standards. PMID:19162959

  19. Dual inhibition of Ang-2 and VEGF receptors normalizes tumor vasculature and prolongs survival in glioblastoma by altering macrophages.

    PubMed

    Peterson, Teresa E; Kirkpatrick, Nathaniel D; Huang, Yuhui; Farrar, Christian T; Marijt, Koen A; Kloepper, Jonas; Datta, Meenal; Amoozgar, Zohreh; Seano, Giorgio; Jung, Keehoon; Kamoun, Walid S; Vardam, Trupti; Snuderl, Matija; Goveia, Jermaine; Chatterjee, Sampurna; Batista, Ana; Muzikansky, Alona; Leow, Ching Ching; Xu, Lei; Batchelor, Tracy T; Duda, Dan G; Fukumura, Dai; Jain, Rakesh K

    2016-04-19

    Glioblastomas (GBMs) rapidly become refractory to anti-VEGF therapies. We previously demonstrated that ectopic overexpression of angiopoietin-2 (Ang-2) compromises the benefits of anti-VEGF receptor (VEGFR) treatment in murine GBM models and that circulating Ang-2 levels in GBM patients rebound after an initial decrease following cediranib (a pan-VEGFR tyrosine kinase inhibitor) administration. Here we tested whether dual inhibition of VEGFR/Ang-2 could improve survival in two orthotopic models of GBM, Gl261 and U87. Dual therapy using cediranib and MEDI3617 (an anti-Ang-2-neutralizing antibody) improved survival over each therapy alone by delaying Gl261 growth and increasing U87 necrosis, effectively reducing viable tumor burden. Consistent with their vascular-modulating function, the dual therapies enhanced morphological normalization of vessels. Dual therapy also led to changes in tumor-associated macrophages (TAMs). Inhibition of TAM recruitment using an anti-colony-stimulating factor-1 antibody compromised the survival benefit of dual therapy. Thus, dual inhibition of VEGFR/Ang-2 prolongs survival in preclinical GBM models by reducing tumor burden, improving normalization, and altering TAMs. This approach may represent a potential therapeutic strategy to overcome the limitations of anti-VEGFR monotherapy in GBM patients by integrating the complementary effects of anti-Ang2 treatment on vessels and immune cells. PMID:27044097

  20. Dust Storm over the Middle East: Retrieval Approach, Source Identification, and Trend Analysis

    NASA Astrophysics Data System (ADS)

    Moridnejad, A.; Karimi, N.; Ariya, P. A.

    2014-12-01

    The Middle East region has been considered to be responsible for approximately 25% of the Earth's global emissions of dust particles. By developing Middle East Dust Index (MEDI) and applying to 70 dust storms characterized on MODIS images and occurred during the period between 2001 and 2012, we herein present a new high resolution mapping of major atmospheric dust source points participating in this region. To assist environmental managers and decision maker in taking proper and prioritized measures, we then categorize identified sources in terms of intensity based on extracted indices for Deep Blue algorithm and also utilize frequency of occurrence approach to find the sensitive sources. In next step, by implementing the spectral mixture analysis on the Landsat TM images (1984 and 2012), a novel desertification map will be presented. The aim is to understand how human perturbations and land-use change have influenced the dust storm points in the region. Preliminary results of this study indicate for the first time that c.a., 39 % of all detected source points are located in this newly anthropogenically desertified area. A large number of low frequency sources are located within or close to the newly desertified areas. These severely desertified regions require immediate concern at a global scale. During next 6 months, further research will be performed to confirm these preliminary results.

  1. An overview of triple infection with hepatitis B, C and D viruses.

    PubMed

    Riaz, Mehwish; Idrees, Muhamad; Kanwal, Hifza; Kabir, Firoz

    2011-01-01

    Viral hepatitis is one of the major health problems worldwide, particularly in South East Asian countries including Pakistan where hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are highly endemic. Hepatitis delta virus (HDV) is also not uncommon world-wide. HCV, HBV, and HDV share parallel routes of transmission due to which dual or triple viral infection can occur in a proportion of patients at the same time. HBV and HCV are important factors in the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). In addition to LC and HCC, chronic HDV infection also plays an important role in liver damage with oncogenic potential.The current article reviews the available literature about the epidemiology, pathogenesis, transmission, symptoms, diagnosis, replication, disease outcome, treatment and preventive measures of triple hepatitis infection by using key words; epidemiology of triple infection, risk factors, awareness status, treatment and replication cycle in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. Total data from 74 different studies published from 1983 to 2010 on triple hepatitis infections were reviewed and included in this study. The present article briefly describes triple infection with HCV, HBV and HDV. PMID:21791115

  2. Data safety and drug safety in Germany: a closing gap?

    PubMed

    Rathmann, W

    2001-12-01

    Pharmacoepidemiology and drug utilization research are more and more involved in a fundamental conflict with data privacy regulations in Germany. In an attempt to close this gap, a working group of German data protection commissioners and representatives from epidemiologic research societies published guidelines on epidemiology and data protection, which are briefly reviewed. There are several data sources for drug utilization research and pharmacoepidemiology in Germany (national health surveys, routine data from hospitals, general practitioners, or statutory health insurance companies) allowing descriptive and analytic epidemiologic studies. Furthermore, since 1980 a random sample of all prescriptions of patients from statutory health insurances (GKV-Arzneimittelindex) is analysed to produce an annual report on prescription drug use. More intensive use of health insurance data for evaluation of medical care including drug prescriptions is in discussion. The MediPlus (IMS HEALTH) database on 400 general and internal medicine practices provides an example to close the gap between the current demand for drug safety studies and data privacy issues. Finally, large provider systems with enormous data storage and data flow are emerging. Therefore, a further development of policies to guarantee ethically correct use of personally identifiable health data in the changing health care environment is urgently required. PMID:11980251

  3. Il ruolo svolto dall’attività lavorativa sull’ipertensione arteriosa

    PubMed Central

    Barbini, N.; Gorini, G.; Ferrucci, L.; Biggeri, A.

    2009-01-01

    RIASSUNTO Introduzione I parametri di pressione arteriosa, sistolica (PAS) o diastolica (PAD) hanno costituito I’oggetto di numerosi studi, alcuni dei quali stabiliscono un’associazione tra I’aumnto di tali parametri e la mortalità, in particolare alle età medie. I fattori di rischio di ipertensione più frequentemente studiati sono il consumo di alcol, il fumo e I’origine etnica in riferimento sia alle differenze genetiche che nella condotta alimentare, mentre i fattori di origine professionale sono stati presi in considerazione più raramente e in maniera poco approfondita, inoltre sono state riferite notevoli differenze nelle pressioni arteriose medie di individui che svolgono professioni diverse. Sembra infatti che i “colletti blu” siano più a rischio dei “colletti bianchi”. Obiettivi Il nostro scopo è valutare se determinati rischi o vincoli connessi con l’attività professionale o determinati stili di vita rappresentano un fattore di rischio per l’ipertensione arteriosa in considerazioni dell’aumentare dell’età. Elementi specifici che rendano conto di questa relazione non sono stati ancora completamente chiariti e soprattutto i dati sulla popolazione italiana sono molto limitati. Metodi La metodologia di ricerca utilizzata è stata quella dell’indagine francese ESTEV (Derriennic, Touranchet, Volkoff) - VISAT (Marquie, Janson), studio epidemiologico longitudinale su oltre 23000 lavoratori attivata in Francia nel 1990 al fine di indagare gli effetti a lungo termine delle condizioni di lavoro, riferite all’intera vita professionale, sia sull’invecchiamento sia sulla salute dei lavoratori. Analoga indagine è stata avviata in Italia, nel 2000, in 6 Regioni, prendendo in esame i lavoratori dipendenti di diversi settori produttivi appartenenti a 5 coorti di età: da 32 a 52 anni con intervallo di 5 anni. Le rilevazioni sono state effettuate dai medici del lavoro di azienda attraverso 3 questionari: 1. sulle condizioni

  4. REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker

    PubMed Central

    Lehtinen, Laura; Vesterkvist, Pia; Roering, Pia; Korpela, Taina; Hattara, Liisa; Kaipio, Katja; Mpindi, John-Patrick; Hynninen, Johanna; Auranen, Annika; Davidson, Ben; Haglund, Caj; Iljin, Kristiina; Grenman, Seija; Siitari, Harri; Carpen, Olli

    2016-01-01

    Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer. PMID:26981633

  5. Reproducibility of Quantitative Susceptibility Mapping in the Brain at Two Field Strengths From Two Vendors

    PubMed Central

    Deh, Kofi; Nguyen, Thanh D.; Eskreis-Winkler, Sarah; Prince, Martin R.; Spincemaille, Pascal; Gauthier, Susan; Kovanlikaya, Ilhami; Zhang, Yan; Wang, Yi

    2015-01-01

    Purpose To assess the reproducibility of brain quantitative susceptibility mapping (QSM) in healthy subjects and in patients with multiple sclerosis (MS) on 1.5 and 3T scanners from two vendors. Materials and Methods Ten healthy volunteers and 10 patients were scanned twice on a 3T scanner from one vendor. The healthy volunteers were also scanned on a 1.5T scanner from the same vendor and on a 3T scanner from a second vendor. Similar imaging parameters were used for all scans. QSM images were reconstructed using a recently developed nonlinear morphology-enabled dipole inversion (MEDI) algorithm with L1 regularization. Region-of-interest (ROI) measurements were obtained for 20 major brain structures. Reproducibility was evaluated with voxel-wise and ROI-based Bland–Altman plots and linear correlation analysis. Results ROI-based QSM measurements showed excellent correlation between all repeated scans (correlation coefficient R ≥ 0.97), with a mean difference of less than 1.24 ppb (healthy subjects) and 4.15 ppb (patients), and 95% limits of agreements of within −25.5 to 25.0 ppb (healthy subjects) and −35.8 to 27.6 ppb (patients). Voxel-based QSM measurements had a good correlation (0.64 ≤ R ≤ 0.88) and limits of agreements of −60 to 60 ppb or less. Conclusion Brain QSM measurements have good interscanner and same-scanner reproducibility for healthy and MS subjects, respectively, on the systems evaluated in this study. PMID:25960320

  6. The association of socio-economic factors with physical fitness and activity behaviours, spinal posture and retinal vessel parameters in first graders in urban Switzerland.

