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Sample records for comportamental aplicado aca

  1. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....402 Section 154.402 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154... through per unit of energy sold or transported (ACA unit charge). The ACA unit charge will be specified...

  2. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ....402 Section 154.402 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154... through per unit of energy sold or transported (ACA unit charge). The ACA unit charge will be specified...

  3. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....402 Section 154.402 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154... through per unit of energy sold or transported (ACA unit charge). The ACA unit charge will be specified...

  4. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ....402 Section 154.402 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154... charges to be flowed through per unit of energy sold or transported (ACA unit charge) for that fiscal...

  5. Alternatives to the ACA's Affordability Firewall

    PubMed Central

    Nowak, Sarah A.; Saltzman, Evan; Cordova, Amado

    2016-01-01

    Abstract The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual “affordability firewall,” which limits subsidies to individuals lacking access to alternative sources of coverage that are “affordable.” This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the “entire family” scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the “dependents only” scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally

  6. Alternatives to the ACA's Affordability Firewall.

    PubMed

    Nowak, Sarah A; Saltzman, Evan; Cordova, Amado

    2016-05-09

    The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the "entire family" scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the "dependents only" scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally estimated that federal

  7. Promoting Systemic Change through the ACA Advocacy Competencies

    ERIC Educational Resources Information Center

    Toporek, Rebecca L.; Lewis, Judith A.; Crethar, Hugh C.

    2009-01-01

    In 2003, the American Counseling Association (ACA) adopted the ACA Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002) to provide guidance to counselors and acknowledge advocacy as an ethical aspect of service to clients. This article provides a foundation for this special section by sharing a historical perspective…

  8. ACA12 Is a Deregulated Isoform of Plasma Membrane Ca2+-ATPase of Arabidopsis thaliana

    PubMed Central

    Limonta, Margherita; Romanowsky, Shawn; Olivari, Claudio; Bonza, Maria Cristina; Luoni, Laura; Rosenberg, Alexa; Harper, Jeffrey F.; De Michelis, Maria Ida

    2014-01-01

    Plant auto-inhibited Ca2+-ATPases (ACA) are crucial in defining the shape of calcium transients and therefore in eliciting plant responses to various stimuli. Arabidopsis thaliana genome encodes ten ACA isoforms that can be divided into four clusters based on gene structure and sequence homology. While isoforms from clusters 1, 2 and 4 have been characterized, virtually nothing is known about members of cluster 3 (ACA12 and ACA13). Here we show that a GFP-tagged ACA12 localizes at the plasma membrane and that expression of ACA12 rescues the phenotype of partial male sterility of a null mutant of the plasma membrane isoform ACA9, thus providing genetic evidence that ACA12 is a functional plasma membrane-resident Ca2+-ATPase. By ACA12 expression in yeast and purification by CaM-affinity chromatography, we show that, unlike other ACAs, the activity of ACA12 is not stimulated by CaM. Moreover, full length ACA12 is able to rescue a yeast mutant deficient in calcium pumps. Analysis of single point ACA12 mutants suggests that ACA12 loss of auto-inhibition can be ascribed to the lack of two acidic residues - highly conserved in other ACA isoforms - localized at the cytoplasmic edge of the second and third transmembrane segments. Together, these results support a model in which the calcium pump activity of ACA12 is primarily regulated by increasing or decreasing mRNA expression and/or protein translation and degradation. PMID:24101142

  9. Report of the Aca Ethics Committee: 2003-2004.

    ERIC Educational Resources Information Center

    Kocet, Michael M.; Freeman, Larry T.

    2005-01-01

    This report summarizes the activities of the American Counseling Association (ACA) Ethics Committee during the period of July 1, 2003, through June 30, 2004. Summary data of the complaints filed and the inquiries received are presented.

  10. 78 FR 49772 - Notice of a Public Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-15

    ... (ACA) AGENCY: Employment and Training Administration (ETA), Labor. ACTION: Notice of a public meeting...), notice is hereby given to announce a public meeting of the Advisory Committee on Apprenticeship (ACA) on Tuesday, September 17, 2013 and Thursday, September 19, 2013. The ACA is a discretionary...

  11. 78 FR 2445 - Notice of Intent To Renew the Advisory Committee on Apprenticeship (ACA) Charter

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-11

    ... (ACA) Charter AGENCY: Employment and Training Administration (ETA), Labor. ACTION: Notice of Intent to... renew the ACA Charter with revisions. The revisions are not intended to change the purpose or the... with the Department's strategic goals and priorities. The charter for the ACA will expire on January...

  12. 76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... Care Act (ACA) appropriations to the Connecticut Department of Public Health and the Georgia...

  13. 77 FR 39516 - Notice of a Public Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    ... activities of apprenticeship and training plans. Finally, the ACA may also consider comments from members of... (ACA) AGENCY: Employment and Training Administration (ETA), Labor. ACTION: Notice of a public meeting... Building, 200 Constitution Avenue NW., Washington, DC 20210. The ACA is a discretionary...

  14. 75 FR 79418 - Notice of an Open Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... (ACA) AGENCY: Employment and Training Administration, Labor. ACTION: Announcement of meeting. SUMMARY... hereby given to announce an open meeting of the Advisory Committee on Apprenticeship (ACA) being held on January 10-11, 2011. The ACA, an advisory board to the Secretary of Labor, is a discretionary...

  15. 77 FR 65395 - Air Cargo Advance Screening (ACAS) Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Air Cargo Advance Screening (ACAS) Pilot Program Correction In notice document 2012-26031 appearing on pages 65006-65009 in the issue of October 24, 2012 make...

  16. 77 FR 65006 - Air Cargo Advance Screening (ACAS) Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... data interchange (EDI) system before the cargo is brought into or departs the United States by any mode... submission of both the ACAS data and the advance electronic cargo information required by 19 CFR 122.48a... mandatory advance electronic information for air cargo. CBP regulations implementing the Trade Act of...

  17. Framing, Engagement, and Policy Change: Lessons for the ACA.

    PubMed

    Karch, Andrew; Rosenthal, Aaron

    2017-04-01

    Supporters of the Patient Protection and Affordable Care Act (ACA) sometimes speculate that public attitudes toward the law will shift if proponents succeed in focusing attention on its more popular components, but the scholarly literature on framing effects provides ample reason to question their assertion. This article contends that engagement, an alternative rhetorical strategy where advocates address the same policy dimensions as their opponents, is a more promising approach. Extending the engagement literature to the elite context in which most ACA-related decisions are made, it argues that elite-level engagement necessitates the additional task of linking policy change to opponents' broader philosophical and policy goals. Current debates surrounding the application of sales taxes to electronic commerce-a policy arena that seems far removed from health care policy but overlaps with the ACA in ways that make it an appropriate source of lesson drawing-illustrate the potential of an engagement strategy. Recently, many conservative lawmakers who previously opposed policy change have instead embraced online sales taxes as a mechanism for additional tax cuts. Analogous connections may facilitate the diffusion of ACA provisions that presently receive hostile receptions in Republican-leaning states.

  18. Structural and functional evidence of high specificity of Cbf5 for ACA trinucleotide

    SciTech Connect

    Zhou, Jing; Liang, Bo; Li, Hong

    2012-07-24

    Cbf5 is the catalytic subunit of the H/ACA small nucleolar/Cajal body ribonucleoprotein particles (RNPs) responsible for site specific isomerization of uridine in ribosomal and small nuclear RNA. Recent evidence from studies on archaeal Cbf5 suggests its second functional role in modifying tRNA U55 independent of guide RNA. In order to act both as a stand-alone and a RNP pseudouridine synthase, Cbf5 must differentiate features in H/ACA RNA from those in tRNA or rRNA. Most H/ACA RNAs contain a hallmark ACA trinucleotide downstream of the H/ACA motif. Here we challenged an archaeal Cbf5 (in the form of a ternary complex with its accessory proteins Nop10 and Gar1) with T-stem-loop RNAs with or without ACA trinucleotide in the stem. Although these substrates were previously shown to be substrates for the bacterial stand-alone pseudouridine synthase TruB, the Cbf5-Nop10-Gar1 complex was only able to modify those without ACA trinucleotide. A crystal structure of Cbf5-Nop10-Gar1 trimer bound with an ACA-containing T-stem-loop revealed that the ACA trinucleotide detracted Cbf5 from the stand-alone binding mode, thereby suggesting that the H/ACA RNP-associated function of Cbf5 likely supersedes its stand-alone function.

  19. ACAS-Xu Initial Self-Separation Flight Tests

    NASA Technical Reports Server (NTRS)

    Marston, Mike; Baca, Gabe

    2015-01-01

    The purpose of this flight test report is to document and report the details of the ACAS Xu (Airborne Collision Avoidance System For Unmanned Aircraft) / Self-Separation flight test series performed at Edwards AFB from November to December of 2014. Included in this document are details about participating aircraft, aircrew, mission crew, system configurations, flight data, flight execution, flight summary, test results, and lessons learned.

  20. Impact of ACA on the Dinner-for-Three Dynamic.

    PubMed

    Schoonveld, Ed; Coyle, Bill; Markham, Jennifer

    2015-04-01

    The Patient Protection and Affordable Care Act (ACA) aims to expand coverage to the previously uninsured, improve the quality of coverage, and help eliminate inefficiencies in the health care market. We evaluated the implications of ACA on the drug industry by examining the impact on the "Dinner-for-Three" dynamic in our health care system. We can think of our system as an odd dinner party in which one person pays (the insurer), one orders the meal (the physician), and yet another eats the meal (the patient). This dynamic requires us to examine each stakeholder and how they interact with one another to assess the impact of the ACA. Of the 6.7 million initial exchange enrollees, ~3.8 million subjects were previously uninsured. A higher percentage of these enrollees are using their pharmacy benefit, and they are disproportionately filling prescriptions for specialty drugs relative to those covered in employer-sponsored plans. Formulary designs in exchange plans are passing on higher cost-sharing for prescription drugs to the patient. ACA has also resulted in the development of accountable care organizations (ACOs); these organizations may play a role going forward in the management of drug spending and the development of formularies and protocols that impact drug prescribing. Payers are tightening control over drug spending and are finding physicians and physician groups increasingly less reluctant allies in doing so. Patients are faced by more complexity than ever in the health care system and are expected to take a more active role in responsibly managing the cost of their care. It is increasingly critical that drug manufacturers develop robust value propositions and communicate that value to all stakeholders. They should re-evaluate trial investment decisions and consider changes in price setting, rebates (how much and to whom), copay programs, and physician and patient support programs in light of changing market needs.

  1. The effect of prism adaptation on the response AC/A ratio.

    PubMed

    Rainey, B B

    2000-05-01

    Vergence adaptation, also known as prism adaptation, is a phenomenon in which a patient's heterophoria changes after prolonged viewing through prism. The effect of prism adaptation on the accommodation-convergence relationship, quantified by the AC/A ratio, is not known. Previous studies of AC/A ratio stability and alterability have used only stimulus AC/A ratio calculations, or have measured accommodative responses to only one or two stimuli. The ideal study of AC/A ratio stability and alterability would measure accommodative responses to several accommodative stimuli, and use these along with vergence responses to calculate response AC/A ratios, rather than stimulus AC/A ratios. In addition, the gradient method should be used to avoid any effect of proximal vergence resulting from changes in target distance. This paper describes a project which investigated the effect of vergence (prism) adaptation on the gradient response AC/A ratio, using accommodative responses measured for five different accommodative stimuli. The response AC/A ratio did not significantly change following a period of adaptation to base-in prism for six of the eight subjects in this study. In addition, the response AC/A ratio did not significantly change following a period of adaptation to base-out prism for six of the eight subjects.

  2. ACA and the Triple Aim: Musings of a Health Care Actuary.

    PubMed

    McCarthy, Mac

    2015-01-01

    In 2008, the Institute for Healthcare Improvement (IHI) promulgated the Triple Aim, which advocates simultaneous improvements in patient experiences, improved population health and lower cost per capita. In 2010, the Patient Protection and Affordable Care Act (ACA) promised quality, affordable health care for all Americans. It's fair to assume that the framers of ACA were aware of the Triple Aim, and it is likely that much of ACA was heavily influenced by IHI's positions. So it is reasonable, from time to time, to assess ACA's impact on health care against the Triple Aim principles.

  3. A computational screen for mammalian pseudouridylation guide H/ACA RNAs.

    PubMed

    Schattner, Peter; Barberan-Soler, Sergio; Lowe, Todd M

    2006-01-01

    The box H/ACA RNA gene family is one of the largest non-protein-coding gene families in eukaryotes and archaea. Recently, we developed snoGPS, a computational screening program for H/ACA snoRNAs, and applied it to Saccharomyces cerevisiae. We report here results of extending our method to screen for H/ACA RNAs in multiple large genomes of related species, and apply it to the human, mouse, and rat genomes. Because of the 250-fold larger search space compared to S. cerevisiae, significant enhancements to our algorithms were required. Complementing extensive cloning experiments performed by others, our findings include the detection and experimental verification of seven new mammalian H/ACA RNAs and the prediction of 23 new H/ACA RNA pseudouridine guide assignments. These assignments include four for H/ACA RNAs previously classified as orphan H/ACA RNAs with no known targets. We also determined systematic syntenic conservation among human and mouse H/ACA RNAs. With this work, 82 of 97 ribosomal RNA pseudouridines and 18 of 32 spliceosomal RNA pseudouridines in mammals have been linked to H/ACA guide RNAs.

  4. Insurance Transitions Following the First ACA Open Enrollment Period.

    PubMed

    Carman, Katherine Grace; Eibner, Christine

    2015-11-30

    While most of the Affordable Care Act's (ACA's) coverage-related provisions took effect in January 2014, there is limited information on insurance transitions that occurred in the period before and after these changes became operational. In Insurance Transitions Following the First ACA Open Enrollment Period, the authors examine insurance transitions between September 2013 and November 2014 using longitudinal data from the RAND Health Reform Opinion Study, a part of the RAND American Life Panel (ALP). The ALP includes 2,953 respondents-ages 18 to 64, in a population-based sample-who were approached to participate in this data collection. Out of the 2,953 individuals, 2,329 (79 percent) responded in September 2013, and 1,972 (67 percent) responded in November 2014; 1,636 (55 percent) responded in both months, and 1,628 (55 percent) provided clear information about their source of insurance. The authors report the type of coverage people had before the law's major provisions took effect (September 2013) and at the end of the Marketplace enrollment year (November 2014). They estimate that 20.4 million nonelderly adults became newly insured and 7.4 million lost coverage, for a net increase of 12.9 million between September 2013 and November 2014. Among those previously uninsured, most (7.5 million) enrolled in Medicaid, followed by employer plans (7.3 million), the Marketplaces (3.1 million), and other insurance sources. Among those losing coverage, most (3.4 million) lost employer coverage, with the remaining insurance losses spread across a variety of coverage sources. The authors estimate that 7.6 million people enrolled in Marketplace plans; this includes the 3.1 million people who became newly insured in Marketplace plans and another 4.5 million people who transitioned to Marketplace plans from another coverage source. The majority of those insured at baseline (81 percent) experienced no change in source of coverage during the study period, suggesting that

  5. A Critical Examination of the Assessment Analysis Capabilities of OCLC ACAS

    ERIC Educational Resources Information Center

    Lyons, Lucy E.

    2005-01-01

    Over 500 libraries have employed OCLC's iCAS and its successor Automated Collection Assessment and Analysis Services (ACAS) as bibliometric tools to evaluate monograph collections. This examination of ACAS reveals both its methodological limitations and its feasibility as an indicator of collecting patterns. The results can be used to maximize the…

  6. New Mandates and Imperatives in the Revised "ACA Code of Ethics"

    ERIC Educational Resources Information Center

    Kaplan, David M.; Kocet, Michael M.; Cottone, R. Rocco; Glosoff, Harriet L.; Miranti, Judith G.; Moll, E. Christine; Bloom, John W.; Bringaze, Tammy B.; Herlihy, Barbara; Lee, Courtland C.; Tarvydas, Vilia M.

    2009-01-01

    The first major revision of the "ACA Code of Ethics" in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised "ACA Code of Ethics" in the areas of confidentiality,…

  7. Grandfathered, Grandmothered, And ACA-Compliant Health Plans Have Equivalent Premiums.

    PubMed

    Whitmore, Heidi; Gabel, Jon R; Satorius, Jennifer L; Green, Matthew

    2017-02-01

    Many small employers offer employees health plans that are not fully compliant with Affordable Care Act (ACA) provisions such as covering preventive services without cost sharing. These "grandfathered" and "grandmothered" plans accounted for about 65 percent of enrollment in the small-group market in 2014. Premium costs for these and ACA-compliant plans were equivalent.

  8. Whole-Genome Sequence of the Cheese Isolate Lactobacillus rennini ACA-DC 565

    PubMed Central

    Kazou, Maria; Alexandraki, Voula; Pot, Bruno; Tsakalidou, Effie

    2017-01-01

    ABSTRACT In this study, we present the first complete genome sequence of Lactobacillus rennini ACA-DC 565, a strain isolated from a traditional Greek overripened Kopanisti cheese called Mana. Although the species has been associated with cheese spoilage, the strain ACA-DC 565 may contribute to the intense organoleptic characteristics of Mana cheese. PMID:28153908

  9. ACA12 is a deregulated isoform of plasma membrane Ca²⁺-ATPase of Arabidopsis thaliana.

    PubMed

    Limonta, Margherita; Romanowsky, Shawn; Olivari, Claudio; Bonza, Maria Cristina; Luoni, Laura; Rosenberg, Alexa; Harper, Jeffrey F; De Michelis, Maria Ida

    2014-03-01

    Plant auto-inhibited Ca²⁺-ATPases (ACA) are crucial in defining the shape of calcium transients and therefore in eliciting plant responses to various stimuli. Arabidopsis thaliana genome encodes ten ACA isoforms that can be divided into four clusters based on gene structure and sequence homology. While isoforms from clusters 1, 2 and 4 have been characterized, virtually nothing is known about members of cluster 3 (ACA12 and ACA13). Here we show that a GFP-tagged ACA12 localizes at the plasma membrane and that expression of ACA12 rescues the phenotype of partial male sterility of a null mutant of the plasma membrane isoform ACA9, thus providing genetic evidence that ACA12 is a functional plasma membrane-resident Ca²⁺-ATPase. By ACA12 expression in yeast and purification by CaM-affinity chromatography, we show that, unlike other ACAs, the activity of ACA12 is not stimulated by CaM. Moreover, full length ACA12 is able to rescue a yeast mutant deficient in calcium pumps. Analysis of single point ACA12 mutants suggests that ACA12 loss of auto-inhibition can be ascribed to the lack of two acidic residues--highly conserved in other ACA isoforms--localized at the cytoplasmic edge of the second and third transmembrane segments. Together, these results support a model in which the calcium pump activity of ACA12 is primarily regulated by increasing or decreasing mRNA expression and/or protein translation and degradation.

  10. Medicare Advantage update: benefits, enrollment, and payments after the ACA.

    PubMed

    Linehan, Kathryn

    2013-07-19

    In 2012, the Medicare program paid private health plans $136 billion to cover about 13 million beneficiaries who received Part A and B benefits through the Medicare Advantage (MA) program rather than traditional fee-for-service (FFS) Medicare. Private plans have been a part of the program since the 1970s. Debate about the policy goals--Should they cost less per beneficiary than FFS Medicare? Should they be available to all beneficiaries? Should they be able to offer additional benefits?--has long accompanied Medicare's private plan option.This debate is reflected in the history of Medicare payment policy,and policy decisions over the years have affected plans' willingness to participate and beneficiaries' enrollment at different periods of the program. Recently, evidence that the Medicare program was paying more per beneficiary in MA relative to what would have been spent under FFS Medicare prompted policymakers to reduce MA payments in the Patient Protection and Affordable Care Act of 2010 (ACA). So far, plans continue to participate in MA and enrollment continues to grow, but payment reductions in 2012 through 2014 have been partially offset by payments made to plans through the quality bonus payment demonstration.This brief contains recent data on plan enrollment, availability, and benefits and discusses MA plan payment policy, including changes to MA payment made in the ACA and their actual and projected effects.

  11. 76 FR 59703 - Notice of Intent To Award Affordable Care Act (ACA) Funding, RFA-TP-08-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... (ACA) Funding, RFA- TP-08-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Affordable Care Act (ACA) funding to Preparedness and Emergency Response Research Centers (PERRCs). This... award Affordable Care Act (ACA) appropriations to the following 4 Preparedness and Emergency...

  12. The Benefit Aftereffects of ACA--Accelerating Toward a New Health Economy.

    PubMed

    Mansur, Greg; Thompson, Michael

    2015-01-01

    While the Affordable Care Act (ACA) focused largely on improving access to health care coverage for the uninsured, its broader and longer-term influence may have been its impact on accelerating key trends and strategies that major employers and other stakeholders have been targeting for years. This article looks at some of these trends, where we were pre-ACA and how ACA (through benefit mandates, shared responsibility penalties, Cadillac plan tax, health information technology, accountable care organizations, etc.) has helped to accelerate and refocus efforts. In addition, the public exchange paradigm has given rise to a private exchange movement that is helping further accelerate the transformation of the New Health Economy.

  13. Advanced Connectivity Analysis (ACA): a Large Scale Functional Connectivity Data Mining Environment.

    PubMed

    Chen, Rong; Nixon, Erika; Herskovits, Edward

    2016-04-01

    Using resting-state functional magnetic resonance imaging (rs-fMRI) to study functional connectivity is of great importance to understand normal development and function as well as a host of neurological and psychiatric disorders. Seed-based analysis is one of the most widely used rs-fMRI analysis methods. Here we describe a freely available large scale functional connectivity data mining software package called Advanced Connectivity Analysis (ACA). ACA enables large-scale seed-based analysis and brain-behavior analysis. It can seamlessly examine a large number of seed regions with minimal user input. ACA has a brain-behavior analysis component to delineate associations among imaging biomarkers and one or more behavioral variables. We demonstrate applications of ACA to rs-fMRI data sets from a study of autism.

  14. [A case of bilateral infraoptic course of ACA associated with multiple cerebral artery aneurysms].

    PubMed

    Ogura, K; Hasegawa, K; Kobayashi, T; Kohno, M; Hondo, H

    1998-06-01

    Infraoptic course of anterior cerebral artery (ACA) is a rare cerebral vascular anomaly frequently associated with intracranial aneurysm. A 58-year-old woman suffered, subarachnoid hemorrhage due to aneurysmal rupture. Carotid angiography revealed multiple aneurysms and bilateral infraoptic course of ACA. Usual A1 segments were not visualized on both sides. These findings were also confirmed by craniotomy. Only 46 cases have been reported including ours. In this paper, we reviewed previously reported cases and the cause of aneurysm formation was discussed.

  15. Human intron-encoded AluACA RNAs and telomerase RNA share a common element promoting RNA accumulation

    PubMed Central

    Ketele, Amandine; Kiss, Tamás; Jády, Beáta E.

    2016-01-01

    ABSTRACT Mammalian cells express hundreds of intron-encoded box H/ACA RNAs which fold into a common hairpin-hinge-hairpin-tail structure, interact with 4 evolutionarily conserved proteins, dyskerin, Nop10, Nhp2 and Gar1, and function mainly in RNA pseudouridylation. The human telomerase H/ACA RNA (hTR) directs telomeric DNA synthesis and it carries a 5′-terminal domain encompassing the telomeric template sequence. The primary hTR transcript is synthesized from an independent gene by RNA polymerase II and undergoes 3′ end processing controlled by the 3′-terminal H/ACA domain. The apical stem-loop of the 3′ hairpin of hTR carries a unique biogenesis-promoting element, the BIO motif that promotes hTR processing and RNP assembly. AluACA RNAs represent a distinct class of human H/ACA RNAs; they are processed from intronic Alu repetitive sequences. As compared to canonical H/ACA RNAs, the AluACA RNAs carry unusually short or long 5′ hairpins and generally, they accumulate at low levels. Here, we demonstrate that the suboptimal 5′ hairpins are responsible for the weak expression of AluACA RNAs. We also show that AluACA RNAs frequently carry a processing/stabilization element that is structurally and functionally indistinguishable from the hTR BIO motif. Both hTR and AluACA biogenesis-promoting elements are located in the terminal stem-loop of the 3′-terminal H/ACA hairpin, they show perfect structural conservation and are functionally interchangeable in in vivo RNA processing reactions. Our results demonstrate that the BIO motif, instead of being confined to hTR, is a more general H/ACA RNP biogenesis-facilitating element that can also promote processing/assembly of intron-encoded AluACA RNPs. PMID:27726486

  16. Removal of cephalosporin antibiotics 7-ACA from wastewater during the cultivation of lipid-accumulating microalgae.

    PubMed

    Guo, Wan-Qian; Zheng, He-Shan; Li, Shuo; Du, Juan-Shan; Feng, Xiao-Chi; Yin, Ren-Li; Wu, Qing-Lian; Ren, Nan-Qi; Chang, Jo-Shu

    2016-12-01

    The aim of this study is to evaluate the feasibility of using lipid-accumulating microalgae to remove cephalosporin antibiotics 7-amino cephalosporanic acid (7-ACA) from wastewater with the additional benefit of biofuels production. Three isolated microalgal strains (namely, Chlorella sp. Cha-01, Chlamydomonas sp. Tai-03 and Mychonastes sp. YL-02) were cultivated under 7-ACA stress and their biomass productivity, lipid production and N-NO3(-) consumption were monitored. It was found that 7-ACA had slight inhibition effects on the microalgal growth at the ratio of 12.0% (Cha-01), 9.6% (YL-02), 11.7% (Tai-03). However, lipid accumulation in the three microalgae was not influenced by the presence of 7-ACA. The investigation on the 7-ACA removal mechanisms during microalgal growth shows that 7-ACA was mainly removed by microalgae adsorption as well as hydrolysis and photolysis reactions. This study demonstrates that using microalgae to treat antibiotic-containing wastewater is promising due to the potential of simultaneous antibiotic removal and biofuel production.

  17. Determination and Analysis of the Putative AcaCD-Responsive Promoters of Salmonella Genomic Island 1

    PubMed Central

    Olasz, Ferenc; Kiss, János

    2016-01-01

    The integrative genomic island SGI1 and its variants confer multidrug resistance in numerous Salmonella enterica serovariants and several Proteus mirabilis and Acinetobacter strains. SGI1 is mobilized by the IncA/C family plasmids. The island exploits not only the conjugation apparatus of the plasmid, but also utilizes the plasmid-encoded master regulator AcaCD to induce the excision and formation of its transfer-competent form, which is a key step in the horizontal transfer of SGI1. Triggering of SGI1 excision occurs via the AcaCD-dependent activation of xis gene expression. AcaCD binds in Pxis to an unusually long recognition sequence. Beside the Pxis promoter, upstream regions of four additional SGI1 genes, S004, S005, S012 and S018, also contain putative AcaCD-binding sites. Furthermore, SGI1 also encodes an AcaCD-related activator, FlhDCSGI1, which has no known function. Here, we have analysed the functionality of the putative AcaCD-dependent promoter regions and proved their activation by either AcaCD or FlhDCSGI1. Moreover, we provide evidence that both activators act on the same binding site in Pxis and that FlhDCSGI1 is able to complement the acaCD deletion of the IncA/C family plasmid R16a. We determined the transcription start sites for the AcaCD-responsive promoters and showed that orf S004 is expressed probably from a different start codon than predicted earlier. Additionally, expression of S003 from promoter PS004 was ruled out. Pxis and the four SGI1 promoters examined here also lack obvious -35 promoter box and their promoter profile is consistent with the class II-type activation pathway. Although the role of the four additionally analysed AcaCD/FlhDCSGI1-controlled genes in transfer and/or maintenance of SGI1 is not yet clear, the conservation of the whole region suggests the existence of some selection for their functionality. PMID:27727307

  18. The Response AC/A Ratio Before and After the Onset of Myopia

    PubMed Central

    Mutti, Donald O.; Mitchell, G. Lynn; Jones-Jordan, Lisa A.; Cotter, Susan A.; Kleinstein, Robert N.; Manny, Ruth E.; Twelker, J. Daniel; Zadnik, Karla

    2017-01-01

    Purpose To investigate the ratio of accommodative convergence per diopter of accommodative response (AC/A ratio) before, during, and after myopia onset. Methods Subjects were 698 children aged 6 to 14 years who became myopic and 430 emmetropic children participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error. Refractive error was measured using cycloplegic autorefraction, near work by parent survey, and the AC/A ratio by simultaneously monitoring convergence and accommodative response. The response AC/A ratios of children who became myopic were compared with age-, sex-, and ethnicity-matched model estimates for emmetropic children from 5 years before through 5 years after the onset of myopia. Results The response AC/A ratio was not significantly different between the two groups 5 years before onset, then increased monotonically in children who became myopic until reaching a plateau at myopia onset of about 7 Δ/D compared to about 4 Δ/D for children who remained emmetropic (differences between groups significant at P < 0.01 from 4 years before onset through 5 years after onset). A higher AC/A ratio was associated with greater accommodative lag but not with the rate of myopia progression regardless of the level of near work. Conclusions An increasing AC/A ratio is an early sign of becoming myopic, is related to greater accommodative lag, but does not affect the rate of myopia progression. The association with accommodative lag suggests that the AC/A ratio increase is from greater neural effort needed per diopter of accommodation rather than change in the accommodative convergence crosslink gain relationship. PMID:28291868

  19. First impressions: geographic variation in media messages during the first phase of ACA implementation.

    PubMed

    Gollust, Sarah E; Barry, Colleen L; Niederdeppe, Jeff; Baum, Laura; Fowler, Erika Franklin

    2014-12-01

    Many Americans will learn about the implementation of the Patient Protection and Affordable Care Act (ACA) through the mass media. We examined geographic variation in the volume and content of mass media during the initial two-week rollout of the new health insurance marketplaces in October 2013 across 210 US media markets, using data from the Wesleyan Media Project. We found substantial geographic variation in the volume and tone of insurance product advertisements, political advertisements, and news coverage of the ACA marketplaces. News coverage of the ACA airing in media markets located in states operating federal or partnership marketplaces was more negative than coverage airing in markets located in states running their own marketplaces. Intrastate variation in media volume and content was also substantial and appears distinguishable from the local political climate. Variation in exposure to media messages likely affects public sentiment regarding the ACA and could contribute to geographic differences in insurance enrollment and public perceptions of US health care options. Researchers and policy makers evaluating the implementation of the ACA-and insurance enrollment in the marketplaces in particular-should consider addressing media influences.

  20. Promoting Value for Consumers: Comparing Individual Health Insurance Markets Inside and Outside the ACA's Exchanges.

    PubMed

    McCue, Michael J; Hall, Mark A

    2016-06-01

    The new health insurance exchanges are the core of the Affordable Care Act's (ACA) insurance reforms, but insurance markets beyond the exchanges also are affected by the reforms. This issue brief compares the markets for individual coverage on and off of the exchanges, using insurers' most recent projections for ACA-compliant policies. In 2016, insurers expect that less than one-fifth of ACA-compliant coverage will be sold outside of the exchanges. Insurers that sell mostly through exchanges devote a greater portion of their premium dollars to medical care than do insurers selling only off of the exchanges, because exchange insurers project lower administrative costs and lower profit margins. Premium increases on exchange plans are less than those for off-exchange plans, in large part because exchange enrollment is projected to shift to closed-network plans. Finally, initial concerns that insurers might seek to segregate higher-risk subscribers on the exchanges have not been realized.

  1. Molecular Cloning and Expression of a New Allergen of Acacia farnesiana (Aca f 2).

    PubMed

    Sepahi, Najmeh; Khodadadi, Ali; Assarehzadegan, Mohammad-Ali; Amini, Akram; Zarinhadideh, Farnoosh; Ali-Sadeghi, Hosein

    2015-08-01

    Inhalation of pollens from different species of Acacia is a common cause of respiratory allergy in tropical areas of the world. Acacia farnesiana is commonly used as street trees in towns and ornamental shade trees in parks and gardens throughout arid and semi-arid regions of Asia. This study aimed to produce and purify the A. farnesiana pollen profilin (Aca f 2) and evaluate its nucleotide sequence homology with profilins of common allergenic plants to predict allergenic cross-reactivity. Thirty-nine patients who were allergic to Acacia pollens were included in the study. Cloning of Acacia profilin-coding sequence was performed by polymerase chain reaction using primers from Acacia pollen RNA. The cDNA of Acacia pollen profilin was then expressed in Escherichia coli using pET-21b(+) vector and purified by metal affinity chromatography. Immunoreactivity of the recombinant Acacia profilin (rAca f 2) was evaluated by specific ELISA, immunoblotting, and inhibition assays. The coding sequence of the Acacia profilin cDNA was recognized as a 399-bp open reading frame encoding 133 amino acid residues. Eighteen patients (18/39, 46.15%) had significant specific IgE levels against Aca f 2. Immunodetection and inhibition assays indicated that purified Aca f 2 might be the same as that in the crude extract. Aca f2, the first allergen from A. farnesiana pollen, was identified as belonging to the family of profilins. The amino acid sequence homology analysis showed high cross-reactivity between Aca f 2 and other profilins from botanically unrelated common allergenic plants.

  2. The complete genome sequence of the yogurt isolate Streptococcus thermophilus ACA-DC 2.

    PubMed

    Alexandraki, Voula; Kazou, Maria; Blom, Jochen; Pot, Bruno; Tsakalidou, Effie; Papadimitriou, Konstantinos

    2017-01-01

    Streptococcus thermophilus ACA-DC 2 is a newly sequenced strain isolated from traditional Greek yogurt. Among the 14 fully sequenced strains of S. thermophilus currently deposited in the NCBI database, the ACA-DC 2 strain has the smallest chromosome, containing 1,731,838 bp. The annotation of its genome revealed the presence of 1,850 genes, including 1,556 protein-coding genes, 70 RNA genes and 224 potential pseudogenes. A large number of pseudogenes were identified. This was also accompanied by the absence of pathogenic features suggesting evolution of strain ACA-DC 2 through genome decay processes, most probably due to adaptation to the milk ecosystem. Analysis revealed the existence of one complete lactose-galactose operon, several proteolytic enzymes, one exopolysaccharide cluster, stress response genes and four putative antimicrobial peptides. Interestingly, one CRISPR-cas system and one orphan CRISPR, both carrying only one spacer, were predicted indicating low activity or inactivation of the cas proteins. Nevertheless, four putative restriction-modification systems were determined that may compensate any deficiencies of the CRISPR-cas system. Furthermore, whole genome phylogeny indicated three distinct clades within S. thermophilus. Comparative analysis among selected strains representative for each clade, including strain ACA-DC 2, revealed a high degree of conservation at the genomic scale, but also strain specific regions. Unique genes and genomic islands of strain ACA-DC 2 contained a number of genes potentially acquired through horizontal gene transfer events, that could be related to important technological properties for dairy starters. Our study suggests genomic traits in strain ACA-DC 2 compatible to the production of dairy fermented foods.

  3. Pulsed infrared thermography processing and defects edge detection using FCA and ACA

    NASA Astrophysics Data System (ADS)

    Yuanlin, Liu; Qingju, Tang; Chiwu, Bu; Chen, Mei; Pingshan, Wang; Jiansuo, Zang

    2015-09-01

    CFRP sheet with delamination defects was detected using pulsed infrared thermography. The principle of polynomial fitting the derivative time algorithm (FDA) and related coefficient algorithm (RCA) was described. A new polynomial fitting the derivative time-related coefficient algorithm (FCA) was formed by combining FDA and RCA, which improves the signal to noise (SNR) of feature images, and is benefit for the detection and identification of defects. The defects edge identification procedure using ant colony algorithm (ACA) is given, and the defect edge features in the infrared image have been extracted using ACA effectively.

  4. Perils ahead: employers cheer mandate's delay, but move leaves ACA open to new attacks.

    PubMed

    Block, Jonathan; Daly, Rich

    2013-07-08

    When the Obama administration announced it was delaying enforcement of the employer mandate in the ACA for one year, employer groups celebrated. But others had some troubling questions. "One has to hope, however, that the administration has thought through the ramifications of this delay for the other provisions," says Tim Jost, left, a law professor at Washington & Lee University.

  5. ACA: Phoenix of-or Cooked in-This Dumpster Fire of an Election.

    PubMed

    Kirkner, Richard Mark

    2016-10-01

    Hillary Clinton and Donald Trump promise divergent approaches to the ACA if elected. Basically, Clinton wants to improve it; Trump promises to dismantle it. Of course, no president acts in a vacuum, and a lot will also depend on which party controls Congress.

  6. 76 FR 5404 - Notice of Renewal of the Advisory Committee on Apprenticeship (ACA) Charter

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... Apprenticeship is a unique public-private partnership that is highly dependent on the engagement and involvement... apprenticeship is necessary and in the public interest. The Department of Labor will renew the ACA Charter with... is no single source or group with the broad representation of labor, employers, and the...

  7. 76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...

  8. 77 FR 75195 - Notice of a Virtual Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... Employment and Training Administration Notice of a Virtual Meeting of the Advisory Committee on Apprenticeship (ACA) AGENCY: Employment and Training Administration (ETA), Labor. ACTION: Notice of a virtual.... 10), notice is hereby given to announce an open virtual meeting of the Advisory Committee...

  9. 77 FR 62264 - Notice of a Virtual Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... No: 2012-25121] DEPARTMENT OF LABOR Employment and Training Administration Notice of a Virtual... (ETA), Labor. ACTION: Notice of a virtual meeting. SUMMARY: Pursuant to Section 10 of the Federal... virtual meeting of the Advisory Committee on Apprenticeship (ACA) on November 14-15, 2012, which can...

  10. Functionality and substrate specificity of human box H/ACA guide RNAs.

    PubMed

    Xiao, Mu; Yang, Chunxing; Schattner, Peter; Yu, Yi-Tao

    2009-01-01

    A large number of box H/ACA RNAs have been identified in human cells, and have been predicted to account for nearly all pseudouridylation sites in human rRNAs. However, the function of these mammalian H/ACA RNAs in directing pseudouridylation has been verified experimentally in only two cases. In this study, we used three in vitro reconstitution systems, including yeast and mammalian systems, to test the function of seven H/ACA RNAs guiding16 pseudouridylation sites. Our results verified 12 of these sites; four predictions were incorrect. Further analyses indicated that three components, including the stability of the hairpin structure harboring the pseudouridylation pocket, the stability of guide sequence-target RNA base-pairing interaction, and the distance between the target uridine and the box H or ACA, were critical for the guide function, as changes in these components were sufficient to alter the functionality and specificity of the pseudouridylation pocket. The dynamic functional changes in response to changes in these three important components were further tested in vivo, and the results were completely consistent with the in vitro results. Finally, we compared our results with predictions made by two computer programs, as well as predictions made by human experts using visual inspection. We found that the predictions of one program (snoGPS) agreed with our experimental results with 100% sensitivity (12/12) and 75% specificity (3/4).