    PubMed

    Imhof, Katharina; Faude, Oliver; Donath, Lars; Bean-Eisenhut, Salome; Hanssen, Henner; Zahner, Lukas

    2016-07-01

    Socio-economic status during childhood has been shown to be a strong predictor of adult health outcome. Therefore, we examined associations of parental educational level, household income and migrant background with physical fitness, spinal flexibility, spinal posture as well as retinal vessel diameters in children of an urban Swiss region. A total of 358 first graders of the Swiss canton Basel-Stadt (age: 7.3, SD: 0.4) were examined. Physical fitness (20 m shuttle run test, 20 m sprint, jumping sidewards and balancing backwards), spinal flexibility and spinal posture (MediMouse(®), Idiag, Fehraltdorf, Switzerland) and retinal microcirculation (Static Retinal Vessel Analyzer, Imedos Systems UG, Jena, Germany) were assessed. Parental education, household income, migrant background and activity behaviour were evaluated with a questionnaire. Parental education was associated with child aerobic fitness (P = 0.03) and screen time (P < 0.001). Household income was associated with jumping sidewards (P = 0.009), balancing backwards (P = 0.03) and sports club participation (P = 0.02). Migrant background was associated with BMI (P = 0.001), body fat (P = 0.03), aerobic fitness (P = 0.007), time spent playing outdoors (P < 0.001) and screen time (P < 0.001). For spinal flexibility and retinal vessel diameter, no associations were found (0.06 < P < 0.8). Low parental education, low household income and a migrant background are associated with poor physical fitness, higher BMI and body fat percentage and low-activity behaviour. PMID:26548899

  7. PASTE: patient-centered SMS text tagging in a medication management system

    PubMed Central

    Johnson, Kevin B; Denny, Joshua C

    2011-01-01

    Objective To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Design Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. Measurements A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Results Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Conclusion Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages. PMID:21984605

  8. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

    PubMed Central

    H., Hildebrandt; C., Hermann; R., Knittel; M., Richter-Reichhelm; A., Siegel; W., Witzenrath

    2010-01-01

    Introduction Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal. Description of integrated care case Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg). Discussion and (preliminary) conclusion The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether—and to what extent—cost reduction may be attributed to a real population health gain. PMID:20689772

  9. Goniometer-spectrometer for index of refraction measurements from the near UV through the near IR

    NASA Astrophysics Data System (ADS)

    Ulbrich, Gerd J.; Trede, Jens

    1990-10-01

    The Ml I erWede Goni ometer-Spectrometer Model 2 is a medi urn-high accuracy instrument for the determination of prism angles and index of refraction in the visible wavelength range (400-700nrn) With its automatic Heidenhain rotary encoder the instrument is capab''e of absolute accuracy to I O arcsec for prism angle measurements and i x I 05 for index of refraction measurements. Recently we have developed a modified version of this instrument to provide absolute index of refraction measurements in the wavelength range from the UV through the near IR (254nm-2325 nm). The absolute accuracy for index of refraction measurements in the range is j INIRQDILTIQt4 The classical methods of Rudberg and Franhoer are still the most accurate means of determining the absolute index oT refraction or bulk optical materials. Both methods utilize a collimator and telescope pair which are both focused at inflnity. The former is normally flxed and the latter is mounted on a goniometer arm equipped with a precision graduated circle to provide absolute angular position of the telescope. The collimator is used to project the slit image o various spectral lines through a prism made from the material to be tested Usually spectral lamps are used for the light sources but lasers have also been used. The telescope and the sample prism are each rotated about the vertical axis of the goniometer so that each is set at proper angle to produce a minimum angle of deflection of the projected slit image with the desired wavelength. The goniometer arm and telescope are then fine-adjusted so that the slit image 32 / SPIE Vol. 1327 Properties and Characteristics of Optical Glass II (1990)

  10. Measuring the Impact of Outreach and Enrollment Strategies for Public Health Insurance in California

    PubMed Central

    Cousineau, Michael R; Stevens, Gregory D; Farias, Albert

    2011-01-01

    Objective and Study Setting To evaluate the effectiveness of different approaches to outreach on public health insurance enrollment in 25 California counties with a Children's Health Initiative. Data Source Administrative enrollment databases. Study Design The use of eight enrollment strategies were identified in each quarter from 2001 to 2007 for each of 25 counties (county quarter). Strategies were categorized as either technology or nontechnology. New enrollments were obtained for Medi-Cal, Healthy Families, and Healthy Kids. Bivariate and multivariate analyses assessed the link between each strategy and new enrollments rates of children. Data Collection Methods Surveys of key informants determined whether a specific outreach strategy was used in each quarter. These were linked to new enrollments in each county quarter. Principal Findings Between 2001 and 2007, enrollment grew in all three children's health programs. We controlled for the effects of counties, seasons, and county-specific child poverty rates. There was an increase in enrollment rates of 11 percent in periods when technology-based systems were in use compared with when these approaches were inactive. Non-technology-based approaches, including school-linked approaches, yielded a 12 percent increase in new enrollments rates. Deploying seven to eight strategies yielded 54 percent more new enrollments per 10,000 children compared with periods with none of the specific strategies. Conclusions and Implications National health care reform provides new opportunities to expand coverage to millions of Americans. An investment in technology-based enrollment systems will maximize new enrollments, particularly into Medicaid; nontechnological approaches may help identify harder-to-reach populations. Moreover, incorporating several strategies, whether phased in or implemented simultaneously, will enhance enrollments. PMID:21054378

  11. Comparing a Combination of Validated Questionnaires and Level III Portable Monitor with Polysomnography to Diagnose and Exclude Sleep Apnea

    PubMed Central

    Pereira, Effie J.; Driver, Helen S.; Stewart, Steven C.; Fitzpatrick, Michael F.

    2013-01-01

    Study Objectives: Questionnaires have been validated as screening tools in adult populations at risk for obstructive sleep apnea (OSA). Portable monitors (PM) have gained acceptance for confirmation of OSA in some patients with a high pretest probability of the disorder. We evaluated the combined diagnostic utility of 3 validated questionnaires and a Level III PM in the diagnosis and exclusion of OSA, as compared with in-laboratory polysomnography (PSG) derived apnea hypopnea index (AHI). Methods: Consecutive patients referred to the Sleep Disorders Clinic completed 3 testing components: (1) 3 questionnaires (Berlin, STOP-Bang, and Sleep Apnea Clinical Score [SACS]); (2) Level III at-home PM (MediByte) study; and (3) Level I in-laboratory PSG. The utility of individual questionnaires, the Level III device alone, and the combination of questionnaires and the Level III device were compared with the PSG. Results: One hundred twenty-eight patients participated in the study (84M, 44F), mean ± SD age 50 ± 12.3years, BMI 31 ± 6.6 kg/m2. At a PSG threshold AHI = 10, the PM derived respiratory disturbance index (RDI) had a sensitivity and specificity of 79% and 86%, respectively. The sensitivity and specificity for the other screening tools were: Berlin 88%, 25%; STOP-Bang 90%, 25%; SACS 33%, 75%. The sensitivity and specificity at a PSG AHI = 15 were: PM 77%, 95%; Berlin 91%, 28%; STOP-Bang 93%, 28%; SACS 35%, 78%. Conclusions: Questionnaires alone, possibly given a reliance on sleepiness as a symptom, cannot reliably rule out the presence of OSA. Objective physiological measurement is critical for the diagnosis and exclusion of OSA. Citation: Pereira EJ; Driver HS; Stewart SC; Fitzpatrick MF. Comparing a combination of validated questionnaires and level III portable monitor with polysomnography to diagnose and exclude sleep apnea. J Clin Sleep Med 2013;9(12):1259-1266. PMID:24340287

  12. [Flowmetric assessment of coronary bypass grafts in the conditions of artificial circulation and on the beating heart].

    PubMed

    Bazylev, V V; Nemchenko, E V; Karnakhin, V A; Pavlov, A A; Mikulyak, A I

    2016-01-01

    Advantages and shortcomings of aortocoronary bypass grafting on the beating heart and in the conditions of artificial circulation (AC) have long been discussed. The data on patency of bypass grafts in the remote period are indicative of comparable results of operations with and without AC or advantages of using AC. In order to determine benefits of each method it is necessary to reveal intraoperative predictors of bypass grafts occlusion in the remote period. We analyzed the results of ultrasound flowmetry of the blood flow through the left internal thoracic artery during bypass grafting of the anterior descending artery with the use of AC and on the beating heart. A retrospective study included a total of 352 patients subdivided into 2 groups: Group One was composed of 120 patients undergoing surgery in the conditions of AC and Group Two comprised 232 patients subjected to similar operations on the beating heart. Blood flow was measured with the help of flowmeter VeryQ MediStim® after termination of AC and inactivation of heparin by protamine, with systolic pressure of 100-110 mm Hg. There were no statistically significant differences between the groups by the diameter and degree of stenosis of the anterior descending artery, diameter of the left internal thoracic artery. The mean volumetric blood flow velocity (Qmean) along the shunts in Group One was higher (p=0.01). No statistically significant differences by the pulsatility index (PI) between the groups were revealed (p=0.2). A conclusion was drawn that coronary bypass grafting of the anterior descending artery by the left internal thoracic artery in the conditions of artificial circulation made it possible to achieve higher volumetric velocity of blood flow through the conduit as compared with operations on the beating heart, with similar resistance index. The immediate results of the operations with the use of the both techniques did not differ. PMID:27100540

  13. Hepatitis B virus in Pakistan: A systematic review of prevalence, risk factors, awareness status and genotypes

    PubMed Central

    2011-01-01

    In Pakistan, there are estimated 7-9 million carriers of hepatitis B virus (HBV) with a carrier rate of 3-5%. This article reviews the available literature about the prevalence, risk factors, awareness status and genotypes of the HBV in Pakistan by using key words; HBV prevalence, risk factors, awareness status and genotypes in Pakistani population in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. One hundred and six different studies published from 1998 to 2010 were included in this study. Weighted mean and standard deviation were determined for each population group. The percentage of hepatitis B virus infection in general population was 4.3318% ± 1.644%, healthy blood donors (3.93% ± 1.58%), military recruits (4.276% ± 1.646%), healthcare persons (3.25% ± 1.202%), pregnant women (5.872% ± 4.984), prisoners (5.75% ± 0.212%), surgical patients (7.397% ± 2.012%), patients with cirrhosis (28.87% ± 11.90%), patients with HCC (22% ± 2.645%), patients with hepatitis (15.896% ± 14.824%), patients with liver diseases (27.54% ± 6.385%), multiple transfused patients (6.223% ± 2.121%), opthalmic patients (3.89% ± 1.004%) and users of injectable drugs (14.95% ± 10.536%). Genotype D (63.71%) is the most prevalent genotype in Pakistani population. Mass vaccination and awareness programs should be initiated on urgent basis especially in populations with HBV infection rates of more than 5%. PMID:21375760

  14. A comprehensive operating room information system using the Kinect sensors and RFID.

    PubMed

    Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

    2015-04-01

    Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner. PMID:25017016

  15. COMPARISON OF TWO MINIMALLY INVASIVE METHODS ON THE LONGEVITY OF GLASS IONOMER CEMENT RESTORATIONS: SHORT-TERM RESULTS OF A PILOT STUDY

    PubMed Central

    Barata, Terezinha Jesus Esteves; Bresciani, Eduardo; Mattos, Maria Cecília Ribeiro; Lauris, José Roberto Pereira; Ericson, Dan; Navarro, Maria Fidela de Lima

    2008-01-01

    The purpose of this study was to evaluate the clinical performance of glass ionomer cement (GIC) restorations comparing two minimally invasive methods in permanent teeth after 12 months. Fifty pregnant women (second trimester of pregnancy), mean age 22 ± 5.30 years, were treated by two previously trained operators. The treatment approaches tested were: chemomechanical method (CarisolvTM; MediTeam) and atraumatic restorative treatment (ART). A split-mouth study design was used in which the two treatments were randomly placed in 50 matched pairs of permanent teeth. The chemomechanical method (CM) was the test group and the ART was the control group. The treatments were performed in Public Health Centers. The tested restorative material was a high-strength GIC (Ketac Molar; 3M/ESPE). The restorations were placed according to the ART guidelines. Two calibrated independent examiners evaluated the restorations in accordance with ART criteria. The interexaminer kappa was 0.97. Data were analyzed using 95% confidence interval on the binomial distribution and Fisher's exact test at 5% significance level. In a 12-month follow-up, 86% of the restorations were evaluated. In the test group (CM), 100% (CI=93.3-100%) of the restorations were considered successful. In the control group (ART) 97.6% (CI=87.4-99.9%) of the restorations were considered successful and 2.4% unsuccessful (marginal defect >0.5 mm). There was no statistically significant difference between the 12-mounth success rate for both groups (Fisher's exact test: P=0.49) and between the two operators (Fisher's exact test: P=1.00). Both minimally invasive methods, chemomechanical method and ART, showed a similar clinical performance after 12 months of follow up. PMID:19089209

  16. The role of the Pharmaceuticals and Medical Devices Agency and healthcare professionals in post-marketing safety.

    PubMed

    Mori, Kazuhiko; Watanabe, Meguru; Horiuchi, Naoya; Tamura, Atsushi; Kutsumi, Hiromu

    2014-04-01

    The development of drugs and medical devices is necessary for medical progress; however, safety measures need to be put in place to protect the health of the population. In order to ensure the safety of drugs and medical devices, it is important to determine measures for appropriate management of risks at any time during the development phase, the regulatory review and the post-marketing phase. Adverse events detected in clinical trials are limited due to the restricted numbers of patients enrolled in the trials. Therefore, it is almost impossible to predict rare serious adverse events during the post-marketing phase. The revised Pharmaceutical Affairs Act was established in Japan in November 20, 2013. The new act focuses on increased safety of drugs and medical devices. The Pharmaceuticals and Medical Devices Agency (PMDA) is the regulatory authority in Japan that promotes safety measures from the development phase through to the post-marketing phase. In the post-marketing phase, the PMDA collects information from the medical product companies and healthcare professionals, as well as instructing and advising them with regard to post-marketing safety measures for each drug and medical device. Since Japan has a national health insurance system, a new drug or a medical device is available throughout the country when the drug price or medical fee is listed in the National Health Insurance price list. Healthcare professionals in medical institutions must learn about the drugs and medical devices they handle, and should make an effort to maintain patient safety. The PMDA medi-navi is a very useful electronic mail delivery service that provides critical information for protecting patients from health hazards caused by adverse events. The 'risk management plan' is also important as it contains important information about safety profile and post-marketing measures of a new drug. PMID:26183623

  17. [An unusual bodily injury].

    PubMed

    Kernbach-Wighton, Gerhard; Hess, Cornelius; Madea, Burkhard

    2016-01-01

    In most cases, bodily harm results from the use of sharp objects or blunt force. This paper deals with a 42-year-old pharmacist who was known to the police and the courts because of several previous convictions for bodily injury. The man had visited a pub just before it closed and was therefore not served any drinks. He got angry about this and returned to his pharmacy (within walking distance) to fetch three disposable syringes which he filled with phosphoric acid (85%). Through the open pub window, he splattered the acid from the syringes on two guests and the host, who were hit on the upper part of their bodies and the arms. All the victims developed dermal alterations such as focal erythema and small blisters (pemphigus-like efflorescences, as already described by Weyrich). At first, the pharmacist denied the use of phosphoric acid and claimed to have used a mixture of urine and water. Examinations of spots on the still unwashed clothes revealed very low pH-values (ca. 2.0; pH-Indicator-Stripes, Merck; Medi-Test, Machery & Nagel). Tests for substances typical of urine produced completely negative results. However, very high phosphate concentrations were found on the spots in question. Thus, the probability that the pharmacist had used phosphoric acid to commit the offence was very high. The pharmacist was sentenced to one year and two months' imprisonment for dangerous bodily harm according to Section 224 German Criminal Code. In accordance with the law, phosphoric acid was classified as "poison", for which application on the skin is sufficient. PMID:27386625

  18. REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker.

    PubMed

    Lehtinen, Laura; Vesterkvist, Pia; Roering, Pia; Korpela, Taina; Hattara, Liisa; Kaipio, Katja; Mpindi, John-Patrick; Hynninen, Johanna; Auranen, Annika; Davidson, Ben; Haglund, Caj; Iljin, Kristiina; Grenman, Seija; Siitari, Harri; Carpen, Olli

    2016-01-01

    Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer. PMID:26981633

  19. Gateways to clinical trials.

    PubMed

    Moral, M A; Tomillero, A

    2008-03-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: 131-I-Chlorotoxin, 423557; Abatacept, Ad.Egr.TNF.11D, Adalimumab, AE-941, Ambrisentan, AMR-001, Anacetrapib, Anakinra, Aripiprazole, Atazanavir sulfate; BAY-639044, Bazedoxifene acetate, Belimumab, Bevacizumab, Bortezomib, Botulinum toxin type B, Brivaracetam, Bucindolol hydrochloride; Carfilzomib, Carisbamate, CCX-282, CD20Bi, Ceftobiprole, Certolizumab pegol, CF-101, Cinacalcet hydrochloride, Cypher; Darifenacin hydrobromide, Degarelix acetate, Denosumab, Desvenlafaxine succinate, Dexlansoprazole, Dexverapamil, Drotrecogin alfa (activated), Duloxetine hydrochloride, Dutasteride; Efalizumab, EPs-7630, Escitalopram oxalate, Etoricoxib; Fluticasone furoate, Fondaparinux sodium, Fospropofol disodium; Hexadecyloxypropyl-cidofovir, HIV gp120/NefTat/AS02A, HPV-6/11/16/18; INCB-18424, Incyclinide, Inhalable human insulin, Insulin detemir; KNS-760704, KW-0761; Lacosamide, Lenalidomide, Levetiracetam, Licofelone, Lidocaine/prilocaine; mAb 216, MEDI-528, Men ACWY, Meningococcal C-CRM197 vaccine, Methylnaltrexone bromide; Nemifitide ditriflutate, Nicotine conjugate vaccine, Nilotinib hydrochloride monohydrate; Octaparin; Parathyroid hormone (human recombinant), Pegaptanib octasodium, Pitrakinra, Prasterone, Pregabalin; Ranelic acid distrontium salt, Rasagiline mesilate, Retigabine, Rimonabant, RTS,S/AS02D; Sarcosine, Sitaxentan sodium, Solifenacin succinate, Sunitinib malate; Taranabant, Taxus, Teduglutide, Teriparatide, Ticagrelor, Travoprost, TRU-015; USlipristal acetate, Urocortin 2; Vardenafil hydrochloride hydrate; YM-155, Yttrium 90 (90Y) ibritumomab tiuxetan; Zanolimumab, Zoledronic acid monohydrate, Zotarolimus