  11. ACA Advocacy Competencies: Social Justice Advocacy at the Client/Student Level

    ERIC Educational Resources Information Center

    Ratts, Manivong J.; Hutchins, A. Michael

    2009-01-01

    There is a rise in calls for counselors to be advocates for social justice. Counselors can meet the growing need to expand their roles to include advocacy by using the ACA (American Counseling Association) Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002). This article operationalizes the client/student level of…

  12. Complete Genome Sequence of the Dairy Isolate Lactobacillus acidipiscis ACA-DC 1533

    PubMed Central

    Kazou, Maria; Alexandraki, Voula; Pot, Bruno; Tsakalidou, Effie

    2017-01-01

    ABSTRACT Lactobacillus acidipiscis is a Gram-positive lactic acid bacterium belonging to the Lactobacillus salivarius clade. Here, we present the first complete genome sequence of L. acidipiscis isolated from traditional Greek Kopanisti cheese. Strain ACA-DC 1533 may play a key role in the strong organoleptic characteristics of Kopanisti cheese. PMID:28126948

  13. Cloning and expression of Aca f 1: a new allergen of Acacia farnesiana pollen

    PubMed Central

    Khosravi, Gholam Reza; Morakabati, Payam; Akbari, Bahareh; Dousti, Fatemeh

    2016-01-01

    Acacia farnesiana is the main source of allergenic pollen and one of the most important causes of respiratory allergic disease in tropical and subtropical regions of the world. The purpose of this study was to produce a recombinant variety of allergenic Ole e 1-like protein from the pollen of this tree. To predict its allergenic cross-reactivity with other members of the Ole e 1-like protein family of common allergenic plants, the nucleotide sequence homology of the Acacia Ole e 1-like protein was evaluated. Amplification of cDNA strands encoding Acacia Ole e 1-like protein was performed by polymerase chain reaction (PCR) and sequenced. Following expression in Escherichia coli using the pET-21b(+) vector, the recombinant protein was purified using metal-affinity chromatography. IgE-binding competence of purified recombinant Ole e 1- like protein (rAca f 1) was analysed by immunoassay using 25 sera collected from Acacia pollen-sensitised patients. Nucleotide sequencing revealed an open reading frame of 453 bp encoding 150 amino acid residues that belonged to the Ole e 1-like protein family, and 11 patients (44%) had considerable specific IgE levels for the rAca f 1. Immunodetection and inhibition assays indicated that the purified rAca f 1 may be the same as that in the crude extract. Aca f 1, the second allergen from Acacia pollen, was identified as a member of the family of Ole e 1-like protein. A high degree of homology was found among amino acid sequences of Aca f 1 and several allergenic members of Ole e 1-like protein family. PMID:27833445

  14. Cloning and expression of Aca f 1: a new allergen of Acacia farnesiana pollen.

    PubMed

    Khosravi, Gholam Reza; Assarehzadegan, Mohammad-Ali; Morakabati, Payam; Akbari, Bahareh; Dousti, Fatemeh

    2016-01-01

    Acacia farnesiana is the main source of allergenic pollen and one of the most important causes of respiratory allergic disease in tropical and subtropical regions of the world. The purpose of this study was to produce a recombinant variety of allergenic Ole e 1-like protein from the pollen of this tree. To predict its allergenic cross-reactivity with other members of the Ole e 1-like protein family of common allergenic plants, the nucleotide sequence homology of the Acacia Ole e 1-like protein was evaluated. Amplification of cDNA strands encoding Acacia Ole e 1-like protein was performed by polymerase chain reaction (PCR) and sequenced. Following expression in Escherichia coli using the pET-21b(+) vector, the recombinant protein was purified using metal-affinity chromatography. IgE-binding competence of purified recombinant Ole e 1- like protein (rAca f 1) was analysed by immunoassay using 25 sera collected from Acacia pollen-sensitised patients. Nucleotide sequencing revealed an open reading frame of 453 bp encoding 150 amino acid residues that belonged to the Ole e 1-like protein family, and 11 patients (44%) had considerable specific IgE levels for the rAca f 1. Immunodetection and inhibition assays indicated that the purified rAca f 1 may be the same as that in the crude extract. Aca f 1, the second allergen from Acacia pollen, was identified as a member of the family of Ole e 1-like protein. A high degree of homology was found among amino acid sequences of Aca f 1 and several allergenic members of Ole e 1-like protein family.

  15. 78 FR 63237 - Extension of the Air Cargo Advance Screening (ACAS) Pilot Program and Reopening of Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... Program and Reopening of Application Period for Participation AGENCY: U.S. Customs and Border Protection... requirements for participation, and invites public comments on any aspect of the test. In brief, the ACAS...

  16. 78 FR 23946 - Extension of the Air Cargo Advance Screening (ACAS) Pilot Program and Reopening of Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... Program and Reopening of Application Period for Participation AGENCY: U.S. Customs and Border Protection... requirements for participation, and invites public comments on any aspect of the test. In brief, the ACAS...

  17. Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform.

    PubMed

    Andrews, Christina; Abraham, Amanda; Grogan, Colleen M; Pollack, Harold A; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

    2015-05-01

    The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment--the state governmental organizations charged with overseeing addiction treatment programs--are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach. In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA's promise to improve access to and quality of addiction treatment.

  18. Arabidopsis ACA7, encoding a putative auto-regulated Ca(2+)-ATPase, is required for normal pollen development.

    PubMed

    Lucca, Noel; León, Gabriel

    2012-04-01

    Microgametogenesis is a complex process that involves numerous well-coordinated cell activities, ending with the production of pollen grains. Pollen development has been studied at the cytological level in Arabidopsis and other plant species, where its temporal time course has been defined. However, the molecular mechanism underlying this process is still unclear, since a relative small number of genes and/or processes have been identified as essential for pollen development. We have designed a methodology to select candidate genes for functional analysis, based on transcriptomic data obtained from different stages of pollen development. From our analyses, we selected At2g22950 as a candidate gene; this gene encodes a protein belonging to the auto-regulated Ca(2+)-ATPase family, ACA7. Microarray data indicate that ACA7 is expressed exclusively in developing pollen grains, with the highest level of mRNA at the time of the second pollen mitosis. Our RT-PCR experiments showed that ACA7 mRNA is detected exclusively in developing flowers. Confocal microscopy experiments showed a plasma membrane localization for the recombinant GFP:ACA7 protein. We identified two different insertional mutant lines, aca7-1 and aca7-2; plants from both mutant lines displayed a normal vegetative development but showed large amounts of dead pollen grains in mature flowers assayed by Alexander's staining. Histological analysis indicated that abnormalities are detected after the first pollen mitosis and we found a strong correlation between ACA7 mRNA accumulation and the severity of the phenotype. Our results indicate that ACA7 is a plasma membrane protein that has an important role during pollen development, possibly through regulation of Ca(2+) homeostasis.

  19. Nudging Leads Consumers In Colorado To Shop But Not Switch ACA Marketplace Plans.

    PubMed

    Marzilli Ericson, Keith M; Kingsdale, Jon; Layton, Tim; Sacarny, Adam

    2017-02-01

    The Affordable Care Act (ACA) dramatically expanded the use of regulated marketplaces in health insurance, but consumers often fail to shop for plans during open enrollment periods. Typically these consumers are automatically reenrolled in their old plans, which potentially exposes them to unexpected increases in their insurance premiums and cost sharing. We conducted a randomized intervention to encourage enrollees in an ACA Marketplace to shop for plans. We tested the effect of letters and e-mails with personalized information about the savings on insurance premiums that they could realize from switching plans and the effect of generic communications that simply emphasized the possibility of saving. The personalized and generic messages both increased shopping on the Marketplace's website by 23 percent, but neither type of message had a significant effect on plan switching. These findings show that simple "nudges" with even generic information can promote shopping in health insurance marketplaces, but whether they can lead to switching remains an open question.

  20. Shifting the open enrollment period for ACA Marketplaces could increase enrollment and improve plan choices.

    PubMed

    Swartz, Katherine; Graves, John A

    2014-07-01

    The next open enrollment period for plans offered in the Affordable Care Act's (ACA's) insurance Marketplaces is set to occur between November 15, 2014, and February 15, 2015--just when many lower-income people are financially stressed by demands of the holiday season. Recent research by experimental psychologists and behavioral economists strongly suggests that when people's decision-making capacity (bandwidth) is stretched thin, either they cannot make decisions or they make poor choices. Using data from nearly a decade of US-based Internet search queries to measure population behavior, we found considerable seasonality in measures of financial stress and in when people seek out information on health insurance plans. A more opportune time for scheduling open enrollment for the ACA Marketplaces may be between February 15 and April 15--weeks when low-income people typically receive income tax refunds and Earned Income Tax Credit payments. Such lump-sum payments could be applied to pay individuals' share of premiums.

  1. Assembly and trafficking of box C/D and H/ACA snoRNPs.

    PubMed

    Massenet, Séverine; Bertrand, Edouard; Verheggen, Céline

    2016-10-07

    Box C/D and box H/ACA snoRNAs are abundant non-coding RNAs that localize in the nucleolus and mostly function as guides for nucleotide modifications. While a large pool of snoRNAs modifies rRNAs, an increasing number of snoRNAs could also potentially target mRNAs. ScaRNAs belong to a family of specific RNAs that localize in Cajal bodies and that are structurally similar to snoRNAs. Most scaRNAs are involved in snRNA modification, while telomerase RNA, which contains H/ACA motifs, functions in telomeric DNA synthesis. In this review, we describe how box C/D and H/ACA snoRNAs are processed and assembled with core proteins to form functional RNP particles. Their biogenesis involve several transport factors that first direct pre-snoRNPs to Cajal bodies, where some processing steps are believed to take place, and then to nucleoli. Assembly of core proteins involves the HSP90/R2TP chaperone-cochaperone system for both box C/D and H/ACA RNAs, but also several factors specific for each family. These assembly factors chaperone unassembled core proteins, regulate the formation and disassembly of pre-snoRNP intermediates, and control the activity of immature particles. The AAA+ ATPase RUVBL1 and RUVBL2 belong to the R2TP co-chaperones and play essential roles in snoRNP biogenesis, as well as in the formation of other macro-molecular complexes. Despite intensive research, their mechanisms of action are still incompletely understood.

  2. An ACA briefing on indefinite NPT extension and on the Moscow summit

    SciTech Connect

    Keeny, S.M. Jr; Mendelsohn, J.; Hartman, A.A.

    1995-06-01

    On May 17, the Arms Control Association (ACA) held a new conference to address important aspects of two events of fundamental importance that occurred in rapid succession. These were the decision by consensus on May 11 by member states meeting in New York to extend indefinitely the nuclear Non-Proliferation Treaty (NPT)- and the May 9-10 summit in Moscow between President Bill Clinton and Russian President Boris Yeltsin.

  3. Most Uninsured Adults Could Schedule Primary Care Appointments Before The ACA, But Average Price Was $160.

    PubMed

    Saloner, Brendan; Polsky, Daniel; Kenney, Genevieve M; Hempstead, Katherine; Rhodes, Karin V

    2015-05-01

    Provisions of the Affordable Care Act (ACA) allow millions more Americans to obtain health insurance. However, a sizable number of people remain uninsured because they live in states that have not expanded Medicaid coverage or because they feel that Marketplace coverage is not affordable. Using data from a ten-state telephone survey in which callers posed as patients, we examined prices for primary care visits offered by physician offices to new uninsured patients in 2012-13, prior to ACA insurance expansions. Patients were quoted a mean price of $160. Significantly lower prices for the uninsured were offered by family practice offices compared to general internists, in offices participating in Medicaid managed care plans, and in federally qualified health centers. Prices were also lower for offices in ZIP codes with higher poverty rates. Only 18 percent of uninsured callers were told that they could bring less than the full amount to the visit and arrange to pay the rest later. ACA insurance expansions could greatly decrease out-of-pocket spending for low-income adults seeking primary care. However, benefits of health reform are likely to be greater in states expanding Medicaid eligibility.

  4. A novel calmodulin-regulated Ca2+-ATPase (ACA2) from Arabidopsis with an N-terminal autoinhibitory domain

    NASA Technical Reports Server (NTRS)

    Harper, J. F.; Hong, B.; Hwang, I.; Guo, H. Q.; Stoddard, R.; Huang, J. F.; Palmgren, M. G.; Sze, H.; Evans, M. L. (Principal Investigator)

    1998-01-01

    To study transporters involved in regulating intracellular Ca2+, we isolated a full-length cDNA encoding a Ca2+-ATPase from a model plant, Arabidopsis, and named it ACA2 (Arabidopsis Ca2+-ATPase, isoform 2). ACA2p is most similar to a "plasma membrane-type" Ca2+-ATPase, but is smaller (110 kDa), contains a unique N-terminal domain, and is missing a long C-terminal calmodulin-binding regulatory domain. In addition, ACA2p is localized to an endomembrane system and not the plasma membrane, as shown by aqueous-two phase fractionation of microsomal membranes. ACA2p was expressed in yeast as both a full-length protein (ACA2-1p) and an N-terminal truncation mutant (ACA2-2p; Delta residues 2-80). Only the truncation mutant restored the growth on Ca2+-depleted medium of a yeast mutant defective in both endogenous Ca2+ pumps, PMR1 and PMC1. Although basal Ca2+-ATPase activity of the full-length protein was low, it was stimulated 5-fold by calmodulin (50% activation around 30 nM). In contrast, the truncated pump was fully active and insensitive to calmodulin. A calmodulin-binding sequence was identified within the first 36 residues of the N-terminal domain, as shown by calmodulin gel overlays on fusion proteins. Thus, ACA2 encodes a novel calmodulin-regulated Ca2+-ATPase distinguished by a unique N-terminal regulatory domain and a non-plasma membrane localization.

  5. Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA.

    PubMed

    Gresenz, Carole Roan; Laugesen, Miriam J; Yesus, Ambeshie; Escarce, José J

    2011-10-01

    Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.

  6. How Will Repealing the ACA Affect Medicaid? Impact on Health Care Coverage, Delivery, and Payment.

    PubMed

    Rosenbaum, Sara; Rothenberg, Sara; Schmucker, Sara; Gunsalus, Rachel; Beckerman, J. Zoë

    2017-03-01

    ISSUE: The Affordable Care Act enhanced Medicaid's role as a health care purchaser by expanding eligibility and broadening the range of tools and strategies available to states. All states have embraced delivery and payment reform as basic elements of their programs. GOAL: To examine the effects of reducing the size and scope of Medicaid under legislation to repeal the ACA. FINDINGS AND CONCLUSIONS: Were the ACA's Medicaid expansion to be eliminated and were federal Medicaid funding to experience major reductions through block grants or per capita caps, the effects on system transformation would be significant. Over 70 percent of Medicaid spending is driven by enrollment in a program that covers 74 million people; on a per capita basis Medicaid costs less than Medicare or commercial insurance. States would need to absorb major financial losses by reducing the number of people served, reducing the scope of services covered, introducing higher cost-sharing, or further reducing already low payments. Far from improving quality and efficiency, these changes would cause the number of uninsured to rise while depriving health care providers and health plans of the resources needed to care for patients and invest in the tools that are essential to system transformation

  7. ACA dependent coverage provision reduced high out-of-pocket health care spending for young adults.

    PubMed

    Busch, Susan H; Golberstein, Ezra; Meara, Ellen

    2014-08-01

    Since September 2010 the Affordable Care Act (ACA) has required that insurers allow children to remain as dependents on their parents' private insurance plans until age twenty-six. Studies have shown that this provision increased coverage rates among young adults. In this article we analyze whether the provision also protected young adults from large and uncertain out-of-pocket expenses. We found that the policy was associated with a statistically significant reduction in the share of young adults facing annual out-of-pocket expenditures greater than $1,500 (decreasing from 4.2 percent to 2.9 percent), compared to an increase in the proportion of their slightly older peers facing such expenditures (increasing from 4.4 percent to 5.4 percent), a net difference of -2.4 percentage points, or 57 percent. We conclude that the dependent coverage provision in the ACA provides financial protection for young adults at a time when they often face high debt burden but low wages.

  8. 76 FR 41262 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH11-1103

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Notice and remains in effect until the expiration of the project period of the ACA funded applications... the scope of health care coverage for Americans. Cost savings through disease prevention is an... activities including prevention research and health screenings, such as the Community Transformation...

  9. Political Ideology and Its Relationship to Perceptions of Social Justice Advocacy among Members of the American Counseling Association (ACA)

    ERIC Educational Resources Information Center

    Steele, Janee Marie

    2010-01-01

    Social justice has become an increasingly controversial topic among members of the American Counseling Association (ACA). Specifically, concerns have been raised over what is perceived to be: (a) the liberal political agenda of social justice advocates, (b) the marginalization of conservative counselors, and (c) the inappropriate use of ACA…

  10. 77 FR 76064 - Reopening of Application Period for Participation in the Air Cargo Advance Screening (ACAS) Pilot...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Reopening of Application Period for Participation in the Air Cargo Advance Screening (ACAS) Pilot Program AGENCY: U.S. Customs and Border Protection, DHS....

  11. 78 FR 315 - Reopening of Application Period for Participation in the Air Cargo Advance Screening (ACAS) Pilot...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ... [Federal Register Volume 78, Number 2 (Thursday, January 3, 2013)] [Notices] [Page 315] [FR Doc No: C1-2012-30922] DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Reopening of Application Period for Participation in the Air Cargo Advance Screening (ACAS) Pilot Program Correction...

  12. Designer Leptin Receptor Antagonist Allo-aca Inhibits VEGF Effects in Ophthalmic Neoangiogenesis Models

    PubMed Central

    Coroniti, Roberta; Farjo, Rafal; Nuno, Didier J.; Otvos, Laszlo; Scolaro, Laura; Surmacz, Eva

    2016-01-01

    Experimental and clinical data suggest that pro-angiogenic, pro-inflammatory and mitogenic cytokine leptin can be implicated in ocular neovascularization and other eye pathologies. At least in part, leptin action appears to be mediated through functional interplay with vascular endothelial growth factor (VEGF). VEGF is a potent regulator of neoangiogenesis and vascular leakage with a proven role in conditions such as proliferative diabetic retinopathy, age-related macular degeneration and diabetic macular edema. Accordingly, drugs targeting VEGF are becoming mainstream treatments for these diseases. The crosstalk between leptin and VEGF has been noted in different tissues, but its involvement in the development of eye pathologies is unclear. Leptin is coexpressed with VEGF during ocular neovascularization and can potentiate VEGF synthesis and angiogenic function. However, whether or not VEGF regulates leptin expression or signaling has never been studied. Consequently, we addressed this aspect of leptin/VEGF crosstalk in ocular models, focusing on therapeutic exploration of underlying mechanisms. Here we show, for the first time, that in retinal (RF/6A) and corneal (BCE) endothelial cells, VEGF (100 ng/mL, 24 h) stimulated leptin mRNA synthesis by 70 and 30%, respectively, and protein expression by 56 and 28%, respectively. In parallel, VEGF induced RF/6A and BCE cell growth by 33 and 20%, respectively. In addition, VEGF upregulated chemotaxis and chemokinesis in retinal cells by ~40%. VEGF-dependent proliferation and migration were significantly reduced in the presence of the leptin receptor antagonist, Allo-aca, at 100–250 nmol/L concentrations. Furthermore, Allo-aca suppressed VEGF-dependent long-term (24 h), but not acute (15 min) stimulation of the Akt and ERK1/2 signaling pathways. The efficacy of Allo-aca was validated in the rat laser-induced choroidal neovascularization model where the compound (5 μg/eye) significantly reduced pathological

  13. The management of esotropia with high AC/A ratio (convergence excess).

    PubMed

    Pratt-Johnson, J A; Tillson, G

    1985-01-01

    This paper reviews the long-term follow-up of esotropia with a high AC/A ratio defined as an increase of 20 delta or more of the esotropia at near compared with distance with the full optical correction of any refractive error in place. Ninety-nine patients were studied for an average follow-up of eight years. Eighty-six achieved fusion but only five achieved central fusion. Forty-five were treated with bifocals. No significant difference in the sensory results were recorded in those patients wearing bifocals compared with those who did not wear bifocals. No patient had miotic therapy for more than a few months. The suppression characteristic of this condition is reviewed.

  14. Women's Health Coverage Since the ACA: Improvements for Most, But Insurer Exclusions Put Many at Risk.

    PubMed

    Palanker, Dania; Davenport, Karen

    2016-08-01

    Issue: Since enactment of the Affordable Care Act (ACA), many more women have health insurance than before the law, in part because it prohibits insurer practices that discriminate against women. However, gaps in women's health coverage persist. Insurers often exclude health services that women are likely to need, leaving women vulnerable to higher costs and denied claims that threaten their economic security and physical health. Goal: To uncover the types and incidence of insurer exclusions that may disproportionately affect women's coverage. Method: The authors examined qualified health plans from 109 insurers across 16 states for 2014, 2015, or both years. Key findings and conclusions: Six types of services are frequently excluded from insurance coverage: treatment of conditions resulting from noncovered services, maintenance therapy, genetic testing, fetal reduction surgery, treatment of self-inflicted conditions, and preventive services not covered by law. Policy change recommendations include prohibiting variations within states' "essential health benefits" benchmark plans and requiring transparency and simplified language in plan documents.

  15. Phosphorylation of serine residues in the N-terminus modulates the activity of ACA8, a plasma membrane Ca2+-ATPase of Arabidopsis thaliana

    PubMed Central

    Giacometti, Sonia; Marrano, Claudia Adriana; Bonza, Maria Cristina; Luoni, Laura; Limonta, Margherita; De Michelis, Maria Ida

    2012-01-01

    ACA8 is a plasma membrane-localized isoform of calmodulin (CaM)-regulated Ca2+-ATPase of Arabidopsis thaliana. Several phosphopeptides corresponding to portions of the regulatory N-terminus of ACA8 have been identified in phospho-proteomic studies. To mimic phosphorylation of the ACA8 N-terminus, each of the serines found to be phosphorylated in those studies (Ser19, Ser22, Ser27, Ser29, Ser57, and Ser99) has been mutated to aspartate. Mutants have been expressed in Saccharomyces cerevisiae and characterized: mutants S19D and S57D—and to a lesser extent also mutants S22D and S27D—are deregulated, as shown by their low activation by CaM and by tryptic cleavage of the N-terminus. The His-tagged N-termini of wild-type and mutant ACA8 (6His-1M-I116) were expressed in Escherichia coli, affinity-purified, and used to analyse the kinetics of CaM binding by surface plasmon resonance. All the analysed mutations affect the kinetics of interaction with CaM to some extent: in most cases, the altered kinetics result in marginal changes in affinity, with the exception of mutants S57D (KD ∼10-fold higher than wild-type ACA8) and S99D (KD about half that of wild-type ACA8). The ACA8 N-terminus is phosphorylated in vitro by two isoforms of A. thaliana calcium-dependent protein kinase (CPK1 and CPK16); phosphorylation of mutant 6His-1M-I116 peptides shows that CPK16 is able to phosphorylate the ACA8 N-terminus at Ser19 and at Ser22. The possible physiological implications of the subtle modulation of ACA8 activity by phosphorylation of its N-terminus are discussed. PMID:22090438

  16. Phosphorylation of serine residues in the N-terminus modulates the activity of ACA8, a plasma membrane Ca2+-ATPase of Arabidopsis thaliana.

    PubMed

    Giacometti, Sonia; Marrano, Claudia Adriana; Bonza, Maria Cristina; Luoni, Laura; Limonta, Margherita; De Michelis, Maria Ida

    2012-02-01

    ACA8 is a plasma membrane-localized isoform of calmodulin (CaM)-regulated Ca(2+)-ATPase of Arabidopsis thaliana. Several phosphopeptides corresponding to portions of the regulatory N-terminus of ACA8 have been identified in phospho-proteomic studies. To mimic phosphorylation of the ACA8 N-terminus, each of the serines found to be phosphorylated in those studies (Ser19, Ser22, Ser27, Ser29, Ser57, and Ser99) has been mutated to aspartate. Mutants have been expressed in Saccharomyces cerevisiae and characterized: mutants S19D and S57D--and to a lesser extent also mutants S22D and S27D--are deregulated, as shown by their low activation by CaM and by tryptic cleavage of the N-terminus. The His-tagged N-termini of wild-type and mutant ACA8 (6His-(1)M-I(116)) were expressed in Escherichia coli, affinity-purified, and used to analyse the kinetics of CaM binding by surface plasmon resonance. All the analysed mutations affect the kinetics of interaction with CaM to some extent: in most cases, the altered kinetics result in marginal changes in affinity, with the exception of mutants S57D (K(D) ≈ 10-fold higher than wild-type ACA8) and S99D (K(D) about half that of wild-type ACA8). The ACA8 N-terminus is phosphorylated in vitro by two isoforms of A. thaliana calcium-dependent protein kinase (CPK1 and CPK16); phosphorylation of mutant 6His-(1)M-I(116) peptides shows that CPK16 is able to phosphorylate the ACA8 N-terminus at Ser19 and at Ser22. The possible physiological implications of the subtle modulation of ACA8 activity by phosphorylation of its N-terminus are discussed.

  17. Single Point Mutations in the Small Cytoplasmic Loop of ACA8, a Plasma Membrane Ca2+-ATPase of Arabidopsis thaliana, Generate Partially Deregulated Pumps*

    PubMed Central

    Fusca, Tiziana; Bonza, Maria Cristina; Luoni, Laura; Meneghelli, Silvia; Marrano, Claudia Adriana; De Michelis, Maria Ida

    2009-01-01

    ACA8 is a type 2B Ca2+-ATPase having a regulatory N terminus whose auto-inhibitory action can be suppressed by binding of calmodulin (CaM) or of acidic phospholipids. ACA8 N terminus is able to interact with a region of the small cytoplasmic loop connecting transmembrane domains 2 and 3. To determine the role of this interaction in auto-inhibition we analyzed single point mutants produced by mutagenesis of ACA8 Glu252 to Asn345 sequence. Mutation to Ala of any of six tested acidic residues (Glu252, Asp273, Asp291, Asp303, Glu302, or Asp332) renders an enzyme that is less dependent on CaM for activity. These results highlight the relevance in ACA8 auto-inhibition of a negative charge of the surface area of the small cytoplasmic loop. The most deregulated of these mutants is D291A ACA8, which is less activated by controlled proteolysis or by acidic phospholipids; the D291A mutant has an apparent affinity for CaM higher than wild-type ACA8. Moreover, its phenotype is stronger than that of D291N ACA8, suggesting a more direct involvement of this residue in the mechanism of auto-inhibition. Among the other produced mutants (I284A, N286A, P289A, P322A, V344A, and N345A), only P322A ACA8 is less dependent on CaM for activity than the wild type. The results reported in this study provide the first evidence that the small cytoplasmic loop of a type 2B Ca2+-ATPase plays a role in the attainment of the auto-inhibited state. PMID:19740735

  18. Single point mutations in the small cytoplasmic loop of ACA8, a plasma membrane Ca2+-ATPase of Arabidopsis thaliana, generate partially deregulated pumps.

    PubMed

    Fusca, Tiziana; Bonza, Maria Cristina; Luoni, Laura; Meneghelli, Silvia; Marrano, Claudia Adriana; De Michelis, Maria Ida

    2009-11-06

    ACA8 is a type 2B Ca(2+)-ATPase having a regulatory N terminus whose auto-inhibitory action can be suppressed by binding of calmodulin (CaM) or of acidic phospholipids. ACA8 N terminus is able to interact with a region of the small cytoplasmic loop connecting transmembrane domains 2 and 3. To determine the role of this interaction in auto-inhibition we analyzed single point mutants produced by mutagenesis of ACA8 Glu(252) to Asn(345) sequence. Mutation to Ala of any of six tested acidic residues (Glu(252), Asp(273), Asp(291), Asp(303), Glu(302), or Asp(332)) renders an enzyme that is less dependent on CaM for activity. These results highlight the relevance in ACA8 auto-inhibition of a negative charge of the surface area of the small cytoplasmic loop. The most deregulated of these mutants is D291A ACA8, which is less activated by controlled proteolysis or by acidic phospholipids; the D291A mutant has an apparent affinity for CaM higher than wild-type ACA8. Moreover, its phenotype is stronger than that of D291N ACA8, suggesting a more direct involvement of this residue in the mechanism of auto-inhibition. Among the other produced mutants (I284A, N286A, P289A, P322A, V344A, and N345A), only P322A ACA8 is less dependent on CaM for activity than the wild type. The results reported in this study provide the first evidence that the small cytoplasmic loop of a type 2B Ca(2+)-ATPase plays a role in the attainment of the auto-inhibited state.

  19. Structure and Interactions of the CS Domain of Human H/ACA RNP Assembly Protein Shq1

    SciTech Connect

    Singh, Mahavir; Wang, Zhonghua; Cascio, Duilio; Feigon, Juli

    2014-12-29

    Shq1 is an essential protein involved in the early steps of biogenesis and assembly of H/ACA ribonucleoprotein particles (RNPs). Shq1 binds to dyskerin (Cbf5 in yeast) at an early step of H/ACA RNP assembly and is subsequently displaced by the H/ACA RNA. Shq1 contains an N-terminal CS and a C-terminal Shq1-specific domain (SSD). Dyskerin harbors many mutations associated with dyskeratosis congenita. Structures of yeast Shq1 SSD bound to Cbf5 revealed that only a subset of these mutations is in the SSD binding site, implicating another subset in the putative CS binding site. Here in this paper, we present the crystal structure of human Shq1 CS (hCS) and the nuclear magnetic resonance (NMR) and crystal structures of hCS containing a serine substitution for proline 22 that is associated with some prostate cancers. The structure of hCS is similar to yeast Shq1 CS domain (yCS) and consists of two β-sheets that form an immunoglobulin-like β-sandwich fold. The N-terminal affinity tag sequence AHHHHHH associates with a neighboring protein in the crystal lattice to form an extra β-strand. Deletion of this tag was required to get spectra suitable for NMR structure determination, while the tag was required for crystallization. NMR chemical shift perturbation (CSP) experiments with peptides derived from putative CS binding sites on dyskerin and Cbf5 revealed a conserved surface on CS important for Cbf5/dyskerin binding. A HADDOCK (high-ambiguity-driven protein-protein docking) model of a Shq1-Cbf5 complex that defines the position of CS domain in the pre-H/ACA RNP was calculated using the CSP data.

  20. Structure and Interactions of the CS Domain of Human H/ACA RNP Assembly Protein Shq1

    DOE PAGES

    Singh, Mahavir; Wang, Zhonghua; Cascio, Duilio; ...

    2014-12-29

    Shq1 is an essential protein involved in the early steps of biogenesis and assembly of H/ACA ribonucleoprotein particles (RNPs). Shq1 binds to dyskerin (Cbf5 in yeast) at an early step of H/ACA RNP assembly and is subsequently displaced by the H/ACA RNA. Shq1 contains an N-terminal CS and a C-terminal Shq1-specific domain (SSD). Dyskerin harbors many mutations associated with dyskeratosis congenita. Structures of yeast Shq1 SSD bound to Cbf5 revealed that only a subset of these mutations is in the SSD binding site, implicating another subset in the putative CS binding site. Here in this paper, we present the crystalmore » structure of human Shq1 CS (hCS) and the nuclear magnetic resonance (NMR) and crystal structures of hCS containing a serine substitution for proline 22 that is associated with some prostate cancers. The structure of hCS is similar to yeast Shq1 CS domain (yCS) and consists of two β-sheets that form an immunoglobulin-like β-sandwich fold. The N-terminal affinity tag sequence AHHHHHH associates with a neighboring protein in the crystal lattice to form an extra β-strand. Deletion of this tag was required to get spectra suitable for NMR structure determination, while the tag was required for crystallization. NMR chemical shift perturbation (CSP) experiments with peptides derived from putative CS binding sites on dyskerin and Cbf5 revealed a conserved surface on CS important for Cbf5/dyskerin binding. A HADDOCK (high-ambiguity-driven protein-protein docking) model of a Shq1-Cbf5 complex that defines the position of CS domain in the pre-H/ACA RNP was calculated using the CSP data.« less

  1. Minimized human telomerase maintains telomeres and resolves endogenous roles of H/ACA proteins, TCAB1, and Cajal bodies.

    PubMed

    Vogan, Jacob M; Zhang, Xiaozhu; Youmans, Daniel T; Regalado, Samuel G; Johnson, Joshua Z; Hockemeyer, Dirk; Collins, Kathleen

    2016-08-15

    We dissected the importance of human telomerase biogenesis and trafficking pathways for telomere maintenance. Biological stability of human telomerase RNA (hTR) relies on H/ACA proteins, but other eukaryotes use other RNP assembly pathways. To investigate additional rationale for human telomerase assembly as H/ACA RNP, we developed a minimized cellular hTR. Remarkably, with only binding sites for telomerase reverse transcriptase (TERT), minimized hTR assembled biologically active enzyme. TERT overexpression was required for cellular interaction with minimized hTR, indicating that H/ACA RNP assembly enhances endogenous hTR-TERT interaction. Telomere maintenance by minimized telomerase was unaffected by the elimination of the telomerase holoenzyme Cajal body chaperone TCAB1 or the Cajal body scaffold protein Coilin. Surprisingly, wild-type hTR also maintained and elongated telomeres in TCAB1 or Coilin knockout cells, with distinct changes in telomerase action. Overall, we elucidate trafficking requirements for telomerase biogenesis and function and expand mechanisms by which altered telomere maintenance engenders human disease.

  2. A common sequence motif determines the Cajal body-specific localization of box H/ACA scaRNAs.

    PubMed

    Richard, Patricia; Darzacq, Xavier; Bertrand, Edouard; Jády, Beáta E; Verheggen, Céline; Kiss, Tamás

    2003-08-15

    Post-transcriptional synthesis of 2'-O-methylated nucleotides and pseudouridines in Sm spliceosomal small nuclear RNAs takes place in the nucleoplasmic Cajal bodies and it is directed by guide RNAs (scaRNAs) that are structurally and functionally indistinguishable from small nucleolar RNAs (snoRNAs) directing rRNA modification in the nucleolus. The scaRNAs are synthesized in the nucleoplasm and specifically targeted to Cajal bodies. Here, mutational analysis of the human U85 box C/D-H/ACA scaRNA, followed by in situ localization, demonstrates that box H/ACA scaRNAs share a common Cajal body-specific localization signal, the CAB box. Two copies of the evolutionarily conserved CAB consensus (UGAG) are located in the terminal loops of the 5' and 3' hairpins of the box H/ACA domains of mammalian, Drosophila and plant scaRNAs. Upon alteration of the CAB boxes, mutant scaRNAs accumulate in the nucleolus. In turn, authentic snoRNAs can be targeted into Cajal bodies by addition of exogenous CAB box motifs. Our results indicate that scaRNAs represent an ancient group of small nuclear RNAs which are localized to Cajal bodies by an evolutionarily conserved mechanism.

  3. What Can Health Communication Science Offer for ACA Implementation? Five Evidence-Informed Strategies for Expanding Medicaid Enrollment

    PubMed Central

    KREUTER, MATTHEW W; McBRIDE, TIMOTHY D; CABURNAY, CHARLENE A; POOR, TIMOTHY; THOMPSON, VETTA L SANDERS; ALCARAZ, KASSANDRA I; EDDENS, KATHERINE S; RATH, SUCHITRA; PERKINS, HANNAH; CASEY, CHRISTOPHER

    2014-01-01

    Context: Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage. Methods: From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA. Findings: We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps. Conclusions: Health communication science can inform the development and execution of strategies to increase the public's understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace. PMID:24597555

  4. The Cbf5-Nop10 Complex is a Molecular Bracket that Organizes Box H/ACA RNPs

    SciTech Connect

    Hamma, Tomoko; Reichow, Steve L.; Varani, Gabriele; Ferre-D'Amare, Adrian R.

    2005-12-01

    Box H/ACA ribonucleoprotein particles (RNPs) catalyze RNA pseudouridylation and direct processing of ribosomal RNA, and are essential architectural components of vertebrate telomerases. H/ACA RNPs comprise four proteins and a multihelical RNA. Two proteins, Cbf5 and Nop10, suffice for basal enzymatic activity in an archaeal in vitro system. We now report their cocrystal structure at 1.95-A resolution. We find that archaeal Cbf5 can assemble with yeast Nop10 and with human telomerase RNA, consistent with the high sequence identity of the RNP componenets between archaea and eukarya. Thus, the Cbf5-Nop10 architecture is phylogenetically conserved. The structure shows how Nop10 buttresses the active site of Cbf5, and it reveals two basic troughs that bidirectionally extend the active site cleft. Mutagenesis results implicate an adjacent basic patch in RNA binding. This tripartite RNA-binding surface may function as a molecular bracket that organizes the multihelical H/ACA and telomerase RNAs.

  5. Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform

    PubMed Central

    Andrews, Christina; Abraham, Amanda; Grogan, Colleen M.; Pollock, Harold A.; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

    2016-01-01

    The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment—the state governmental organizations charged with overseeing addiction treatment programs—are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach. In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA’s promise to improve access to and quality of addiction treatment. PMID:25941285

  6. The ACA's pediatric essential health benefit has resulted in a state-by-state patchwork of coverage with exclusions.

    PubMed

    Grace, Aimee M; Noonan, Kathleen G; Cheng, Tina L; Miller, Dorothy; Verga, Brittany; Rubin, David; Rosenbaum, Sara

    2014-12-01

    The Affordable Care Act (ACA) establishes essential health benefits as the coverage standard for health plans sold in the individual and small-group markets for all fifty states and the District of Columbia, including the health insurance Marketplaces. "Pediatric services" is one of the required classes of coverage under the ACA. However, other than oral health and vision care, neither the act nor the regulations for implementing it define what these services should be. We investigated how state benchmark plans-the base plan chosen in each state as the standard or benchmark of coverage in that state under ACA rules-address pediatric coverage in plans governed by the essential health benefits standard. Our review of summaries of all the state benchmark plans found that no state specified a distinct pediatric services benefit class. Furthermore, although benchmark plans explicitly included multiple pediatric conditions, many plans also specifically excluded services for children with special health care needs. The Department of Health and Human Services has made a commitment in the essential health benefits regulations to review its approach for the 2016 plan year. Thus, our findings have implications for future regulations regarding the essential health benefits standard for pediatric services.

  7. Preliminary engineering design and cost of Advanced Compressed-Air Storage (ACAS) A-5 hybrid

    NASA Astrophysics Data System (ADS)

    Sosnowicz, E. J.; Blackman, J.; Woodhull, A. S.; Zaugg, P.

    1981-08-01

    The advanced compressed air energy (ACAS) plant investiated operates on a partial adiabatic, partial fuel fired cycle. Only a limited advancement in state-of-the-art technology is projected for this hybrid arrangement. The A-5 hybrid systems stores the heat of compression from the low pressure and intermediate pressure compressors in a thermal energy store (TES). The heat collected in the TES is available for preheating the air from the storage cavern prior to its entering the low pressure turbine combustor. This reduces the amount of fuel consumed during power generation. The fuel heat rate for the hybrid cycle is 2660 Btu/kWh as compared to approximately 4000 Btu/kWh for a conventional CAES plant. A virtual stand-off between the hybrid plant and a conventional CAES plant at 235 mills/kWh in 1990 dollars is shown. With a lower cost and increased fuel cost projections, the hybrid system operating cost is less than that for a conventional CAES plant.