  20. Mycobacterium terrae: a potential surrogate for Mycobacterium tuberculosis in a standard disinfectant test.

    PubMed

    Griffiths, P A; Babb, J R; Fraise, A P

    1998-03-01

    The susceptibility of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare to the disinfections used for spillage and heat sensitive instruments has received much attention in recent years. The use of clinical isolates of M. tuberculosis and M. avium-intracellulare as test organisms is considered unsuitable for standard tests due to their hazardous nature (category 3 pathogens and slow growth rates). This has led to much debate in standards committees on the selection and use of a possible surrogate which would be safer and more practical to use and yet mimic the susceptibility of clinical isolates. This study compared the susceptibility of one possible surrogate Mycobacterium terrae NCTC 10856, with that of clinical isolates of M. tuberculosis H37 Rv and M. avium-intracellulare using a quantitative suspension test. The instrument and environmental disinfectants tested were a chlorine-releasing agent, sodium dichloroisocyanyurate (NaDCC) at 1000 ppm and 10,000 ppm av. Cl, chlorine dioxide at 1100 ppm av. ClO2 (Tristel, HayMan MediChem), 0.35% peracetic acid (NuCidex, Johnson & Johnson), 70% industrial methylated spirit (IMS), 2% alkaline glutaraldehyde (Asep, Galen), 10% succine dialdehyde and formaldehyde mixture (Gigasept, Schulke and Mayr). Results showed that the clinical isolate of M. avium-intracellulare was the most resistant of the three test organisms. M. terrae, which is not a category 3 pathogen, was slightly more resistant than M. tuberculosis and this would appear to be a suitable surrogate for establishing tuberculocidal activity. However, with an increase in the clinical significance of M. avium-intracellulare, particularly in human immunodeficiency virus (HIV) and immunocompromised patients, a more resistant surrogate is required. In the absence of such a surrogate, testing with M. avium-intracellulare in a clinical laboratory equipped for handling category 3 pathogens is still advised to establish mycobactericidal activity. PMID

  1. alpha-Thalassaemia in Tunisia: some epidemiological and molecular data.

    PubMed

    Siala, H; Ouali, F; Messaoud, T; Bibi, A; Fattoum, S

    2008-12-01

    Unlike the other haemoglobinopathies, few researches have been published concerning alpha-thalassaemia in Tunisia. The aim of the present work is to acquire further data concerning alpha-thalassaemia prevalence and molecular defects spectrum in Tunisia, by collecting and studying several kinds of samples carrying alpha-thalassaemia. The first survey conducted on 529 cord blood samples using cellulose acetate electrophoresis, have displayed the prevalence of 7.38% Hb Bart's carriers at birth. Molecular analyses were conducted by PCR and DNA sequencing on 20 families' cases from the above survey carrying the Hb Bart's at birth and on 10 Hb H diseased patients. The results showed six alpha-globin gene molecular defects and were responsible for alpha-thalassaemia: -alpha(3.7), - -(MedI), alpha(TSaudi), alpha(2)(cd23GAG->Stop), Hb Greone Hart: alpha(1)(119CCT->TCT) corresponding to 11 genotypes out of which two are responsible for Hb H disease (- -(Med)/-alpha(3.7)) and (alpha(TSaudi)alpha/alpha(TSaudi)alpha) and a newly described polymorphism: alpha+6C->G. The geographical repartition of alpha-thal carriers showed that the -alpha3.7 deletion is distributed all over the country, respectively the alpha(HphI) and alpha(TSaudi) seem to be more frequent in the central region of the northeast region. The haematological and clinical data showed a moderate phenotype with a late age of diagnosis for Hb H disease. This work had permitted, in addition to an overview on alpha-thalassaemia in the country, the optimization of protocols for alpha-thalassaemia detection in our lab, allowing further investigations concerning phenotype-genotype correlation in sickle cell disease or beta-thalassaemia. PMID:19147907

  2. Electromagnetic Reciprocity.

    SciTech Connect

    Aldridge, David F.

    2014-11-01

    A reciprocity theorem is an explicit mathematical relationship between two different wavefields that can exist within the same space - time configuration. Reciprocity theorems provi de the theoretical underpinning for mod ern full waveform inversion solutions, and also suggest practical strategies for speed ing up large - scale numerical modeling of geophysical datasets . In the present work, several previously - developed electromagnetic r eciprocity theorems are generalized to accommodate a broader range of medi um, source , and receiver types. Reciprocity relations enabling the interchange of various types of point sources and point receivers within a three - dimensional electromagnetic model are derived. Two numerical modeling algorithms in current use are successfully tested for adherence to reciprocity. Finally, the reciprocity theorem forms the point of departure for a lengthy derivation of electromagnetic Frechet derivatives. These mathe matical objects quantify the sensitivity of geophysical electromagnetic data to variatio ns in medium parameters, and thus constitute indispensable tools for solution of the full waveform inverse problem. ACKNOWLEDGEMENTS Sandia National Labor atories is a multi - program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the US Department of Energy's National Nuclear Security Administration under contract DE - AC04 - 94AL85000. Signif icant portions of the work reported herein were conducted under a Cooperative Research and Development Agreement (CRADA) between Sandia National Laboratories (SNL) and CARBO Ceramics Incorporated. The author acknowledges Mr. Chad Cannan and Mr. Terry Pa lisch of CARBO Ceramics, and Ms. Amy Halloran, manager of SNL's Geophysics and Atmospheric Sciences Department, for their interest in and encouragement of this work. Special thanks are due to Dr . Lewis C. Bartel ( recently retired from Sandia National Labo ratories and now a

  3. Impact of HIV-specialized pharmacies on adherence and persistence with antiretroviral therapy.

    PubMed

    Murphy, Patricia; Cocohoba, Jennifer; Tang, Andrew; Pietrandoni, Glen; Hou, John; Guglielmo, B Joseph

    2012-09-01

    Patient adherence (the degree to which patients follow their therapeutic regimen as prescribed within a set period of time) and persistence (the time to treatment discontinuation, with a permissible gap) with drug therapy are essential components of HIV/AIDS treatment. Select community pharmacies offer specialized services for HIV/AIDS patients to help combat some of the barriers to adherence and persistence. We assessed adherence and persistence with antiretroviral therapy (ART) for patients using HIV-specialized pharmacies in nine cities from seven states compared to traditional community pharmacy users over a 1-year period. Data were limited to one pharmacy chain. Propensity scoring was used to obtain 1:1 matches for "Specialized" and "Traditional" pharmacy users based on age, gender, number of prescription-inferred chronic conditions (obtained by mapping a patient's prescriptions to the Medi-Span Drug Indications Database), and presence of prescription anxiety and/or depression medication, resulting in 7064 patients in each group. Proportion of days covered (PDC) was used to measure adherence. Specialized pharmacy users had a significantly greater mean (74.1% versus 69.2%, p<0.0001) and median (90.3% versus 86.3%, p<0.0001) PDC. A greater percentage of patients in the Specialized group were able to obtain a PDC of 95% or better (39.3% versus 35.5%). Patients in the Specialized group were significantly more persistent (p=0.0117). Community pharmacies specialized in HIV services may be effective avenues for helping patients achieve greater adherence and persistence with ART. Given the value of specialized community pharmacies, payers should consider implementing policies to encourage the use of such pharmacies for filling ART. PMID:22860900

  4. Anti program death-1/anti program death-ligand 1 in digestive cancers

    PubMed Central

    de Guillebon, Eléonore; Roussille, Pauline; Frouin, Eric; Tougeron, David

    2015-01-01

    Human tumors tend to activate the immune system regulatory checkpoints as a means of escaping immunosurveillance. For instance, interaction between program death-1 (PD-1) and program death-ligand 1 (PD-L1) will lead the activated T cell to a state of anergy. PD-L1 is upregulated on a wide range of cancer cells. Anti-PD-1 and anti-PD-L1 monoclonal antibodies (mAbs), called immune checkpoint inhibitors (ICIs), have consequently been designed to restore T cell activity. Accumulating data are in favor of an association between PD-L1 expression in tumors and response to treatment. A PD-L1 expression is present in 30% to 50% of digestive cancers. Multiple anti-PD-1 (nivolumab, pembrolizumab) and anti-PD-L1 mAbs (MPDL3280A, Medi4736) are under evaluation in digestive cancers. Preliminary results in metastatic gastric cancer with pembrolizumab are highly promising and phase II will start soon. In metastatic colorectal cancer (CRC), a phase III trial of MPDL3280A as maintenance therapy will shortly be initiated. Trials are also ongoing in metastatic CRC with high immune T cell infiltration (i.e., microsatellite instability). Major challenges are ahead in order to determine how, when and for which patients we should use these ICIs. New radiologic criteria to evaluate tumor response to ICIs are awaiting prospective validation. The optimal therapeutic sequence and association with cytotoxic chemotherapy needs to be established. Finally, biomarker identification will be crucial to selection of patients likely to benefit from ICIs. PMID:26306141

  5. Mycobactericidal activity of selected disinfectants using a quantitative suspension test.

    PubMed

    Griffiths, P A; Babb, J R; Fraise, A P

    1999-02-01

    In this study, a quantitative suspension test carried out under both clean and dirty conditions was used to assess the activity of various instrument and environmental disinfectants against the type strain NCTC 946 and an endoscope washer disinfector isolate of Mycobacterium chelonae, Mycobacterium fortuitum NCTC 10,394, Mycobacterium tuberculosis H37 Rv NCTC 7416 and a clinical isolate of Mycobacterium avium-intracellulare (MAI). The disinfectants tested were; a chlorine releasing agent, sodium dichloroisocyanurate (NaDCC) at 1000 ppm and 10,000 ppm av Cl; chlorine dioxide at 1100 ppm av ClO2 (Tristel, MediChem International Limited); 70% industrial methylated spirits (IMS); 2% alkaline glutaraldehyde (Asep, Galan); 10% succinedialdehyde and formaldehyde mixture (Gigasept, Schulke & Mayr); 0.35% peracetic acid (NuCidex, Johnson & Johnson); and a peroxygen compound at 1% and 3% (Virkon, Antec International). Results showed that the clinical isolate of MAI was much more resistant than M. tuberculosis to all the disinfectants, while the type strains of M. chelonae and M. fortuitum were far more sensitive. The washer disinfector isolate of M. chelonae was extremely resistant to 2% alkaline activated glutaraldehyde and appeared to be slightly more resistant than the type strain to Nu-Cidex, Gigasept, Virkon and the lower concentration of NaDCC. This study has shown peracetic acid (Nu-Cidex), chlorine dioxide (Tristel), alcohol (IMS) and high concentrations of a chlorine releasing agent (NaDCC) are rapidly mycobactericidal. Glutaraldehyde, although effective, is a slow mycobactericide. Gigasept and Virkon are poor mycobactericidal agents and are not therefore recommended for instruments or spillage if mycobacteria are likely to be present. PMID:10063473

  6. Uranium miner lung cancer study. Progress report, 1 July 1980-1 July 1981

    SciTech Connect

    Saccomanno, G.

    1981-08-21

    The projects supported during the past year consist of: (a) collection of material from uranium miners known to have cancer of the lung into a tumor registry; (b) collection of interesting cases for second edition of the Manual on Pulmonary Cytology; (c) the regression study has been modified by computerization of re-reads of all cases which showed moderate atypical squamous cell metaplasia or higher since 1968; (d) continuation of sputum collection, and collection of lungs from deceased miners; (e) cooperation with fluorescent bronchoscopy development for localization of carcinoma in situ of the lung; (f) the immunological studies are presently funded by The Abbott Laboratories, but are closely associated with the lung cancer studies. Our findings suggest that patients developing lung cancer concomitantly develop immune suppression; and (g) a small plastic tube has been developed which will aid in the removal of cells from fiberoptic brushings. The plastic mold is presently being developed by Medi-Tech Corporation in Boston and the tube will be available in September 1981. Analysis of the incidence of small cell cancers of the lung over the last 30 years indicates that the incidence has dropped to 22% during 1975-1979 whereas it was 76.5% during the five year span from 1954-1959. General observations indicate that cigarette smoking is the most potent carcinogen, but that tumors are increased in miners who smoke. Moreover, the ultimate incidence of oat cell carcinoma results in earlier death than with other tumor types. The most commonly found tumor in the non-smoking miner is the small cell type.

  7. Scenarios of Future Water use on Mediterranean Islands based on an Integrated Assessment of Water Management

    NASA Astrophysics Data System (ADS)

    Lange, M. A.

    2006-12-01

    The availability of water in sufficient quantities and adequate quality presents considerable problems on Mediterranean islands. Because of their isolation and thus the impossibility to draw on more distant or more divers aquifers, they rely entirely on precipitation as natural replenishing mechanism. Recent observations indicate decreasing precipitation, increasing evaporation and steadily growing demand for water on the islands. Future climate change will exacerbate this problem, thus increasing the already pertinent vulnerability to droughts. Responsible planning of water management strategies requires scenarios of future supply and demand through an integrated assessment including climate scenarios based on regional climate modeling as well as scenarios on changes in societal and economical determinants of water demand. Constructing such strategies necessitates a thorough understanding about the interdependencies and feedbacks between physical/hydrological and socio-economic determinants of water balances on an island. This has to be based on a solid understanding of past and present developments of these drivers. In the framework of the EU-funded MEDIS project (Towards sustainable water use on Mediterranean Islands: addressing conflicting demands and varying hydrological, social and economic conditions, EVK1-CT-2001-00092), detailed investigations on present vulnerabilities and adaptation strategies to droughts have been carried out on Mallorca, Corsica, Sicily, Crete and Cyprus. This was based on an interdisciplinary study design including hydrological, geophysical, agricultural-, social and political sciences investigations. A central element of the study has been the close interaction with stakeholders on the islands and their contribution to strategy formulation. An important result has been a specification of vulnerability components including: a physical/environmental-, an economical/regulatory- and a social/institutional/political component. Their

  8. Projecting future drug expenditures--1997.

    PubMed

    Mehl, B; Santell, J P

    1997-01-15

    Use of the producer price index; data from independent sources, drug industry analyst, group purchasing organizations (GPOs), and health maintenance organizations (HMOs); pharmacoeconomics; and legal developments to project drug expenditures and prepare pharmacy budgets for 1997 is discussed. The producer price index indicates that prices for drugs and pharmaceuticals increased 2.2% during January to May 1996; the increase for prescription preparations was 3.4%. Medi-Span reports an average increase for all drug products of 1.2% for the first six months of 1996. IMS America data show the price of all drugs increasing 1.8% between the second quarters of 1995 and 1996. Drug industry analysts project the overall price increase in the next 12 months at 2.5-5.0%. GPOs predict an average increase over the next 12 months of 2.2% for contracted drugs and 4.3% for non-contracted drugs. HMO pharmacy directors predict pharmacy expenditures will increase by 4.5% per member in 1997. Caution must be applied in using pharmacoeconomics to project drug costs and their impact on health care expenditures. Today's budget must account for the greater integration of drug expenditures into the institution's objectives, possible reductions in other service costs, capitation, competition, shifting of control of the drug budget to specific patient care centers, relocation of services to the ambulatory care setting, and outsourcing. Legal actions in 1996 that may affect price increases and drug budgets included a class-action lawsuit by community and chain pharmacies alleging price discrimination by manufactures and wholesalers. Prices of pharmaceutical products are fairly stable and may remain so in 1997, but projections of future drug expenditures must account for the continuing reshaping of the health care landscape. PMID:9117803

  9. Projecting future drug expenditures--1998.

    PubMed

    Mehl, B; Santell, J P

    1998-01-15

    Drug cost projections for 1998, factors that directly influence drug costs, and tools for projecting drug expenditures are discussed. The producer price index indicates that prices for drugs and pharmaceuticals increased 2.1% between January and June 1997; the increase for prescription preparations was 2.7%. Medi-Span data show an average increase for all drug products of 1.02% during the first six months of 1997; First Data-Bank reports a 1.7% increase for the same period. IMS America data, which take account of weighting for individual drugs or drug classes, show the prices of all drugs increasing 2.3% between the second quarters of 1996 and 1997. Drug industry analysts project the overall price increase in the next 12 months at 2-4%. Group purchasing organizations predict an average increase over the next 12 months of 0.56% for contracted drugs and 3.6% for noncontracted drugs. Various health care provider indexes suggest that increases in drug costs could be smaller over the next few years. The current trend of takeovers and mergers of pharmaceutical companies and health systems is likely to continue into 1998. As a result of generic competition and the loss of patent protection for many pharmaceutical products, the number of drugs to be introduced onto the market and the number of drugs in development are expected to escalate until the year 2000. These and other major changes in the health care environment, including changes in drug distribution and controversies over the use of formularies, will make future forecasting difficult. Compared with previous years, smaller increases in drug costs have been projected for 1998 and beyond, but changes in the health care environment mean that greater knowledge will be required to forecast future drug expenditures. PMID:9465976

  10. Hepatitis B virus in Pakistan: a systematic review of prevalence, risk factors, awareness status and genotypes.

    PubMed

    Ali, Muhammad; Idrees, Muhammad; Ali, Liaqat; Hussain, Abrar; Ur Rehman, Irshad; Saleem, Sana; Afzal, Samia; Butt, Sadia

    2011-01-01

    In Pakistan, there are estimated 7-9 million carriers of hepatitis B virus (HBV) with a carrier rate of 3-5%. This article reviews the available literature about the prevalence, risk factors, awareness status and genotypes of the HBV in Pakistan by using key words; HBV prevalence, risk factors, awareness status and genotypes in Pakistani population in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. One hundred and six different studies published from 1998 to 2010 were included in this study. Weighted mean and standard deviation were determined for each population group. The percentage of hepatitis B virus infection in general population was 4.3318% ± 1.644%, healthy blood donors (3.93% ± 1.58%), military recruits (4.276% ± 1.646%), healthcare persons (3.25% ± 1.202%), pregnant women (5.872% ± 4.984), prisoners (5.75% ± 0.212%), surgical patients (7.397% ± 2.012%), patients with cirrhosis (28.87% ± 11.90%), patients with HCC (22% ± 2.645%), patients with hepatitis (15.896% ± 14.824%), patients with liver diseases (27.54% ± 6.385%), multiple transfused patients (6.223% ± 2.121%), opthalmic patients (3.89% ± 1.004%) and users of injectable drugs (14.95% ± 10.536%). Genotype D (63.71%) is the most prevalent genotype in Pakistani population. Mass vaccination and awareness programs should be initiated on urgent basis especially in populations with HBV infection rates of more than 5%. PMID:21375760

  11. [Teoria della Mente e funzionamento sociale nella schizofrenia: correlazione con anomalie del linguaggio figurato, sintomatologia clinica e intelligenza generale].