  8. Macedovicin, the second food-grade lantibiotic produced by Streptococcus macedonicus ACA-DC 198.

    PubMed

    Georgalaki, Marina; Papadimitriou, Konstantinos; Anastasiou, Rania; Pot, Bruno; Van Driessche, Gonzalez; Devreese, Bart; Tsakalidou, Effie

    2013-02-01

    Streptococcus macedonicus ACA-DC 198 was found to produce a second lantibiotic named macedovicin in addition to macedocin. Macedovicin was purified to homogeneity and mass spectrometric analysis identified a peptide of approximately 3.4 kDa. Partial N-terminal sequence analysis and tandem mass spectrometry revealed that macedovicin was identical to bovicin HJ50 and thermophilin 1277 produced by Streptococcus bovis and Streptococcus thermophilus, respectively. Macedovicin inhibits a broad spectrum of lactic acid bacteria, several food spoilage species (e.g. Clostridium spp.) and oral streptococci. We determined the complete biosynthetic gene cluster of macedovicin. Even though the gene clusters of macedovicin, thermophilin 1277 and bovicin HJ50 were almost identical at the nucleotide level, there were important differences in their predicted genes and proteins. Bovicin HJ50-like lantibiotics were also found to be encoded by Streptococcus suis strains SC84 and D12, Enterococcus columbae PLCH2, Clostridium perfringens JGS1721 and several Bacillus strains. All these lantibiotics contained a number of conserved amino acids that may be important for their biosynthesis and activity, while phylogenetic analysis supported their dispersion by horizontal gene transfer. In conclusion, the production of multiple bacteriocins may enhance the bio-protective potential of S. macedonicus during food fermentation.

  9. Interrelation of preventive care benefits and shared costs under the Affordable Care Act (ACA).

    PubMed

    Dixon, Robert Brent; Hertelendy, Attila J

    2014-08-01

    With the implementation of the Affordable Care Act (ACA), access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact, behavioral shifts on the part of healthcare consumers may alter healthcare. Rather than the current status quo of treating presenting conditions, preventive treatment is largely anticipated to require more resources and may impact the consumer's financial capacity. This report will explore how these two concepts are co-dependent, and highlight the need for continued reform.

  10. At-ACA8 Encodes a Plasma Membrane-Localized Calcium-ATPase of Arabidopsis with a Calmodulin-Binding Domain at the N Terminus1

    PubMed Central

    Bonza, Maria Cristina; Morandini, Piero; Luoni, Laura; Geisler, Markus; Palmgren, Michael Gjedde; De Michelis, Maria Ida

    2000-01-01

    A Ca2+-ATPase was purified from plasma membranes (PM) isolated from Arabidopsis cultured cells by calmodulin (CaM)-affinity chromatography. Three tryptic fragments from the protein were microsequenced and the corresponding cDNA was amplified by polymerase chain reaction using primers designed from the microsequences of the tryptic fragments. At-ACA8 (Arabidopsis-autoinhibited Ca2+-ATPase, isoform 8, accession no. AJ249352) encodes a 1,074 amino acid protein with 10 putative transmembrane domains, which contains all of the characteristic motifs of Ca2+-transporting P-type Ca2+-ATPases. The identity of At-ACA8p as the PM Ca2+-ATPase was confirmed by immunodetection with an antiserum raised against a sequence (valine-17 through threonine-31) that is not found in other plant CaM-stimulated Ca2+-ATPases. Confocal fluorescence microscopy of protoplasts immunodecorated with the same antiserum confirmed the PM localization of At-ACA8. At-ACA8 is the first plant PM localized Ca2+-ATPase to be cloned and is clearly distinct from animal PM Ca2+-ATPases due to the localization of its CaM-binding domain. CaM overlay assays localized the CaM-binding domain of At-ACA8p to a region of the N terminus of the enzyme around tryptophan-47, in contrast to a C-terminal localization for its animal counterparts. Comparison between the sequence of At-ACA8p and those of endomembrane-localized type IIB Ca2+-ATPases of plants suggests that At-ACA8 is a representative of a new subfamily of plant type IIB Ca2+-ATPases. PMID:10938365

  11. The clinical significance of anti-mitotic spindle apparatus antibody (MSA) and anti-centromere antibody (ACA) detected in patients with small cell lung cancer (SCLC)

    PubMed Central

    Tan, Liming; Zhang, Yuhong; Jiang, Yongqing; Li, Hua; Chen, Juanjuan; Ming, Feng; Wang, Waimei; Yu, Jianlin; Zeng, Tingting; Tian, Yongjian; Wu, Yang

    2017-01-01

    Purpose: The project is aimed to detect anti-mitotic spindle apparatus antibody (MSA) and anti-centromere antibody (ACA) and explore the clinical value for the diagnosis of small cell lung cancer (SCLC), providing clinical evidence for molecular studies of SCLC. Methods: 93 SCLC patients, 208 patients with other cancers and 50 healthy controls were enrolled in this study. MSA antibodies were detected by enzyme linked immunosorbent assay (ELISA). MSA, ACA and anti nuclear antibodies (ANA) were examined by indirect immuno-fluorescence (IIF). And the results were retrospectively analyzed. Results: ① the positivity for MSA and ACA by IIF assay was respectively 36.56% and 30.11% in SCLC group, higher than in other tumor groups (P<0.01), ② in correlative analysis, the RR (Relative Ratio) value between MSA and SCLC was as high as 12.93, 12.74, and the RR value of ACA and ANA with SCLC was respectively 4.31 and 3.48. ③ the area under ROC (Receiver operating characteristic) curve (AUC) of MSA detection for SCLC was 0.778, with medium diagnostic value. Conclusion: MSA and ACA might serve as a new marker for SCLC because of its high detection rate. These two markers may participate in the occurrence and development of SCLC, resulting from the highly strong risk. So, the study have some application value for early detection, clinical diagnosis and potential treatments of SCLC. PMID:28337388

  12. Adenylyl cyclase-associated protein Aca1 regulates virulence and differentiation of Cryptococcus neoformans via the cyclic AMP-protein kinase A cascade.

    PubMed

    Bahn, Yong-Sun; Hicks, Julie K; Giles, Steven S; Cox, Gary M; Heitman, Joseph

    2004-12-01

    The evolutionarily conserved cyclic AMP (cAMP) signaling pathway controls cell functions in response to environmental cues in organisms as diverse as yeast and mammals. In the basidiomycetous human pathogenic fungus Cryptococcus neoformans, the cAMP pathway governs virulence and morphological differentiation. Here we identified and characterized adenylyl cyclase-associated protein, Aca1, which functions in parallel with the Galpha subunit Gpa1 to control the adenylyl cyclase (Cac1). Aca1 interacted with the C terminus of Cac1 in the yeast two-hybrid system. By molecular and genetic approaches, Aca1 was shown to play a critical role in mating by regulating cell fusion and filamentous growth in a cAMP-dependent manner. Aca1 also regulates melanin and capsule production via the Cac1-cAMP-protein kinase A pathway. Genetic epistasis studies support models in which Aca1 and Gpa1 are necessary and sufficient components that cooperate to activate adenylyl cyclase. Taken together, these studies further define the cAMP signaling cascade controlling virulence of this ubiquitous human fungal pathogen.

  13. Long-Term Outcome of Medial Rectus Recession and Pulley Posterior Fixation in Esotropia With High AC/A Ratio

    PubMed Central

    Wabulembo, Geoffrey; Demer, Joseph L.

    2014-01-01

    Purpose: Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). Methods: In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Results: Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6Δ ± 10.5Δ and 36.9Δ ± 18.9Δ, respectively. Mean near-distance (N-D) disparity was 16.4Δ ± 12.3Δ. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3Δ at distance and 2.8Δ ± 5.2Δ at near. Mean late postoperative ET was 0.1Δ ± 5.8Δ and 1.0Δ ± 6.2Δ at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9Δ ± 3.6Δ. Discussion: MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. Conclusion: MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures. PMID:22906381

  14. How the ACA's Health Insurance Expansions Have Affected Out-of-Pocket Cost-Sharing and Spending on Premiums.

    PubMed

    Glied, Sherry; Solís-Román, Claudia; Parikh, Shivani

    2016-09-01

    One important benefit gained by the millions of Americans with health insurance through the Affordable Care Act (ACA) is protection from high out-of-pocket health spending. While Medicaid unambiguously reduces out-of-pocket premium and medical costs for low-income people, it is less certain that marketplace coverage and other types of insurance purchased to comply with the law's individual mandate also protect from high health spending. Goal: To compare out-of-pocket spending in 2014 to spending in 2013; assess how this spending changed in states where many people enrolled in the marketplaces relative to states where few people enrolled; and project the decline in the percentage of people paying high amounts out-of-pocket. Methods: Linear regression models were used to estimate whether people under age 65 spent above certain thresholds. Key findings and conclusions: The probability of incurring high out-of-pocket costs and premium expenses declined as marketplace enrollment increased. The percentage reductions were greatest among those with incomes between 250 percent and 399 percent of poverty, those who were eligible for premium subsidies, and those who previously were uninsured or had very limited nongroup coverage. These effects appear largely attributable to marketplace enrollment rather than to other ACA provisions or to economic trends.

  15. Algorithmic co-optimization of genetic constructs and growth conditions: application to 6-ACA, a potential nylon-6 precursor.

    PubMed

    Zhou, Hui; Vonk, Brenda; Roubos, Johannes A; Bovenberg, Roel A L; Voigt, Christopher A

    2015-12-02

    Optimizing bio-production involves strain and process improvements performed as discrete steps. However, environment impacts genotype and a strain that is optimal under one set of conditions may not be under different conditions. We present a methodology to simultaneously vary genetic and process factors, so that both can be guided by design of experiments (DOE). Advances in DNA assembly and gene insulation facilitate this approach by accelerating multi-gene pathway construction and the statistical interpretation of screening data. This is applied to a 6-aminocaproic acid (6-ACA) pathway in Escherichia coli consisting of six heterologous enzymes. A 32-member fraction factorial library is designed that simultaneously perturbs expression and media composition. This is compared to a 64-member full factorial library just varying expression (0.64 Mb of DNA assembly). Statistical analysis of the screening data from these libraries leads to different predictions as to whether the expression of enzymes needs to increase or decrease. Therefore, if genotype and media were varied separately this would lead to a suboptimal combination. This is applied to the design of a strain and media composition that increases 6-ACA from 9 to 48 mg/l in a single optimization step. This work introduces a generalizable platform to co-optimize genetic and non-genetic factors.

  16. Factors Affecting Health Insurance Enrollment Through the State Marketplaces: Observations on the ACA's Third Open Enrollment Period.

    PubMed

    Giovannelli, Justin; Curran, Emily

    2016-07-01

    Issue: Nearly 12.7 million individuals signed up for coverage in the Affordable Care Act's (ACA) health insurance marketplaces during the third open enrollment period, and by the end of March there were 11.1 million consumers with active coverage. States that operate their own marketplaces posted a year-to-year enrollment gain of 8.8 percent. To maintain membership and attract new consumers, the state-based marketplaces must sponsor enrollment assistance programs and conduct consumer outreach. These marketplaces relied heavily on such efforts during the third enrollment period, despite declining funding. Goal: To learn which outreach strategies, assistance programs, and other factors marketplace officials viewed as having exerted the greatest influence on enrollment. Methods: Survey of officials representing each of the 17 state-based marketplaces (15 responses). Key findings and conclusions: The cost of coverage and low health insurance literacy pose significant barriers to enrollment for many consumers. Marketplaces sought to overcome them by encouraging consumers to obtain in-person enrollment assistance from ACA-created assistance programs and from insurance brokers, and by partnering with community organizations for outreach activities. Many marketplaces also enhanced their web portals to make them easier to navigate and to give consumers better tools with which to evaluate their coverage options.

  17. Layout Design of Human-Machine Interaction Interface of Cabin Based on Cognitive Ergonomics and GA-ACA.

    PubMed

    Deng, Li; Wang, Guohua; Yu, Suihuai

    2016-01-01

    In order to consider the psychological cognitive characteristics affecting operating comfort and realize the automatic layout design, cognitive ergonomics and GA-ACA (genetic algorithm and ant colony algorithm) were introduced into the layout design of human-machine interaction interface. First, from the perspective of cognitive psychology, according to the information processing process, the cognitive model of human-machine interaction interface was established. Then, the human cognitive characteristics were analyzed, and the layout principles of human-machine interaction interface were summarized as the constraints in layout design. Again, the expression form of fitness function, pheromone, and heuristic information for the layout optimization of cabin was studied. The layout design model of human-machine interaction interface was established based on GA-ACA. At last, a layout design system was developed based on this model. For validation, the human-machine interaction interface layout design of drilling rig control room was taken as an example, and the optimization result showed the feasibility and effectiveness of the proposed method.

  18. Algorithmic co-optimization of genetic constructs and growth conditions: application to 6-ACA, a potential nylon-6 precursor

    PubMed Central

    Zhou, Hui; Vonk, Brenda; Roubos, Johannes A.; Bovenberg, Roel A.L.; Voigt, Christopher A.

    2015-01-01

    Optimizing bio-production involves strain and process improvements performed as discrete steps. However, environment impacts genotype and a strain that is optimal under one set of conditions may not be under different conditions. We present a methodology to simultaneously vary genetic and process factors, so that both can be guided by design of experiments (DOE). Advances in DNA assembly and gene insulation facilitate this approach by accelerating multi-gene pathway construction and the statistical interpretation of screening data. This is applied to a 6-aminocaproic acid (6-ACA) pathway in Escherichia coli consisting of six heterologous enzymes. A 32-member fraction factorial library is designed that simultaneously perturbs expression and media composition. This is compared to a 64-member full factorial library just varying expression (0.64 Mb of DNA assembly). Statistical analysis of the screening data from these libraries leads to different predictions as to whether the expression of enzymes needs to increase or decrease. Therefore, if genotype and media were varied separately this would lead to a suboptimal combination. This is applied to the design of a strain and media composition that increases 6-ACA from 9 to 48 mg/l in a single optimization step. This work introduces a generalizable platform to co-optimize genetic and non-genetic factors. PMID:26519464

  19. Layout Design of Human-Machine Interaction Interface of Cabin Based on Cognitive Ergonomics and GA-ACA

    PubMed Central

    Deng, Li; Wang, Guohua; Yu, Suihuai

    2016-01-01

    In order to consider the psychological cognitive characteristics affecting operating comfort and realize the automatic layout design, cognitive ergonomics and GA-ACA (genetic algorithm and ant colony algorithm) were introduced into the layout design of human-machine interaction interface. First, from the perspective of cognitive psychology, according to the information processing process, the cognitive model of human-machine interaction interface was established. Then, the human cognitive characteristics were analyzed, and the layout principles of human-machine interaction interface were summarized as the constraints in layout design. Again, the expression form of fitness function, pheromone, and heuristic information for the layout optimization of cabin was studied. The layout design model of human-machine interaction interface was established based on GA-ACA. At last, a layout design system was developed based on this model. For validation, the human-machine interaction interface layout design of drilling rig control room was taken as an example, and the optimization result showed the feasibility and effectiveness of the proposed method. PMID:26884745

  20. The ACA Standards Organizer. A Tool for the Preparation of Camps for Visitation for American Camping Association Camp Accreditation and Site Approval.

    ERIC Educational Resources Information Center

    Chenery, Mary Faeth

    This comprehensive guide helps camp administrators prepare for camp accreditation and site approval visits by the American Camping Association (ACA). The introductory sections outline the purpose and administration of the standards program and provide definitions of camping terms. Standards are organized under one section for camp accreditation…

  1. Seismic ambient noise H/V spectral ratio using the ACA (autocorrelations of coda of autocorrelations) approach

    NASA Astrophysics Data System (ADS)

    Sanchez-Sesma, F. J.; Piña, J.; Campillo, M.; Luzón, F.; García-Jerez, A.; Albarello, D.; Lunedei, E.

    2012-12-01

    The seismic ambient noise horizontal-to-vertical spectral ratios (NHVSR) are valuable for microzonation, and seismic prospecting. This is particularly true for low-cost dense spatial sampling projects. Arai and Tokimatsu (2004) proposed to use average energy densities to compose the ratios. It means that H/V comes from the square root of the ratio of averages. On the other hand, a popular approach makes the average of spectral ratios. For ergodic processes peak values are usually the same using these two approaches. Sometimes however, the observations are insufficient and computed values for low frequencies display large variability and the corresponding H/V estimates may be inaccurate. The bias caused by localized sources may be the source of errors in the estimates. In this work we propose to compute the NHVSR using the Autocorrelations of Coda of Autocorrelations. This ACA approach is inspired in the work by Stehly et al. (2008). They used the Correlations of Coda of Correlations (C3) to isotropize the field. In our ACA approach the whole time series, say of 30 minutes, for each component is autocorrelated and the averages of the spectral density of selected windows (late coda windows are eliminated) are then improved estimates of directional energy densities. The computation of NHVSR using ACA appears more stable and free of transient effects. It remains to establish how this may be accounted for in forward calculation of H/V spectral ratios for models like a layered medium (e.g. Sánchez-Sesma et al., 2011; Albarello and Lunedei, 2011). This will require further scrutiny. References. Albarello, D. & E. Lunedei (2011). Structure of ambient vibration wavefield in the frequency range of engineering interest ([0.5, 20] Hz): insights from numerical modelling. Near Surface Geophysics 9, 543-559. Arai, H. & K. Tokimatsu (2004). S-wave velocity profiling by inversion of microtremor H/V spectrum, Bull. Seismol. Soc. Am. 94, 53-63. Sánchez-Sesma, F. J., M. Rodr

  2. Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Advanced Collision Avoidance System for UAS (ACAS Xu) Interoperability White Paper Presentation

    NASA Technical Reports Server (NTRS)

    Fern, Lisa

    2017-01-01

    The Phase 1 DAA Minimum Operational Performance Standards (MOPS) provided requirements for two classes of DAA equipment: equipment Class 1 contains the basic DAA equipment required to assist a pilot in remaining well clear, while equipment Class 2 integrates the Traffic Alert and Collision Avoidance (TCAS) II system. Thus, the Class 1 system provides RWC functionality only, while the Class 2 system is intended to provide both RWC and Collision Avoidance (CA) functionality, in compliance with the Minimum Aviation System Performance (MASPS) for the Interoperability of Airborne Collision Avoidance Systems. The FAAs TCAS Program Office is currently developing Airborne Collision Avoidance System X (ACAS X) to support the objectives of the Federal Aviation Administrations (FAA) Next Generation Air Transportation System Program (NextGen). ACAS X has a suite of variants with a common underlying design that are intended to be optimized for their intended airframes and operations. ACAS Xu being is designed for UAS and allows for new surveillance technologies and tailored logic for platforms with different performance characteristics. In addition to Collision Avoidance (CA) alerting and guidance, ACAS Xu is being tuned to provide RWC alerting and guidance in compliance with the SC 228 DAA MOPS. With a single logic performing both RWC and CA functions, ACAS Xu will provide industry with an integrated DAA solution that addresses many of the interoperability shortcomings of Phase I systems. While the MOPS for ACAS Xu will specify an integrated DAA system, it will need to show compliance with the RWC alerting thresholds and alerting requirements defined in the DAA Phase 2 MOPS. Further, some functional components of the ACAS Xu system such as the remote pilots displayed guidance might be mostly references to the corresponding requirements in the DAA MOPS. To provide a seamless, integrated, RWC-CA system to assist the pilot in remaining well clear and avoiding collisions, several

  3. The ACA's Pediatric Essential Health Benefit Has Resulted In A State-By-State Patchwork of Coverage With Exclusions

    PubMed Central

    Grace, Aimee M.; Noonan, Kathleen G.; Cheng, Tina L.; Miller, Dorothy; Verga, Brittany; Ruben, David; Rosenbaum, Sara

    2015-01-01

    The ACA establishes “essential health benefits” (EHBs) as the coverage standard for health plans sold in the individual and small group markets, including the health insurance Marketplace. “Pediatric services” are a required EHB coverage class. However, other than oral health and vision care, neither the statute nor the implementing regulations define the term. This study aimed to determine how state benchmark plans address pediatric coverage in EHB-governed plans. Our review of state benchmark plan summaries for all 50 states and D.C. found that no state specified a distinct “pediatric services” benefit class. Furthermore, although benchmark plans explicitly included multiple pediatric conditions, many state benchmark plans also specifically excluded services for children with special health care needs. These findings suggest important policy directions in preparing for the 2016 plan year. PMID:25489031

  4. The apoptotic effect of 1’S-1’-Acetoxychavicol Acetate (ACA) enhanced by inhibition of non-canonical autophagy in human non-small cell lung cancer cells

    PubMed Central

    Sok, Sophia P. M.; Arshad, Norhafiza M.; Azmi, Mohamad Nurul; Awang, Khalijah; Ozpolat, Bulent

    2017-01-01

    Autophagy plays a role in deciding the fate of cells by inducing either survival or death. 1’S-1-acetoxychavicol acetate (ACA) is a phenylpropanoid isolated from rhizomes of Alpinia conchigera and has been reported previously on its apoptotic effects on various cancers. However, the effect of ACA on autophagy remains ambiguous. The aims of this study were to investigate the autophagy-inducing ability of ACA in human non-small cell lung cancer (NSCLC), and to determine its role as pro-survival or pro-death mechanism. Cell viability assay was conducted using MTT. The effect of autophagy was assessed by acridine orange staining, GFP-LC3 punctate formation assay, and protein level were analysed using western blot. Annexin V-FITC/PI staining was performed to detect percentage of cells undergoing apoptosis by using flow cytometry. ACA inhibits the cell viability and induced formation of cytoplasmic vacuoles in NSCLC cells. Acidic vesicular organelles and GFP-LC3 punctate formation were increased in response to ACA exposure in A549 and SK-LU-1 cell lines; implying occurrence of autophagy. In western blot, accumulation of LC3-II accompanied by degradation of p62 was observed, which further confirmed the full flux of autophagy induction by ACA. The reduction of Beclin-1 upon ACA treatment indicated the Beclin-1-independent autophagy pathway. An early autophagy inhibitor, 3-methyaldenine (3-MA), failed to suppress the autophagy triggered by ACA; validating the existence of Beclin-1-independent autophagy. Silencing of LC3-II using short interfering RNA (siRNA) abolished the autophagy effects, enhancing the cytotoxicity of ACA through apoptosis. This proposed ACA triggered a pro-survival autophagy in NSCLC cells. Consistently, co-treatment with lysosomal inhibitor, chloroquine (CQ), exerted a synergistic effect resulting in apoptosis. Our findings suggested ACA induced pro-survival autophagy through Beclin-1-independent pathway in NSCLC. Hence, targeting autophagy pathway

  5. ACA-Pro: calibration protocol for quantitative diffuse reflectance spectroscopy. Validation on contact and noncontact probe- and CCD-based systems

    NASA Astrophysics Data System (ADS)

    Sorgato, Veronica; Berger, Michel; Emain, Charlotte; Vever-Bizet, Christine; Dinten, Jean-Marc; Bourg-Heckly, Geneviève; Planat-Chrétien, Anne

    2016-06-01

    We have developed an adaptive calibration algorithm and protocol (ACA-Pro) that corrects from the instrumental response of various spatially resolved diffuse reflectance spectroscopy (DRSsr) systems to enable the quantification of absorption and scattering properties based on a Monte Carlo-based look-up-table approach. The protocol involves the use of a calibration reference base built with measurements of a range of different diffusive intralipid phantoms. Moreover, an advanced strategy was established to take into account the experimental variations with an additional measurement of a common solid material, allowing the use of a single calibration reference base for all experiments. The ACA-Pro is validated in contact and noncontact probe-based DRSsr systems. Furthermore, the first results of a setup replacing the probe with a CCD detector are shown to confirm the robustness of the approach.

  6. Health Insurance Challenges in the Post-Affordable Care Act (ACA) Era: a Qualitative Study of the Perspective of Low-Income People of Color in Metropolitan Detroit.

    PubMed

    Patel, Minal R; Jensen, Alison; Ramirez, Erminia; Tariq, Madiha; Lang, Ian; Kowalski-Dobson, Theresa; Pettway, Joslyn; Famulare, Michelle; Lichtenstein, Richard

    2017-02-07

    Low-income people of color are at risk of remaining uninsured due to a variety of factors. This study examined Affordable Care Act (ACA)-related and other health insurance enrollment experiences, observations, navigation needs, and experiences maintaining health insurance coverage among low-income communities of color in an economically disadvantaged community (Metropolitan Detroit). We conducted nine focus groups (n = 87) between May and June 2015. Participants were recruited through community-based organizations serving our key populations of interest. Using an inductive thematic analysis approach, codes and themes were generated. Findings from six themes demonstrated that although health insurance is perceived as important, confusion and frustration persist around health plan benefits and coverage, eligibility requirements and key provisions of the ACA, and enrollment. Individuals face difficulties justifying the cost of health insurance. More focused insurance outreach efforts are needed to achieve the ultimate goal of improving the health of low-income communities of color.

  7. Policy Commercializing Nonprofits in Health: The History of a Paradox From the 19th Century to the ACA

    PubMed Central

    FOX, DANIEL M

    2015-01-01

    Policy Points: Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector. This policy paradox persists during the implementation of the Affordable Care Act of 2010. Context For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox. Methods This article explores the origin and persistence of the paradox using what many scholars call “interpretive social science.” This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality. Findings A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness. Conclusions The policy paradox that has incentivized the

  8. Tissue-specific root ion profiling reveals essential roles of the CAX and ACA calcium transport systems in response to hypoxia in Arabidopsis

    PubMed Central

    Wang, Feifei; Chen, Zhong-Hua; Liu, Xiaohui; Colmer, Timothy David; Zhou, Meixue; Shabala, Sergey

    2016-01-01

    Waterlogging is a major abiotic stress that limits the growth of plants. The crucial role of Ca2+ as a second messenger in response to abiotic and biotic stimuli has been widely recognized in plants. However, the physiological and molecular mechanisms of Ca2+ distribution within specific cell types in different root zones under hypoxia is poorly understood. In this work, whole-plant physiological and tissue-specific Ca2+ changes were studied using several ACA (Ca2+-ATPase) and CAX (Ca2+/proton exchanger) knock-out Arabidopsis mutants subjected to waterlogging treatment. In the wild-type (WT) plants, several days of hypoxia decreased the expression of ACA8, CAX4, and CAX11 by 33% and 50% compared with the control. The hypoxic treatment also resulted in an up to 11-fold tissue-dependent increase in Ca2+ accumulation in root tissues as revealed by confocal microscopy. The increase was much higher in stelar cells in the mature zone of Arabidopsis mutants with loss of function for ACA8, ACA11, CAX4, and CAX11. In addition, a significantly increased Ca2+ concentration was found in the cytosol of stelar cells in the mature zone after hypoxic treatment. Three weeks of waterlogging resulted in dramatic loss of shoot biomass in cax11 plants (67% loss in shoot dry weight), while in the WT and other transport mutants this decline was only 14–22%. These results were also consistent with a decline in leaf chlorophyll fluorescence (F v/F m). It is suggested that CAX11 plays a key role in maintaining cytosolic Ca2+ homeostasis and/or signalling in root cells under hypoxic conditions. PMID:26889007

  9. Fisher: a program for the detection of H/ACA snoRNAs using MFE secondary structure prediction and comparative genomics – assessment and update

    PubMed Central

    Freyhult, Eva; Edvardsson, Sverker; Tamas, Ivica; Moulton, Vincent; Poole, Anthony M

    2008-01-01

    Background The H/ACA family of small nucleolar RNAs (snoRNAs) plays a central role in guiding the pseudouridylation of ribosomal RNA (rRNA). In an effort to systematically identify the complete set of rRNA-modifying H/ACA snoRNAs from the genome sequence of the budding yeast, Saccharomyces cerevisiae, we developed a program – Fisher – and previously presented several candidate snoRNAs based on our analysis [1]. Findings In this report, we provide a brief update of this work, which was aborted after the publication of experimentally-identified snoRNAs [2] identical to candidates we had identified bioinformatically using Fisher. Our motivation for revisiting this work is to report on the status of the candidate snoRNAs described in [1], and secondly, to report that a modified version of Fisher together with the available multiple yeast genome sequences was able to correctly identify several H/ACA snoRNAs for modification sites not identified by the snoGPS program [3]. While we are no longer developing Fisher, we briefly consider the merits of the Fisher algorithm relative to snoGPS, which may be of use for workers considering pursuing a similar search strategy for the identification of small RNAs. The modified source code for Fisher is made available as supplementary material. Conclusion Our results confirm the validity of using minimum free energy (MFE) secondary structure prediction to guide comparative genomic screening for RNA families with few sequence constraints. PMID:18710502

  10. Synthesis, crystal structure, and magnetism of A2Co12As7 (A=Ca, Y, Ce-Yb)

    NASA Astrophysics Data System (ADS)

    Tan, Xiaoyan; Ovidiu Garlea, V.; Chai, Ping; Geondzhian, Andrey Y.; Yaroslavtsev, Alexander A.; Xin, Yan; Menushenkov, Alexey P.; Chernikov, Roman V.; Shatruk, Michael

    2016-04-01

    Ternary intermetallics, A2Co12As7 (A=Ca, Y, Ce-Yb), have been synthesized by annealing mixtures of elements in molten Bi at 1223 K. The materials obtained crystallize in the P63/m variant of the Zr2Fe12P7 structure type. The unit cell volume shows a monotonic decrease with the increasing atomic number of the rare-earth metal, with the exception of Ce-, Eu-, and Yb-containing compounds. An examination of these outliers with X-ray absorption near edge structures (XANES) spectroscopy revealed mixed valence of Ce, Eu, and Yb, with the average oxidation states of +3.20(1), +2.47(5), and +2.91(1), respectively, at room temperature. Magnetic behavior of A2Co12As7 is generally characterized by ferromagnetic ordering of Co 3d moments at 100-140 K, followed by low-temperature ordering of rare-earth 4f moments. The 3d-4f magnetic coupling changes from antiferromagnetic for A=Pr-Sm to ferromagnetic for A=Ce and Eu-Yb. Polarized neutron scattering experiments were performed to support the postulated ferro- and ferrimagnetic ground states for Ce2Co12As7 and Nd2Co12As7, respectively.

  11. Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

    PubMed

    Becker, Nora V; Polsky, Daniel

    2015-07-01

    The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance.

  12. Synthesis, crystal structure, and magnetism of A2Co12As7 (A=Ca, Y, Ce–Yb)

    DOE PAGES

    Tan, Xiaoyan; Ovidiu Garlea, V.; Chai, Ping; ...

    2015-08-28

    In this study, ternary intermetallics, A2Co12As7 (A=Ca, Y, Ce–Yb), have been synthesized by annealing mixtures of elements in molten Bi at 1223 K. The materials obtained crystallize in the P63/m variant of the Zr2Fe12P7 structure type. The unit cell volume shows a monotonic decrease with the increasing atomic number of the rare-earth metal, with the exception of Ce-, Eu-, and Yb-containing compounds. An examination of these outliers with X-ray absorption near edge structures (XANES) spectroscopy revealed mixed valence of Ce, Eu, and Yb, with the average oxidation states of +3.20(1), +2.47(5), and +2.91(1), respectively, at room temperature. Magnetic behavior ofmore » A2Co12As7 is generally characterized by ferromagnetic ordering of Co 3d moments at 100–140 K, followed by low-temperature ordering of rare-earth 4f moments. The 3d-4f magnetic coupling changes from antiferromagnetic for A=Pr–Sm to ferromagnetic for A=Ce and Eu–Yb. Finally, polarized neutron scattering experiments were performed to support the postulated ferro- and ferrimagnetic ground states for Ce2Co12As7 and Nd2Co12As7, respectively.« less

  13. Functional expression in yeast of an N-deleted form of At-ACA8, a plasma membrane Ca(2+)-ATPase of Arabidopsis thaliana, and characterization of a hyperactive mutant.

    PubMed

    Bonza, Maria Cristina; Luoni, Laura; De Michelis, Maria Ida

    2004-03-01

    A constitutively active form of At-ACA8, a plasma membrane Ca(2+)-ATPase from Arabidopsis thaliana (L.) Heynh., from which the first 74 amino acids containing the calmodulin-binding domain (delta74- At-ACA8) had been deleted, was expressed in Saccharomyces cerevisiae strain K616, which lacks the main endogenous active Ca(2+) transport systems. Delta74- At-ACA8 complemented the K616 phenotype, making it able to grow in a calcium-depleted medium. Delta74- At-ACA8 protein, which co-migrated with the endoplasmic reticulum marker BiP in a sucrose-density gradient, catalyzed MgATP-dependent Ca(2+) uptake and Ca(2+)-dependent MgATP hydrolysis, and retained the biochemical characteristics of the native plant plasma membrane Ca(2+)-ATPase (low specificity for nucleoside triphosphate, high sensitivity to inhibition by the fluorescein derivatives erythrosin B and eosin Y), thus confirming that it is correctly folded and functional. Substitution of the (794)HE residues (numbers refer to full-length At-ACA8) following the highly conserved TGDG(TV)NDP(AS)L motif in the cytoplasmic headpiece with two lysine residues generated an hyperactive protein, with a catalytic activity 2-fold higher than that of delta74- At-ACA8. The (794)HE-->KK mutant was also about 6-fold more sensitive than delta74- At-ACA8 to inhibition by vanadate, indicating that the mutation determines an increase in the proportion of enzyme in the E(2) state during the catalytic cycle.

  14. Computational prediction and validation of C/D, H/ACA and Eh_U3 snoRNAs of Entamoeba histolytica

    PubMed Central

    2012-01-01

    Background Small nucleolar RNAs are a highly conserved group of small RNAs found in eukaryotic cells. Genes encoding these RNAs are diversely located throughout the genome. They are functionally conserved, performing post transcriptional modification (methylation and pseudouridylation) of rRNA and other nuclear RNAs. They belong to two major categories: the C/D box and H/ACA box containing snoRNAs. U3 snoRNA is an exceptional member of C/D box snoRNAs and is involved in early processing of pre-rRNA. An antisense sequence is present in each snoRNA which guides the modification or processing of target RNA. However, some snoRNAs lack this sequence and often they are called orphan snoRNAs. Results We have searched snoRNAs of Entamoeba histolytica from the genome sequence using computational programmes (snoscan and snoSeeker) and we obtained 99 snoRNAs (C/D and H/ACA box snoRNAs) along with 5 copies of Eh_U3 snoRNAs. These are located diversely in the genome, mostly in intergenic regions, while some are found in ORFs of protein coding genes, intron and UTRs. The computationally predicted snoRNAs were validated by RT-PCR and northern blotting. The expected sizes were in agreement with the observed sizes for all C/D box snoRNAs tested, while for some of the H/ACA box there was indication of processing to generate shorter products. Conclusion Our results showed the presence of snoRNAs in E. histolytica, an early branching eukaryote, and the structural features of E. histolytica snoRNAs were well conserved when compared with yeast and human snoRNAs. This study will help in understanding the evolution of these conserved RNAs in diverse phylogenetic groups. PMID:22892049

  15. Production of a single-chain fragment of the murine anti-idiotypic antibody ACA125 as phage-displayed and soluble antibody by recombinant phage antibody technique.

    PubMed

    Schlebusch, H; Reinartz, S; Kaiser, R; Grünn, U; Wagner, U

    1997-02-01

    The F(ab')2 fragment of the murine monoclonal anti-idiotypic antibody ACA125 mimicking the tumor-associated antigen CA125 is used as a vaccine for the induction of an anti-tumoral immunity in patients with ovarian carcinoma. We tried to generate a single-chain fragment (ScFv) composed of ACA125 heavy- and light-chain variable domains connected by a polypeptide linker as an alternative to the corresponding F(ab')2 fragment. Heavy- and light-chain genes of antibody-producing mouse hybridoma cell line were amplified separately and assembled into a ScFv gene with linker DNA by the polymerase chain reaction (PCR). The ScFv gene was ligated into the phagemid vector pCANTAB5E, which allows the production of both phage-displayed and soluble ScFv. Transformed Escherichia coli TG1 cells were infected with M13K07 helper phage to yield recombinant phage, which display ScFv fragments as a g3p fusion protein on the surface of the filamentous phage M13. Recombinant phages could be selected by binding to the idiotypic antibody OC125 after one round of panning and directly used to reinfect E. coli TG1 cells. The E. coli nonsuppressor strain HB2151 was infected with an antigen-positive phage clone, previously screened by enzyme-linked immunosorbent assay (ELISA), to express soluble ScFv fragments. Functional soluble ScFv binding to the idiotypic antibody OC125 F(ab')2 could be detected in the bacterial periplasm by Western blot and ELISA. The variable heavy- and light-chain genes of the ACA125 ScFv fragment were further sequenced and compared with known antibody sequences.

  16. A calcium-dependent protein kinase can inhibit a calmodulin-stimulated Ca2+ pump (ACA2) located in the endoplasmic reticulum of Arabidopsis

    NASA Technical Reports Server (NTRS)

    Hwang, I.; Sze, H.; Harper, J. F.; Evans, M. L. (Principal Investigator)

    2000-01-01

    The magnitude and duration of a cytosolic Ca(2+) release can potentially be altered by changing the rate of Ca(2+) efflux. In plant cells, Ca(2+) efflux from the cytoplasm is mediated by H(+)/Ca(2+)-antiporters and two types of Ca(2+)-ATPases. ACA2 was recently identified as a calmodulin-regulated Ca(2+)-pump located in the endoplasmic reticulum. Here, we show that phosphorylation of its N-terminal regulatory domain by a Ca(2+)-dependent protein kinase (CDPK isoform CPK1), inhibits both basal activity ( approximately 10%) and calmodulin stimulation ( approximately 75%), as shown by Ca(2+)-transport assays with recombinant enzyme expressed in yeast. A CDPK phosphorylation site was mapped to Ser(45) near a calmodulin binding site, using a fusion protein containing the N-terminal domain as an in vitro substrate for a recombinant CPK1. In a full-length enzyme, an Ala substitution for Ser(45) (S45/A) completely blocked the observed CDPK inhibition of both basal and calmodulin-stimulated activities. An Asp substitution (S45/D) mimicked phosphoinhibition, indicating that a negative charge at this position is sufficient to account for phosphoinhibition. Interestingly, prior binding of calmodulin blocked phosphorylation. This suggests that, once ACA2 binds calmodulin, its activation state becomes resistant to phosphoinhibition. These results support the hypothesis that ACA2 activity is regulated as the balance between the initial kinetics of calmodulin stimulation and CDPK inhibition, providing an example in plants for a potential point of crosstalk between two different Ca(2+)-signaling pathways.

  17. Will the Affordable Care Act (ACA) Improve Racial/Ethnic Disparity of Eye Examination Among US Working-Age Population with Diabetes?