    PubMed

    Piovan, Cristiano; Gava, Laura; Campeol, Mara

    2016-01-01

    RIASSUNTO. Scopo. Negli ultimi decenni gli studi hanno mostrato come la Teoria della Mente (ToM) non sia un processo unitario, ma un sistema che include aspetti cognitivi e affettivi. Nell'ambito dei domini che definiscono la social cognition, la ToM rappresenta il miglior predittore dello scarso funzionamento sociale nella schizofrenia. Lo scopo del presente lavoro è stato di esaminare la competenza di un gruppo di pazienti ambulatoriali affetti da schizofrenia in compiti di ToM, di riconoscimento di aspetti metaforici e idiomatici del linguaggio, in una prova di rispetto di regole conversazionali e di indagarne la relazione con il funzionamento sociale. Metodi. Sono stati reclutati 30 pazienti ambulatoriali con diagnosi di schizofrenia e 24 controlli sani. Sono stati somministrati il TIB per il calcolo del QI premorboso, la PANSS, il Theory of Mind Picture Sequencing Task, un test di comprensione di metafore e idiomi e un test conversazionale. Il funzionamento sociale è stato valutato con la PSP. Risultati. Non vi era differenza significativa tra i valori medi del QI premorboso del gruppo dei pazienti e dei controlli. Ai test di ToM e di competenza pragmatica, la differenza tra i gruppi è risultata altamente significativa, con i pazienti che hanno eseguito le prove in modo peggiore. È emersa una correlazione tra la comprensione di metafore e idiomi e le false credenze di secondo ordine. La PSP è risultata correlata con la PANSS e con la quota di ToM cognitiva, ma non con la ToM affettiva. Conclusioni. I risultati hanno mostrato che i soggetti affetti da schizofrenia, in condizione clinica di stabilizzazione, hanno evidenti difficoltà nelle prove di ToM e di comprensione del linguaggio figurato. Nel nostro modello teorico, la correlazione evidenziata tra la ToM cognitiva, i deficit pragmatici, lo stato clinico e il livello di funzionamento sociale suggerisce l'utilità di interventi riabilitativi di recupero delle funzioni metacognitive e delle abilit

  12. Study of Nox Levels At The Castellon Area (spain) By Means of Passive Samplers

    NASA Astrophysics Data System (ADS)

    Delgado, J. M.; Esteve, V.

    Medi Ambient) and Ms. C. Clemente for their contribution and work on this project as well as to Generalitat Valenciana for the FPI grant.

  13. Prevalence of Hepatitis C Virus Genotypes Among Patients in Countries of the Eastern Mediterranean Regional Office of WHO (EMRO): A Systematic Review and Meta-Analysis

    PubMed Central

    Sadeghi, Farzin; Salehi-Vaziri, Mostafa; Almasi-Hashiani, Amir; Gholami-Fesharaki, Mohammad; Pakzad, Reza; Alavian, Seyed Moayed

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major global public health issue. The Eastern Mediterranean regional office (EMRO) of the world health organization (WHO) seems to have one of the highest prevalence rates worldwide, with at least 21.3 million HCV-infected patients. Objectives The aim of the present study was to review systematically all epidemiological data related to the prevalence of HCV genotypes in infected patients in EMRO countries. Data Sources A systematic search was conducted of peer-reviewed journals indexed in electronic databases (PubMed, Scopus, ISI, PakMediNet, and IMEMR, and Persian-specific databases including SID, Iran Medex, and MagIran). Study Selection A systematic search was performed with temporal limits (papers published between January 2000 up to June 2015), regarding the prevalence and distribution of HCV genotypes in EMRO countries. Data Extraction The prevalence rates of HCV genotypes were pooled by metan command in Stata 14. Statistical heterogeneity was explored using the I-square at the 5% significance level. Publication bias was assessed, graphically and statistically, by funnel plot and Begg and Egger tests. Results A total of 563 records were identified through the electronic search. Of these records, 134 studies comprising 67681 HCV-infected individuals were included in the meta-analysis. In Iran, subtype 1a was the predominant subtype with a rate of 42% (95% CI, 39 - 46), followed by subtype 3a, 35% (95% CI, 31 - 38). In Pakistan, Subtype 3a was the most common subtype with a rate of 56% (95% CI, 49 - 62), followed by subtype 3b, 10% (95% CI, 7 - 12). In Saudi Arabia and Egypt, genotype 4 was the most prevalent genotype with a rate of 65% (95% CI, 59 - 72) and 69% (95% CI, 36 - 100) respectively. In Tunisia and Morocco, subtype 1b was the most common subtype with a rate of 69% (95% CI, 50 - 88) and 32% (95% CI, 7 - 56) respectively. Conclusions The genotype distribution of HCV takes diverse patterns in EMRO countries

  14. The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study

    PubMed Central

    Lauche, Romy; Cramer, Holger; Hohmann, Claudia; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Musial, Frauke; Langhorst, Jost; Dobos, Gustav

    2012-01-01

    Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP. PMID:22203873

  15. Evaluation of a CdTe semiconductor based compact gamma camera for sentinel lymph node imaging

    SciTech Connect

    Russo, Paolo; Curion, Assunta S.; Mettivier, Giovanni; Esposito, Michela; Aurilio, Michela; Caraco, Corradina; Aloj, Luigi; Lastoria, Secondo

    2011-03-15

    Purpose: The authors assembled a prototype compact gamma-ray imaging probe (MediPROBE) for sentinel lymph node (SLN) localization. This probe is based on a semiconductor pixel detector. Its basic performance was assessed in the laboratory and clinically in comparison with a conventional gamma camera. Methods: The room-temperature CdTe pixel detector (1 mm thick) has 256x256 square pixels arranged with a 55 {mu}m pitch (sensitive area 14.08x14.08 mm{sup 2}), coupled pixel-by-pixel via bump-bonding to the Medipix2 photon-counting readout CMOS integrated circuit. The imaging probe is equipped with a set of three interchangeable knife-edge pinhole collimators (0.94, 1.2, or 2.1 mm effective diameter at 140 keV) and its focal distance can be regulated in order to set a given field of view (FOV). A typical FOV of 70 mm at 50 mm skin-to-collimator distance corresponds to a minification factor 1:5. The detector is operated at a single low-energy threshold of about 20 keV. Results: For {sup 99m}Tc, at 50 mm distance, a background-subtracted sensitivity of 6.5x10{sup -3} cps/kBq and a system spatial resolution of 5.5 mm FWHM were obtained for the 0.94 mm pinhole; corresponding values for the 2.1 mm pinhole were 3.3x10{sup -2} cps/kBq and 12.6 mm. The dark count rate was 0.71 cps. Clinical images in three patients with melanoma indicate detection of the SLNs with acquisition times between 60 and 410 s with an injected activity of 26 MBq {sup 99m}Tc and prior localization with standard gamma camera lymphoscintigraphy. Conclusions: The laboratory performance of this imaging probe is limited by the pinhole collimator performance and the necessity of working in minification due to the limited detector size. However, in clinical operative conditions, the CdTe imaging probe was effective in detecting SLNs with adequate resolution and an acceptable sensitivity. Sensitivity is expected to improve with the future availability of a larger CdTe detector permitting operation at shorter

  16. Correlates for Completion of 3-Dose Regimen of HPV Vaccine in Female Members of a Managed Care Organization

    PubMed Central

    Chao, Chun; Velicer, Christine; Slezak, Jeff M.; Jacobsen, Steven J.

    2009-01-01

    OBJECTIVE: To examine the rate and correlates of completion of the quadrivalent human papillomavirus vaccine (HPV4) 3-dose regimen because nonadherence to the regimen may adversely affect vaccine efficacy. PARTICIPANTS AND METHODS: Female members of Kaiser Permanente Southern California who were 9 to 26 years old, received the first dose of HPV4 between October 2006 and March 2007, and maintained health plan membership 12 months afterward were identified and followed up for regimen completion. We examined the following: (1) demographics/socioeconomic status, (2) primary care physician characteristics, (3) historical health service utilization, (4) women's health-related conditions, and (5) selected immune-related conditions for their association with completion in 2 age groups: 9 to 17 years and 18 to 26 years. Multivariable log-binomial regression was used to directly estimate relative risk (RR). RESULTS: Of the 34,193 females who initiated HPV4, the completion rate was 41.9% in the 9- to 17-year-old group and 47.1% in the 18- to 26-year-old group. Black race (RR, 0.70; 95% confidence interval [CI], 0.64-0.77) and lower neighborhood education level were associated with lower regimen completion. However, those in the 9- to 17-year-old group who were covered by the state-subsidized program Medi-Cal were more likely to complete the regimen (RR, 1.14; 95% CI, 1.07-1.22). Historical hospitalizations and emergency department visits (RR, 0.92; 95% CI, 0.87-0.96; and RR, 0.96; 95% CI, 0.94-0.98 per visit, respectively) and having a pediatrician were also predictors of noncompletion. A history of sexually transmitted diseases, abnormal Papanicolaou test results, and immune-related conditions (eg, asthma/infections) were not associated with regimen completion. CONCLUSION: These findings suggest that factors such as race or socioeconomic status should be considered when human papillomavirus vaccination programs are being designed and evaluated. PMID:19797775

  17. Assessment of Worldwide Acute Kidney Injury, Renal Angina and Epidemiology in Critically Ill Children (AWARE): A Prospective Study to Improve Diagnostic Precision

    PubMed Central

    Basu, Rajit K; Kaddourah, Ahmad; Terrell, Tara; Mottes, Theresa; Arnold, Patricia; Jacobs, Judd; Andringa, Jennifer; Armor, Melissa; Hayden, Lauren; Goldstein, Stuart L

    2015-01-01

    Background Acute kidney injury (AKI) is associated with poor outcomes in critically ill children. Recent international consensus panels recommend standardized classification systems to improve the precision of AKI diagnosis, but there is a paucity of data to enable this refinement, particularly in pediatric critical care. Methods/Design This is a prospective observational study. We anticipate collecting data from more than 5500 critically ill children admitted to 32 pediatric intensive care units (PICUs) across the world, during the calendar year of 2014. Data will be collected continuously for three months at each center on all children older than 90 days and younger than 25 years admitted to the ICU. Demographic, resuscitative, and daily physiological and lab data will be captured at individual centers using MediData Rave™, a commercial system designed to manage and report clinical research data. Kidney specific measured variables include changes in serum creatinine and urine output, cumulative fluid overload (%), serum creatinine corrected for fluid balance, and KDIGO AKI stage. Urinary AKI biomarkers to be measured include: urinary neutrophil gelatinase lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (l-FABP), and interleukin-18 (IL-18). Biomarker combinations will be created from different pairs and triplets of urinary biomarkers. The primary analysis will compare the discrimination of these panels versus changes in creatinine for prediction of severe AKI by Day 7 of ICU admission. Secondary analysis will investigate the prediction of biomarkers for injury ‘time based phenotypes’: duration (>2 days), severity (KDIGO stage, use of renal replacement therapy), reversibility (time to return of serum creatinine to baseline), association with fluid overload > 10%, and disease association (sepsis, hypovolemia, hypoxemia, or nephrotoxic). Discussion The Assessment of Worldwide Acute Kidney Injury, Renal Angina and

  18. The diagnostic value of supine blood pressure in hypertension

    PubMed Central

    Stańczyk, Adam; Gielerak, Grzegorz; Piotrowicz, Katarzyna; Banak, Małgorzata; Wójcik, Agnieszka

    2016-01-01

    Introduction Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension. Material and methods This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring. Results The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p < 0.000001). The correlations between ABP and supBP/OBP were moderate and strong (correlation coefficients in range 0.55–0.76). The ROC analysis revealed that mean supBP ≥ 130/80 mm Hg was more precise than OBP ≥ 140/90 mm Hg in diagnosing hypertension (AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p < 0.0001) and the additive value derived mostly from its higher predictive power of identifying patients with increased night-time BP. Conclusions In young and middle-aged hypertensive patients the blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension. PMID:27186174

  19. Risk of Emergent Bradycardia Associated with Initiation of Immediate- or Slow-Release Metoprolol

    PubMed Central

    Shin, Jaekyu; Gonzales, Marco; Pletcher, Mark J

    2013-01-01

    Objectives To estimate and compare the risk of emergent bradycardia associated with initiation of immediate-release (IR) and slow-release (SR) formulations of metoprolol. Design Retrospective analysis of administrative claims data. Data Source State of California Medicaid program (Medi-Cal) claims database. Patients A total of 31,574 adults initiating metoprolol between May 1, 2004, and November 1, 2009, without a pharmacy claim for a beta blocker within the previous 6 months of metoprolol initiation; patients with a primary or secondary diagnosis of symptomatic bradycardia, pacemaker, or implantable cardioverter-defibrillator placement before metoprolol initiation were excluded. Measurements and Main Results The study outcome was the time to first occurrence of emergent bradycardia, measured at an emergency department visit or hospitalization due to diagnosis of symptomatic bradycardia, after metoprolol initiation. We calculated the incidence and compared the risk of emergent bradycardia by using a proportional hazards model that included the metoprolol formulation with adjustment for total daily metoprolol dose and the use of other medications as time-varying covariates, as well as demographics and comorbidities. Among 31,574 patients initiating metoprolol, 18,516 (58.6%) initiated the IR formulation. The incidence of emergent bradycardia was 19.1 per 1000 person-years overall but was nearly twice as common in patients using the IR versus the SR formulation (24.1 per 1000 person-years in the IR group vs. 12.9 per 1000 person-years in the SR group; unadjusted hazard ratio [HR] 1.81; 95% CI 1.28-2.56). Adjustment for other medications also associated with symptomatic bradycardia (cytochrome P450 2D6 inhibitors, class I or III antiarrhythmics, and atrioventricular node–blocking agents), metoprolol dose, and other participant characteristics somewhat attenuated the association (adjusted HR 1.48, 95% CI 1.03-2.13). Conclusion The risk of emergent bradycardia

  20. Pediatric cardiothoracic program in Malaysia: a study based on the outcome of the program

    PubMed Central

    Piros Kulandasamy Pillai, Cornelius; Yoshida, Yoshitoku; Justin Lawrence, Patrick; Yamamoto, Eiko; Reyer, Joshua A.; Hamajima1, Nobuyuki

    2016-01-01

    ABSTRACT Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher’s exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5–4.4). In

  1. Cannabis as a substitute for alcohol and other drugs

    PubMed Central

    2009-01-01

    Background Substitution can be operationalized as the conscious choice to use one drug (legal or illicit) instead of, or in conjunction with, another due to issues such as: perceived safety; level of addiction potential; effectiveness in relieving symptoms; access and level of acceptance. This practice of substitution has been observed among individuals using cannabis for medical purposes. This study examined drug and alcohol use, and the occurrence of substitution among medical cannabis patients. Methods Anonymous survey data were collected at the Berkeley Patient's Group (BPG), a medical cannabis dispensary in Berkeley, CA. (N = 350) The sample was 68% male, 54% single, 66% White, mean age was 39; 74% have health insurance (including MediCal), 41% work full time, 81% have completed at least some college, 55% make less than $40,000 a year. Seventy one percent report having a chronic medical condition, 52% use cannabis for a pain related condition, 75% use cannabis for a mental health issue. Results Fifty three percent of the sample currently drinks alcohol, 2.6 was the average number of drinking days per week, 2.9 was the average number of drinks on a drinking occasion. One quarter currently uses tobacco, 9.5 is the average number of cigarettes smoked daily. Eleven percent have used a non-prescribed, non OTC drug in the past 30 days with cocaine, MDMA and Vicodin reported most frequently. Twenty five percent reported growing up in an abusive or addictive household. Sixteen percent reported previous alcohol and/or drug treatment, and 2% are currently in a 12-step or other recovery program. Forty percent have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis. Conclusion The substitution of one psychoactive substance for

  2. Organic wastes decomposition technology, perspective for long-term autonomous missions

    NASA Astrophysics Data System (ADS)

    Viacheslav, Ilyin; Korshunov, Denis; Mardanov, Robert; Starkova, Lyubov; Deshevaya, Elena; Smirnov, Igor

    At present time there is no large problem in waste management in ISS space flight conditions, since spacecrafts "Progress" is used for it's removal from orbital station and the wastes burns in dense layers of Earth's atmosphere. However such method does not approach for far inter-planetary flights since interplanetary quarantine desires do not allow to deposit contaminated wastes outside the spacecraft. Essential part of wastes is formed by disposed means of personal hygiene and greenhouse wastes which are not safe from sanitary-epidemiological aspect. Above mentioned materials have one common feature: they can be subjected to biodegradation using different microbial compositions. Microbial decomposition of wastes as meets the main crite-ria of safety and power consumption. We investigated the effectiveness of method of disposed personal hygiene means biodegradation by anaerobic thermophiles with further purification of obtained decomposition products from chemical solvents with the help of mesophilic isolates in microaerophile conditions. Bacteria of Clostridium genera were selected for cellulolysis be-cause of their high specific endoglucanasic activity which less depends on substrate nature and relatively high growth rate on cellulose contaning substrates. As result some strains in case of optimal conditions (substrata pretreating, pH correction) decomposed means of personal hygiene with level of biodegradation up to 90With the purpose of purification, liqiud medi-ums originating from Closrtidium sp. exhibiting used like substrates for cellololitic fungi. It was shown that the cultures are able to change pH of media from slow-acid to neutral. Also the effectiveness of plant wastes biodegradation (vegetables homogenates) was studied using associations of mesophile aerobes trophically adapted to substrates. Rate of biodestruction of dry mass varied near 76To purify liquid products of biodegradation from chemicals cellulolytic fungal strains as well as bacterial

  3. Pediatric cardiothoracic program in Malaysia: a study based on the outcome of the program.

    PubMed

    Piros Kulandasamy Pillai, Cornelius; Yoshida, Yoshitoku; Justin Lawrence, Patrick; Yamamoto, Eiko; Reyer, Joshua A; Hamajima1, Nobuyuki

    2016-02-01

    Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher's exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5-4.4). In conclusion, the