    PubMed

    Shi, Qian; Fonseca, Vivian; Krousel-Wood, Marie; Zhao, Yingnan; Nellans, Frank P; Luo, Qingyang; Shi, Lizheng

    2016-07-01

    This study aimed to examine the racial/ethnic disparity of eye examination rates among US adults with diabetes before and after the ACA. Working-age adults (18-64 years) with diabetes for years 2014-2017 were simulated by bootstrapping from the working-age diabetes patient sample of Medical Expenditure Panel Survey (MEPS) Household Component 2011. Insurance coverage rates were separately predicted for each racial/ethnic group based on the Congressional Budgeting Office (CBO) report in 2014 and the proportions of Medicaid eligibility. Eye examination rates were weighted to national estimates and compared between racial/ethnic groups. Confidence intervals were estimated using the bootstrap percentile method. Health insurance coverage after the ACA is projected to increase from 90.23 % in 2011 to 98.33 % in 2014 among non-Hispanic Whites (NHW), reaching 98.96 % in 2017. Minorities are forecasted to have about 15 % expansion of insurance coverage from 2011 (80.65 %) to 2014 (96.00 %), reaching 97.25 % in 2017. In 2011, 63.01 % of NHW had eye examinations with forecasted increase to 65.83 % in 2014 and 66.05 % in 2017, while the eye examination rate in the minorities will increase from 55.75 % in 2011 to 59.23 % in 2014 and remain at 59.48 % in 2017. Therefore, racial disparity in eye examination rates is forecasted to persist (ranging from 6.57 % in 2017 to 6.69 % in 2016). The ACA is projected to improve the eye examination rate along with the expansion in insurance coverage. Although predicted racial/ethnic disparities will improve, some differences will persist. Comprehensive strategies need to be developed to eliminate the disparity.

  18. Calibration of the human immunoglobulin BRPs for ACA and molecular size (batch 1) and for Fc function and molecular size (batches 1 & 2).

    PubMed

    Sandberg, E; Costanzo, A; Daas, A; Buchheit, K-H

    2012-04-01

    The current European Pharmacopoeia (Ph. Eur.) Biological Reference Preparation batch 3 (BRP3) for Human Immunoglobulin was established in 2005. Stocks of this BRP are dwindling and a replacement batch is needed to serve as working standard in the tests for distribution of molecular size by HPLC, anticomplementary activity (ACA) and Fc function, in accordance with the requirements of the Ph. Eur. monographs Human normal immunoglobulin (0338) and Human normal immunoglobulin for intravenous administration (0918). The European Directorate for the Quality of Medicines & HealthCare (EDQM) carried out a project (BSP099) to establish replacement batches for this BRP. The project was run in 2 phases, a prequalification phase (Phase 1) and an international collaborative study (Phase 2) involving 19 laboratories. Three batches of candidate materials of various sizes, Samples A, B and C, were procured from 2 different manufacturers on the European market. Based on the results of the study, Sample A was shown to be suitable as a reference standard for the ACA test and for molecular size determination by HPLC, whereas Samples B and C were demonstrated to be suitable for the Fc function test and for the molecular size determination by HPLC. All 3 BRPs are to be used in conjunction with the monographs Human normal immunoglobulin (0338) and Human normal immunoglobulin for intravenous administration (0918). The BRPs were adopted by the Ph. Eur. Commission at its 141st session in November 2011 as official Ph. Eur. Human Immunoglobulin BRPs for ACA and molecular size Batch 1 (Sample A) and Fc function and molecular size Batch 1 and Batch 2 (Samples B and C respectively).

  19. Studies on bacteriocin (thermophilin T) production by Streptococcus thermophilus ACA-DC 0040 in batch and fed-batch fermentation modes.

    PubMed

    Aktypis, Anastasios; Tychowski, Matheus; Kalantzopoulos, George; Aggelis, George

    2007-08-01

    Growth conditions that support bacteriocin (thermophilin T) production by Streptococcus thermophilus ACA-DC 0040 were identified. Synthesis of thermophilin T occurred during primary metabolic growth, while its specific rate of synthesis seemed to be optimal at T = 30 degrees C. Thermophilin T activity rapidly decreased in the stationary phase, especially at high growth temperature (i.e. T = 42 degrees C). In media with high content of complex nitrogen sources, high amounts of bacteriocin were detected in the growth environment, while about an 8-fold increase of thermophilin T titer and a 2-fold increase of specific synthesis rate was achieved when a fed-batch fermentation mode was applied.

  20. Comparative study of two box H/ACA ribonucleoprotein pseudouridine-synthases: relation between conformational dynamics of the guide RNA, enzyme assembly and activity.

    PubMed

    Fourmann, Jean-Baptiste; Tillault, Anne-Sophie; Blaud, Magali; Leclerc, Fabrice; Branlant, Christiane; Charpentier, Bruno

    2013-01-01

    Multiple RNA-guided pseudouridine synthases, H/ACA ribonucleoprotein particles (RNPs) which contain a guide RNA and four proteins, catalyze site-specific post-transcriptional isomerization of uridines into pseudouridines in substrate RNAs. In archaeal particles, the guide small RNA (sRNA) is anchored by the pseudouridine synthase aCBF5 and the ribosomal protein L7Ae. Protein aNOP10 interacts with both aCBF5 and L7Ae. The fourth protein, aGAR1, interacts with aCBF5 and enhances catalytic efficiency. Here, we compared the features of two H/ACA sRNAs, Pab21 and Pab91, from Pyrococcus abyssi. We found that aCBF5 binds much more weakly to Pab91 than to Pab21. Surprisingly, the Pab91 sRNP exhibits a higher catalytic efficiency than the Pab21 sRNP. We thus investigated the molecular basis of the differential efficiencies observed for the assembly and catalytic activity of the two enzymes. For this, we compared profiles of the extent of lead-induced cleavages in these sRNAs during a stepwise reconstitution of the sRNPs, and analyzed the impact of the absence of the aNOP10-L7Ae interaction. Such probing experiments indicated that the sRNAs undergo a series of conformational changes upon RNP assembly. These changes were also evaluated directly by circular dichroism (CD) spectroscopy, a tool highly adapted to analyzing RNA conformational dynamics. In addition, our results reveal that the conformation of helix P1 formed at the base of the H/ACA sRNAs is optimized in Pab21 for efficient aCBF5 binding and RNP assembly. Moreover, P1 swapping improved the assembly of the Pab91 sRNP. Nonetheless, efficient aCBF5 binding probably also relies on the pseudouridylation pocket which is not optimized for high activity in the case of Pab21.

  1. Synthesis, crystal structure, and magnetism of A{sub 2}Co{sub 12}As{sub 7} (A=Ca, Y, Ce–Yb)

    SciTech Connect

    Tan, Xiaoyan; Ovidiu Garlea, V.; Chai, Ping; Geondzhian, Andrey Y.; Yaroslavtsev, Alexander A.; Xin, Yan; Menushenkov, Alexey P.; Chernikov, Roman V.; Shatruk, Michael

    2016-04-15

    Ternary intermetallics, A{sub 2}Co{sub 12}As{sub 7} (A=Ca, Y, Ce–Yb), have been synthesized by annealing mixtures of elements in molten Bi at 1223 K. The materials obtained crystallize in the P6{sub 3}/m variant of the Zr{sub 2}Fe{sub 12}P{sub 7} structure type. The unit cell volume shows a monotonic decrease with the increasing atomic number of the rare-earth metal, with the exception of Ce-, Eu-, and Yb-containing compounds. An examination of these outliers with X-ray absorption near edge structures (XANES) spectroscopy revealed mixed valence of Ce, Eu, and Yb, with the average oxidation states of +3.20(1), +2.47(5), and +2.91(1), respectively, at room temperature. Magnetic behavior of A{sub 2}Co{sub 12}As{sub 7} is generally characterized by ferromagnetic ordering of Co 3d moments at 100–140 K, followed by low-temperature ordering of rare-earth 4f moments. The 3d-4f magnetic coupling changes from antiferromagnetic for A=Pr–Sm to ferromagnetic for A=Ce and Eu–Yb. Polarized neutron scattering experiments were performed to support the postulated ferro- and ferrimagnetic ground states for Ce{sub 2}Co{sub 12}As{sub 7} and Nd{sub 2}Co{sub 12}As{sub 7}, respectively. - Graphical abstract: Title arsenides were synthesized by Bi‐flux method. They exhibit mixed valence for A = Ce, Eu, Yb, ferrimagnetism for A = Ca, Y, Pr–Sm, and ferromagnetism for A = Eu–Tm. - Highlights: • A2Co12As7 (A=Ca, Y, Ce–Yb) were synthesized in Bi flux. • Ce, Eu, Yb exhibit mixed valence in the corresponding structures. • The character of 3d‐4f magnetic coupling changes at the half‐filled f shell. • Materials behave as ferrimagnets for A=Ca, Y, Pr–Sm and as ferromagnets for A=Eu–Yb.

  2. OsACA6, a P-type IIB Ca²⁺ ATPase promotes salinity and drought stress tolerance in tobacco by ROS scavenging and enhancing the expression of stress-responsive genes.

    PubMed

    Huda, Kazi M K; Banu, M Sufara Akhter; Garg, Bharti; Tula, Suresh; Tuteja, Renu; Tuteja, Narendra

    2013-12-01

    Calcium (Ca²⁺) regulates several signalling pathways involved in growth, development and stress tolerance. Cellular Ca²⁺ homeostasis is achieved by the combined action of channels, pumps and antiporters, but direct evidence for a role of Ca²⁺ATPase pumps in stress tolerance is lacking. Here we report the characterization of a Ca²⁺ ATPase gene (OsACA6) from Oryza sativa, and elucidate its functions in stress tolerance. OsACA6 transcript levels are enhanced in response to salt, drought, abscisic acid and heat. In vivo localization identified plasma membranes as an integration site for the OsACA6-GFP fusion protein. Using transgenic tobacco lines, we demonstrate that over-expression of OsACA6 is triggered during salinity and drought stresses. The enhanced tolerance to these stresses was confirmed by changes in several physiological indices, including water loss rate, photosynthetic efficiency, cell membrane stability, germination, survival rate, malondialdehyde content, electrolyte leakage and increased proline accumulation. Furthermore, over-expressing lines also showed higher leaf chlorophyll and reduced accumulation of H₂O₂ and Na⁺ ions compared to the wild-type. Reduced accumulation of reactive oxygen species (ROS) was observed in transgenic lines. The increased proline accumulation and ROS scavenging enzyme activities in transgenic plants over-expressing OsACA6 efficiently modulate the ROS machinery and proline biosynthesis through an integrative mechanism. Transcriptional profiling of these plants revealed altered expression of genes encoding many transcription factors, stress- and disease-related proteins, as well as signalling components. These results suggest that Ca²⁺ ATPases have diverse roles as regulators of many stress signalling pathways, leading to plant growth, development and stress tolerance.

  3. Americans' Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February–April 2016.

    PubMed

    Collins, Sara R; Gunja, Munira; Doty, Michelle M; Beutel, Sophie

    2016-05-01

    The fourth wave of the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016, finds at the close of the third open enrollment period that the working-age adult uninsured rate stands at 12.7 percent, statistically unchanged from 2015 but significantly lower than 2014 and 2013. Uninsured rates in the past three years have fallen most steeply for low-income adults though remain higher compared to wealthier adults. ACA marketplace and Medicaid coverage is helping to end long bouts without insurance, bridge gaps when employer insurance is lost, and improve access to health care. Sixty-one percent of enrollees who had used their insurance to get care said they would not have been able to afford or access it prior to enrolling. Doctor availability and appointment wait times are similar to those reported by insured Americans overall. Majorities with marketplace or Medicaid coverage continue to be satisfied with their insurance.

  4. Half-metallic ferromagnetism in full-Heusler compounds ACaX{sub 2} (A = K and Rb; X = N and O)

    SciTech Connect

    Umamaheswari, R. Vijayalakshmi, D. Yogeswari, M. Kalpana, G.

    2014-04-24

    Electronic structure and magnetic properties of hypothetical ACaX{sub 2} (A = K and Rb; X= N and O) compounds in full-Heusler phase have been investigated based on density functional theory (DFT) within the local density approximation (LDA). The electronic band structures and density of states of these compounds show that the spin-down electrons have metallic, and the spin-up electrons have a semi conducting gap resulting in stable half-metallic ferromagnetic behaviour. The strong spin polarization of 2p states of N and O atoms is found to be the origin of ferromagnetism which results in a total magnetic moment of 3{sub μB} and 1{sub μB} respectively.

  5. Modelo de accesibilidad de conceptos matematicos aplicados en el curso de Astronomia Descriptiva para estudiantes con impedimentos visuales en la UPR

    NASA Astrophysics Data System (ADS)

    Isidro Villamizar, Gloria Maria

    Este estudio utiliza metodologia de investigacion cualitativa, con el proposito de describir, analizar y evaluar los procesos de diseno y desarrollo de un modelo de accesibilidad que consiste en estrategias de ensenanza de las matematicas para estudiantes con impedimentos visuales matriculados en el curso de Astronomia Descriptiva en la UPR. Se utilizaron las siguientes estrategias para recopilar la informacion, 1) reflexiones de la investigadora en el proceso de diseno y desarrollo de las lecciones adaptadas, que se registraron en un diario reflexivo. 2) entrevista semiestructurada luego de haber trabajado las lecciones de aprendizaje adaptadas con los participantes. 3) observaciones y notas de la investigadora del trabajo de los participantes. Para obtener la informacion de los participantes se obtuvo los permisos institucionales necesarios; se seleccionaron los participantes y se validaron los instrumentos; se realizo el desarrollo de las lecciones adaptadas con los participantes; y finalmente, se analizo la informacion obtenida. El diseno de las lecciones de aprendizaje adaptadas se hizo siguiendo las recomendaciones curriculares de los temas de matematicas aplicados en el curso de Astronomia Descriptiva realizado por la investigadora durante su semestre de internado. El testimonio de las voces de los participantes se obtuvo del proceso de desarrollo de las lecciones de aprendizaje adaptadas de temas seleccionados de conceptos matematicos requeridos en el curso de Astronomia Descriptiva y de la entrevista semiestructurada con los participantes, luego de haber trabajado las lecciones de aprendizaje. Para el desarrollo de las lecciones de aprendizaje, se utilizaron materiales tactiles adaptados, materiales tactiles disenados y materiales disponibles comercialmente. Los textos de las lecciones se imprimieron en tinta y en Braille. Se exhorta a disenar y desarrollar estrategias de ensenanza accesibles, considerando como recursos para evaluar su efectividad a

  6. Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA).

    PubMed

    Eibner, Christine; Girosi, Federico; Miller, Amalia; Cordova, Amado; McGlynn, Elizabeth A; Pace, Nicholas M; Price, Carter C; Vardavas, Raffaele; Gresenz, Carole Roan

    2011-01-01

    The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA) changes the regulatory environment within which health insurance policies on the small-group market are bought and sold. New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include "essential health benefits." While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations. As a result, some firms may have a stronger incentive to offer self-insured plans after the ACA takes full effect. In this article we identify factors that influence employers' decisions to self-insure and estimate how the ACA will influence self-insurance rates. We also consider the implications of higher self-insurance rates for adverse selection in the non-self-insured small-group market and whether enrollees in self-insured plans receive different benefits than enrollees in fully-insured plans. Results are based on data analysis, literature review, findings from discussions with stakeholders, and microsimulation analysis using the COMPARE model. Overall, we find little evidence that self-insured plans differ systematically from fully insured plans in terms of benefit generosity, price, or claims denial rates. Stakeholders expressed significant concern about adverse selection in the health insurance exchanges due to regulatory exemptions for self-insured plans. However, our microsimulation analysis predicts a sizable increase in self-insurance only if comprehensive stop-loss policies become widely available after the ACA takes full effect and the expected cost of self-insuring with stop-loss is comparable to the cost of being fully insured in a market without rating regulations.

  7. Strain Dependent Electronic Structure and Band Offset Tuning at Heterointerfaces of ASnO3 (A=Ca, Sr, and Ba) and SrTiO3

    PubMed Central

    Baniecki, John D.; Yamazaki, Takashi; Ricinschi, Dan; Van Overmeere, Quentin; Aso, Hiroyuki; Miyata, Yusuke; Yamada, Hiroaki; Fujimura, Norifumi; Maran, Ronald; Anazawa, Toshihisa; Valanoor, Nagarajan; Imanaka, Yoshihiko

    2017-01-01

    The valence band (VB) electronic structure and VB alignments at heterointerfaces of strained epitaxial stannate ASnO3 (A=Ca, Sr, and Ba) thin films are characterized using in situ X-ray and ultraviolet photoelectron spectroscopies, with band gaps evaluated using spectroscopic ellipsometry. Scanning transmission electron microscopy with geometric phase analysis is used to resolve strain at atomic resolution. The VB electronic structure is strain state dependent in a manner that correlated with a directional change in Sn-O bond lengths with strain. However, VB offsets are found not to vary significantly with strain, which resulted in ascribing most of the difference in band alignment, due to a change in the band gaps with strain, to the conduction band edge. Our results reveal significant strain tuning of conduction band offsets using epitaxial buffer layers, with strain-induced offset differences as large as 0.6 eV possible for SrSnO3. Such large conduction band offset tunability through elastic strain control may provide a pathway to minimize the loss of charge confinement in 2-dimensional electron gases and enhance the performance of photoelectrochemical stannate-based devices. PMID:28195149

  8. Strain Dependent Electronic Structure and Band Offset Tuning at Heterointerfaces of ASnO3 (A=Ca, Sr, and Ba) and SrTiO3

    NASA Astrophysics Data System (ADS)

    Baniecki, John D.; Yamazaki, Takashi; Ricinschi, Dan; van Overmeere, Quentin; Aso, Hiroyuki; Miyata, Yusuke; Yamada, Hiroaki; Fujimura, Norifumi; Maran, Ronald; Anazawa, Toshihisa; Valanoor, Nagarajan; Imanaka, Yoshihiko

    2017-02-01

    The valence band (VB) electronic structure and VB alignments at heterointerfaces of strained epitaxial stannate ASnO3 (A=Ca, Sr, and Ba) thin films are characterized using in situ X-ray and ultraviolet photoelectron spectroscopies, with band gaps evaluated using spectroscopic ellipsometry. Scanning transmission electron microscopy with geometric phase analysis is used to resolve strain at atomic resolution. The VB electronic structure is strain state dependent in a manner that correlated with a directional change in Sn-O bond lengths with strain. However, VB offsets are found not to vary significantly with strain, which resulted in ascribing most of the difference in band alignment, due to a change in the band gaps with strain, to the conduction band edge. Our results reveal significant strain tuning of conduction band offsets using epitaxial buffer layers, with strain-induced offset differences as large as 0.6 eV possible for SrSnO3. Such large conduction band offset tunability through elastic strain control may provide a pathway to minimize the loss of charge confinement in 2-dimensional electron gases and enhance the performance of photoelectrochemical stannate-based devices.

  9. Enthalpies of Formation of La 1- xAxMnO 3± δ ( A=Ca and Sr) Measured by High-Temperature Solution Calorimetry

    NASA Astrophysics Data System (ADS)

    Rørmark, Lisbeth; Stølen, Svein; Wiik, Kjell; Grande, Tor

    2002-01-01

    High-temperature reaction calorimetry using molten lead borate as a solvent has been used to study the thermochemistry of La1-xAxMnO3 (A=Ca and Sr, 0≤x≤1). The structural properties and the oxygen stoichiometry of the calcined powders were characterized by powder X-ray diffraction, thermogravimetry, and iodometry. The enthalpy of formation of the materials from their binary constituents has been calculated from measured enthalpy of solutions. The enthalpy of formation of La1-xCaxMnO3 from the component oxides becomes more exothermic with increasing substitution level x due to the increasing valence state of Mn, and demonstrates a nearly linear dependence of the average valence state of manganese. La1-xSrxMnO3 has a significantly more exothermic enthalpy of formation from the binary constituents than the Ca-substituted materials, and demonstrates a negative deviation from ideal behavior. The present thermodynamic data are discussed in relation to the Goldschmidt tolerance factor for the perovskite structure. Finally, the phase stability of Sr- and Ca-substituted LaMnO3 is addressed in relation to the application of these materials in solid oxide fuel cells.

  10. Noncanonical Wnt5a-Ca(2+) -NFAT signaling axis in pesticide induced bone marrow aplasia mouse model: A study to explore the novel mechanism of pesticide toxicity.

    PubMed

    Chattopadhyay, Sukalpa; Chatterjee, Ritam; Law, Sujata

    2016-10-01

    According to case-control studies, long-term pesticide exposure can cause bone marrow aplasia like hematopoietic degenerative disease leading to impaired hematopoiesis and increased risk of aplastic anemia in human subjects. However, the exact mechanism of pesticide mediated hematotoxicity still remains elusive. In this study, we investigated the role of noncanonical Wnt signaling pathway, a crucial regulator of adult hematopoiesis, in pesticide induced bone marrow aplasia mouse model. Aplasia mouse model was developed following inhalation and dermal exposure of 5% aqueous mixture of common agriculturally used pesticides for 6 h/day for 5 days a week up to 90 days. After that, blood hemogram, marrow smear, cellularity, scanning electron microscopy, extramedullary hematopoiesis and flowcytometric expression analysis of noncanonical Wnt signaling components, such as Wnt 5a, fzd5, NFAT, IFN-γ, intracellular Ca(2+) level were evaluated in the bone marrow hematopoietic stem/progenitor compartment of the control and pesticide induced aplasia groups of animals. Results showed that pesticide exposed mice were anemic with peripheral blood pancytopenia, hypocellular degenerative marrow, and extramedullary hematopoiesis in the spleen. Upon pesticide exposure, Wnt 5a expression was severely downregulated with a decline in intracellular Ca(2+) level. Moreover, downstream of Wnt5a, we observed sharp downregulation of NFATc2 transcription factor expression, the major target of pesticide toxicity and its target molecule IFN-γ. Taken together, our result suggests that deregulation of Wnt5a-Ca(2+) -NFAT signaling axis in the hematopoietic stem/progenitor compartment plays a crucial role behind the pathogenesis of pesticide mediated bone marrow aplasia by limiting primitive hematopoietic stem cells' ability to maintain hematopoietic homeostasis and reconstitution mechanism in vivo during xenobiotic stress leading to ineffective hematopoiesis and evolution of bone marrow aplasia.

  11. Synthesis, crystal structure, and magnetism of A2Co12As7 (A=Ca, Y, Ce–Yb)

    SciTech Connect

    Tan, Xiaoyan; Ovidiu Garlea, V.; Chai, Ping; Geondzhian, Andrey Y.; Yaroslavtsev, Alexander A.; Xin, Yan; Menushenkov, Alexey P.; Chernikov, Roman V.; Shatruk, Michael

    2015-08-28

    In this study, ternary intermetallics, A2Co12As7 (A=Ca, Y, Ce–Yb), have been synthesized by annealing mixtures of elements in molten Bi at 1223 K. The materials obtained crystallize in the P63/m variant of the Zr2Fe12P7 structure type. The unit cell volume shows a monotonic decrease with the increasing atomic number of the rare-earth metal, with the exception of Ce-, Eu-, and Yb-containing compounds. An examination of these outliers with X-ray absorption near edge structures (XANES) spectroscopy revealed mixed valence of Ce, Eu, and Yb, with the average oxidation states of +3.20(1), +2.47(5), and +2.91(1), respectively, at room temperature. Magnetic behavior of A2Co12As7 is generally characterized by ferromagnetic ordering of Co 3d moments at 100–140 K, followed by low-temperature ordering of rare-earth 4f moments. The 3d-4f magnetic coupling changes from antiferromagnetic for A=Pr–Sm to ferromagnetic for A=Ce and Eu–Yb. Finally, polarized neutron scattering experiments were performed to support the postulated ferro- and ferrimagnetic ground states for Ce2Co12As7 and Nd2Co12As7, respectively.

  12. Comparative pharmacokinetics of puerarin, daidzin, baicalin, glycyrrhizic acid, liquiritin, berberine, palmatine and jateorhizine by liquid chromatography-mass spectrometry after oral administration of Gegenqinlian decoction and active components alignment (ACA) to rats.

    PubMed

    Xu, Beilei; Li, Pengyue; Zhang, Guijun

    2015-04-15

    An LC-MS/MS method was developed for simultaneous analysis of puerarin, daidzin, baicalin, glycyrrhizic acid, liquiritin, berberine, palmatine and jateorhizine of Gegenqinlian Decoction (GQD) and active components alignment (ACA) in rat plasma using hesperidin as the internal standard (I.S.). Chromatography was performed using a C18 column, with gradient elution with 1% acetic acid-0.001 mol/L ammonium acetate and acetonitrile at 0.2 ml/min. All analytes including I.S. were monitored under positive ionization conditions by selected reaction monitoring with an electrospray ionization source. The optimized mass transition ion-pairs (m/z) for quantitation were 471/297 for puerarin, 471/255 for daidzin, 447/271 for baicalin, 823/453 for glycyrrhizic acid, 419/257 for liquiritin, 336/320 for berberine, 352/336 for palmatine, 338/322 for jateorhizine and 611/303 for hesperidin. The calibration curves were linear over the concentration ranges from 0.15-63.0 to 6.3-6340.0 ng/mL. Intra-day and inter-day precisions (RSD%) were within 15.0%, and accuracy (RE%) ranged from -7.4 to 13.2%. The extraction recoveries were ranged from 60.4 to 93.3%. The proposed method was further applied to compare the pharmacokinetics of all analytes following a single oral administration of GQD and ACA. In conclusion, the eight analytes of GQD and ACA had partly similar pharmacokinetics, which were different from single composition (such as puerarin).

  13. The Box H/ACA snoRNP Assembly Factor Shq1p is a Chaperone Protein Homologous to Hsp90 Cochaperones that Binds to the Cbf5p Enzyme

    SciTech Connect

    Godin, Katherine S.; Walbott, Helene; Leulliot, Nicolas; van Tilbeurgh, Herman; Varani, Gabriele

    2009-05-06

    Box H/ACA small nucleolar (sno) ribonucleoproteins (RNPs) are responsible for the formation of pseudouridine in a variety of RNAs and are essential for ribosome biogenesis, modification of spliceosomal RNAs, and telomerase stability. A mature snoRNP has been reconstituted in vitro and is composed of a single RNA and four proteins. However, snoRNP biogenesis in vivo requires multiple factors to coordinate a complex and poorly understood assembly and maturation process. Among the factors required for snoRNP biogenesis in yeast is Shq1p, an essential protein necessary for stable expression of box H/ACA snoRNAs. We have found that Shq1p consists of two independent domains that contain casein kinase 1 phosphorylation sites. We also demonstrate that Shq1p binds the pseudourydilating enzyme Cbf5p through the C-terminal domain, in synergy with the N-terminal domain. The NMR solution structure of the N-terminal domain has striking homology to the ‘Chord and Sgt1’ domain of known Hsp90 cochaperones, yet Shq1p does not interact with the yeast Hsp90 homologue in vitro. Surprisingly, Shq1p has stand-alone chaperone activity in vitro. This activity is harbored by the C-terminal domain, but it is increased by the presence of the N-terminal domain. These results provide the first evidence of a specific biochemical activity for Shq1p and a direct link to the H/ACA snoRNP.

  14. Structure and function of CrACA1, the major PM-type Ca2+-ATPase, expressed at the peak of the gravity-directed trans-cell calcium current in spores of the fern Ceratopteris richardii.

    PubMed

    Bushart, T J; Cannon, A; Clark, G; Roux, S J

    2014-01-01

    Spores of the fern Ceratopteris richardii have proven to be a valuable single-cell system for studying gravity responses. The earliest cellular change directed by gravity in these cells is a trans-cell calcium current, which peaks near 10 h after the spores are induced to germinate. This current is needed for gravity-directed axis alignment, and its peak is coincident with the time period when gravity polarises the direction of subsequent nuclear migration and rhizoid growth. Transcriptomic analysis of genes expressed at the 10-h time point revealed several that encode proteins likely to be key components that either drive the current or regulate it. Notable among these is a plasma membrane (PM)-type Ca(2+) ATPase, CrACA1, whose activity pumping Ca(2+) out of cells is regulated by gravity. This report provides an initial characterisation of the structure and expression of this protein, and demonstrates its heterologous function complementing the K616 mutant of yeast, which is deficient in PM-type Ca(2+) pump activity. Gravity-induced changes in the trans-cell Ca(2+) current occur within seconds, a result consistent with the hypothesis that the force of gravity can rapidly alter the post-translational state of the channels and pumps that drive this current across spore cells. This report identifies a transporter likely to be a key driver of the current, CrACA1, and characterises the role of this protein in early germination and gravity-driven polarity fixation through analysis of expression levels, functional complementation and pharmacological treatments. These data, along with newly available transcriptomic data obtained at the 10-h time point, indicate that CrACA1 is present, functional and likely a major contributing component of the trans-cell Ca(2+) efflux. CrACA1 is not necessary for polar axis alignment, but pharmacological perturbations of it disrupt rhizoid development. These data support and help refine the post-translational modification model for

  15. Comparative genomics of the dairy isolate Streptococcus macedonicus ACA-DC 198 against related members of the Streptococcus bovis/Streptococcus equinus complex

    PubMed Central

    2014-01-01

    Background Within the genus Streptococcus, only Streptococcus thermophilus is used as a starter culture in food fermentations. Streptococcus macedonicus though, which belongs to the Streptococcus bovis/Streptococcus equinus complex (SBSEC), is also frequently isolated from fermented foods mainly of dairy origin. Members of the SBSEC have been implicated in human endocarditis and colon cancer. Here we compare the genome sequence of the dairy isolate S. macedonicus ACA-DC 198 to the other SBSEC genomes in order to assess in silico its potential adaptation to milk and its pathogenicity status. Results Despite the fact that the SBSEC species were found tightly related based on whole genome phylogeny of streptococci, two distinct patterns of evolution were identified among them. Streptococcus macedonicus, Streptococcus infantarius CJ18 and Streptococcus pasteurianus ATCC 43144 seem to have undergone reductive evolution resulting in significantly diminished genome sizes and increased percentages of potential pseudogenes when compared to Streptococcus gallolyticus subsp. gallolyticus. In addition, the three species seem to have lost genes for catabolizing complex plant carbohydrates and for detoxifying toxic substances previously linked to the ability of S. gallolyticus to survive in the rumen. Analysis of the S. macedonicus genome revealed features that could support adaptation to milk, including an extra gene cluster for lactose and galactose metabolism, a proteolytic system for casein hydrolysis, auxotrophy for several vitamins, an increased ability to resist bacteriophages and horizontal gene transfer events with the dairy Lactococcus lactis and S. thermophilus as potential donors. In addition, S. macedonicus lacks several pathogenicity-related genes found in S. gallolyticus. For example, S. macedonicus has retained only one (i.e. the pil3) of the three pilus gene clusters which may mediate the binding of S. gallolyticus to the extracellular matrix. Unexpectedly

  16. Performance and model of a novel multi-sparger multi-stage airlift loop membrane bioreactor to treat high-strength 7-ACA pharmaceutical wastewater: effect of hydraulic retention time, temperature and pH.

    PubMed

    Chen, Zhao-bo; He, Zhang-wei; Tang, Cong-cong; Hu, Dong-xue; Cui, Yu-bo; Wang, Ai-jie; Zhang, Ying; Yan, Li-long; Ren, Nan-qi

    2014-09-01

    In this study, three novel multi-sparger multi-stage airlift loop membrane bioreactors (Ms(2)ALMBRs) were set up in parallel for treating synthetic high-strength 7-ACA pharmaceutical wastewater under different HRTs, temperatures and pHs, respectively. During the 200-day operating time, average COD removal efficiencies were 94.96%, 96.05% and 93.9%. While average 7-ACA removal efficiencies were 66.44%, 59.04% and 59.60%, respectively. The optimal conditions were 10h, 15-35°C and 7-9 for HRT, temperature and pH, respectively. Moreover, the sludge characteristics and microorganism drug-resistances were explored. Results showed that different temperatures and pHs influenced contaminant removals by affecting MLSS concentration and β-lactamase activity significantly. In addition, mathematical statistical models, built on the polynomial and linear regression techniques, were developed for exploring the inner relationships between HRT, temperature and pH changes and MLSS concentrations, β-lactamase activities and contaminant removals of the Ms(2)ALMBR system.

  17. Performance of the auxotrophic Saccharomyces cerevisiae BY4741 as host for the production of IL-1β in aerated fed-batch reactor: role of ACA supplementation, strain viability, and maintenance energy

    PubMed Central

    2009-01-01

    Background Saccharomyces cerevisiae BY4741 is an auxotrophic commonly used strain. In this work it has been used as host for the expression and secretion of human interleukin-1β (IL1β), using the cell wall protein Pir4 as fusion partner. To achieve high cell density and, consequently, high product yield, BY4741 [PIR4-IL1β] was cultured in an aerated fed-batch reactor, using a defined mineral medium supplemented with casamino acids as ACA (auxotrophy-complementing amino acid) source. Also the S. cerevisiae mutant BY4741 Δyca1 [PIR4-IL1β], carrying the deletion of the YCA1 gene coding for a caspase-like protein involved in the apoptotic response, was cultured in aerated fed-batch reactor and compared to the parental strain, to test the effect of this mutation on strain robustness. Viability of the producer strains was examined during the runs and a mathematical model, which took into consideration the viable biomass present in the reactor and the glucose consumption for both growth and maintenance, was developed to describe and explain the time-course evolution of the process for both, the BY4741 parental and the BY4741 Δyca1 mutant strain. Results Our results show that the concentrations of ACA in the feeding solution, corresponding to those routinely used in the literature, are limiting for the growth of S. cerevisiae BY4741 [PIR4-IL1β] in fed-batch reactor. Even in the presence of a proper ACA supplementation, S. cerevisiae BY4741 [PIR4-IL1β] did not achieve a high cell density. The Δyca1 deletion did not have a beneficial effect on the overall performance of the strain, but it had a clear effect on its viability, which was not impaired during fed-batch operations, as shown by the kd value (0.0045 h-1), negligible if compared to that of the parental strain (0.028 h-1). However, independently of their robustness, both the parental and the Δyca1 mutant ceased to grow early during fed-batch runs, both strains using most of the available carbon source for

  18. Método numérico das diferenças finitas no domínio do tempo aplicado a ondas Alfvén em plasma astrofísico

    NASA Astrophysics Data System (ADS)

    Dos Santos, L. C.; Kintopp, J. A.; Jatenco-Pereira, V.; Opher, R.

    2003-08-01

    Ondas Alfvén em plasma astrofísico têm sido objeto de intenso estudo nas últimas décadas pelo fato de apresentarem papel importante em muitas áreas de pesquisa na astrofísica. Particularmente são importantes no mecanismo de aquecimento da coroa solar; em ventos estelares; em jatos galácticos e extragalácticos; em discos protoestelares, etc. A formulação para diferenças finitas no domínio do tempo (FDTD), aplicada a plasma magnetizado é desenvolvida para estudo das propriedades de ondas Alfvén em três dimensões (3D-FDTD). O método é aplicado inicialmente a um plasma homogêneo e isotérmico imerso em uma região com campo magnético externo B0, que sofre uma pequena perturbação. Uma vez gerada a onda, esta perturbação é retirada e, então analisamos a evolução temporal das ondas, bem como a forma de seu amortecimento.

  19. New members of the A{sub 2}M′M{sub 2}{sup ″} structure family (A=Ca, Sr, Yb, La; M′=In,Sn,Pb; M″=Si,Ge)

    SciTech Connect

    Jehle, Michael; Dürr, Ines; Fink, Saskia; Lang, Britta; Langenmaier, Michael; Steckhan, Julia; Röhr, Caroline

    2015-01-15

    structure calculations within the FP-LAPW DFT approach together with the Zintl formalism, extended by the presence of hypervalent bonding of the heavier M′ elements, give insight into the chemical bonding of this series of p-block metallides. An analysis of the band structure for the border phases Sr{sub 2}PbGe{sub 2} and Ca{sub 2}SnGe{sub 2} shows the considerable π bonding contributions within the Ge building units, which also become apparent from the short Ge–Ge bond lengths. - Graphical abstract: Example of one of the mixed metallides A{sub 2}(In/Sn/Pb)(Si/Ge){sub 2} with planar Si/Ge zig-zag chain segments of variable lengths. - Highlights: • Mixed metallides A{sub 2}(In/Sn/Pb)(Si/Ge){sub 2} were prepared for A=Ca, Sr, Yb, La. • The structures exhibit planar Si/Ge zig-zag chain segments of variable lengths. • In, Sn and Pb atoms are connecting the Si/Ge anions to planar nets. • Atomic size effects are investigated by the synthesis of mixed Ca/Sr germanides. • Bandstructure calculations indicate Si/Ge–Si/Ge π bonding contributions.

  20. Legal Issues in Clinical Supervision. ACA Legal Series, Volume 10.

    ERIC Educational Resources Information Center

    Disney, M. Janelle; Stephens, Anthony M.

    In recent decades, mental health professionals have expanded their role in the legal process. This monograph tries to help clinical supervisors avoid legal pitfalls by explaining some of the legal principles involved in their work. Although familiarity with relevant ethical standards is important, a discussion of these standards is presented only…

  1. Documentation in Counseling Records. Second Edition. The ACA Legal Series.

    ERIC Educational Resources Information Center

    Mitchell, Robert

    In an age of legal, clinical, and fiscal accountability, record keeping is an important component of professional counseling. The second edition of this book is intended to be used to: (1) explain the uses of a case record and who has access to it; (2) comprehend everyday problems associated with ineffective communication, including how records…

  2. Arts Education Beyond the Classroom. ACA Arts Research Seminar Series.

    ERIC Educational Resources Information Center

    Balfe, Judith H., Ed.; Heine, Joni Cherbo, Ed.

    The 13 seminar papers presented in this collection discuss various avenues used for educating adults in the arts in order to enrich existing arts audiences and to educate the widest possible adult population in the practice and history of art and aesthetics. These efforts will ensure that the quality and quantity of arts participation and support…

  3. The Status of Evaluation in ACA Accredited Camping Programs.

    ERIC Educational Resources Information Center

    Henderson, Karla A.; Bialeschki, M. Deborah

    Questionnaires covering evaluation strategies and practices were sent to directors of 200 camps accredited by the American Camping Association. Half received questionnaires designed to collect quantitative data in the form of yes/no responses and Likert scales; the other half received qualitative questionnaires covering the same information in an…

  4. DURIP - Upgrade of the Meridian ACAS-470 for Toxicological Research

    DTIC Science & Technology

    1990-01-18

    Carcincxgenesi2. 10(1): 13-20. Oh, S.Y., ByV. Madhukar and J.E. Trosko. (1988) Inhibition of Gap Junction Blockage by Palmltoyl Carnitine and TMB-S In a Rat...medium (DMEM, Nissui Seiyaku, Tokyo), supplemented wit. 10% fetal bovine serum (FBS, M.A. Bioproducts, Walkersville, MD). Another XP cell strain, XP12BE... supplemented with nonessential amino acids (100% increase), 1 mM sodium pyruvate, and 10% FBS (Hazleton Research Products, Denver PA). Cells were grcwn in

  5. Inclusion of Qualitative Research: Content Analysis of ACA Journals.

    ERIC Educational Resources Information Center

    Portman, Tarrell Awe Agahe

    This paper provides descriptive statistics related to published articles which utilized qualitative methodologies in research studies, as well as conceptual articles pertaining to qualitative research methodologies. The articles examined covered the years 1967-1999. During the 32-year time period, 15 qualitative research articles were published.…

  6. Avoiding Counselor Malpractice. ACA Legal Series, Volume 12.

    ERIC Educational Resources Information Center

    Crawford, Robert L.

    The possibility of lawsuits is a general condition of citizenship; potential lawsuits based on allegations of malpractice is a routine part of professional practice. This monograph provides a guide for taking some reasonable precautions to avoid malpractice suits. The text provides an outline that counselors may use in developing a legal and…

  7. Third-Party Payments. ACA Legal Series, Volume 9.

    ERIC Educational Resources Information Center

    Strosnider, J. Steve; Grad, John D.

    Professional counselors are often uninformed about insurance matters. This monograph is for counselors who wish to participate in third-party reimbursement activities. The text addresses general issues related to professional counselors and health care reimbursement. It describes major health reimbursement plans such as Blue Cross/Blue Shield,…

  8. Ryan Floats Tax Credits, Other Plans as ACA Alternative.

    PubMed

    Kirkner, Richard Mark

    2016-08-01

    But the centerpiece of Ryan's proposal-tax credits for everyone who needs to purchase individual policies regardless of income-may not go far enough to prevent people from losing coverage while creating new spending that would benefit high-income earners who can already buy their own health insurance.

  9. A Strategic Plan for AACD's Future: The Precursors of ACA.

    ERIC Educational Resources Information Center

    Nejedlo, Robert J.; And Others

    1994-01-01

    Presents process that American Association for Counseling and Development (AACD), now American Counseling Association, used beginning in 1988 in developing association's first three-year strategic plan. Includes description of strategic planning process itself, historical account of how AACD embarked on strategic planning, and documentation of…

  10. A Twist of Fate: Tornado Strikes Four ACA Camps.

    ERIC Educational Resources Information Center

    Brokaw, Christine O'Connor

    1989-01-01

    Describes the reactions of four Connecticut camps to a July 1989 tornado. Discusses damages incurred, the importance of emergency plans, reactions of campers and staff, the use of a crisis management team, budgeting for emergencies, communications with campers' families, rebuilding, and reopening. Suggests disasters, handled properly, can be…

  11. On random walk de Lévy aplicado aos mapas de variâncias

    NASA Astrophysics Data System (ADS)

    Klafke, J. C.

    2003-08-01

    Uma pergunta que surge ao nos confrontarmos com os mapas de variâncias, ou s-Maps [Klafke, J. C. "Estudo da Difusão Caótica em Ressonâncias Asteroidais", Tese de Doutorado, IAG/USP, 2002] diz respeito ao conteúdo físico de tais representações do espaço de fase. Ou seja, o que representa as variâncias das ações obtidas para uma determinada condição inicial e como relacioná-las com o tempo de difusão das órbitas, supondo-se que estas de fato estejam envolvidas em um processo difusivo? Para discutirmos essa questão, lançamos mão da modelagem dos processos estocásticos subjacentes às variâncias determinadas e implementamos uma série de simulações do tipo Monte Carlo a partir das informações registradas nos s-Maps calculados para algumas ressonâncias asteroidais bem estudadas (p.ex. 3: 1, 2: 1 e 3: 2). Para tanto, temos usado uma função de densidade de probabilidade gaussiana ao definir os n passos que permitirão estabelecer uma relação direta entre o Mapa de Difusão e o Mapa de Variâncias. Contudo, os resultados obtidos até agora tem subestimado o tempo de difusão esperado para os fenômenos conhecidos. Tal se deve ao fato de que, no processo difusivo real, é possível existirem passos de comprimento consideravelmente maiores que a média estabelecida pelas distribuições gaussiana ou normal, sobretudo quando se cruza uma região caótica. Neste trabalho, apresentamos os resultados comparativos de simulações de Monte Carlo com base no random walk de Lévy [Klafter, J. et al. 2002. "Beyond Brownian motion", Phys. Today, Feb, 33-39.], o qual possibilita passos esporádicos de comprimento acima do valor médio (saltos) permitindo estabelecer uma escala de tempo mais próxima da esperada para a difusão.

  12. Suppression associated with esotropia with convergence excess (high AC/A ratio).

    PubMed

    Pratt-Johnson, J A

    1984-08-15

    With binocular perimetry suppression was found for near vision in patients with esotropia with convergence excess, whereas fusion was present for distance. If a bitenuporal stimulation was obtained by means of base-out prisms, diplopia was elicited instead.

  13. Optical properties of AFe2As2 ( A=Ca , Sr, and Ba) single crystals

    DOE PAGES

    Dai, Y. M.; Akrap, Ana; Bud'ko, S. L.; ...

    2016-11-23

    The detailed optical properties have been determined for the iron-based materials A Fe2 As2 , where A = Ca , Sr, and Ba, for light polarized in the iron-arsenic (a-b) planes over a wide frequency range, above and below the magnetic and structural transitions at TN = 138 , 195, and 172 K, respectively. The real and imaginary parts of the complex conductivity are fit simultaneously using two Drude terms in combination with a series of oscillators. Above TN, the free-carrier response consists of a weak, narrow Drude term, and a strong, broad Drude term, both of which show only a weak temperature dependence. Below TN there is a slight decrease of the plasma frequency but a dramatic drop in the scattering rate for the narrow Drude term, and for the broad Drude term there is a significant decrease in the plasma frequency, while the decrease in the scattering rate, albeit significant, is not as severe. The small values observed for the scattering rates for the narrow Drude term for Tmore » $$\\ll$$ TN may be related to the Dirac conelike dispersion of the electronic bands. Below TN new features emerge in the optical conductivity that are associated with the reconstruction Fermi surface and the gapping of bands at Δ1 ≃ 45 – 80 meV, and Δ2 ≃ 110 – 210 meV. In conclusion, the reduction in the spectral weight associated with the free carriers is captured by the gap structure; specifically, the spectral weight from the narrow Drude term appears to be transferred into the low-energy gap feature, while the missing weight from the broad term shifts to the high-energy gap.« less

  14. Field emission from aCa nanotip grown on aMo⟨110⟩ microtip

    NASA Astrophysics Data System (ADS)

    Zhao, Xin; Outlaw, R. A.; Champion, R. L.; Wang, J. J.; Manos, D. M.; Holloway, B. C.

    2004-08-01

    We have observed field emission with an energy distribution of 68meV full width at half maximum (FWHM) from a thermally cleaned Mo⟨110⟩ single tip. The emission spectra are taken with the emitting surface at 295K, using a double-pass cylindrical mirror analyzer in ultrahigh vacuum. This narrow energy distribution is attributed to a nanotip spontaneously formed on the ˜75nm radius Mo tip from in situ buildup by field-induced surface diffusion. Auger electron spectroscopy showed that residual surface Ca segregated from the bulk during thermal cleaning and is likely the source of mobile atoms that formed the nanotip. The emission spectra show a discernible doublet that is attributed to a variation in the localized density of states of the nanotip. Sub-Langmuir oxygen exposure of the Mo tip immediately increased the energy distribution to a FWHM of >1eV.

  15. The financial burden of medical spending: estimates and implications for evaluating the impact of ACA reforms.

    PubMed

    Abramowitz, Joelle; O'Hara, Brett

    2015-04-01

    This article uses the 2013 Current Population Survey Annual Social and Economic Supplement to estimate the financial burden of medical out-of-pocket costs by comparing medical out-of-pocket expenditures to income. This measure is important for evaluating the magnitude of burden, better understanding who bears it, and establishing a baseline to assess the impact of the Patient Protection and Affordable Care Act. We examine the distribution of burden and the incidence of high burden across all families and by individuals' health insurance status and demographic and socioeconomic characteristics. We look more closely at one group vulnerable to having high burden: those younger than age 65 with incomes between 138% and 200% of the federal poverty line. We find that 18.5% of these individuals have incomes below the threshold of expansion Medicaid eligibility after accounting for non-over-the-counter medical expenses and examine the characteristics associated with being classified below this threshold.

  16. Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements.

    PubMed

    Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina

    2014-10-01

    The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.

  17. 75 FR 56578 - Renewal of the Advisory Committee on Apprenticeship (ACA), and an Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-16

    ..., IIIAFT Administrator, Heat and Frost Insulators and Allied Workers Int'l Union, Lanham, Maryland. Mr..., Director of YouthBuild & Building Futures, The Providence Plan, Providence, Rhode Island. Ms. Phaedra Ellis... President, Workforce Development Division, National Urban League, New York, New York. Mr. Martin...

  18. Efficacy of ACA Strategies in Biography-Driven Science Teaching: An Investigation

    ERIC Educational Resources Information Center

    MacDonald, Grizelda L.; Miller, Stuart S.; Murry, Kevin; Herrera, Socorro; Spears, Jacqueline D.

    2013-01-01

    This study explored the biography-driven approach to teaching culturally and linguistically diverse students in science education. Biography-driven instruction (BDI) embraces student diversity by incorporating students' sociocultural, linguistic, cognitive, and academic dimensions of their biographies into the learning process (Herrera in…

  19. Efficacy of ACA strategies in biography-driven science teaching: an investigation

    NASA Astrophysics Data System (ADS)

    MacDonald, Grizelda L.; Miller, Stuart S.; Murry, Kevin; Herrera, Socorro; Spears, Jacqueline D.

    2013-12-01

    This study explored the biography-driven approach to teaching culturally and linguistically diverse students in science education. Biography-driven instruction (BDI) embraces student diversity by incorporating students' sociocultural, linguistic, cognitive, and academic dimensions of their biographies into the learning process (Herrera in Biography-driven culturally responsive teaching. Teachers College Press, New York, 2010). Strategies have been developed (Herrera, Kavimandan and Holmes in Crossing the vocabulary bridge: differentiated strategies for diverse secondary classrooms. Teachers College Press, New York, 2011) that provide teachers with instructional routines that facilitate BDI. Using systematic classroom observations we empirically demonstrate that these activate, connect, affirm, strategies are likely to be effective in increasing teachers' biography-driven practices. Implications for theory and practice are discussed.

  20. Health and Access to Care during the First 2 Years of the ACA Medicaid Expansions.

    PubMed

    Miller, Sarah; Wherry, Laura R

    2017-03-09

    Background By September 2015, a total of 29 states and Washington, D.C., were participating in Medicaid expansions under the Affordable Care Act. We examined whether Medicaid expansions were associated with changes in insurance coverage, health care use, and health among low-income adults. Methods We compared changes in outcomes during the 2 years after implementation of the Medicaid expansion (2014 and 2015) relative to the 4 years before expansion (2010 through 2013) in states with and without expansions, using data from the National Health Interview Survey. The sample consisted of 60,766 U.S. citizens who were 19 to 64 years of age and had incomes below 138% of the federal poverty level. Outcomes included insurance coverage, access to and use of medical care in the past 12 months, and health status as reported by the respondents. Results A total of 29 states and Washington, D.C., expanded Medicaid by September 1, 2015. In year 2 after implementation, uninsurance rates were reduced in expansion states relative to nonexpansion states (difference-in-differences estimate, -8.2 percentage points; P<0.001) and rates of Medicaid coverage were increased (difference-in-differences estimate, 15.6 percentage points; P<0.001). Expansions were not associated with significant changes in the likelihood of a doctor visit or overnight hospital stay or health status as reported by the respondent. However, as compared with nonexpansion states, expansion states had a decrease in reports of inability to afford needed follow-up care (difference-in-differences estimate, -3.4 percentage points; P=0.002) and in reports of worry about paying medical bills (difference-in-differences estimate, -7.9 percentage points; P=0.002) and an increase in reports of medical care being delayed because of wait times for appointments (difference-in-differences estimate, 2.6 percentage points; P=0.02). Conclusions Medicaid expansion was associated with increased insurance coverage and access to care during the second year of implementation, but it was also associated with longer wait times for appointments, which suggests that challenges in access to care persist.

  1. 5 strategies for lessening the self-insurance impact of the ACA.

    PubMed

    Frese, Richard C

    2014-05-01

    Many healthcare organizations use self-insurance programs to control professional liability and workers' compensation exposures, such as self-insured retention, a large deductible program, a trust fund, or a captive. The impact of the Affordable Care Act on self-insurance programs may take years to determine. Communication among all areas involved in the self-insurance program and the evaluation of different cost perspectives will be key to keeping the self-insurance program financially healthy. Empowering actuaries to create different scenarios also will help leaders stay on top of the issue.

  2. Health: Policy or Law? A Population-Based Analysis of the Supreme Court's ACA Cases.

    PubMed

    Parmet, Wendy E

    2016-08-16

    This essay argues that it matters for the fate of health policies challenged in court whether courts consider health merely as a policy goal that must be subordinate to law, or as a legal norm warranting legal weight and consideration. Applying population-based legal analysis, this article demonstrates that courts have traditionally treated health as a legal norm. However, this norm appears to have weakened in recent years, a trend evident in the Supreme Court's first two decisions concerning the Affordable Care Act, NFIB v. Sebelius and Burwell v. Hobby Lobby However, in its more recent Affordable Care Act decision, King v. Burwell, the health legal norm is once again evident. Whether the Court will continue to treat health as a legal norm will prove critical to the deference and weight it grants health policies in the future.

  3. Total Transformation: How ACA Is Driving Changes in the Provider Landscape.

    PubMed

    Taylor, Michael; Calhoun, Ron

    2015-01-01

    Motivated by Affordable Care Act provisions designed to put the brakes on rapidly increasing health care costs, employers are adopting numerous strategies for creating greater efficiency in how they purchase health care. The strategies are centered on holding providers more accountable for improving patient outcomes and reducing unnecessary expenses. In conjunction with the federal agency for health care, Centers for Medicare and Medicaid Services (CMS), they will drastically transform the provider landscape. This article discusses those strategies, along with their potential impact on providers.

  4. The Impact of the ACA on Premiums: Evidence from the Self-Employed.

    PubMed

    Heim, Bradley T; Hunter, Gillian; Lurie, Ithai Z; Ramnath, Shanthi P

    2015-10-01

    This article examines the impact of the Affordable Care Act on premiums by studying a segment of the nongroup market, the self-employed. Because self-employed health insurance premiums are deductible, tax data contain comprehensive individual-level information on the premiums paid by this group prior to the establishment of health insurance exchanges. We compare these prior premiums to reference silver premiums available on the exchanges and find that exchange premiums are 4.2 percent higher on average among the entire sample but 42.3 percent lower on average after taxes and subsidies. We also examine which type of exchange coverage would cost less than the individual's prior health insurance premiums and find that almost 60 percent of families could purchase bronze plans for less than their prior premiums, though only about a quarter could purchase platinum plans. After taxes and subsidies, the fractions increase to over 85 percent for bronze plans and over half for platinum plans.

  5. Maybe the ACA Is Here To Stay, But Employers Wish That Cadillac Tax Would Go Away.

    PubMed

    Huff, Charlotte

    2016-09-01

    The Cadillac tax, which has drawn fire from both Democrats and Republicans, was initially slated to go into effect in 2018 but last year Congress delayed it until 2020. But it remains an election-year point of friction, with proposals ranging from repeal to modifications.

  6. Law and Management of a Counseling Agency or Private Practice. The ACA Legal Series. Volume 3.

    ERIC Educational Resources Information Center

    Bullis, Ronald K.

    This monograph addresses laws that govern the business and management of mental health practices. The preface warns that this book only raises legal issues, concentrates on federal law, and does not exhaust the issues and information on any topic. A glossary of terms such as "burden of proof,""fiduciary,""negligence," and "torts" is presented.…

  7. 78 FR 20695 - Notice of a Public Meeting of the Advisory Committee on Apprenticeship (ACA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Notice of a Public Meeting of the Advisory Committee on Apprenticeship... bags (i.e., knapsacks, camera bags, backpacks and shopping bags, etc). Anyone with the mentioned...

  8. Sensor de orvalho/chuva aplicado à operação de telescópios

    NASA Astrophysics Data System (ADS)

    Raffaelli, J. C.; Neres, N. L.; Strauss, C.

    2003-08-01

    Foi desenvolvida uma estação meteorológica para o telescópio robótico Obelix do Observatório Abrahão de Moraes que inclui sensores de temperatura e umidade, além de um inédito sensor de orvalho e chuva que comanda o fechamento automático da cúpula caso haja perigo de condensação. Este sensor é composto de uma malha de segmentos metálicos próximos e detecta o aumento da condutividade do ar que precede a condensação. Esse método é mais confiável que o critério de 100% de umidade, que pode causar falsos alarmes devido a imprecisão dos sensores de umidade em geral e por não considerar a influência dos ventos que dificultam a condensação. O trabalho apresenta o método de construção desse sensor e os testes de avaliação. Sugere-se portanto a inclusão desse sensor nas estações meteorológicas dos telescópios do país.

  9. Recursos Publicos Aplicados Em Educacao-1960/1967 [Public Contributions to Education in Brazil from 1960 to 1967].

    ERIC Educational Resources Information Center

    Machado de Souza, Edson

    An analysis of the financial contributions to educational programs made by the Brazilian government attempts to outline the actual costs, describe the ways in which the funds were spent, and ascertain whether or not the amounts were sufficient for the projects on hand. The report is intended to shed new light on the general educational situation…

  10. 76 FR 41263 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1004

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... date of publication of this Notice and remains in effect until the expiration of the project period of... to improve and expand the scope of health care coverage for Americans. Cost savings through disease... prevention research and health screenings, such as the Community Transformation Grant Program, the...

  11. 76 FR 41261 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1003

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... projects for facilitating linkages between health outcome and environmental data. The NAHDO- Tracking collaboration has proven to be an important step in establishing access to existing hospital and emergency... application under funding opportunity EH10-1003, ``National Environmental Public Health Tracking...

  12. ACA Provisions Associated With Increase In Percentage Of Young Adult Women Initiating And Completing The HPV Vaccine.

    PubMed

    Lipton, Brandy J; Decker, Sandra L

    2015-05-01

    Affordable Care Act provisions implemented in 2010 required insurance plans to offer dependent coverage to people ages 19-25 and to provide targeted preventive services with zero cost sharing. These provisions both increased the percentage of young adults with any source of health insurance coverage and improved the generosity of coverage. We examined how these provisions affected use of the human papillomavirus (HPV) vaccine, which is among the most expensive of recommended vaccines, among young adult women. Using 2008-12 data from the National Health Interview Survey, we estimated that the 2010 policy implementation increased the likelihood of HPV vaccine initiation and completion by 7.7 and 5.8 percentage points, respectively, for women ages 19-25 relative to a control group of women age 18 or 26. These estimates translate to approximately 1.1 million young women initiating and 854,000 young women completing the vaccine series.

  13. The Volume Of TV Advertisements During The ACA's First Enrollment Period Was Associated With Increased Insurance Coverage.

    PubMed

    Karaca-Mandic, Pinar; Wilcock, Andrew; Baum, Laura; Barry, Colleen L; Fowler, Erika Franklin; Niederdeppe, Jeff; Gollust, Sarah E

    2017-04-01

    The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public.

  14. 77 FR 35981 - Notice of Intent To Award Affordable Care Act (ACA) Funding, HM10-1001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... Tracking Network. This network builds on ongoing efforts within the public health and environmental sectors... Public Tracking Network as a potential data tool for laboratories. This award was proposed in the grantee... Network. Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section...

  15. 76 FR 41501 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH09-907

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... public health by supporting the Tracking Network. This network builds on ongoing efforts within the... Networks. These activities are proposed by the above-mentioned grantees in their FY 2011 applications...--Network Implementation (EPHT),'' Catalogue of Federal Domestic Assistance Number (CFDA):...

  16. Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review.

    PubMed

    Kruse, Clemens Scott; Bouffard, Shelby; Dougherty, Michael; Parro, Jenna Stewart

    2016-06-01

    Native American communities face serious health disparities and, living in rural areas, often lack regular access to healthcare services as compared to other Americans. Since the early 1970's, telecommunication technology has been explored as a means to address the cost and quality of, as well as access to, healthcare on rural reservations. This systematic review seeks to explore the use of telemedicine in rural Native American communities using the framework of cost, quality, and access as promulgated by the Affordable Care Act of 2010 and urge additional legislation to increase its use in this vulnerable population. As a systematic literature review, this study analyzes 15 peer-reviewed articles from four databases using the themes of cost, quality, and access. The theme of access was referenced most frequently in the reviewed literature, indicating that access to healthcare may be the biggest obstacle facing widespread adoption of telemedicine programs on rural Native American reservations. The use of telemedicine mitigates the costs of healthcare, which impede access to high-quality care delivery and, in some cases, deters prospective patients from accessing healthcare at all. Telemedicine offers rural Native American communities a means of accessing healthcare without incurring high costs. With attention to reimbursement policies, educational services, technological infrastructure, and culturally competent care, telemedicine has the potential to decrease costs, increase quality, and increase access to healthcare for rural Native American patients. While challenges facing the implementation of telemedicine programs exist, there is great potential for it to improve healthcare delivery in rural Native American communities. Public policy that increases funding for programs that help to expand access to healthcare for Native Americans will improve outcomes because of the increase in access.

  17. Camp Creates a World of Magic: The Trail to Innovative Thinking Begins at the ACA National Conference.

    ERIC Educational Resources Information Center

    Coleman, Marla

    2001-01-01

    The American Camping Association 2001 National Conference at Walt Disney World draws parallels between the administration of camp programs and practices at Disney World. Seminars led by Disney managers focus on recruitment of college students, development of a corporate culture and philosophy, emphasis on environment, and quality service that…

  18. Changes in Consumer Cost-Sharing for Health Plans Sold in the ACA's Insurance Marketplaces, 2015 to 2016.

    PubMed

    Gabel, Jon; Green, Matthew; Call, Adrienne; Whitmore, Heidi; Stromberg, Sam; Oran, Rebecca

    2016-05-01

    This brief examines changes in consumer health plan cost-sharing--deductibles, copayments, coinsurance, and out-of-pocket limits--for coverage offered in the Affordable Care Act's marketplaces between 2015 and 2016. Three of seven measures studied rose moderately in 2016, an increase attributable in part to a shift in the mix of plans offered in the marketplaces, from plans with higher actuarial value (platinum and gold plans) to those that have less generous coverage (bronze and silver plans). Nearly 60 percent of enrollees in marketplace plans receive cost-sharing reductions as part of income-based assistance. For enrollees without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits remain considerably higher under bronze and silver plans than under employer-based plans; cost-sharing is similar in gold plans and employer plans. Marketplace plans are more likely than employer-based plans to impose a deductible for prescription drugs but no less likely to do so for primary care visits.

  19. In Second Year Of Marketplaces, New Entrants, ACA 'Co-Ops,' And Medicaid Plans Restrain Average Premium Growth Rates.

    PubMed

    Gabel, Jon R; Whitmore, Heidi; Green, Matthew; Stromberg, Sam T; Weinstein, Daniel S; Oran, Rebecca

    2015-12-01

    Premiums for health insurance plans offered through the federally facilitated and state-based Marketplaces remained steady or increased only modestly from 2014 to 2015. We used data from the Marketplaces, state insurance departments, and insurer websites to examine patterns of premium pricing and the factors behind these patterns. Our data came from 2,964 unique plans offered in 2014 and 4,153 unique plans offered in 2015 in forty-nine states and the District of Columbia. Using descriptive and multivariate analysis, we found that the addition of a carrier in a rating area lowered average premiums for the two lowest-cost silver plans and the lowest-cost bronze plan by 2.2 percent. When all plans in a rating area were included, an additional carrier was associated with an average decline in premiums of 1.4 percent. Plans in the Consumer Operated and Oriented Plan Program and Medicaid managed care plans had lower premiums and average premium increases than national commercial and Blue Cross and Blue Shield plans. On average, premiums fell by an appreciably larger amount for catastrophic and bronze plans than for gold plans, and premiums for platinum plans increased. This trend of low premium increases overall is unlikely to continue, however, as insurers are faced with mounting medical claims.

  20. Arkansas's alternative to Medicaid expansion raises important questions about how HHS will implement new ACA waiver authority in 2017.

    PubMed

    Allison, Andrew

    2014-10-01

    This essay presents Arkansas's alternative to Medicaid expansion as a case study motivating John McDonough's assessment of the recommendations states may want to make to the Department of Health and Human Services regarding the implementation of statewide Patient Protection and Affordable Care Act-alternative waivers scheduled to begin in 2017. Arkansas's private option uses federal funds to purchase marketplace silver-level qualified health plans for low-income, low-risk participants, while "medically frail" adults are covered through Medicaid. By improving the size and risk profile of Arkansas's health insurance marketplace, the private option will also encourage entry of and competition among private carriers. If it succeeds in keeping insurance premiums below the level they would otherwise be in the marketplace, Arkansas's private option could reduce subsidy costs for the federal government. Under the broadened scope of section 1332 waivers, states will be able to capture such savings and use them to support innovation across both Medicaid-funded and Treasury-subsidized programs and populations.

  1. Insurance Coverage, Access to Care, and Medical Debt Since the ACA: a Look at California, Florida, New York, and Texas.

    PubMed

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle McEvoy; Beutel, Sophie

    2017-03-01

    ISSUE: The Affordable Care Act has significantly increased health insurance coverage and access to care among U.S. adults nationwide. However, the law gives states flexibility in implementing certain provisions, leading to wide variations between states in consumers’ experiences. GOAL: To examine the differences in insurance coverage, access to care, and medical bill problems in the four largest states—California, Florida, New York, and Texas—all of which have made different choices in implementing the law. METHODS: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. FINDINGS AND CONCLUSIONS: In 2016, uninsured rates among adults ages 19 to 64 across the four states varied from 7 percent in New York and 10 percent in California to 16 percent in Florida and 25 percent in Texas. This variation was also apparent in the proportions of residents reporting problems getting needed care because of the cost—significantly lower in California and New York than in Florida and Texas. Lower percentages of Californians and New Yorkers reported having a medical bill problem in the past 12 months or having accrued medical debt compared to Floridians and Texans. These variations might be explained by several factors: whether the state expanded Medicaid eligibility; whether it ran its own health insurance marketplace; what the uninsured rate was prior to the Affordable Care Act; differences in the cost protections provided by private health plans; and demographic differences.

  2. Health benefits in 2012: moderate premium increases for employer-sponsored plans; young adults gained coverage under ACA.

    PubMed

    Claxton, Gary; Rae, Matthew; Panchal, Nirmita; Damico, Anthony; Whitmore, Heidi; Kenward, Kevin; Osei-Anto, Awo

    2012-10-01

    Health care premiums rose moderately for single and family employer-sponsored coverage this year, the 2012 annual Kaiser Family Foundation/Health Research and Educational Trust (HRET) Survey of Employer Health Benefits found. Even with the lingering effects of the recession, cost-sharing levels remained relatively stable in 2012. Also remaining stable was the rate at which employers offered coverage, according to the survey, which was based on telephone interviews with 2,121 public and private employers contacted from January through May 2012. The average annual premiums in 2012 were $5,615 for single coverage and $15,745 for family coverage, an increase of 3 and 4 percent, respectively, from 2011. The percentage of firms offering health benefits, 61 percent, was similar to last year's, as was the percentage of workers at offering firms who were covered by their firm's health benefits, 62 percent. One noteworthy change, because of a provision of the Affordable Care Act, is that 2.9 million young adults who would not otherwise have been enrolled in a parent's employer-sponsored health insurance were covered by that insurance in 2012.

  3. La influencia de la rotación terrestre en el método de los arcos aplicado a observaciones VLBI

    NASA Astrophysics Data System (ADS)

    de Biasi, M. S.; Arias, E. F.

    We analyze the influence of the model or Earth's rotation in the arclength method envisioned to analyze VLBI astrometric observations. We particulary focus in the case of quasi-simultaneous observations.

  4. 76 FR 28438 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-17

    ... Care Act (ACA): Childhood Obesity Research Funding Opportunity Announcement (FOA) DP11- 007, Panel B... evaluation of ``Affordable Care Act (ACA): Childhood Obesity Research Funding Opportunity Announcement...

  5. Canonical Wnt signaling protects hippocampal neurons from Aβ oligomers: role of non-canonical Wnt-5a/Ca(2+) in mitochondrial dynamics.

    PubMed

    Silva-Alvarez, Carmen; Arrázola, Macarena S; Godoy, Juan A; Ordenes, Daniela; Inestrosa, Nibaldo C

    2013-01-01

    Alzheimer's disease (AD) is the most common type of age-related dementia. The disease is characterized by a progressive loss of cognitive abilities, severe neurodegeneration, synaptic loss and mitochondrial dysfunction. The Wnt signaling pathway participates in the development of the central nervous system and growing evidence indicates that Wnts also regulate the function of the adult nervous system. We report here, that indirect activation of canonical Wnt/β-catenin signaling using Bromoindirubin-30-Oxime (6-BIO), an inhibitor of glycogen synthase kinase-3β, protects hippocampal neurons from amyloid-β (Aβ) oligomers with the concomitant blockade of neuronal apoptosis. More importantly, activation with Wnt-5a, a non-canonical Wnt ligand, results in the modulation of mitochondrial dynamics, preventing the changes induced by Aβ oligomers (Aβo) in mitochondrial fission-fusion dynamics and modulates Bcl-2 increases induced by oligomers. The canonical Wnt-3a ligand neither the secreted Frizzled-Related Protein (sFRP), a Wnt scavenger, did not prevent these effects. In contrast, some of the Aβ oligomer effects were blocked by Ryanodine. We conclude that canonical Wnt/β-catenin signaling controls neuronal survival, and that non-canonical Wnt/Ca(2+)signaling modulates mitochondrial dysfunction. Since mitochondrial dysfunction is present in neurodegenerative diseases, the therapeutic possibilities of the activation of Wnt signaling are evident.

  6. The expansion of Medicaid coverage under the ACA: implications for health care access, use, and spending for vulnerable low-income adults.

    PubMed

    Clemans-Cope, Lisa; Long, Sharon K; Coughlin, Teresa A; Yemane, Alshadye; Resnick, Dean

    2013-05-01

    The expansion of Medicaid coverage under the Affordable Care Act offers the potential for significant increases in health care access, use, and spending for vulnerable nonelderly adults who are uninsured. Using pooled data from the Medical Expenditure Panel Survey, this study estimates the potential effects of Medicaid, controlling for individual and local community characteristics. Our findings project significant gains in health care access and use for uninsured adults who enroll in Medicaid coverage and have chronic health conditions and mental health conditions. With that increased use, annual per capita health care spending for those newly insured individuals (excluding out-of-pocket spending) is projected to grow from $2,677 to $6,370 in 2013 dollars, while their out-of-pocket spending would drop by $921. It is expected that these increases in spending would be offset at least in part by reductions in uncompensated care and charity care.

  7. Canonical Wnt signaling protects hippocampal neurons from Aβ oligomers: role of non-canonical Wnt-5a/Ca2+ in mitochondrial dynamics

    PubMed Central

    Silva-Alvarez, Carmen; Arrázola, Macarena S.; Godoy, Juan A.; Ordenes, Daniela; Inestrosa, Nibaldo C.

    2013-01-01

    Alzheimer's disease (AD) is the most common type of age-related dementia. The disease is characterized by a progressive loss of cognitive abilities, severe neurodegeneration, synaptic loss and mitochondrial dysfunction. The Wnt signaling pathway participates in the development of the central nervous system and growing evidence indicates that Wnts also regulate the function of the adult nervous system. We report here, that indirect activation of canonical Wnt/β-catenin signaling using Bromoindirubin-30-Oxime (6-BIO), an inhibitor of glycogen synthase kinase-3β, protects hippocampal neurons from amyloid-β (Aβ) oligomers with the concomitant blockade of neuronal apoptosis. More importantly, activation with Wnt-5a, a non-canonical Wnt ligand, results in the modulation of mitochondrial dynamics, preventing the changes induced by Aβ oligomers (Aβo) in mitochondrial fission-fusion dynamics and modulates Bcl-2 increases induced by oligomers. The canonical Wnt-3a ligand neither the secreted Frizzled-Related Protein (sFRP), a Wnt scavenger, did not prevent these effects. In contrast, some of the Aβ oligomer effects were blocked by Ryanodine. We conclude that canonical Wnt/β-catenin signaling controls neuronal survival, and that non-canonical Wnt/Ca2+signaling modulates mitochondrial dysfunction. Since mitochondrial dysfunction is present in neurodegenerative diseases, the therapeutic possibilities of the activation of Wnt signaling are evident. PMID:23805073

  8. Transport properties and photo electrochemical characterization of oxygen-deficient ASnO 3- δ (A=Ca, Sr and Ba)

    NASA Astrophysics Data System (ADS)

    Zidi, N.; Omeiri, S.; Hadjarab, B.; Bouguelia, A.; Akroun, A.; Trari, M.

    2010-08-01

    The deficient stannate BaSnO 3- δ, prepared at 980 °C in sealed tube, crystallizes in an ideal perovskite structure. The oxide exhibits a blue color, the bandgap is found to be 2.65 eV and the transition is directly allowed. The non-stoichiometry could not be measured, indicating no appreciable oxygen deficiency. Nevertheless, the transport properties were found to change markedly with the heat treatment. BaSnO 3- δ behaves as degenerate SC with a conductivity σ300 K (=1.63 Ω -1 cm -1) and where the level Ef drops above mobility edge to delocalized states. The electric balance leads to a simultaneous reduction of Sn 4+ inducing n-type behavior. The thermal variation of the thermopower indicates an electron mobility μ300 K (=0.013 cm 2 V -1 s -1) thermally activated. The metal-insulating transition is considered of Anderson type due to the random potential to oxygen vacancies. A predominant variable range hopping is predicted from the non-linearity of Ln σ versus T-1 plot. The capacitance measurement ( C-2- V), measured in KOH media, shows a linear behavior from which a flat band potential Vfb (=-0.67 VSCE) and a density ND (=7.59×10 20 cm -3) are determined. The deficient stannates CaSnO 3 and SrSnO 3 are reported for a comparative purpose. The decrease of Eg is ascribed to the increase of the conduction band width when going from Ba to Ca.

  9. New members of the A2 M ‧ M2″ structure family (A=Ca, Sr, Yb, La; M ‧ = In , Sn , Pb; M ″ = Si , Ge)

    NASA Astrophysics Data System (ADS)

    Jehle, Michael; Dürr, Ines; Fink, Saskia; Lang, Britta; Langenmaier, Michael; Steckhan, Julia; Röhr, Caroline

    2015-01-01

    The new mixed tetrelides Sr2PbGe2 and Yb2SnGe2, several mixed Ca/Sr (AII) germanides A2II (Sn , Pb)Ge2 and two polymorphs of La2 InSi2 represent new members of the general structure family of ternary alkaline-earth/lanthanoid main group silicides/germanides A2 M ‧ M2″ (M ‧ = In , Sn , Pb ; M ″ = Si , Ge). All compounds were synthesized from melts of the elements and their crystal structures have been determined by means of single crystal X-ray diffraction. Sr2PbGe2 (Cmmm, a=402.36(11), b=1542.3(4), c=463.27(10) pm) crystallizes with the Mn2AlB2 -type structure. In exhibiting infinite planar Ge zig-zag chains, it represents one border of the compound series. The other borderline case, where only [Ge2 ] dumbbells are left as Ge building units, is represented by the Ca/Yb tin germanides Ca2SnGe2 and Yb2SnGe2 (Mo2FeB2 -type; P4/mbm, a=748.58(13)/740.27(7), c=445.59(8)/435.26(5) pm). In between these two border structures compounds with variable Si/Ge chain lengths could be obtained by varying the averaged size of the AII cations: Ca0.45Sr1.55PbGe2 (new structure type; Pbam, a=791.64(5), b=2311.2(2), c=458.53(3) pm) contains planar six-membered chain segments [Ge6 ]. Tetrameric pieces [Ge4 ] are the conspicuous structure elements in Ca1.16Sr0.84SnGe2 and La2 InSi2 (La2 InNi2 -type; Pbam, a=781.01(2)/762.01(13), b=1477.95(3)/1494.38(6), c=457.004(9)/442.1(3) pm). The tetragonal form of 'La2 In Si2‧ (exact composition: La2In1.07Si1.93, P4/mbm, a=1309.11(12), c=443.32(4) pm) also crystallizes in a new structure type, containing only [Si3 ] trimers as cutouts of the planar chains. In all structures the Si/Ge zig-zag chains/chain segments are connected by In/Sn/Pb atoms to form planar M layers, which are separated by pure A layers. Band structure calculations within the FP-LAPW DFT approach together with the Zintl formalism, extended by the presence of hypervalent bonding of the heavier M ‧ elements, give insight into the chemical bonding of this series of p-block metallides. An analysis of the band structure for the border phases Sr2PbGe2 and Ca2SnGe2 shows the considerable π bonding contributions within the Ge building units, which also become apparent from the short Ge-Ge bond lengths.

  10. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

    PubMed

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2016-07-01

    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

  11. Adults with Down syndrome: characterization of a Portuguese sample.

    PubMed

    Breia, Paula; Mendes, Rosário; Silvestre, Ana; Gonçalves, Maria Joao; Figueira, Maria Joao; Bispo, Regina

    2014-01-01

    Introdução: A síndrome de Down ou Trissomia 21 afeta o desenvolvimento físico, comportamental e cognitivo. No decurso do envelhecimento, a ocorrência de comorbilidades aumenta nesta população, sendo a sua deteção e tratamento precoces determinantes na sua qualidade de vida. Objetivo: Analisar numa amostra de adultos com síndrome de Down a existência de doenças médicas comuns, uso regular de medicação, eventual disfunção cognitiva e capacidades de comunicação oral. Material e Métodos: Foram coletados os dados sociodemográficos e clínicos de 209 adultos portugueses (20 - 58 anos), com síndrome de Down. Vinte e seis indivíduos foram avaliados com a WAIS-III. Os dados foram analisados estatisticamente - SPSS (v.19). Resultados: Quase metade da amostra (47,36%) sofre de comorbilidades, sendo as doenças cardíacas, psiquiátricas, epilepsia e hipotiroidismo as mais prevalentes. Setenta e dois indivíduos (34,45%) tomam medicação com ação no sistema nervoso central. Na WAIS-III, os valores de QI situam-se entre 45-61 (m = 49,65, dp = 4,93) existindo 141 indivíduos (67,5%) capazes de se expressar através de linguagem oral básica. Discussão: Os indivíduos desta amostra são vulneráveis a várias comorbilidades. A maioria tem linguagem oral básica, mas os valores de QI situam-se na faixa ‘extremamente baixo’, sendo melhor o desempenho em tarefas verbais. Conclusão: As limitações cognitivas e dificuldades comunicacionais na população com síndrome de Down podem condicionar o reconhecimento clínico precoce de comorbilidades que lhe estão associadas no decurso do envelhecimento. A valorização semiológica, com apoio do cuidador, é essencial para garantir que os cuidados de saúde adequados são prestados a esta população.