  4. A review of accessibility of administrative healthcare databases in the Asia-Pacific region

    PubMed Central

    Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

    2015-01-01

    Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but

  5. Do we need hip-ankle radiographs to assess the coronal alignment and implant position after total knee replacement?

    PubMed Central

    Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Penning, Lenhard

    2016-01-01

    Aims and Objectives: Restoration of the coronal alignment of the knee is known to be one of the major criteria of a successful total knee arthroplasty (TKA). It therefore appears to be mandatory to routinely assess the postoperative limb alignment using hip-ankle radiographs and to identify implants that may be at risk of premature failure. However, there is no clear consensus whether weight-bearing hip-ankle radiographs or rather standardized a-p knee-radiographs should be used to assess implant position and coronal alignment after TKA. It is the aim of the present study to investigate if implant position and the mechanical alignment after TKA can reproducibly be assessed using standardized a-p knee-radiographs or rather if weight-bearing hip-ankle radiographs are needed. Materials and Methods: This study was performed on 100 postoperative weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position (MPTA, LDFA) was assessed using the MediCAD software, which served as a control. The hip-ankle radiographs were then digitally cropped to 80%, 60% and 40% of the leg-length. In each cropped radiograph, tibial coronal implant position was assessed by referencing against the visible mid-shaft, whereas femoral implant position was referenced against the visible mid-shaft (anatomical axis) or against a surrogate mechanical axis, which was drawn perpendicular to the distal tangent of the femoral component. Each measurement was performed by three independent observers. The difference between the alignment parameters in the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated for each parameter. Results: The ICC for inter-observer agreement of measurement of the mechanical femorotibial angle was significantly higher in hip-ankle radiographs (.95) when compared with a radiograph cropped

  6. Classificação geométrica de galáxias bianeladas através do metódo CART (Classification And Regression Trees)

    NASA Astrophysics Data System (ADS)

    Ormeño, M. I.; Faúndez-Abans, M.; Cavada, G.

    2003-08-01

    A importância deste trabalho deve-se à seleção de objetos ainda não tratados particularmente como uma família e ao emprego de procedimento estatístico robusto que não precisa de pressupostos ou condições de contorno. Contribui, assim, ao melhor entendimento do cenário das Galáxias Aneladas do diagrama de Hubble via classificação e estudo de subclasses. Selecionaram-se 100 galáxias possuidoras de dois anéis do Catalog of Southern Ringed Galaxies compilado por Ronald Buta, de modo a construir uma amostra completa em termos de conhecimento dos semi-eixos dos anéis interno e externo projetados no plano do céu. Visando uma possível classificação destas galáxias aneladas normais em famílias de acordo com as características geométricas dos anéis, empregou-se primeiramente a Análise de Aglomerados (ferramenta de classificação: medições de semelhança em um espaço bidimensional) para explorar a possível existência de famílias. As variáveis analisadas foram: os diâmetros interiores menores d(I) e maiores D(I), os diâmetros exteriores menores d(E) e maiores D(E), e os ângulos de inclinação dos semi-eixos maiores interiores q(I) e exteriores q(E) dos anéis. Como metodologia de discriminação, empregou-se a construção de Árvores de Classificação. As árvores de classificação constituem um método de discriminação alternativo aos modelos clássicos, tais como a Análise Discriminante e a Regressão Logística, onde uma base de dados é dividida em partições (subgrupos) da árvore por ação de um predictor (variável específica). Os pacotes estatísticos utilizados para o processamento da informação foram: SAS versão 8.0 (Statistical Analisys System) e CART versão 3.6.3. Esta análise estatística sugere a existência de três possíveis famílias de galáxias bianeladas, com base apenas na geometria dos anéis. Como forma exploratória inicial deste resultado, a construção de um diagrama BT (magnitude total) versus o

  7. High-precision timing of millisecond pulsars. 3: Long-term monitoring of PSRs B1855+09 and B1937+21

    NASA Astrophysics Data System (ADS)

    Kaspi, V. M.; Taylor, J. H.; Ryba, M. F.

    1994-06-01

    Biweekly timing observations of PSRs B1855+09 and B1937+21 have been made at the Arecibo Observatory for more than 7 and 8 year, respectively, with uniform procedures and only a few modest gaps. On each observing date we measure an equivalent pulse arrival time for PSR B1855+09 at 1.4 GHz, with typical accuracies of about 0.8 micrometers and for PSR B1937 + 21 at both 1.4 and 2.4 GHz, with accuracies around 0.2 micrometers. The pulse arrival times are fitted to a simple model for each pulsar, yielding high-precision astrometric, rotational, and orbital parameters, and a diverse range of conclusions. The celestial coordinates and proper motions of the two pulsars are determined with uncertainties less than or equal to 0.12 mas and less than or equal to 0.06 mas/year in the reference frame of the DE200 planetary ephemeris. The annual parallaxes are found to be pi=1.1 +/- 0.3 mas and pi less than 0.28 mas for PSRs B1855+09 and B1937+21, respectively. The general relativistic Shapiro delay is measured in the PSR B1855+09 system and used to obtain masses m1 = 1.50 +0.26 -0.14 solar mass and m (sub2) = 0.258 +0.028-0.016solar mass for the pulsar and its orbiting companion. The extremely stable orbital period of this system provides a phenomenological limit on the secular change of Newton's gravitational constant, dot-G/G=(-9 +/- 18) x 10-12/year. Variations in the dispersion measure of PSR B1937 + 21 indicate that the spectrum of electron-density fluctuations in the interstellar medi um has a power-law index beta = 3.874 +/- 0.011, slightly steeper than the Kolmogorov value of 11/3, and we find no strong evidence for an 'inner scale' greater than about 2 x 109cm. In the residual pulse arrival times for PSR B1937+21 we have observed small systematic trends not explained by our deterministic timing model. We discuss a number of possible causes; although the results are not yet conclusive, the most straightforward interpretation is that the unmodeled noise (a few

  8. Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children

    PubMed Central

    Elsayed Yousef, Yousseria; Abo El-Magd, Essam A.; El-Asheer, Osama M.; Kotb, Safaa

    2015-01-01

    Background. Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups in both developing and industrialized countries. Aim of the Study. This study aimed to assess the impact of educational program on the management of children with CSOM. Subjects and Methods. An experimental study design was used. This study included 100 children of both sexes of 2 years and less of age with CSOM. Those children were divided into 3 groups: group I: it involved 50 children with CSOM (naive) who received the designed educational program; control group: it involved 50 children who were under the traditional treatment and failed to respond; group II: those children in the control group were given the educational program and followed up in the same way as group I and considered as group II. Tools of the Study. Tool I is a structured questionnaire interview sheet for mothers. It consists of four parts: (1) personal and sociodemographic characteristics of child and (2) data about risk factors of otitis media (3) assessment of maternal practice about care of children with suppurative otitis medi (4) diagnostic criteria for suppurative otitis media. Tool II is the educational program: an educational program was developed by the researchers based on the knowledge and practices needs. This study was carried out through a period of 9 months starting from September 2013 to May 2014. The educational program was implemented for mothers of children with CSOM in the form of 5 scheduled sessions at the time of diagnosis, after one week, 1, 3, and 6 months. Results. There were significant differences between children who received the educational program and control group regarding the response to treatment after one and 3 months. The percentages of complete cure increased progressively 32%, 60%, and 84% after 1, 3, and 6 months in group I while they were 24%, 44%, and 64% in group II

  9. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant

    SciTech Connect

    Furstoss, C.; Reniers, B.; Bertrand, M. J.; Poon, E.; Carrier, J.-F.; Keller, B. M.; Pignol, J. P.; Beaulieu, L.; Verhaegen, F.

    2009-05-15

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of {sup 125}I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast {sup 125}I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V{sub 85}, V{sub 100}, and V{sub 200} for this kind of treatment in the target. D{sub 90} and D{sub 50} were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT

  10. Mechanical and Structural Behavior of Granular Material Packed Beds for Space Life Support System Applications

    NASA Technical Reports Server (NTRS)

    Malla, Ramesh B.; Anandakumar, Ganesh

    2005-01-01

    results show that the axial normal stress distribution along the length of the activated alumina medi

  11. Towards a Moon Village: Young Lunar Explorers Report

    NASA Astrophysics Data System (ADS)

    Kamps, Oscar; Foing, Bernard; Batenburg, Peter

    2016-04-01

    facilitate the progress of the Moon Village initiative it is necessary to attract private industry investments. Potential sources range from technology testing in the moon environment and private R&D funding from science and academia fields, to space tourism, and more ambitious endeavors such as building a prototype launcher site as a ground segment for debris de-orbiting and satellite recycling activities. The Science and Technology team has identified key technologies and possible major scientific disciplines for a Moon Village and ranked them by importance and by Technology Readiness Level (TRL). In terms of basic technologies and objectives, rover exploration, life support systems, navigation and surveying technologies resulted to have the highest importance and readiness. Technologies for the development of the habitats (materials, modules connections, power supply, alternative energy technologies and energy storage) ended up on having high importance with medium-low technology readiness. Technologies intended to help the astronauts or improve techniques had low-medium importance together with low-medium TRL (e.g. space lift to transfer resources, bio cybernetic augmentation "Exoskeleton", jumping rover, telescope). After brainstorming for required technologies, the fo-cus was shifted to what kinds of science can be ex-pected to be performed, once a functional and usable habitat would be available. The group has categorized studies of planetary formation and the Solar System as a highly important scientific discipline with a medi-um-high TRL. Scientific areas with high-medium im-portance, but low technological readiness, were found to be ISRU, psychological effects, adaptations of life to low gravity and plant cultivation. The physiological effects of low-gravity on the body were considered of medium importance and readiness. The Engaging Stakeholders working group started by identifying the main stakeholders and groups that play a role or that could play a role towards