  12. 78 FR 6141 - Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... through Friday. SUPPLEMENTARY INFORMATION: Title of Collection: Antarctic emergency response plan and....) (``ACA'') regulates certain non- governmental activities in Antarctica. The ACA was amended in 1996 by... owner has an emergency response plan. The rule also requires persons organizing a...

  13. 75 FR 53303 - Farm Credit Administration Board; Sunshine Act; Regular Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... Ag Credit ACA, and Subsidiaries with Southern AgCredit, ACA, and Subsidiaries. Fall 2010 Abstract of... Plan. Farm Credit Administration Revised FY 2011 and Proposed FY 2012 Budget. Closed Session*...

  14. 75 FR 18551 - Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-12

    ... Friday. SUPPLEMENTARY INFORMATION: Title of Collection: Antarctic emergency response plan and....) (``ACA'') regulates certain non- governmental activities in Antarctica. The ACA was amended in 1996 by... owner has an emergency response plan. The rule also requires persons organizing a...

  15. [Two cases of anterior cerebral artery aneurysm associated with accessory anterior cerebral artery: review of the literature and points of diagnosis].

    PubMed

    Maeda, Kazushi; Tanaka, Shunya; Hatae, Ryusuke; Maeda, Yoshihisa; Miyazono, Masayuki

    2014-05-01

    The accessory anterior cerebral artery (AccACA) is an anomalous vessel arising from the anterior communicating artery. Although AccACA is not particularly rare, aneurysms arising from the AccACA is extremely rare. Here, we report two cases of unruptured AccACA aneurysms. Patient 1 was a 58-year-old woman with an unruptured distal AccACA aneurysm. Magnetic resonance imaging and three-dimensional computed tomography angiography(3D-CTA)demonstrated a left middle cerebral artery aneurysm that was subsequently clipped successfully by direct surgery. No aneurysm was detected in the distal anterior cerebral artery(ACA)due to the narrow imaging range at that time. Postoperatively, an aneurysm of the distal ACA was incidentally identified on 3D-CTA. This AccACA aneurysm was also clipped by direct surgery about 5 months later, and the patient was discharged without any neurological deficits. Patient 2 was a 46-year-old woman with an aneurysm at the proximal portion of the AccACA. Since the aneurysm was small and patient was asymptomatic, the observation-approach was selected. In introducing these cases, we discuss AccACA aneurysms and the process of diagnosis. Aneurysm can arise over the entire length of the ACA, from the anterior communicating artery to the peripheral portion, particularly the supracallosal portion, so observation and imaging of the peripheral region is important in cases where an AccACA is present.

  16. The Association of Collegiate Alumnae, 1880-1912: Progressivism, College Women and the Problem of 'Woman's Nature'".

    ERIC Educational Resources Information Center

    Holt, Sharon Ann

    The history of the Association of Collegiate Alumnae (ACA) is examined. ACA is the parent organization of the American Association of University Women and the National Association of Women Deans and Counselors. ACA played a crucial bridging role in the history of higher education for women by simultaneously supporting conventional and radical…

  17. Ethical Guidelines for Counselors when Working with Clients with Terminal Illness Requesting Physician Aid in Dying

    ERIC Educational Resources Information Center

    Kurt, Layla J.; Piazza, Nick J.

    2012-01-01

    In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the "ACA Code of Ethics" (ACA, 2005).

  18. Alcoholism in the Families of Origin of MSW Students: Estimating the Prevalence of Mental Health Problems Using Standardized Measures.

    ERIC Educational Resources Information Center

    Hawkins, Catherine A.; Hawkins, Raymond C., II

    1996-01-01

    A 1991 study of 136 graduate social work students determined students' status as adult children of alcoholics (ACAs) by self-report and standardized screening test scores, and evaluated mental health functioning with four standardized measures. Results found that 47% of the social work students were ACAs, and not all (or only) ACAs were vulnerable…

  19. Two-step immobilized enzyme conversion of cephalosporin C to 7-aminocephalosporanic acid.

    PubMed

    Conlon, H D; Baqai, J; Baker, K; Shen, Y Q; Wong, B L; Noiles, R; Rausch, C W

    1995-06-20

    The first large-scale production of 7-aminocephalosporanic acid (7ACA) from cephalosporin C (CPC) using a wholly enzymatic synthesis method is reported here. We produced 7ACA from CPC in as high a molar yield as 85% using the immobilized enzymes D-amino acid oxidase (D-AOD) and glutaryl-7-ACA acylase (GL-acylase). In the first reactor, CPC is converted to keto-adipyl-7-aminocephalosporanic acid (keto-7ACA) using an immobilized D-AOD isolated from a yeast, Trigonopsis variabilis. The keto-7ACA is then spontaneously converted to glutaryl-7-aminocephalosporanic acid (GL-7ACA) via a chemical reaction with hydrogen peroxide. The hydrogen peroxide is also a product of the D-AOD reaction. Near quantitative conversion of the keto-7ACA to GL-7ACA was observed. The second reactor converts GL-7ACA to 7ACA using an immobilized GL-acylase, which was isolated from a recombinant Escherichia coli. The final 7ACA crystalline product is a high quality product. The reactions are conducted under very mild aqueous conditions: pH 8.0 and 20 degrees to 25 degrees C. The production of desacetyl side products is minimal. This process is currently being implemented on an industrial scale to produce 7ACA.

  20. 76 FR 16792 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... of the ACA requires the Secretary to establish and post information on the CMS' public Internet Web... addition, section 6409(b) of the ACA gives the Secretary authority to reduce the amounts due and owing for.... In addition, the authority granted to the Secretary under section 6409(b) of the ACA,...

  1. 77 FR 38298 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... to Assess Access Issues for Specific Medicare Beneficiaries as Defined in Section 3131(d) of the ACA... Affordable Care Act (ACA). The study is focused on two major issues: (1) supporting CMS' efforts to improve payment accuracy and (2) understanding issues of access for the ACA populations under the existing...

  2. 76 FR 160 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... presentations on key provisions from the Affordable Care Act (ACA). The Committee will be examining the rural implications of several provisions from the ACA, including health insurance exchanges, the Maternal and Early... Committee will continue to hear panel presentations on ACA-related provisions and will then break...

  3. 77 FR 73032 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ... Affordable Care Act (ACA). The ACA requires CMS to establish a Physician Compare Web site by January 1, 2011... periods beginning no earlier than January 1, 2012), CMS is required to implement a plan to make... reporting requirements under the ACA is public reporting on physician performance that includes...

  4. 78 FR 71667 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... Protection and Affordable Care Act (ACA), Public Law 111-148, section 1251 provides that certain plans and... ACA grandfathered plan provision, requires a grandfathered health plan to include a statement in any... ] grandfathered health plan within the meaning of ACA section1251. To maintain its status as a...

  5. American Camping Association Annual Report, 2000.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    The American Camping Association (ACA) is a community of camp professionals dedicated to enriching the lives of children and adults through the camp experience. This annual report describes ACA activities during 2000, grouped in five areas: (1) expansion of services and other development of ACA's 24 regional sections and partnerships with other…

  6. Synthesis, crystal structures, and physical properties of the new Zintl phases A21Zn4Pn18 (A=Ca, Eu; Pn=As, Sb)-Versatile arrangements of [ZnPn4] tetrahedra

    NASA Astrophysics Data System (ADS)

    Suen, Nian-Tzu; Wang, Yi; Bobev, Svilen

    2015-07-01

    Four new Zintl phases, Ca21Zn4As18, Ca21Zn4Sb18, Eu21Zn4As18 and Eu21Zn4Sb18 have been synthesized by metal flux reactions. Their structures have been established from single-crystal X-ray diffraction. Despite the similar chemical makeup and the identical formulae, the structures of the four compounds are not the same-Ca21Zn4As18, Ca21Zn4Sb18 and Eu21Zn4As18 crystallize in the monoclinic space group C2/m (No. 12, Z=4) with the β-Ca21Mn4Sb18 structure type, while Eu21Zn4Sb18 adopts the Ba21Cd4Sb18 structure type with the orthorhombic space group Cmce (No. 64, Z=8). Both structures are based on ZnAs4 or ZnSb4 tetrahedra, linked in slightly different ways, and Ca2+ and Eu2+ cations that fill the space between them. The structural relationships between the title compounds and other known ternary phases with intricate structures are discussed. Electrical resistivity measurement on single-crystalline Eu21Zn4Sb18 suggests an intrinsic semiconductor behavior with a band gap of ca. 0.2 eV. The temperature dependent DC magnetization measurement on the same material indicates Curie-Weiss paramagnetism in the high-temperature regime, and a spontaneous antiferromagnetic ordering below 8 K. The calculated effective moments of Eu confirm the divalent Eu2+ ground state, as expected from the Zintl-Klemm concept.

  7. A retrospective study on IVF outcome in patients with anticardiolipin antibody: effects of methylprednisolone plus low-dose aspirin adjuvant treatment.

    PubMed

    Ying, Ying; Zhong, Yi-ping; Zhou, Can-quan; Xu, Yan-wen; Wang, Qiong; Li, Jie; Wu, Hai-tao; Shen, Xiao-ting

    2012-06-01

    Patients undergoing in vitro fertilization-embryo transfer have a high prevalence of anticardiolipin antibody (ACA). However, the relationship between ACA and IVF outcome is still controversial. The aim of the present study was to evaluate the potential effect of anticardiolipin antibody on IVF outcome and determine the role of adjuvant treatment in these ACA positive patients. The study included a total of 116 infertile women (116 IVF-ET cycles) positive for ACA, including 56 women pretreated with methylprednisolone plus low-dose aspirin before IVF (treated ACA+ group) and 60 patients without treatment (untreated ACA+ group). In addition, 518 infertile women (518 IVF-ET cycles) negative for ACA were enroled as controls (ACA- group). The results show that ACA+ patients who did not receive any adjuvant treatment showed a significantly lower fertilization rate, less high-quality embryos, as well as a markedly lower pregnancy rate and implantation rate than controls. Moreover, ACA+ patients who received methylprednisolone plus aspirin achieved significantly higher fertilization, pregnancy and implantation rates than untreated ACA+ patients (FR 69.0%, PR 46.4% and IR 25.4% vs. FR 60.0%, PR 33.3% and IR 17.9%, respectively). The overall IVF results in the treated ACA+ group were comparable to patients negative for ACA (PR 53.9% and IR 32.3%). Thus, while the presence of ACA exerts a detrimental effect on IVF outcome, ACA+ patients have a better outcome if given methylprednisolone for immunosuppression and low-dose aspirin as an anti-thrombotic agent.

  8. Purification, cloning, and functional characterization of a novel immunomodulatory protein from Antrodia camphorata (bitter mushroom) that exhibits TLR2-dependent NF-κB activation and M1 polarization within murine macrophages.

    PubMed

    Sheu, Fuu; Chien, Po-Jung; Hsieh, Kuang-Yang; Chin, Kah-Lock; Huang, Wan-Ting; Tsao, Chiao-Yin; Chen, Yin-Fang; Cheng, Hui-Chung; Chang, Hui-Hsin

    2009-05-27

    A new immunomodulatory protein, designated ACA, was purified from the mycelium extract of Antrodia camphorata , a well-known folk medicine bitter mushroom in Taiwan, and N-terminally sequenced. By taking advantage of its N-terminal amino acid sequence, the full-length ACA gene was cloned using rapid amplification of cDNA ends (RACE) approach. This gene encodes a 136 amino acid protein that is homologous to the phytotoxic proteins from fungi. On the basis of the data of N-terminal sequencing and N-glycosidase F treatment, the native ACA was confirmed to be a glycoprotein. The similarity in activation of TLR4-deficient macrophages by both the native ACA and recombinant ACA (rACA) suggested that the glycosyl group(s) of the native ACA was insignificant in macrophage activation. Moreover, the failure of rACA to induce TLR2-deficient macrophages and to activate the RAW 264.7 macrophages transfected with the dominate-negative MyD88 (dnMyD88) indicated that the ACA-mediated macrophage activation was TLR2/MyD88 dependent. Microarray assay of the ACA-activated NFκB-related gene expression showed that rACA demonstrated a LPS-mimetic proinflammatory response toward RAW 264.7 macrophages. Furthermore, rACA enhanced phagocytosis activity and CD86 (B7-2) expression as well as induced TNF-α and IL-1β production within murine peritoneal macrophages. A time-dependent induction of mRNA expression of cytokines TNF-α, IL-1β, IL-6, and IL-12 as well as chemokines CCL3, CCL4, CCL5, and CCL10, but not IL-10, CCL17, CCL22, and CCL24, was observed after the ACA treatment of the macrophages. These results proposed that ACA exhibited M1 polarization and differentiation in macrophages. Thus, ACA is an important immunomodulatory protein of A. camphorata.

  9. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    PubMed

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA.

  10. 1'-Acetoxychavicol acetate-induced cytotoxicity is accompanied by a rapid and drastic modulation of glutathione metabolism.

    PubMed

    Higashida, Mami; Xu, Shenghui; Kojima-Yuasa, Akiko; Kennedy, David Opare; Murakami, Akira; Ohigashi, Hajime; Matsui-Yuasa, Isao

    2009-01-01

    The effect of 1'-acetoxychavicol acetate (ACA), an anticarcinogenic compound naturally obtained from rhizomes and seeds of South East Asia plants, on the intracellular concentration of glutathione and the activities of enzymes related to glutathione metabolism was studied in Ehrlich ascites tumor cells. We showed in a previous study that ACA induced apoptosis in tumor cells and the cell death was reversed by the addition of N-acetlycysteine or glutathione ethylester. Here we found that ACA caused a rapid decrease in glutathione level in less than 10 min after ACA exposure. At the time, glutathione reductase activity was significantly inhibited and gamma-glutamyl cysteine increased by ACA exposure. These results show that ACA caused the decrease in the intracellular GSH levels in Ehrlich ascites tumor cells, suggesting that ACA-induced decrease of the cellular GSH levels can lead to growth arrest of cancer and enhancement of the efficacy other anticancer drugs.

  11. Social, Reproductive, and Attitudinal Factors Associated with U.S. Women's Disagreement with the Passage of the Affordable Care Act

    PubMed Central

    Nadella, Samantha Paturu; Zochowski, Melissa K.; Patel, Divya; Dalton, Vanessa K.

    2015-01-01

    Abstract Background: Notably absent from research and public and policy dialogue on the Affordable Care Act (ACA) and reproductive health care are women's perspectives and a broader understanding of factors that shape ACA attitudes. We investigated social, reproductive, and attitudinal factors associated with women's disagreement with the passage of the ACA. Methods: Data were drawn from the Women's Health Care Experiences and Preferences Study, our population-based internet survey of 1,078 randomly sampled United States women ages 18–55 years conducted in September 2013. Items measured ACA attitudes, including disagreement with the ACA's passage. We examined relationships between ACA disagreement, sociodemographic and reproductive characteristics, health service experiences, and reproductive health care and policy attitudes with logistic regression. Results: Among women who had heard of the ACA (n=888), 35% disagreed with it and 38% did not know how they felt. Black women (adjusted odds ratio [aOR] 0.12, 95% confidence interval [CI] 0.03–0.55) and women with incomes of >$75k (aOR 0.38, CI 0.17–0.88), Medicare/Medicaid insurance (aOR 0.24, CI 0.10–0.61), and infrequent religious service attendance (aOR 0.57, CI 0.35–0.93) were less likely to disagree with the ACA's passage, compared with their counterparts. Republican party affiliation was the strongest predictor of ACA disagreement (aOR 17.10, CI 9.12–32.09). Negative beliefs about the ACA's ability to improve access to preferred care and regarding employers' and the government's roles in reproductive health care were positively associated with ACA disagreement. Conclusions: Many women who could benefit from the ACA disagree with or do not know how they feel about its passage, which may influence participation in ACA benefits and services. PMID:26125483

  12. Knowledge and perceptions of the Affordable Care Act by uninsured patients at a free clinic.

    PubMed

    Petrany, Stephen M; Christiansen, Matthew

    2014-05-01

    The Affordable Care Act (ACA) has as one of its main objectives to reduce the number of uninsured Americans. The understanding of the ACA reforms by uninsured patients will likely influence the degree of success in achieving this objective. This study assessed the basic knowledge and opinions regarding the ACA of patients at a free clinic and the impact of a brief educational intervention on respondents' knowledge and opinions. One hundred uninsured adult patients completed a brief survey about the ACA before and after viewing a video outlining the major features of the act. The study cohort initially performed worse than national polls on all knowledge questions. Significant improvement was observed after the educational video. Our study suggests a need for educational efforts directed at those individuals most likely to benefit from the ACA. We demonstrated that a brief intervention during a routine office visit may improve knowledge of the ACA.

  13. Nonlinear systems modeling based on self-organizing fuzzy-neural-network with adaptive computation algorithm.

    PubMed

    Han, Honggui; Wu, Xiao-Long; Qiao, Jun-Fei

    2014-04-01

    In this paper, a self-organizing fuzzy-neural-network with adaptive computation algorithm (SOFNN-ACA) is proposed for modeling a class of nonlinear systems. This SOFNN-ACA is constructed online via simultaneous structure and parameter learning processes. In structure learning, a set of fuzzy rules can be self-designed using an information-theoretic methodology. The fuzzy rules with high spiking intensities (SI) are divided into new ones. And the fuzzy rules with a small relative mutual information (RMI) value will be pruned in order to simplify the FNN structure. In parameter learning, the consequent part parameters are learned through the use of an ACA that incorporates an adaptive learning rate strategy into the learning process to accelerate the convergence speed. Then, the convergence of SOFNN-ACA is analyzed. Finally, the proposed SOFNN-ACA is used to model nonlinear systems. The modeling results demonstrate that this proposed SOFNN-ACA can model nonlinear systems effectively.

  14. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    PubMed

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide.

  15. Factors influencing the implementation of health care reform: an examination of the Concurrent Care for Children provision.

    PubMed

    Lindley, Lisa C; Edwards, Sheri; Bruce, Donald J

    2014-08-01

    In the wake of the 2013 Presidential reelection, states now face the reality of implementing the healthcare reform, including ACA section 2302 (Concurrent Care for Children). The purpose of our study was to examine the influence of economic, political, and legal factors on state implementation of ACA 2302. Using data from 2010 to 2012, our analysis revealed that for early implementers economic, political or legal factors did not influence implementation of ACA 2302. In 2011, states that were engaged in Medicaid cost containment efforts were more likely to implement ACA 2302 and in 2012, states experiencing a budgetary crisis were less likely to implement ACA 2302. Our findings suggest that state-level implementation of ACA 2302 may be an important bellwether for future healthcare reform implementations.

  16. Amoxicillin combined with clavulanic acid for the treatment of soft tissue infections in children.

    PubMed Central

    Fleisher, G R; Wilmott, C M; Campos, J M

    1983-01-01

    We compared responses to amoxicillin combined with clavulanic acid (ACA) with a cefaclor regimen in children with skin and soft tissue infections (impetigo and cellulitis) due to Staphylococcus aureus, Streptococcus pyogenes, and Haemophilus species. All isolates from the 41 patients we were able to evaluate were susceptible to ACA by disk susceptibility testing at the onset of treatment. The 21 children receiving ACA and 18 (90%) of 20 taking cefaclor responded to therapy. Clinical cure was achieved in 18 (86%) of 21 and 18 (90%) of 20 in the two groups, respectively. Bacteriological failure occurred in 2 (10%) patients in the cefaclor group and none in the group receiving ACA; however, there were 2 (9%) relapses and 1 (5%) reinfection among the 21 children taking ACA. Adverse effects, although mild, occurred more commonly (9 of 21 versus 1 of 20; P = 0.005) with ACA than with cefaclor. PMID:6660847

  17. Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act

    DTIC Science & Technology

    2013-11-22

    preexisting conditions, and a reinsurance program to reimburse employers for a portion of the health insurance claims’ costs for their 55- to 64-year-old...accounts, as well as ACA mandatory funds (e.g., HIRIF, PPHF) to support implementation activities. CMS and the IRS have both requested additional...discretionary funding for ACA-related activities in their annual budget submissions. For FY2013, CMS requested an additional $1 billion for ACA

  18. Galangal pungent component, 1'-acetoxychavicol acetate, activates TRPA1.

    PubMed

    Narukawa, Masataka; Koizumi, Kanako; Iwasaki, Yusaku; Kubota, Kikue; Watanabe, Tatsuo

    2010-01-01

    We investigated the activation of transient receptor potential cation channel (TRP) subfamily V, member 1 (TRPV1) and TRP subfamily A, member 1 (TRPA1) by 1'-acetoxychavicol acetate (ACA), the main pungent component in galangal. ACA did not activate TRPV1-expressing human embryonic kidney (HEK) cells, but strongly activated TRPA1-expressing HEK cells. ACA was more potent than allyl isothiocyanate, the typical TRPA1 agonist.

  19. Molecular Characterization of Adenylyl Cyclase Complex Proteins Using Versatile Protein-Tagging Plasmid Systems in Cryptococcus neoformans.

    PubMed

    So, Yee-Seul; Yang, Dong-Hoon; Jung, Kwang-Woo; Huh, Won-Ki; Bahn, Yong-Sun

    2017-02-28

    In this study, we aimed to generate a series of versatile tagging plasmids that can be used in diverse molecular biological studies of the fungal pathogen Cryptococcus neoformans. We constructed 12 plasmids that can be used to tag a protein of interest with a GFP, mCherry, 4×FLAG, or 6×HA, along with nourseothricin-, neomycin-, or hygromycin-resistant selection markers. Using this tagging plasmid set, we explored the adenylyl cyclase complex (ACC), consisting of adenylyl cyclase (Cac1) and its associated protein Aca1, in the cAMP-signaling pathway, which is critical for the pathogenicity of C. neoformans. We found that Cac1-mCherry and Aca1-GFP were mainly colocalized as punctate forms in the cell membrane and nonnuclear cellular organelles. We also demonstrated that Cac1 and Aca1 interacted in vivo by coimmunoprecipitation, using Cac1-6×HA and Aca1-4×FLAG tagging strains. Bimolecular fluorescence complementation further confirmed the in vivo interaction of Cac1 and Aca1 in live cells. Finally, protein pull-down experiments using aca1Δ::ACA1-GFP and aca1Δ::ACA1- GFP cac1Δ strains and comparative mass spectrometry analysis identified Cac1 and a number of other novel ACC-interacting proteins. Thus, this versatile tagging plasmid system will facilitate diverse mechanistic studies in C. neoformans and further our understanding of its biology.

  20. Identification of a calmodulin-regulated Ca2+-ATPase in the endoplasmic reticulum

    NASA Technical Reports Server (NTRS)

    Hong, B.; Ichida, A.; Wang, Y.; Gens, J. S.; Pickard, B. G.; Harper, J. F.; Evans, M. L. (Principal Investigator)

    1999-01-01

    A unique subfamily of calmodulin-dependent Ca2+-ATPases was recently identified in plants. In contrast to the most closely related pumps in animals, plasma membrane-type Ca2+-ATPases, members of this new subfamily are distinguished by a calmodulin-regulated autoinhibitor located at the N-terminal instead of a C-terminal end. In addition, at least some isoforms appear to reside in non-plasma membrane locations. To begin delineating their functions, we investigated the subcellular localization of isoform ACA2p (Arabidopsis Ca2+-ATPase, isoform 2 protein) in Arabidopsis. Here we provide evidence that ACA2p resides in the endoplasmic reticulum (ER). In buoyant density sucrose gradients performed with and without Mg2+, ACA2p cofractionated with an ER membrane marker and a typical "ER-type" Ca2+-ATPase, ACA3p/ECA1p. To visualize its subcellular localization, ACA2p was tagged with a green fluorescence protein at its C terminus (ACA2-GFPp) and expressed in transgenic Arabidopsis. We collected fluorescence images from live root cells using confocal and computational optical-sectioning microscopy. ACA2-GFPp appeared as a fluorescent reticulum, consistent with an ER location. In addition, we observed strong fluorescence around the nuclei of mature epidermal cells, which is consistent with the hypothesis that ACA2p may also function in the nuclear envelope. An ER location makes ACA2p distinct from all other calmodulin-regulated pumps identified in plants or animals.

  1. 78 FR 54470 - National Committee on Vital and Health Statistics: Meeting Standards Subcommittee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ... administrative standards, including new versions of HIPAA transactions, operating rules, ICD-10 and Health Plan..., Identifiers, and Operating Rules; (2) ACA- related health information exchange requirements; (3)...

  2. Communication and Shared Practices are Bringing NASA STEM Resources to Camp Youth

    NASA Astrophysics Data System (ADS)

    LaConte, K.; Shaner, A.; Shipp, S.; Garst, B.; Bialeschki, M. D.; Netting, R.; Erickson, K.

    2015-11-01

    In 2012, NASA and the American Camp Association (ACA) entered into an alliance to further both organizations' goals and objectives with regard to science, technology, engineering, and mathematics (STEM) education. This alliance is providing camp staff—and their young audiences—access to NASA's resources. NASA disseminates resources (e.g., pathways for requesting guest presenters, informal learning lesson plans), conducts ACA professional development (online and at ACA conferences), and coordinates efforts around key events (e.g., spacecraft launches). ACA promotes awareness of NASA resources through their communications and services. Together, the organizations are working to inspire a new generation of scientists, engineers, explorers, educators, and innovators to pursue STEM careers.

  3. States' implementation of the Affordable Care Act and the supply of physicians waivered to prescribe buprenorphine for opioid dependence

    PubMed Central

    Knudsen, Hannah K.; Lofwall, Michelle R.; Havens, Jennifer R.; Walsh, Sharon L.

    2015-01-01

    Background Although the Affordable Care Act (ACA) is anticipated to affect substance use disorder (SUD) treatment, its impact on the supply of physicians waivered to treat opioid dependence with buprenorphine has not been considered. This study examined whether states more supportive of ACA, meaning those that had opted to expand Medicaid and establish a state-based health insurance exchange, experienced greater growth in physician supply than less supportive states. Methods Buprenorphine physician supply, including total physician supply, supply of 30-patient physicians, and supply of 100-patient physicians per 100,000 state residents, was measured from June 2013 to May 2015. State characteristics were drawn from multiple secondary sources, with states categorized as ACA-supportive, ACA-hybrid (where states either expanded Medicaid or established a state-based exchange), or ACA-resistant (where states took neither action). Mixed effects regression was used to estimate state-level growth curves to test whether rates of growth varied by states' approaches to implementing ACA. Results The supply of waivered physicians grew significantly over the two-year period. Rates of growth were significantly lower in ACA-hybrid and ACA-resistant states relative to growth in ACA-supportive states. Average buprenorphine physician supply at baseline varied by region, the percentage of residents covered by Medicaid, and the supply of specialty SUD treatment programs. Conclusions This study found a positive impact of the ACA on growth in the supply of buprenorphine-waivered physicians in US states. Future research should address whether the ACA affects the number of patients receiving buprenorphine, Medicaid spending, and the quality of treatment services delivered. PMID:26483356

  4. The Relationship between American Counseling Association Members' Professional Affiliations and Advocacy Attitudes and Actions as Defined by the Lange Profession Advocacy Scale

    ERIC Educational Resources Information Center

    Lange, Amber

    2009-01-01

    A sample of American Counseling Association (ACA) members and the entire population of the ACA Legislative Institute attendants was investigated to determine if any variables were contributing to strong scores on the Lange Profession Advocacy Scale (LPAS), a Rasch analyzed instrument. A total of 563 cases had a valid measure score and were…

  5. Subchronic Studies of Chlorotrifluorethylene

    DTIC Science & Technology

    1989-06-01

    Blood)................ 47 4 ABBREVIATIONS ACA Automated Chemistry Analyzer CTFE Chlorotri fl uoroethylene dL Deciliter ECD Electron capture detector F-344...clinical chemistry evaluation were assayed on an Automated Chemistry Analyzer (ACA) (DuPont Company, Wilmington, DE). Selected hematological parameters and

  6. Establishment of a reference material for standardization of the anti-complementary activity test in intravenous immunoglobulin products used in Japan: A collaborative study.

    PubMed

    Nojima, Kiyoko; Okuma, Kazu; Ochiai, Masaki; Kuramitsu, Madoka; Tezuka, Kenta; Ishii, Mieko; Ueda, Sadao; Miyamoto, Takashi; Kamimura, Koichiro; Kou, Enki; Uchida, Sanae; Watanabe, Yoshiharu; Okada, Yoshiaki; Hamaguchi, Isao

    2017-03-01

    Aggregates of human plasma-derived intravenous immunoglobulins (IVIGs) carries a risk of severe adverse events after nonspecific complement activation induced in humans administrated. Therefore, the anti-complementary activity (ACA) test is legally required in every batch of IVIGs in Japan. However, due to the intrinsic nature of this bioassay, there might be large differences in the results of ACA tests from laboratories, even when the same batch of IVIGs was measured. Our six laboratories evaluated whether there were such differences and argued for establishment of a reference material (RM) for standardization of the ACA test. Our results revealed inter-laboratory differences in ACA values, indicating a need to establish an RM. Therefore, after ACA values in candidate RMs were measured collaboratively, one RM was selected from two candidates and unit value-assigned. The RM in fact normalized the ACA test values for samples measured in parallel at almost all the laboratories, when the values were calculated relative to the assigned unit value of the RM. Thus, we established a first RM to standardize the ACA test in Japan, which enabled each laboratory to normalize ACA values constantly for IVIGs. This indicates that the establishment of an RM can contribute to quality control of IVIGs.

  7. 76 FR 67195 - Announcing the Award of a Single-Source Program Expansion Supplement Grant to the Johns Hopkins...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... section 3021 of the Patient Protection and Affordable Care Act (ACA) and the Improper Payments Elimination... that will be used as a model to facilitate State and local agencies in information exchanges among... Services (CMS) under the requirements of the Patient Protection and Affordable Care Act (ACA). To...

  8. 75 FR 62407 - Office of Administration; Single-Source Cooperative Agreement Award; Announcing the Award a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... will be made pursuant to the Patient Protection and Affordable Care Act (ACA) [Pub. L. 111-148] and the... that will be used as a model to facilitate State and local agencies in information exchanges among... Services (CMS) under the requirements of the Patient Protection and Affordable Care Act (ACA). To...

  9. 78 FR 1101 - Hazardous Materials: Harmonization With the United Nations Recommendations on the Transport of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ...: American Coatings Association (ACA). Association of Hazmat Shippers, Inc. (AHS). Dangerous Goods Advisory... (Alaska). American Coatings Association (ACA). American Veterinary Distributors Association (AVDA... against the phase-out in the preamble to the final rule, PHMSA did not discuss arguments raised in...

  10. Successful pregnancy after rituximab in a women with recurrent in vitro fertilisation failures and anti-phospholipid antibody positive.

    PubMed

    Ng, C T; O'Neil, M; Walsh, D; Walsh, T; Veale, D J

    2009-12-01

    We report a case of successful pregnancy after rituximab in a patient with a history of in vitro fertilisation (IVF) failures and positive anti-cardiolipin antibody (ACA). Following a course of rituximab, her ACA became negative and she successfully conceived with IVF treatment. This is the first case in literature describing the use of rituximab therapy in this clinical scenario.

  11. 78 FR 66360 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... available as a result of the Affordable Care Act (ACA). Grantees will be asked to collect and report... services. In 2012, 98 Title X grantees provided family planning services to five million women and men... are available as a result of the ACA. Some sites already assist individuals with enrolling in...

  12. You and Health Insurance: Making a Smart Choice for Farm Families

    ERIC Educational Resources Information Center

    Riportella, Roberta; O'Neill, Barbara

    2015-01-01

    This article describes and encourages use of a curriculum that was developed for Extension educators to provide farm families with information about the Affordable Care Act (ACA) and the procedure to become certified to use it. It also describes features of the ACA and unique challenges and opportunities that this law provides to farm families,…

  13. Awareness, Perceptions, and Communication Needs about the Affordable Care Act across the Life Span

    ERIC Educational Resources Information Center

    Bergeron, Caroline D.; Friedman, Daniela B.; Sisson, Diana C.; Tanner, Andrea; Kornegay, Vance L.; Owens, Otis L.; Weis, Megan A.; Patterson, Lee L.

    2016-01-01

    Background: By March 2014, all U.S. citizens were required to have health insurance according to the Affordable Care Act (ACA). Purpose: Study objectives were to explore individuals' opinions, perceptions, and communication sources and needs about the ACA and to assess differences by age group. Methods: In November 2013, 10 1-hour focus groups (5…

  14. Effect of microencapsulation of Lactobacillus plantarum 25 into alginate/chitosan/alginate microcapsules on viability and cytokine induction.

    PubMed

    Jiang, Tao; Kim, You-Kyoung; Singh, Bijay; Kang, Sang-Kee; Choi, Yun-Jaie; Cho, Chong-Su

    2013-08-01

    Lactobacillus plantarum 25 (LP25) encapsulated into alginate/chitosan/alginate (ACA) microcapsules (LP25-ACA MCs) prepared by an extrusion methods were characterized to assess their efficacy in oral delivery. The particle sizes of LP25-ACA MCs were 1.11 +/- 0.32 mm. The loading content of LP25 was 1.11 x 10(7) colony forming unit (cfu)/microcapsule and encapsulation efficiency was above 98%. The viability of LP25 in ACA MCs was more than 65% in simulated gastric fluid (SGF, pH 2.0) and 75% in simulated small intestinal fluid (SIF, pH 7.2) up to 2 h. Encapsulated LP25 were completely released from LP25-ACA MCs in SIF and simulated colon fluid (SCF, pH 6.0) within 12 h and 8 h respectively. The viability of LP25 in ACA MCs till 5 weeks was above 58%, whereas viability of free LP25 stored at room temperature up to 5 weeks was zero. Besides, LP25-ACA MCs induced the secretion of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) from macrophages and dendritic cells showing the immunomodulatory effect of LP25. These findings demonstrate that the encapsulation of LP25 by ACA is a suitable strategy for oral delivery of probiotics.

  15. Standards for Day and Resident Camps: The Accreditation Programs of the American Camping Association. 1990 Edition, Revised 1993.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    This book outlines standards that provide a basis for camp accreditation and site approval by the American Camping Association (ACA), Inc. The purpose of the ACA accreditation programs is to educate camp owners and directors in the administration of key aspects of camp operation, particularly those related to program quality and the health and…

  16. A Preclinical Evaluation of Antrodia camphorata Alcohol Extracts in the Treatment of Non-Small Cell Lung Cancer Using Non-Invasive Molecular Imaging

    PubMed Central

    Chiou, Jeng-Feng; Wu, Alexander T. H.; Wang, Wei-Tin; Kuo, Tsu-Hsiang; Gelovani, Juri G.; Lin, I-Hsin; Wu, Chih-Hsiung; Chiu, Wen-Ta; Deng, Win-Ping

    2011-01-01

    This study was carried out to provide a platform for the pre-clinical evaluation of anti-cancer properties of a unique CAM (complementary and alternative medicine) agent, Antrodia camphorata alcohol extract (ACAE), in a mouse model with the advantageous non-invasive in vivo bioluminescence molecular imaging technology. In vitro analyses on the proliferation, migration/invasion, cell cycle and apoptosis were performed on ACAE-treated non-small cell lung cancer cells, H441GL and control CGL1 cells. In vivo, immune-deficient mice were inoculated subcutaneously with H441GL followed by oral gavages of ACAE. The effect of ACAE on tumor progression was monitored by non-invasive bioluminescence imaging. The proliferation and migration/invasion of H441GL cells were inhibited by ACAE in a dose-dependent manner. In addition, ACAE induced cell cycle arrest at G0/G1 phase and apoptosis in H441GL cells as shown by flow cytometric analysis, Annexin-V immunoflourescence and DNA fragmentation. In vivo bioluminescence imaging revealed that tumorigenesis was significantly retarded by oral treatment of ACAE in a dose-dependent fashion. Based on our experimental data, ACAE contains anti-cancer properties and could be considered as a potential CAM agent in future clinical evaluation. PMID:21785640

  17. 77 FR 19455 - Regulations Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ...This document contains proposed regulations implementing amendments to the Black Lung Benefits Act (BLBA or Act) made by the Patient Protection and Affordable Care Act (ACA). The ACA amended the BLBA in two ways. First, it revived a rebuttable presumption of total disability or death due to pneumoconiosis for certain claims. Second, it reinstituted derivative entitlement to benefits for......

  18. American Camping Association. Annual Report, 1985.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    The 1985 American Camping Association (ACA) annual report reviews trends and successes of the year. The document is in the format of a calendar covering the period October 1985 through September 1986. Calendar pages, on which relevant camping events are noted, alternate with pages of text. An introductory message from ACA President Jean McMullan…

  19. Health Care Disparities in the Post–Affordable Care Act Era

    PubMed Central

    Preston, Michael A.; Gonzales, Gilbert

    2015-01-01

    Disparities in health care have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care. PMID:25879149

  20. Heparin stimulates a plasma membrane Ca2+-ATPase of Arabidopsis thaliana.

    PubMed

    Meneghelli, Silvia; Luoni, Laura; De Michelis, Maria Ida

    2008-02-01

    We have studied the effect of heparin, a glycosaminoglycan widely used in releasing tags from fusion proteins, on isoform 8 of Arabidopsis thaliana PM Ca(2+)-ATPase (ACA8) expressed in Saccharomyces cerevisiae strain K616. Heparin stimulates hydrolytic activity of ACA8 with an estimated K(0.5) value for the complex of 15 +/- 1 microg ml(-1), which is unaffected by free [Ca(2+)]. Heparin increases V(max) up to 3-fold while it does not significantly affect the apparent K(m) for free Ca(2+) and for the nucleoside triphosphate substrate. The heparin effect is not additive with that of exogenous calmodulin and heparin is ineffective on a mutant devoid of the N-terminal auto-inhibitory domain (Delta74-ACA8). Altogether, these results indicate that heparin activation is due to partial suppression of the auto-inhibitory function of ACA8 N-terminus. Pull-down assays using heparin-agarose gel show that heparin directly interacts with ACA8. Binding to the heparin-agarose gel occurs also with a peptide reproducing ACA8 sequence (1)M-I(116). Several single-point mutations within ACA8 sequence A56-T63 significantly alter the enzyme response to heparin, suggesting that heparin interaction with this site may be involved in ACA8 activation. These results highlight a new difference between the plant PM Ca(2+)-ATPase and its animal counterpart, which is inhibited by heparin.

  1. Why Uninsured Free Clinic Patients Don't Apply for Affordable Care Act Health Insurance in a Non-expanding Medicaid State.

    PubMed

    Kamimura, Akiko; Tabler, Jennifer; Chernenko, Alla; Aguilera, Guadalupe; Nourian, Maziar M; Prudencio, Liana; Ashby, Jeanie

    2016-02-01

    Even after the introduction of the Patient Protection and Affordable Care Act (ACA), uninsured visits remain high, especially in states that opted out of Medicaid expansion. Since the ACA does not provide universal coverage, free clinics serve as safety nets for the un- or under-insured, and will likely continue serving underserved populations. The purpose of this study is to examine factors influencing intentions to not apply for health insurance via the ACA among uninsured free clinic patients in a state not expanding Medicaid. Uninsured primary care patients utilizing a free clinic (N = 551) completed a self-administered survey in May and June 2015. Difficulty obtaining information, lack of instruction to apply, and cost, are major factors influencing intention not to apply for health insurance through the ACA. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of perceived barriers to applying for health insurance through the ACA. Age is an important factor impacting individuals' intentions not to apply for health insurance through the ACA, as older patients in particular need assistance to obtain relevant information about the ACA and other resources. A number of unchangeable factors limit the free clinics' ability to promote enrollment of health insurance through the ACA. Yet free clinics could be able to provide some educational programs or the information of resources to patients. In particular, non-US born English speakers, Spanish speakers, and older adults need specific assistance to better understand health insurance options available to them.

  2. 50 CFR 402.34 - Oversight.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ACT OF 1973, AS AMENDED Counterpart Regulations for Implementing the National Fire Plan § 402.34 Oversight. (a) Through the periodic program evaluation set forth in the ACA, the Service will determine... the results of the periodic program evaluation described in the ACA to recommend changes to the...

  3. 78 FR 28222 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ...; Use: Under the Section 1003 of the Affordable Care Act (ACA) (Section 2794 of the Public Health... process for the annual review, beginning with the 2010 plan year, of unreasonable increases in premiums... were subject to provisions of the ACA and hence eligible for the Rate Review Grants. Forty-five...

  4. 50 CFR 300.103 - Procedure for according protection to CCAMLR Ecosystem Monitoring Program Sites.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Director of the NSF for a permit under applicable provisions of the ACA or any superseding legislation. The permit granted by NSF shall constitute a joint CEMP/ACA Protected Site permit and any person holding such a permit must comply with the appropriate CEMP Protected Site Management Plan. In all other...

  5. 78 FR 48337 - Federal Employees Health Benefits Program: Members of Congress and Congressional Staff

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... those plans offered on Exchanges. The ACA did not, however, alter the definition of ``employee'' as used... imposes no new requirements on qualified health plans or Exchanges. Prior to the passage of the ACA, there... . . . the only health plans that the Federal Government may make available to Members of Congress...

  6. 76 FR 16790 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    .... Starting in January 2011, the HHS Hotline will begin to refer ACA calls to CCIIO. To date, the HHS Hotline receives, on average, 400 calls per month pertaining to ACA. Accordingly, a system to collect, track and... existing group health plans or individual policies in the market between September 23, 2010 and January...

  7. 77 FR 1496 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... be followed by presentations on provisions from the Affordable Care Act (ACA). The Committee will be... Committee will continue to hear panel presentations on ACA-related provisions and will then break into... key findings from the meeting and develop a work plan for the next quarter and the June meeting....

  8. 76 FR 14670 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-17

    ... Plan for Responding to Identified Needs. OMB No.: New Collection. Description: Section 511(h)(2)(A) of... Care Act of 2010 (Pub. L. 111-148, Affordable Care Act or ACA), authorizes the Secretary of HHS to... total ACA Maternal, Infant, and Early Childhood Home Visiting Program appropriation (authorized...

  9. 50 CFR 300.103 - Procedure for according protection to CCAMLR Ecosystem Monitoring Program Sites.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Director of the NSF for a permit under applicable provisions of the ACA or any superseding legislation. The permit granted by NSF shall constitute a joint CEMP/ACA Protected Site permit and any person holding such a permit must comply with the appropriate CEMP Protected Site Management Plan. In all other...

  10. 1984 Annual Report of the American Camping Association.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    The 1984 American Camping Association (ACA) annual report reviews trends and successes of the year. A preliminary message from ACA President Charles Kujawa recognizes the year's significant progress and indicates nine specific examples of success, including implementation of the Association Directions Study, approval of new camp standards,…

  11. 50 CFR 402.34 - Oversight.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACT OF 1973, AS AMENDED Counterpart Regulations for Implementing the National Fire Plan § 402.34 Oversight. (a) Through the periodic program evaluation set forth in the ACA, the Service will determine... the results of the periodic program evaluation described in the ACA to recommend changes to the...

  12. 77 FR 34044 - National Committee on Vital and Health Statistics: Meeting Standards Subcommittee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... identifiers, and commentary from industry concerning issues pertaining to health plan compliance certification. The NCVHS has been named in the Patient Protection and Affordable Care Act (ACA) of 2010 to review and... required by Sec. 1104 of the ACA. Contact Person for More Information: Marjorie S. Greenberg,...

  13. 78 FR 40542 - Privacy Act of 1974, As Amended: Proposed New Routine Use

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... Reconciliation Act of 2010 (Pub. L. 111-152) (collectively, the ACA) requires the use of a single, streamlined... Health Plan (QHP) through an Exchange, Advance Payments of the Premium Tax Credit (APTC), Cost-Sharing... certifications of exemption under the ACA. We discuss the routine use in detail in the Supplementary...

  14. 50 CFR 402.34 - Oversight.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ACT OF 1973, AS AMENDED Counterpart Regulations for Implementing the National Fire Plan § 402.34 Oversight. (a) Through the periodic program evaluation set forth in the ACA, the Service will determine... the results of the periodic program evaluation described in the ACA to recommend changes to the...

  15. 78 FR 17676 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... December 30, 2010, to meet requirements set forth by Section 10331 of the Affordable Care Act (ACA). The ACA requires CMS to establish a Physician Compare Web site by January 1, 2011, containing information... periods beginning no earlier than January 1, 2012), CMS is required to implement a plan to...

  16. 75 FR 65351 - Proposed Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... Home Visiting Program Needs Assessment and Plan for Responding to Identified Needs. OMB No.: New... ACA), authorizes the Secretary of HHS to award grants to Indian Tribes (or a consortium of Indian... program. The legislation sets aside 3 percent of the total ACA Maternal, Infant, and Early Childhood...

  17. 50 CFR 402.34 - Oversight.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ACT OF 1973, AS AMENDED Counterpart Regulations for Implementing the National Fire Plan § 402.34 Oversight. (a) Through the periodic program evaluation set forth in the ACA, the Service will determine... the results of the periodic program evaluation described in the ACA to recommend changes to the...

  18. 75 FR 81278 - Medicare Program: Solicitation of Comments Regarding Development of a Recovery Audit Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... effectiveness of those anti-fraud plans. In accordance with section 1893(h) of the ACA, the RACs for the Part C.... 111-152), (collectively known as The Affordable Care Act (ACA)) that requires the expansion of the... plan, if one was offered where the beneficiary lived. The primary goal of the M+C program was...

  19. 75 FR 35507 - Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    .... SUPPLEMENTARY INFORMATION: Title of Collection: Antarctic emergency response plan and environmental protection... 1978 (16 U.S.C. 2401 et seq.) (``ACA'') regulates certain non- governmental activities in Antarctica. The ACA was amended in 1996 by the Antarctic Science, Tourism, and Conservation Act. On September...

  20. Camp Standards with Interpretations for the Accreditation of Organized Camps. Revised Edition. Basic Standards Course Participant Workbook.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    The American Camping Association's (ACA) Camp Standards Program assists camp administrators in providing a quality camp experience and assists the public in selecting camps that meet standards accepted by the industry and recognized by the government. ACA Camp Standards represent desirable practices basic to quality programs. Accredited camps and…

  1. 50 CFR 402.34 - Oversight.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ACT OF 1973, AS AMENDED Counterpart Regulations for Implementing the National Fire Plan § 402.34 Oversight. (a) Through the periodic program evaluation set forth in the ACA, the Service will determine... the results of the periodic program evaluation described in the ACA to recommend changes to the...

  2. 77 FR 34953 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... ACA), authorizes the Secretary of HHS to award grants to Indian Tribes (or a consortium of Indian... program. The legislation sets aside 3 percent of the total ACA Maternal, Infant, and Early Childhood Home... needs assessments, plan for and implement (in accordance with an Implementation Plan submitted at...

  3. 50 CFR 300.103 - Procedure for according protection to CCAMLR Ecosystem Monitoring Program Sites.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Director of the NSF for a permit under applicable provisions of the ACA or any superseding legislation. The permit granted by NSF shall constitute a joint CEMP/ACA Protected Site permit and any person holding such a permit must comply with the appropriate CEMP Protected Site Management Plan. In all other...

  4. Aneurysm of azygos anterior cerebral artery: A report of two cases

    PubMed Central

    Ghanta, Rajesh Kumar; Kesanakurthy, Murthy V. S. N.; Vemuri, Varaprasad N.

    2016-01-01

    Aneurysms of azygos anterior cerebral artery (ACA) are rare with very few cases reported in medical literature. We report here two cases of aneurysm of azygos ACA among 105 patients with subarachnoid hemorrhage. The two aneurysms were successfully clipped by using the bifrontal basal interhemispheric approach. PMID:27366270

  5. Variant course of bilateral anterior cerebral artery in semilobar holoprosencephaly.

    PubMed

    Pendharkar, Hima; Venkateshappa, Bhaskar Madivala; Prasad, Chandrajit

    2015-12-01

    We report an unusual case of semilobar holoprosencephaly with variant course of bilateral anterior cerebral arteries (ACA) in a 1-year-old child. This is a very rare arterial variant, given that holoprosencephalic brains are usually associated with azygous ACAs.

  6. National Coalition for Cancer Survivorship

    MedlinePlus

    ... said, “The ACA is the law of the land for the foreseeable future.” But this week lawmakers ... Care Act (ACA) is the “law of the land for the foreseeable future.” The National Coalition for ...

  7. Counselor and Theological Identity Formation and the Ethic of Inclusion for Lesbian, Gay, and Bisexual Clients

    ERIC Educational Resources Information Center

    Miller, Joanne

    2014-01-01

    This qualitative study used interpretative phenomenological analysis to examine how Christian counselors-in-training engaged their theological beliefs about sexual orientation in relation to the Code of Ethics of the American Counseling Association (ACA). The ACA Code of Ethics requires counselors to refrain from imposing their personal values on…

  8. [Enzymatic conversion of cephalosporin C to glutaryl-7-aminocephalosporanic acid using whole cells of the yeast Trigonopsis variabilis FA10].

    PubMed

    Chen, J; Zhu, T B; Zhang, Y F; Yang, Y L; Jiao, R S

    2001-03-01

    A process for the production of glutaryl-7-aminocephalosporanic acid (GL-7ACA) from cephalosporin C(CPC) using permeabilized cells of yeast Trigonopsis variabilis FA10 containing D-amino acid oxidase (DAO) is described. It was found that the bioconversion of CPC to GL-7ACA was interfered by the catalase activity presented in the cells that hydrolyzed the hydrogen peroxide and resulted in the accumulation of alpha-keto-adipyl-7-ACA (AKA-7ACA) and decrease of GL-7ACA yield. the methods to overcome this problem including the addition of extra H2O2 and use of catalase inhibitor, NaN3, were developed and the rate of GL-7ACA from CPC were 73% and 70.1%, respectively. Another alternative method was to incubate the permeabilized FA10 cells at pH10.5-11.0 for 30 minutes at 20 degrees C which served to selectively inactivate the catalase. In the bioconversion of CPC to GL-7ACA using pH10.5-treated cells without catalase activity, the high reaction yield of GL-7ACA(84%) was achieved.

  9. Adenylyl cyclase A expression is tip-specific in Dictyostelium slugs and directs StatA nuclear translocation and CudA gene expression.

    PubMed

    Verkerke-van Wijk, I; Fukuzawa, M; Devreotes, P N; Schaap, P

    2001-06-01

    cAMP oscillations, generated by adenylyl cyclase A (ACA), coordinate cell aggregation in Dictyostelium and have also been implicated in organizer function during multicellular development. We used a gene fusion of the ACA promoter with a labile lacZ derivative to study the expression pattern of ACA. During aggregation, most cells expressed ACA, but thereafter expression was lost in all cells except those of the anterior tip. Before aggregation, ACA transcription was strongly upregulated by nanomolar cAMP pulses. Postaggregative transcription was sustained by nanomolar cAMP pulses, but downregulated by a continuous micromolar cAMP stimulus and by the stalk-cell-inducing factor DIF. Earlier work showed that the transcription factor StatA displays tip-specific nuclear translocation and directs tip-specific expression of the nuclear protein CudA, which is essential for culmination. Both StatA and CudA were present in nuclei throughout the entire slug in an aca null mutant that expresses ACA from the constitutive actin15 promoter. This suggests that the tip-specific expression of ACA directs tip-specific nuclear translocation of StatA and tip-specific expression of CudA.

  10. American Counseling Association Branch Journals: Viable, Scholarly Means for Publishing.

    ERIC Educational Resources Information Center

    McGowan, A. Scott

    1994-01-01

    Outlines the efficacy of publishing research, theoretically based articles, and in-the-field articles in refereed, professional branch journals of American Counseling Association (ACA). Addresses means and ways of writing successfully for publication. Presents ACA branch journals as alternative means for publishing and to encourage professional…

  11. Adult Children of Alcoholics: Security, Avoidance and Ambivalence in Attachment to Parents.

    ERIC Educational Resources Information Center

    Ballard, Mary E.

    Children of alcoholics are at risk for socioemotional and behavioral problems. Adult children of alcoholic parents (ACAs) are at risk for problems in interpersonal relationships. ACAs have been found to have decreased self-esteem and self-acceptance in comparison to adults whose parents are not alcoholic (NACAs). College students who were young…

  12. American Camping Association Annual Report, 1999.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    Founded in 1910 as the Camp Directors' Association of America, the American Camping Association (ACA) is the largest organization serving the organized camping industry. Over 5,500 members come from all segments of the camp profession. This annual report for 1999 describes ACA activities in support of organizational commitments. These commitments…

  13. Quality criteria for i.v.-immunoglobulins: importance of tests and product properties.

    PubMed

    Gronski, P; Kanzy, E J; Ronneberger, H J; Geursen, R; Seiler, F R

    1986-06-01

    Quality criteria for i.v.-immunoglobulins (i.v.- Igs) are critically discussed laying emphasis on spontaneous anticomplementary activity (aca) and size-dependent composition. Considering the percentage of fractions obtained by gel filtration (Ultrogel AcA 34), however, the monomeric IgG containing fraction contributed the major part of aca under the experimental conditions chosen. Subclass IgG3 seems to contribute considerably to aca. No correlation was found between aca and the percentage of fractions containing components larger in size than IgG dimers in various commercially available Igs. Moreover, the subclass distribution in different batches of individual products showed considerable variations. The amount of IgG4 is correlated with that of IgA in chemically unmodified products relatively poor in IgA (approx. less than or or equal to 10 mg/5 g Ig), indicating that attempts to reduce IgA consequently result in removal of IgG4.

  14. Application of the dynamic ant colony algorithm on the optimal operation of cascade reservoirs

    NASA Astrophysics Data System (ADS)

    Tong, X. X.; Xu, W. S.; Wang, Y. F.; Zhang, Y. W.; Zhang, P. C.

    2016-08-01

    Due to the lack of dynamic adjustments between global searches and local optimization, it is difficult to maintain high diversity and overcome local optimum problems for Ant Colony Algorithms (ACA). Therefore, this paper proposes an improved ACA, Dynamic Ant Colony Algorithm (DACA). DACA applies dynamic adjustments on heuristic factor changes to balance global searches and local optimization in ACA, which decreases cosines. At the same time, by utilizing the randomness and ergodicity of the chaotic search, DACA implements the chaos disturbance on the path found in each ACA iteration to improve the algorithm's ability to jump out of the local optimum and avoid premature convergence. We conducted a case study with DACA for optimal joint operation of the Dadu River cascade reservoirs. The simulation results were compared with the results of the gradual optimization method and the standard ACA, which demonstrated the advantages of DACA in speed and precision.

  15. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  16. How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

    PubMed

    Beronio, Kirsten; Glied, Sherry; Frank, Richard

    2014-10-01

    The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

  17. The Affordable Care Act and Abortion Comparing the U.S. and Western Europe.

    PubMed

    McFarlane, Deborah R

    2015-01-01

    The 2010 Affordable Health Care Act (ACA) treats abortion differently than any other health service, precluding public funding for abortion and imposing other restrictions on American states. To determine whether the ACA's abortion restrictions are uniquely American or have counterparts in other national health systems, this study employs a cross-sectional design comparing abortion restrictions in the ACA with those in 17 Western European countries. Using a six-item scale, the intensity of abortion restrictions is compared across Western European nations. A similar scale is employed for a five-state sample of state-level abortion restrictions. Although the United States is not alone in having abortion restrictions, how abortion is proscribed in the ACA has no counterpart in Western Europe. Unlike many Western European countries, the ACA's restrictions focus on abortion funding, not the length of gestation or the health of the pregnant woman.

  18. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Montana, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Montana will fall to 3 percent; without the law, it would remain at 18 percent. The model projects that total state government spending on health care will be 3 percent higher for the combined 2011-2020 period because of the ACA.

  19. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Illinois, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Illinois will fall to 3 percent; without the law, it would remain near 15 percent. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  20. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011-2020 period because of the ACA.

  1. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Texas, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Texas will fall to 6 percent; without the law, it would remain at 28 percent, the highest in the nation. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  2. The Future of the Affordable Care Act and Insurance Coverage.

    PubMed

    Glied, Sherry; Jackson, Adlan

    2017-04-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.

  3. Critical Anthropology of Global Health "takes a stand" statement: a critical medical anthropological approach to the U.S.'s Affordable Care Act.

    PubMed

    Horton, Sarah; Abadía, Cesar; Mulligan, Jessica; Thompson, Jennifer Jo

    2014-03-01

    The Affordable Care Act (ACA) of 2010--the U.S.'s first major health care reform in over half a century-has sparked new debates in the United States about individual responsibility, the collective good, and the social contract. Although the ACA aims to reduce the number of the uninsured through the simultaneous expansion of the private insurance industry and government-funded Medicaid, critics charge it merely expands rather than reforms the existing fragmented and costly employer-based health care system. Focusing in particular on the ACA's individual mandate and its planned Medicaid expansion, this statement charts a course for ethnographic contributions to the on-the-ground impact of the ACA while showcasing ways critical medical anthropologists can join the debate. We conclude with ways that anthropologists may use critiques of the ACA as a platform from which to denaturalize assumptions of "cost" and "profit" that underpin the global spread of market-based medicine more broadly.

  4. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices

    PubMed Central

    Rodney, Robert C.; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-01-01

    Abstract With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level. PMID:27346694

  5. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices.

    PubMed

    McManus, Kathleen A; Rodney, Robert C; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-09-01

    With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level.

  6. Opportunities for social work under the Affordable Care Act: A call for action.

    PubMed

    Lynch, Sean; Greeno, Catherine; Teich, Judith; Delany, Peter

    2016-10-01

    The Affordable Care Act (ACA) has profoundly restructured American health care. Numerous social work authors have commented on the importance of the ACA's reforms to social work practice, education, and research. This article summarizes the literature, adds relevant information, and makes recommendations for future actions. The policy, opinion, and peer-reviewed literatures were systematically reviewed. Sixty-three publications appeared between 2010 and 2015 are included. Five themes emerged, as follows: 1) the crucial provisions of the ACA, 2) the natural affinity of social work and the ACA reforms, 3) curricular adaptations needed to address changing workforce needs, 4) areas for continued social work advocacy, and 5) opportunities for high-impact social work research. This article provides a comprehensive introduction to the ACA, its reforms, and opportunities for social work to assume a high visibility leadership role in implementing the reforms, with particular emphasis on needed curricular changes and opportunities for research.

  7. Hydrogen Impurity Effects. A5Tt3 Intermetallic Compounds between A=Ca, Sr, Ba, Eu and Tt=Si, Ge, Sn with Cr 5B 3-like Structures that are Stable Both as Binary and as Ternary Hydride and Fluoride Phases

    NASA Astrophysics Data System (ADS)

    Leon-Escamilla, E. Alejandro; Corbett, John D.

    2001-06-01

    All of the binary systems Ca, Sr, Ba, or Eu (A) with Tt (tetrel)=Si or Ge as well as Sr-Sn form both binary Cr5B3-type A5Tt3 phases and the corresponding ternary hydrides with stuffed Cr5B3- (Ca5Sn3F-) type structures. All of those tested, Ca-Si, Ba-Si, Ca-Ge, also yield the isotypic A5Tt3Fx phases. The tetragonal structures of Ca5Si3, Ca5Si3F0.42, Sr5Si3, Eu5Si3Hx, Ca5Ge3, Ca5Ge3Hx, Ca5Ge3F0.66(I4/mcm, No. 140) and of Ba5Si3F0.16 (P4/ncc, Ba5Si3-type) were refined from single-crystal X-ray diffraction data. The interstitial H, F atoms are bound in a constricted tetrahedral (A2+)4 cavity in the Cr5B3-type heavy atom structure, which can be described ideally as (A2+)5(Tt2)6-(Tt)4-. Many of 14 previous reports of the phases reported here were apparently hydrides according to lattice constant differences or, for Sr5Si3, the fractional coordinates of Sr2 about the tetrahedral site. An articulated model is developed that allows description of the relationship between the dimensions of the tetrahedral interstitial site and the cation cavity about Tt2 and for some matrix effects in this structure type. The model suggests limitations on the stability of these binary A5Tt3 compounds for the heavier tetrels, as observed. The resistivities of Ca5Ge3 and Ca5Ge3Hx are both characteristic of poor metals, and Pauli-like magnetic susceptibilities are exhibited by Ca5Ge3, Ca5Ge3Hx, Ca5Ge3F0.66, Sr5Ge3, and Sr5Sn3. The characteristic ideal Tt6-2 dimers are evidently not realistic descriptions for these phases; rather at least some of the π*4 electrons in the dimers are delocalized in a conduction band. This effect appears to be greater in two europium salts. Bond lengths of dimers in the Ca-Si and Ca-Ge families appear to shorten slightly in three instances of their oxidation to form the hydride or the fluoride, as might be expected.

  8. Synthesis, crystal structures, and physical properties of the new Zintl phases A{sub 21}Zn{sub 4}Pn{sub 18} (A=Ca, Eu; Pn=As, Sb)—Versatile arrangements of [ZnPn{sub 4}] tetrahedra

    SciTech Connect

    Suen, Nian-Tzu; Wang, Yi; Bobev, Svilen

    2015-07-15

    Four new Zintl phases, Ca{sub 21}Zn{sub 4}As{sub 18}, Ca{sub 21}Zn{sub 4}Sb{sub 18}, Eu{sub 21}Zn{sub 4}As{sub 18} and Eu{sub 21}Zn{sub 4}Sb{sub 18} have been synthesized by metal flux reactions. Their structures have been established from single-crystal X-ray diffraction. Despite the similar chemical makeup and the identical formulae, the structures of the four compounds are not the same—Ca{sub 21}Zn{sub 4}As{sub 18}, Ca{sub 21}Zn{sub 4}Sb{sub 18} and Eu{sub 21}Zn{sub 4}As{sub 18} crystallize in the monoclinic space group C2/m (No. 12, Z=4) with the β-Ca{sub 21}Mn{sub 4}Sb{sub 18} structure type, while Eu{sub 21}Zn{sub 4}Sb{sub 18} adopts the Ba{sub 21}Cd{sub 4}Sb{sub 18} structure type with the orthorhombic space group Cmce (No. 64, Z=8). Both structures are based on ZnAs{sub 4} or ZnSb{sub 4} tetrahedra, linked in slightly different ways, and Ca{sup 2+} and Eu{sup 2+} cations that fill the space between them. The structural relationships between the title compounds and other known ternary phases with intricate structures are discussed. Electrical resistivity measurement on single-crystalline Eu{sub 21}Zn{sub 4}Sb{sub 18} suggests an intrinsic semiconductor behavior with a band gap of ca. 0.2 eV. The temperature dependent DC magnetization measurement on the same material indicates Curie–Weiss paramagnetism in the high-temperature regime, and a spontaneous antiferromagnetic ordering below 8 K. The calculated effective moments of Eu confirm the divalent Eu{sup 2+} ground state, as expected from the Zintl–Klemm concept. - Graphical abstract: The four new Zintl phases—Ca{sub 21}Zn{sub 4}As{sub 18}, Ca{sub 21}Zn{sub 4}Sb{sub 18}, Eu{sub 21}Zn{sub 4}As{sub 18}, and Eu{sub 21}Zn{sub 4}Sb{sub 18}—crystallize in two structure types, showing the versatility in the arrangements of ZnAs{sub 4} and ZnSb{sub 4} tetrahedra. - Highlights: • Ca{sub 21}Zn{sub 4}As{sub 18}, Ca{sub 21}Zn{sub 4}Sb{sub 18}, Eu{sub 21}Zn{sub 4}As{sub 18}, and Eu{sub 21}Zn{sub 4}Sb{sub 18} are new compounds in the respective ternary phase diagrams. • They form with structure types, showing the versatility in the arrangements of ZnAs{sub 4} and ZnSb{sub 4} tetrahedra. • For both structures, the valence electron count follows the Zintl–Klemm rules.

  9. Characterization of onion lectin (Allium cepa agglutinin) as an immunomodulatory protein inducing Th1-type immune response in vitro.

    PubMed

    Prasanna, Vaddi K; Venkatesh, Yeldur P

    2015-06-01

    Onion (Allium cepa), a bulb crop of economic importance, is known to have many health benefits. The major objective of the present study is to address the immunomodulatory properties of onion lectin (A. cepa agglutinin; ACA). ACA was purified from onion extract by D-mannose-agarose chromatography (yield: ~1 mg/kg). ACA is non-glycosylated and showed a molecular mass of ~12 kDa under reducing/non-reducing SDS-PAGE; glutaraldehyde cross-linking indicated that ACA is a non-covalent tetramer of ~12 kDa subunits. Its N-terminal sequence (RNVLLNNEGL; UniProt KB Accn. C0HJM8) showed 70-90% homology to mannose-specific Allium agglutinins. ACA showed specific hemagglutination activity of 8200 units/mg and is stable in the pH range 6-10 and up to 45° C. The immunomodulatory activity of ACA was assessed using the macrophage cell line, RAW264.7 and rat peritoneal macrophages; at 0.1 μg/well, it showed a significant increase (6-8-fold vs. control) in the production of nitric oxide at 24h, and significantly stimulated (2-4-fold vs. control) the production of pro-inflammatory cytokines (TNF-α and IL-12) at 24h. ACA (0.1 μg/well) enhanced the proliferation of murine thymocytes by ~4 fold (vs. control) at 24h; however, ACA does not proliferate B cell-enriched rat splenocytes. Further, it significantly elevated the expression levels of cytokines (IFN-γ and IL-2) over the control in murine thymocytes. Taken together, purified ACA induces a Th1-type immune response in vitro. Though present in low amounts, ACA may contribute to the immune-boosting potential of the popular spice onion since considerable amounts are consumed on a daily basis universally.

  10. Plastic Surgeons’ Perceptions of the Affordable Care Act: Results of a National Survey

    PubMed Central

    Israel, Jacqueline S.; Chen, Jenny T.; Rao, Venkat K.

    2015-01-01

    Background: The Affordable Care Act (ACA) aims to expand coverage to the uninsured, improve quality, and contain costs. The goal of this study was to ascertain how plastic surgeons perceive the ACA. Methods: An electronic questionnaire was e-mailed to members of the American Society of Plastic Surgeons between May and June 2014. The survey was anonymous and voluntary and included questions to assess understanding and opinions of the ACA. Results: The survey was sent to 3070 members of the American Society of Plastic Surgeons, and the response rate was 17%. Sixty-eight percent agree or strongly agree that they understand the basic concepts of the ACA. The majority of respondents disagree (38% strongly disagree, 31% disagree) with the notion that the ACA will positively affect their practice, and 51% agree with the statement, “I do not support the ACA, and I believe it did too much.” Two thirds (66%) believe that the ACA deserves a grade of D or F. When answers were analyzed across demographics, 42% of respondents with “Academic” practice background identify with the statement, “I support the ACA but I think it needs more work,” compared to 15% of those who selected “Solo Practice” (p <0.001). Conclusions: The ACA will affect all specialties, including plastic surgery. The results of this survey suggest that many plastic surgeons believe that they have a baseline understanding of current health-care reform. The majority of surveyed surgeons do not support the Act. It is imperative that plastic surgeons possess the knowledge of the ACA; its changes, both current and impending, will likely affect patient mix, coverage of procedures, and reimbursement. PMID:25674374

  11. Complex antithrombotic therapy: determinants of patient preference and impact on medication adherence

    PubMed Central

    Abraham, Neena S; Naik, Aanand D; Street, Richard L; Castillo, Diana L; Deswal, Anita; Richardson, Peter A; Hartman, Christine M; Shelton, George; Fraenkel, Liana

    2015-01-01

    Purpose For years, older patients have been prescribed multiple blood-thinning medications (complex antithrombotic therapy [CAT]) to decrease their risk of cardiovascular events. These therapies, however, increase risk of adverse bleeding events. We assessed patient-reported trade-offs between cardioprotective benefit, gastrointestinal bleeding risk, and burden of self-management using adaptive conjoint analysis (ACA). As ACA could be a clinically useful tool to obtain patient preferences and guide future patient-centered care, we examined the clinical application of ACA to obtain patient preferences and the impact of ACA on medication adherence. Patients and methods An electronic ACA survey led 201 respondents through medication risk–benefit trade-offs, revealing patients’ preferences for the CAT risk/benefit profile they valued most. The post-ACA prescription regimen was categorized as concordant or discordant with elicited preferences. Adherence was measured using VA pharmacy refill data to measure persistence of use prior to and 1 year following preference-elicitation. Additionally, we analyzed qualitative interviews of 56 respondents regarding their perception of the ACA and the preference elicitation experience. Results Participants prioritized 5-year cardiovascular benefit over preventing adverse events. Medication side effects, medication-associated activity restrictions, and regimen complexity were less important than bleeding risk and cardioprotective benefit. One year after the ACA survey, a 15% increase in adherence was observed in patients prescribed a preference-concordant CAT strategy. An increase of only 6% was noted in patients prescribed a preference-discordant strategy. Qualitative interviews showed that the ACA exercise contributed to increase inpatient activation, patient awareness of preferences, and patient engagement with clinicians about treatment decisions. Conclusion By working through trade-offs, patients actively clarified their

  12. Adenylyl cyclase localization to the uropod of aggregating Dictyostelium cells requires RacC

    PubMed Central

    Wang, C.; Jung, D.; Cao, Z.; Chung, C. Y.

    2015-01-01

    The localization of adenylyl cyclase A (ACA) to uropod of cells is required for the stream formation during Dictyostelium development. RacC is a Dictyostelium orthologue of Cdc42. We identified a streaming defect of racC− cells as they are clearly less polarized and form smaller and fragmented streams. ACA-YFP is mainly associated with intracellular vesicular structures, but not with the plasma membrane in racC− cells. racC− cells have a slightly higher number of vesicles than Ax3 cells, suggesting that the defect of ACA trafficking is not simply due to the lack of vesicle formation. While the ACA-YFP vesicles traveled with an average velocity of 9.1 µm/min in Ax3 cells, a slow and diffusional movement without direction with an average velocity of 4 µm/min was maintained in racC− cells. Images acquired by using total internal reflection fluorescence (TIRF) microscopy and fluorescence recovery after photobleaching (FRAP) analysis revealed that a significantly decreased number of ACA-YFP vesicles appeared near the cell membrane, indicating a defect in ACA-YFP vesicle trafficking. These results suggest an important role of RacC in the rapid and directional movements of ACA vesicles on microtubules to the plasma membrane, especially to the back of polarized cell. PMID:26315268

  13. Anticardiolipin antibody isotype profile in lupus nephritis--a cross sectional survey.

    PubMed

    Azizah, M R; Loo, C S; Zulkifli, M N; Shahnaz, M; Zaki, M; Nasuruddin, B A

    1998-09-01

    Thirty-six patients with lupus nephritis (LN) attending the Nephrology Clinic, Hospital Kuala Lumpur were studied for the prevalence of anticardiolipin antibody (ACA) isotypes (IgG and IgM) and other associated antibodies, antinuclear antibody (ANA) and anti-ds DNA antibody and to determine the possible association between serological and clinical parameters. The study population consisted of 20 (55.6%) Malays, 15 (41.7%) Chinese and 1 (2.8%) Indian with a mean age of 31.4 +/- 11.3 years, range 14 to 60 years. The female to male ratio was 11:1. The average time between diagnosis and blood sampling was 4.4 years (range 0.25 to 15 years). Increased ACA levels were found in 20 (55.6%) patients where raised IgG ACA and IgM ACA were observed in 20 (55.6%) and 2 (5.6%) cases respectively. ANA and anti-ds DNA antibodies were detected in 22 (61.1%) and 4 (11.1%) individuals respectively, with the majority (82%) showing a speckled pattern of nuclear staining. However, neither the IgM ACA nor IgG ACA showed any significant association with thrombosis or any other clinical parametres. Our preliminary study indicates that ACA is a frequent finding in lupus nephritis and that the IgG isotype is more prevalent.

  14. Health care reform: understanding individuals' attitudes and information sources.

    PubMed

    Shue, Carolyn K; McGeary, Kerry Anne; Reid, Ian; Khubchandani, Jagdish; Fan, Maoyong

    2014-01-01

    Since passage of the Affordable Care Act (ACA) was signed into law by President Barrack Obama, little is known about state-level perceptions of residents on the ACA. Perceptions about the act could potentially affect implementation of the law to the fullest extent. This 3-year survey study explored attitudes about the ACA, the types of information sources that individuals rely on when creating those attitudes, and the predictors of these attitudes among state of Indiana residents. The respondents were split between favorable and unfavorable views of the ACA, yet the majority of respondents strongly supported individual components of the act. National TV news, websites, family members, and individuals' own reading of the ACA legislation were identified as the most influential information sources. After controlling for potential confounders, the respondent's political affiliation, age, sex, and obtaining ACA information from watching national television news were the most important predictors of attitudes about the ACA and its components. These results mirror national-level findings. Implications for implementing health care reform at the state-level are discussed.

  15. Adenylyl cyclase localization to the uropod of aggregating Dictyostelium cells requires RacC.

    PubMed

    Wang, C; Jung, D; Cao, Z; Chung, C Y

    2015-09-25

    The localization of adenylyl cyclase A (ACA) to uropod of cells is required for the stream formation during Dictyostelium development. RacC is a Dictyostelium orthologue of Cdc42. We identified a streaming defect of racC(-) cells as they are clearly less polarized and form smaller and fragmented streams. ACA-YFP is mainly associated with intracellular vesicular structures, but not with the plasma membrane in racC(-) cells. racC(-) cells have a slightly higher number of vesicles than Ax3 cells, suggesting that the defect of ACA trafficking is not simply due to the lack of vesicle formation. While the ACA-YFP vesicles traveled with an average velocity of 9.1 μm/min in Ax3 cells, a slow and diffusional movement without direction with an average velocity of 4 μm/min was maintained in racC(-) cells. Images acquired by using total internal reflection fluorescence (TIRF) microscopy and fluorescence recovery after photobleaching (FRAP) analysis revealed that a significantly decreased number of ACA-YFP vesicles appeared near the cell membrane, indicating a defect in ACA-YFP vesicle trafficking. These results suggest an important role of RacC in the rapid and directional movements of ACA vesicles on microtubules to the plasma membrane, especially to the back of polarized cell.

  16. Antiphospholipid antibodies and hyperhomocysteinaemia in patients with vascular occlusive disease.

    PubMed

    Casais, Patricia; Meschengieser, Susana S; Gennari, Laura C; Alberto, Maria F; Sanchez-Luceros, Analia; Blanco, Alicia N; Lazzari, Maria A

    2006-07-01

    Hyperhomocysteinemia (HHcy), lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) are independent risk factors for thrombosis. Even though risks are cumulative, the clinical impact of the association is unknown. Preliminary data suggested that HHcy might be associated with transient LA and ACA, disappearing after lowering HHcy. We prospectively evaluated the association of HHcy and LA/ACA, the effect of lowering HHcy with folic acid in LA behavior, and the correlation of the initial dRVVT with LA behavior after folic acid in 210 patients with thrombosis and adverse pregnancy outcomes. Prevalence of HHcy among patients with LA/ACA was 40%. Thirty-one patients exhibited only HHcy (15%; Group 1), 106 (50%; Group 2) had only LA/ACA, while 73 (35%; Group 3) had both. After therapy, 63% and 64% of LA/ACA remained positive in Group 3 and 2, respectively. We observed a trend towards a more positive dRVVT in persistent LA after lowering HHcy. No differences in clinical presentation or in outcomes after two years of followup were observed among the groups. Even though the association of HHcy and LA/ACA is common in patients with thrombosis, it might have no prognostic implications if Hcy levels are lowered. Currently, no laboratory findings correlate with LA behavior, which is independent of homocysteine levels and vitamin treatment.

  17. Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States.

    PubMed

    Courtemanche, Charles; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela

    2017-01-01

    The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates. This strategy allows us to identify the effects of the ACA in both Medicaid expansion and non-expansion states. Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 2.8 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those without a college degree, non-whites, young adults, unmarried individuals, and those without children in the home. We find no evidence that the Medicaid expansion crowded out private coverage.

  18. The azygos anterior cerebral artery bypass: double reimplantation technique for giant anterior communicating artery aneurysms.

    PubMed

    Mirzadeh, Zaman; Sanai, Nader; Lawton, Michael T

    2011-04-01

    The authors introduce the azygos anterior cerebral artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant anterior communicating artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A(2) segment of the ACA serves as a donor vessel for a short radial artery graft. The contralateral pericallosal artery (PcaA) and the callosomarginal artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneurysm supplied by the A(1) segment of the left ACA, with left PcaA and CmaA originating from the aneurysm base. The authors conclude that the azygos ACA bypass is a novel option for revascularizing PcaA and CmaA, as part of the overall treatment of giant ACoA aneurysms.

  19. Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

    PubMed

    2015-06-01

    Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential.

  20. Oral delivery of probiotic expressing M cell homing peptide conjugated BmpB vaccine encapsulated into alginate/chitosan/alginate microcapsules.

    PubMed

    Jiang, Tao; Singh, Bijay; Maharjan, Sushila; Li, Hui-Shan; Kang, Sang-Kee; Bok, Jin-Duck; Cho, Chong-Su; Choi, Yun-Jaie

    2014-11-01

    Oral administration of live probiotics as antigen delivery vectors is a promising approach in vaccine development. However, the low survival of probiotics in the gastrointestinal tract limits this approach. Therefore, the aim of this study was the encapsulation of probiotic expressing vaccine into alginate/chitosan/alginate (ACA) microcapsules (MCs) for efficient oral vaccine delivery. Here, recombinant Lactobacillus plantarum 25 (LP25) expressing M cell homing peptide fused BmpB protein was used as a model probiotic. The viability of LP25 in ACA MCs was more than 65% in simulated gastric fluid (SGF, pH 2.0) and 75% in simulated small intestinal fluid (SIF, pH 7.2) up to 2h. Encapsulated LP25 was completely released from ACA MCs in SIF within 12h. When stored at room temperature (RT) or 4°C, the viability of LP25 in ACA MCs was higher than free LP25. Interestingly, the viability of LP25 in ACA MCs at 4°C for 5weeks was above 58%, whereas viability of free LP25 stored at RT up to 5weeks was zero. After 4weeks from the first immunization, LP25-M-BmpB-loaded ACA MCs induced a stronger BmpB-specific IgG and IgA production in mice. Collectively, these findings suggest that encapsulation of probiotic by ACA MCs is a promising delivery system for oral administration of probiotic expressing vaccine.

  1. Antioxidant, antibacterial, anti-inflammatory and wound healing effects of Artemisia campestris aqueous extract in rat.

    PubMed

    Ghlissi, Zohra; Sayari, Nadhim; Kallel, Rim; Bougatef, Ali; Sahnoun, Zouheir

    2016-12-01

    This study investigated some biological properties of Artemisia campestris aqueous extract (ACAE) as well its global chemical compositions. Twenty four rats were excised on the posterior neck skin area and divided into 4 groups, treated respectively with: sterile saline, glycerol, CICAFLORA and ACAE. The wound closure rate, histopathology evolution and the superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) level in skin tissue were evaluated. Anti-inflammatory activity was studied by carrageenan-induced rat paw edema. Animals were divided into 3 groups pre-treated respectively with sterile saline, acetylsalicylic acid (AA) and ACAE. The antibacterial activity was tested against six bacteria and the antioxidant activity was estimated by the 1,1-diphenyl-2-picrylhydrazyl (DPPH), reducing power and β-carotene activities. Our results demonstrated a significant improvement in wound healing progression and in oxidative stress damage in the wounds tissues of ACAE-treated rats, compared to control. ACAE-treated rats revealed also a significant inhibition of carrageenan-induced hind paws edema as confirmed by the histological analysis. In addition to the antioxidant activity, ACAE showed considerable antibacterial activities. ACAE exhibited important wound healing effect probably due to the anti-inflammatory, antibacterial and antioxidant activities of its phytochemical contents. Therefore, this study confirms its popular use and highlights its promise in the development of new drugs.

  2. Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs

    PubMed Central

    Buysse, Christina A.; Hubner, Lauren M.; Huffman, Lynne C.; Loe, Irene M.

    2015-01-01

    ABSTRACT: The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN. PMID:25793891

  3. Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.

    PubMed

    Feldman, Heidi M; Buysse, Christina A; Hubner, Lauren M; Huffman, Lynne C; Loe, Irene M

    2015-04-01

    The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.

  4. Starch composites with aconitic acid.

    PubMed

    Gilfillan, William Neil; Doherty, William O S

    2016-05-05

    The aim of this project is to examine the effectiveness of using aconitic acid (AcA), a tricarboxylic acid which contains a carbon/carbon double bond (CC), to enhance the properties of starch-based films. Starch/glycerol cast films were prepared with 0, 2, 5, 10 and 15wt% AcA (starch wt% basis) and the properties analysed. It was shown that AcA acted as both a cross-linking agent and also a strong plasticising agent. The 5wt% AcA derived starch films were the most effectively cross-linked having the lowest solubility (28wt%) and decreased swelling coefficient (35vol.%) by approximately 3 times and 2.4 times respectively compared to the control film submerged in water (23°C). There was also a significant increase in the film elongation at break by approximately 35 times (compared to the control) with the addition of 15wt% AcA, emphasising the plasticising effect of AcA. However, generally there was a reduced tensile strength, softening of the film, and reduced thermal stability with increased amounts of AcA.

  5. Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.

    PubMed

    Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J

    2017-01-01

    This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

  6. Health Care Reform: Understanding Individuals' Attitudes and Information Sources

    PubMed Central

    Shue, Carolyn K.; McGeary, Kerry Anne; Reid, Ian; Fan, Maoyong

    2014-01-01

    Since passage of the Affordable Care Act (ACA) was signed into law by President Barrack Obama, little is known about state-level perceptions of residents on the ACA. Perceptions about the act could potentially affect implementation of the law to the fullest extent. This 3-year survey study explored attitudes about the ACA, the types of information sources that individuals rely on when creating those attitudes, and the predictors of these attitudes among state of Indiana residents. The respondents were split between favorable and unfavorable views of the ACA, yet the majority of respondents strongly supported individual components of the act. National TV news, websites, family members, and individuals' own reading of the ACA legislation were identified as the most influential information sources. After controlling for potential confounders, the respondent's political affiliation, age, sex, and obtaining ACA information from watching national television news were the most important predictors of attitudes about the ACA and its components. These results mirror national-level findings. Implications for implementing health care reform at the state-level are discussed. PMID:25045705

  7. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making.

  8. Nano-sized Mn-doped activated carbon aerogel as electrode material for electrochemical capacitor: effect of activation conditions.

    PubMed

    Lee, Yoon Jae; Park, Hai Woong; Park, Sunyoung; Song, In Kyu

    2012-07-01

    Carbon aerogel (CA) was prepared by a sol-gel polymerization of resorcinol and formaldehyde, and a series of activated carbon aerogels (ACA-KOH-X, X = 0, 0.3, 0.7, 1, and 2) were then prepared by a chemical activation using different amount of potassium hydroxide (X represented weight ratio of KOH with respect to CA). Specific capacitances of activated carbon aerogels were measured by cyclic voltammetry and galvanostatic charge/discharge methods in 6 M KOH electrolyte. Among the samples prepared, ACA-KOH-0.7 showed the highest specific capacitance (149 F/g). In order to combine excellent electrochemical performance of activated carbon aerogel with pseudocapacitive property of manganese oxide, 7 wt% Mn was doped on activated carbon aerogel (Mn/ACA-KOH-0.7) by an incipient wetness impregnation method. For comparison, 7 wt% Mn was also impregnated on carbon aerogel (Mn/ACA-KOH-0) by the same method. It was revealed that 7 wt% Mn-doped activated carbon aerogel (Mn/ACA-KOH-0.7) showed higher specific capacitance than 7 wt% Mn-doped carbon aerogel (Mn/ACA-KOH-0) (178 F/g vs. 98 F/g). The enhanced capacitance of Mn/ACA-KOH-0.7 was attributed to the outstanding electric properties of activated carbon aerogel as well as the faradaic redox reactions of manganese oxide.

  9. Prevalence of elevated anticardiolipin antibodies in pregnant women with unexplained elevations of alpha-fetoprotein.

    PubMed

    Yetman, D L; Kutteh, W H; Castorena, R; Brown, C; Baskin, L

    1997-04-01

    The goal was to determine what proportion of pregnant women with unexplained elevations of maternal serum alpha-fetoprotein (MSAFP) have increased levels of anticardiolipin antibodies (ACA), and if this might explain the increased prevalence of adverse pregnancy outcomes. Maternal serum alpha-fetoprotein levels of 12,295 pregnant women were evaluated at 15-19.5 gestational weeks. Elevated readings (> 2.5 MOM) were identified in 190 women (1.5%) and 86 (0.7%) of these had unexplained causes. Specimens (80) were recovered and ACA levels for cardiolipin were determined using enzyme-linked immunosorbant assay. Positive IgG ACA were identified in 10 out of 80 cases (12.5%) of elevated MSAFP; 3 out of 80 cases (3.8%) had positive IgM ACA. The control women with normal MSAFP levels had positive IgG ACA in 3 of 86 cases (3.5%) and 1 of 86 cases (1.2%) for IgM. Women with increased MSAFP and positive ACA had infants with an average birth weight of 2684 +/- 889 g compared to 2793 +/- 847 g in women with increased MSAFP and normal ACA. No significant differences in IgG ACA were found in pregnant women with unexplained elevated MSAFP (10/80, 12.5%) compared to women with normal MSAFP (3/86, 3.5%). As expected, lower birth weight was identified in women who had elevated MSAFP (2738 +/- 868 g) vs. women with normal MSAFP 3181 +/- 1082 g (P = 0.004), independent of ACA positivity.

  10. A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act.

    PubMed

    Hood, Julia E; Buskin, Susan E; Anderson, Bridget J; Gagner, Alexandra; Kienzle, Jennifer; Maggio, David; Markey, Katie; Reuer, Jennifer; Benbow, Nanette; Wortley, Pascale

    2017-04-01

    The impact of the Affordable Care Act (ACA) on HIV care patients, aged 18-64, was evaluated in three jurisdictions with Medicaid expansion (Chicago, New York State, and Washington) and three jurisdictions without Medicaid expansion (Georgia, Texas, and Virginia) using data from the Medical Monitoring Project. Multivariate regression models were used to evaluate insurance status that was reported pre- and post-ACA; self-reported impact of ACA on HIV care was explored with descriptive statistics. The likelihood of having insurance was significantly greater post-ACA compared to pre-ACA in Chicago (aRR = 1.33, 95%CI = 1.20, 1.47), Washington (aRR = 1.15, 95%CI = 1.08, 1.22), and Virginia (aRR = 1.14, 95%CI = 1.00, 1.29). In Washington and Chicago, the likelihood of being Medicaid-insured was greater post-ACA compared to pre-ACA implementation (Chicago: aRR = 1.25, 95%CI = 1.03,1.53; Washington: aRR = 1.66 95% CI = 1.30, 2.13). No other significant differences were observed. Only a subset of HIV care patients (range: 15-35%) reported a change in insurance that would have coincided with the implementation of ACA; and within this subset, a change in medical care costs was the most commonly noted issue. In conclusion, the influence of ACA on insurance coverage and other factors affecting HIV care likely varies by jurisdiction.

  11. Photoreversible micellar solution as a smart drag-reducing fluid for use in district heating/cooling systems.

    PubMed

    Shi, Haifeng; Ge, Wu; Oh, Hyuntaek; Pattison, Sean M; Huggins, Jacob T; Talmon, Yeshayahu; Hart, David J; Raghavan, Srinivasa R; Zakin, Jacques L

    2013-01-08

    A photoresponsive micellar solution is developed as a promising working fluid for district heating/cooling systems (DHCs). It can be reversibly switched between a drag reduction (DR) mode and an efficient heat transfer (EHT) mode by light irradiation. The DR mode is advantageous during fluid transport, and the EHT mode is favored when the fluid passes through heat exchangers. This smart fluid is an aqueous solution of cationic surfactant oleyl bis(2-hydroxyethyl)methyl ammonium chloride (OHAC, 3.4 mM) and the sodium salt of 4-phenylazo benzoic acid (ACA, 2 mM). Initially, ACA is in a trans configuration and the OHAC/ACA solution is viscoelastic and exhibits DR (of up to 80% relative to pure water). At the same time, this solution is not effective for heat transfer. Upon UV irradiation, trans-ACA is converted to cis-ACA, and in turn, the solution is converted to its EHT mode (i.e., it loses its viscoelasticity and DR) but it now has a heat-transfer capability comparable to that of water. Subsequent irradiation with visible light reverts the fluid to its viscoelastic DR mode. The above property changes are connected to photoinduced changes in the nanostructure of the fluid. In the DR mode, the OHAC/trans-ACA molecules assemble into long threadlike micelles that impart viscoelasticity and DR capability to the fluid. Conversely, in the EHT mode the mixture of OHAC and cis-ACA forms much shorter cylindrical micelles that contribute to negligible viscoelasticity and effective heat transfer. These nanostructural changes are confirmed by cryo-transmission electron microscopy (cryo-TEM), and the photoisomerization of trans-ACA and cis-ACA is verified by (1)H NMR.

  12. [The esotropia of the convergence-excess type subdivided into two forms].

    PubMed

    Niu, Lan-jun

    2008-11-01

    There are two types of convergence excess esotropia in the classification of strabismus in our country. One is nonrefractive accommodative esotropia and another is nonaccommodative convergence excess esotropia. Inadequate heterophoria method to determine the AC/A ratio does not distinguish between a high AC/A ratio and nonaccommodative convergence excess. The diagnosis of nonrefractive accommodative esotropia is based on the presence of a high AC/A ratio as established with the gradient method to distinguish this condition from nonaccommative convergence excess.

  13. Risky Cerebrovascular Anatomic Orientation: Implications for Brain Revascularization.

    PubMed

    Nagm, Alhusain; Horiuchi, Tetsuyoshi; Yanagawa, Takao; Hongo, Kazuhiro

    2016-12-01

    This study documents a risky vascular anatomic orientation that might play an important role in the postoperative hemodynamics following anterior cerebral artery (ACA) revascularization. A 71-year-old woman presented with uncontrollable frequent right lower limb transient ischemic attacks (TIAs) attributed to a left cerebral ischemic lesion due to severe left ACA stenosis. She underwent successful left-sided superficial temporal artery-ACA bypass using interposed vascular graft. The patient awoke satisfactory from anesthesia; however, on postoperative day 1, she developed right-sided hemiparesis. Extensive postoperative investigations disclosed that watershed shift infarction was considered the etiology for this neurologic deterioration.

  14. Development and validation of a risk score for advanced colorectal adenoma recurrence after endoscopic resection

    PubMed Central

    Facciorusso, Antonio; Di Maso, Marianna; Serviddio, Gaetano; Vendemiale, Gianluigi; Muscatiello, Nicola

    2016-01-01

    AIM: To develop and validate a risk score for advanced colorectal adenoma (ACA) recurrence after endoscopic polypectomy. METHODS: Out of 3360 patients who underwent colon polypectomy at University of Foggia between 2004 and 2008, data of 843 patients with 1155 ACAs was retrospectively reviewed. Surveillance intervals were scheduled by guidelines at 3 years and primary endpoint was considered 3-year ACA recurrence. Baseline clinical parameters and the main features of ACAs were entered into a Cox regression analysis and variables with P < 0.05 in the univariate analysis were then tested as candidate variables into a stepwise Cox regression model (conditional backward selection). The regression coefficients of the Cox regression model were multiplied by 2 and rounded in order to obtain easy to use point numbers facilitating the calculation of the score. To avoid overoptimistic results due to model fitting and evaluation in the same dataset, we performed an internal 10-fold cross-validation by means of bootstrap sampling. RESULTS: Median lesion size was 16 mm (12-23) while median number of adenomas was 2.5 (1-3), whereof the number of ACAs was 1.5 (1-2). At 3 years after polypectomy, recurrence was observed in 229 ACAs (19.8%), of which 157 (13.5%) were metachronous neoplasms and 72 (6.2%) local recurrences. Multivariate analysis, after exclusion of the variable “type of resection” due to its collinearity with other predictive factors, confirmed lesion size, number of ACAs and grade of dysplasia as significantly associated to the primary outcome. The score was then built by multiplying the regression coefficients times 2 and the cut-off point 5 was selected by means of a Receiver Operating Characteristic curve analysis. In particular, 248 patients with 365 ACAs fell in the higher-risk group (score ≥ 5) where 3-year recurrence was detected in 174 ACAs (47.6%) whereas the remaining 595 patients with 690 ACAs were included in the low-risk group (score < 5) where 3

  15. An assessment of the atmospheric centers of action in the northern hemisphere winter

    NASA Astrophysics Data System (ADS)

    Sun, X. J.; Wang, P. X.; Wang, J. X. L.

    2017-02-01

    In the northern hemisphere, there are six permanent or semi-permanent atmospheric activity centers, namely the Icelandic Low, Aleutian Low, India Low, Mongolia High, North Pacific High, and North Atlantic High. The first four are semi-permanent action centers and the last two are permanent circulation systems. The India Low exists only during the summer. By using 160 years (1850-2009) of monthly mean sea level pressure data from the Hadley Centre in the UK, we conduct a comprehensive study of the five boreal winter atmospheric centers of action (ACAs). Based on a unified definition and a method determined in previous studies, we calculate the indices of areal coverage (S), intensity (P), and position of action center ( λ c, φ c) for each of these five ACAs. Through an in-depth analysis of these indices and their relationships with climate variables, we evaluate the indices by describing and explaining areal climate anomalies, particularly precipitation and temperature anomalies in China. We show that (1) ACAs significantly influence the climate anomalies of surrounding areas (2) the influences of oceanic ACAs are larger and the intensity anomalies of ACAs have a greater impact than their location displacement, and (3) ACAs exert more control on temperature than they do on precipitation. For the two ACAs over the north Atlantic, the impacts of their intensities on the anomalies of temperature and precipitation are similar. For the two ACAs over the north Pacific, their influences are almost the opposite. The most influential ACA for climate anomalies in China during the boreal winter is HMO. When HMO is stronger, China has a colder winter and it is wetter in the north. With stronger ACAs in the upstream, i.e., the Icelandic Low and North Atlantic High, northern China has a warmer winter. The ACAs over the north Pacific exert little influence on climate anomalies in China during winter. The analyses presented in this paper provide a set of useful indices for

  16. Acute post-infectious cerebellar ataxia due to co-infection of human herpesvirus-6 and adenovirus mimicking myositis.

    PubMed

    Naselli, Aldo; Pala, Giovanna; Cresta, Federico; Finetti, Martina; Biancheri, Roberta; Renna, Salvatore

    2014-11-26

    Acute cerebellar ataxia (ACA) is a relatively common neurological disease in children. Most common types of ACA are acute post-infectious (APCA) and acute disseminated encephalomyelitis (ADEM). Less common but important causes include opsoclonus-myoclonus syndrome (OMS) and acute cerebellitis. Cerebellar neoplasms and acute hydrocephalus are additional causes of paediatric ataxia. APCA is the most common cause of ACA in children, comprising about 30-50% of total cases. This is a report about an immunocompetent 4-yrs-old male affected by APCA, due to co-infection by human herpesvirus-6 (HHV-6) and adenovirus, with symptoms mimicking myositis.

  17. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions.

    PubMed

    Khawam, Edward; Abiad, Bachir; Boughannam, Alaa; Saade, Joanna; Alameddine, Ramzi

    2015-01-01

    Great discrepancies are often encountered between the distance fixation and the near-fixation esodeviations and exodeviations. They are all attributed to either anomalies of the AC/A ratio or anomalies of the fusional convergence or divergence amplitudes. We report a case with pseudoconvergence insufficiency and another one with pseudoaccommodative convergence excess. In both cases, conv./div. excess and insufficiency were erroneously attributed to anomalies of the AC/A ratio or to anomalies of the fusional amplitudes. Our purpose is to show that numerous factors, other than anomalies in the AC/A ratio or anomalies in the fusional conv. or divergence amplitudes, can contaminate either the distance or the near deviations. This results in significant discrepancies between the distance and the near deviations despite a normal AC/A ratio and normal fusional amplitudes, leading to erroneous diagnoses and inappropriate treatment models.

  18. 75 FR 62370 - Procurement List Proposed Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ..., Fort Gordon, GA NPA: Good Vocations, Inc., Macon, GA Contracting Activity: DEPT OF THE ARMY, XR W6BB ACA GORDON, FORT GORDON, GA Service Type/Location: Linen Service, VA Medical Center, Danville, IL...

  19. Institutional Self-Study and the Department Chair

    ERIC Educational Resources Information Center

    Arnold, William E.

    1977-01-01

    Discusses some of the criteria and assumptions useful to department chairpeople planning for the future of academic departments. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg Pike, Suite 1001, Falls Church, VA 22041. (MH)

  20. Curriculum Revision for the Future

    ERIC Educational Resources Information Center

    Applbaum, Ronald L.; Koehler, Jerry W.

    1975-01-01

    Advocates an integrated approach in the formulation of speech communication curriculum. Published by the Association for Communication Administration Bulletin, Staff Coordinator, ACA 5205 Leesburg Pike, Falls Church, VA 22041, $25.00 annual dues. (JW)

  1. A Rating of Doctoral Programs in Speech Communication, 1976

    ERIC Educational Resources Information Center

    Edwards, Renee; Barker, Larry

    1977-01-01

    Reviews a survey evaluation of speech communication doctoral programs existing in 1976. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg Pike, Suite 1001, Falls Church, VA 22041. (MH)

  2. Graduate Programs in Speech Communication: A Position Paper

    ERIC Educational Resources Information Center

    Goldberg, Alvin A.

    1977-01-01

    Details a position paper concerning the major focus of graduate programs in speech communication. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg Pike, Suite 1001, Falls Church, VA 22041. (MH)

  3. The Atacama Compact Array: An Overview

    NASA Astrophysics Data System (ADS)

    Iguchi, S.; Wilson, T. L.

    2010-01-01

    When completed, ALMA will comprise a 12-meter diameter antennas array (12-m Array) of a minimum of fifty antennas, and the ACA (Atacama Compact Array), composed of four 12-meter diameter antennas and twelve 7-meter diameter antennas. Out of the fifty antennas of the 12-m Array, one-half are provided by the North American partners of ALMA, the other half by the European partners. The sixteen antennas that will comprise the ACA are provided by the East Asian Partners of ALMA. In the last issue of the ALMA Science Newsletter, we outlined the testing of the prototype ALMA 12-meter diameter antennas and the procurement process for these antennas. In that article, only a short account was given of the antennas for the Atacama Compact Array (ACA). In the following we give an overview of the ACA, starting with an introduction to imaging using interferometers.

  4. Treatment of a Giant Serpentine Aneurysm in the Anterior Cerebral Artery.

    PubMed

    Kim, Sung Tae; Jeong, Young-Gyun; Jeong, Hae Woong

    2016-06-01

    A giant serpentine aneurysm (GSA) in the anterior cerebral artery (ACA) poses a technical challenge in treatment given its large size, unique neck, and dependent distal vessels. Here we report the case of a GSA in the ACA successfully treated with a combined surgical and endovascular approach. A 54-year-old woman presented with dull headache. On brain computed tomography (CT), a large mass (7 cm × 5 cm × 5 cm) was identified in the left frontal lobe. Cerebral angiography revealed a GSA in the left ACA. Bypass surgery of the distal ACA was performed, followed byocclusion of the entry channel via an endovascular approach. Follow-up CT performed 5 days after treatment revealed disappearance of the vascular channel and peripheral rim enhancement. Follow-up imaging studies performed 7 months after treatment revealed gradual reduction of the mass effect and patency of bypass flow. No complications were noted over a period of 1 year after surgery.

  5. 78 FR 8538 - Privacy Act of 1974

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... Affordable Care Act (ACA) requires Exchanges to use a single, streamlined application for consumers to use in... subject individual's name (woman's maiden name, if applicable), and SSN (furnishing the SSN is...

  6. Key Facts about the Uninsured Population

    MedlinePlus

    ... access to affordable private coverage left millions without health insurance. Beginning in 2014, the ACA expanded coverage to ... the expansion of Medicaid and the establishment of Health Insurance Marketplaces. Data show substantial gains in public and ...

  7. Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

    PubMed

    Russell, Mark C; Figley, Charles R

    2014-01-01

    On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems.

  8. Medicaid Moving Forward

    MedlinePlus

    ... Media Contacts About Us About Us Our Programs Key Staff Media Fellowships Barbara Jordan Conference Center Contact ... Medicaid program and far-reaching ACA provisions in key Medicaid domains, Medicaid is in a period of ...

  9. 76 FR 6452 - Procurement List; Additions and Deletions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ..., Philadelphia, PA. Service Type/Location: Grounds Maintenance Service, Redstone Arsenal, 5298 Redstone Arsenal..., Huntsville, AL. Contracting Activity: Dept of the Army, XR W6BB ACA Redstone Arsenal, Redstone Arsenal,...

  10. Participatory Evaluation of a Community Mobilization Effort to Enroll Wyandotte County, Kansas, Residents Through the Affordable Care Act

    PubMed Central

    Sepers, Charles E.; McKain, Wesley

    2015-01-01

    Successful implementation of the Affordable Care Act (ACA) depends on the capacity of local communities to mobilize for action. Yet the literature offers few systematic investigations of what communities are doing to ensure support for enrollment. In this empirical case study, we report implementation and outcomes of Enroll Wyandotte, a community mobilization effort to facilitate enrollment through the ACA in Wyandotte County, Kansas. We describe mobilization activities during the first round of open enrollment in coverage under the ACA (October 1, 2013–March 31, 2014), including the unfolding of community and organizational changes (e.g., new enrollment sites) and services provided to assist enrollment over time. The findings show an association between implementation measures and newly created accounts under the ACA (the primary outcome). PMID:25905820

  11. Questions and Answers about Carotid Endarterectomy

    MedlinePlus

    ... other material inside the artery walls is called atherosclerosis, popularly known as "hardening of the arteries." The ... more informed decisions. In another trial (Asymptomatic Carotid Atherosclerosis Study, or ACAS), the procedure has also been ...

  12. 78 FR 65658 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ..., nursing facilities, home health agencies, providers of home health care, hospices, religious nonmedical... Collection: Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection; Use: Section 1311(c)(4) of the Affordable Care Act (ACA) requires...

  13. Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

    The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140

  14. Thermoelectric Mechanism and Interface Characteristics of Cyanide-Free Nanogold-Coated Silver Wire

    NASA Astrophysics Data System (ADS)

    Tseng, Yi-Wei; Hung, Fei-Yi; Lui, Truan-Sheng

    2016-01-01

    Traditional bath-plated gold contains a cyanide complex, which is an environmental hazard. In response, our study used a green plating process to produce cyanide-free gold-coated silver (cyanide-free ACA) bonding wire that has been proven to be a feasible alternative to gold bonding wire in semiconductor packaging. In this work, ACA wire annealed at 550°C was found to have stable microstructure and superior mechanical properties. Intermetallic compounds Ag2Al and AuAl2 grew from Ag-Au balls and Al pads after aging at 175°C for 500 h. After current testing, ACA wire was found to have improved electrical properties due to equiaxed grain growth. The gold nanolayer on the Ag surface increased the oxidation resistance. These results provide insights regarding the reliability of ACA wire in advanced bonding processes.

  15. 78 FR 58568 - Notice of Permit Applications Received Under the Antarctic Conservation Act of 1978 (Pub. L. 95-541)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-24

    .... FOR FURTHER INFORMATION CONTACT: Adrian Dahood, ACA Permit Officer, at the above address or ACApermits... with the management plan for the Area. The applicant also seeks permission to salvage shed...

  16. 77 FR 9660 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ...) Recommendation letter on standards for Claims Attachments; (2) recommendation letter on ACA requirements to seek... discussed on the first day. Additionally, the Committee will hear subcommittee reports, strategic plans...

  17. 78 FR 48200 - Notice of Permit Applications Received Under the Antarctic Conservation Act of 1978 (Pub. L. 95-541)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ..., ACA Permit Officer, at the above address or ACApermits@nsf.gov or (703) 292-7149. SUPPLEMENTARY... ashore at any one time will be limited to 100 persons. On selected voyages Quark plans to offer:...

  18. 78 FR 9056 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ... required to enroll individuals and small business health options plan (SHOP) employers/employees through.../brokers, and to ensure compliance with the ACA provisions under 45 CFR 155.220. If CMS detects...

  19. 78 FR 55730 - Agency Information Collection Activities: Submission to OMB for Review and Approval; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... of the Affordable Care Act of 2010 (ACA) amended section 340H of the Public Health Service (PHS) Act... are accepted to THC programs. The graduation questionnaire collects information on career plans....

  20. Dansyl-labeled anionic amphiphile with a hexadecanoic carbon chain: synthesis and detection for shape transitions in organized molecular assemblies.

    PubMed

    Gao, Lining; Xia, Huiyun; Wang, Xiaoman; Li, Li; Chen, Huaxin

    2015-03-15

    The probing properties of a new fluorophore-labeled anionic surfactant, sodium 16-(N-dansyl)aminocetylate (16-DAN-ACA) were investigated systematically in molecular assemblies, especially in the transitions between micelles and vesicles. 16-DAN-ACA can efficiently differentiate the two different aggregate types in mixed cationic and anionic surfactant systems. The fluorescence anisotropy of 16-DAN-ACA was found to be sensitive for directly detecting the micellar growth in micelles containing oppositely charged surfactants; both cationic cetyltrimethylammonium bromide (CTAB) systems and anionic sodium dodecyl sulfate (SDS) systems were studied. The results indicated that the 16-DAN-ACA is a good fluorescent probe for differentiating the different aggregates, and even more can be used to detect the micellar growth.

  1. The Future of Health Care Reform: What Is Driving Enrollment?

    PubMed

    Callaghan, Timothy H; Jacobs, Lawrence R

    2017-04-01

    Against a backdrop of ongoing operational challenges, insurance market turbulence, and the ever present pull of partisanship, enrollment in the ACA's programs has soared and significant variations have developed across states in terms of their pace of coverage expansion. Our article explores why ACA enrollment has varied so dramatically across states. We explore the potential influence of party control, presidential cueing, administrative capacity, the reverberating effects of ACA policy decisions, affluence, and unemployment on enrollment. Our multivariate analysis finds that party control dominated early state decision making, but that relative enrollment in insurance exchanges and the Medicaid expansion are driven by a changing mix of political and administrative factors. Health politics is entering a new era as Republicans replace the ACA and devolve significant discretion to states to administer Medicaid and other programs. Our findings offer insights into future directions in health reform and in learning and diffusion.

  2. The Affordable Care Act, remedy, and litigation reform.

    PubMed

    Maher, Brendan S

    2014-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate.

  3. 76 FR 53896 - Combined Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ..., September 06, 2011. Docket Numbers: RP11-2410-000. Applicants: Gulf States Transmission LLC. Description: Gulf States Transmission LLC submits tariff filing per 154.402: Gulf States Transmission LLC ACA...

  4. Advanced composite aileron for L-1011 transport aircraft

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Design and evaluation of alternate concepts for the major subcomponents of the advanced composite aileron (ACA) was completed. From this array of subcomponents, aileron assemblies were formulated and evaluated. Based on these analyses a multirib assembly with graphite tape/syntactic core covers, a graphite tape front spar, and a graphite fabric rib was selected for development. A weight savings of 29.1 percent (40.8 pounds per aileron) is predicted. Engineering cost analyses indicate that the production cost of the ACA will be 7.3 percent less than the current aluminum aileron. Fabrication, machining, and testing of the material evaluation specimens for the resin screening program was completed. The test results lead to the selection of Narmco 5208 resin for the ACA. Other activities completed include: the detailed design of the ACA, construction of a three dimensional finite element model for structural analysis, and formulation of detail plans for material verification and process development.

  5. Butyrylcholinesterase activity and lymphocyte subpopulations in peripheral blood of Kuwaiti women experiencing recurrent spontaneous abortion.

    PubMed

    Mahmoud, F F; Abul, H T; Haines, D D; Omu, A E; Diejomaoh, M; Wise, J A; Abu Donia, M B

    2008-04-01

    This study has evaluated the hypothesis that activity of the detoxifying enzyme butyrylcholinesterase (BuChE) correlates with levels of serum anti-cardiolipin antibodies (ACA) and T lymphocytes in peripheral blood of women experiencing recurrent spontaneous abortion (RSA). Peripheral venous blood from 16 non-pregnant, RSA-afflicted women and 8 healthy non-pregnant women was analyzed for frequency of T lymphocyte subpopulations by two-color flow cytometry and for serum BuChE using butyrylthiocholine iodide/spectrophotometry. RSA-afflicted women with high serum ACA, but not those with normal ACA levels, exhibited significantly increased percentages of CD4+CD25+ cells (p<0.01) and CD4+HLA-DR+ cells (p<0.05) relative to healthy women. CD4+CD25+(high) cells were significantly lower (p<0.05), while CD4+CD25+(low) cells were significantly higher (p<0.01), in women with elevated ACA compared to healthy women and to RSA women with normal ACA. Relative to healthy, non-pregnant subjects, serum BuChE activity in RSA patients was elevated, both for those with normal ACA (p<0.001) and elevated ACA levels (p<0.01). Among healthy controls, a significant positive correlation was observed between frequency of CD3+NK cells and BuChE activity (p<0.01), but not for RSA-afflicted subjects. A positive correlation between BuChE activity and frequency of CD4+CD25+ cells, as well as CD4+CD25+(high) cells, was observed in the RSA-afflicted subject group with elevated ACA (p<0.05), which may be related to induction of BuChE by toxic metabolites resulting from pathogenic T cell activity. It is concluded that, among RSA patients, high serum ACA correlates with elevated levels of activated T cells and reduced CD4+CD25+(high)/CD4+CD25+(low) cells in comparison to healthy women or those afflicted with RSA but with normal ACA. BuChE activity is observed to be elevated in RSA patients irrespective of serum ACA status.

  6. Cerebral Hemodynamics With rTMS in Alcohol Dependence: A Randomized, Sham-Controlled Study.

    PubMed

    Mishra, Biswa Ranjan; Maiti, Rituparna; Nizamie, S Haque

    2016-04-08

    The authors studied cerebral hemodynamics in alcohol dependence and evaluated their changes with application of high-frequency rTMS. A prospective, single-blind, randomized, parallel-group, sham-controlled clinical study was conducted with patients with alcohol dependence (DSM-IV-TR). The study population comprised 25 subjects each in active rTMS, sham rTMS, and healthy control groups. At baseline, cerebral hemodynamic indices were measured with transcranial Doppler sonography. Subjects in the active rTMS group received 10 sessions of rTMS daily; the sham group was administered sham rTMS with the same parameters. Cerebral hemodynamic parameters were repeated 5 minutes after the last rTMS session. At baseline, mean velocity (MV) of both middle cerebral artery (MCA; R-MCA: p=0.003; L-MCA: p=0.002) and anterior cerebral artery (ACA; R-ACA: p=0.003; L-ACA: p=.001) was significantly reduced. Pulsatility index (PI) of MCA (p<0.001) and resistance index (RI) of ACA (R-ACA: p=0.009; L-ACA: p=0.008) were increased in alcohol-dependent subjects in comparison with healthy controls. In the active rTMS group, except L-MCA PI, significant differences were observed in values of MV, PI, and RI of both MCA and ACA following rTMS intervention; such changes were not evident in the sham rTMS group. The changes in mean difference in MV of L-MCA (p=0.006) and L-ACA (p=0.015) were statistically significant in the active rTMS group, in comparison with the sham group. Significant differences were also observed between the two groups postintervention, in RI of L-MCA (p=0.001) and ACA (R-ACA: p=0.010; L-ACA: p=0.015). Alcohol dependence may result in altered cerebral hemodynamic parameters, which can be improved with high-frequency rTMS application.

  7. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    PubMed Central

    Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness. PMID:23237245

  8. Bone bonding ability of a chemically and thermally treated low elastic modulus Ti alloy: gum metal.

    PubMed

    Tanaka, Masashi; Takemoto, Mitsuru; Fujibayashi, Shunsuke; Kawai, Toshiyuki; Yamaguchi, Seiji; Kizuki, Takashi; Matsushita, Tomiharu; Kokubo, Tadashi; Nakamura, Takashi; Matsuda, Shuichi

    2014-03-01

    The gum metal with composition Ti-36Nb-2Ta-3Zr-0.3O, is free from cytotoxic elements and exhibits a low elastic modulus as well as high mechanical strength. We have previously demonstrated that this gum metal, once subjected to a series of surface treatments--immersion in 1 M NaOH (alkali treatment) and then 100 mM CaCl2, before heating at 700 °C (sample: ACaH-GM), with an optional final hot water immersion (sample: ACaHW-GM)--has apatite-forming ability in simulated body fluid. To confirm the in vivo bioactivity of these treated alloys, failure loads between implants and bone at 4, 8, 16, and 26 weeks after implantation in rabbits' tibiae were measured for untreated gum metal (UT-GM), ACaH-GM and ACaHW-GM, as well as pure titanium plates after alkali and heat treatment (AH-Ti). The ACaH-GM and UT-GM plates showed almost no bonding, whereas ACaHW-GM and AH-Ti plates showed successful bonding by 4 weeks, and their failure loads subsequently increased with time. The histological findings showed a large amount of new bone in contact with the surface of ACaHW-GM and AH-Ti plates, suggesting that the ACaHW treatment could impart bone-bonding bioactivity to a gum metal in vivo. Thus, with this improved bioactive treatment, these advantageous gum metals become useful candidates for orthopedic and dental devices.

  9. Prevalence of anticardiolipin antibody in Bangladeshi patients with recurrent pregnancy loss.

    PubMed

    Giasuddin, A S M; Mazhar, Ishrat; Haq, A M Mujibul

    2010-04-01

    The objective of the present study was to see the prevalence of anticardiolipin antibody (ACA) in Bangladeshi patients (35) with recurrent pregnancy loss. Thirty-seven women with normal pregnancy were included as control. Serum levels (mean +/- SD) of ACA (u/mL) was significantly higher, whereas ANA (Ab-index) and anti-dsDNA (Ab-index) were similar in cases compared to controls (Cases vs Controls --> ACA: 31.8 +/- 24.3 vs 10.5 +/- 3.4, p < 0.001; ANA: 1.07 +/- 0.34 vs 0.92 +/- 0.15, p > 0.5; A-dsDNA: 0.53 +/- 0.16 vs 0.52 +/- 0.18, p > 0.5). The cases positive for ACA, ANA and anti-dsDNA were 37.1% (p < 0.001), 20% (p > 0.05) and 2.8% (p > 0.1) respectively. Among the seropositive cases 4/35 (11.4%) and 4/13 (30.8%) were positive for both ACA and ANA. In controls only 2/37 (5.4%) and 2/37 (5.4%) were positive for ACA and ANA respectively and none were positive for both ACA and ANA together simultaneously. Significantly high proportion of cases had O positive blood group (23/35: 65.7%, 10/13: 76.9%) (p < 0.01). The prevalence of ACA varies according to population being 37.1% (13/35) in our patients with recurrent pregnancy loss and 5.4% in controls.

  10. Literature Search through Mixed-Membership Community Discovery

    NASA Astrophysics Data System (ADS)

    Eliassi-Rad, Tina; Henderson, Keith

    We introduce a new approach to literature search that is based on finding mixed-membership communities on an augmented co-authorship graph (ACA) with a scalable generative model. An ACA graph contains two types of edges: (1) coauthorship links and (2) links between researchers with substantial expertise overlap. Our solution eliminates the biases introduced by either looking at citations of a paper or doing a Web search. A case study on PubMed shows the benefits of our approach.

  11. Anticentromere autoantibodies in patients without Raynaud's disease or systemic sclerosis.

    PubMed

    Vázquez-Abad, D; Grodzicky, T; Senécal, J L

    1999-02-01

    Anticentromere autoantibodies (ACA) are associated with Raynaud's disease and systemic sclerosis (SSc). ACA usually bind at least one of three major centromere proteins (CENPs), particularly CENP-B. We identified 16 patients with ACA who do not have Raynaud's disease or SSc. The objective of this study was to determine whether these 16 ACA differ in antigenic specificity from the ACA found in patients with Raynaud's disease or SSc. Binding of these serum ACA was tested using competition experiments with recombinant CENP-B, and native centromere proteins from HEp-2 cells and HeLa nuclear extracts in ELISAs, immunoblots, and indirect immunofluorescence assays. The ACA from these 16 patients are strikingly different from those obtained from patients who have Raynaud's disease or SSc. Only 5 of the 16 index sera (31.25%) bound CENP-B from two or more different sources by at least two methods. Six of these 16 sera (37.5%) did not bind CENP-B on ELISA, and 8 of 16 (43.75%) did not bind CENP-B on immunoblots. Three sera did not bind CENP-B either by ELISA or immunoblots. Of the 13 sera that bound CENP-B, their patterns of binding to CENP-B strongly suggested that they bind different epitopes within the CENP-B antigen. Independently of their binding to CENP-B, these sera reacted mainly with minor CENP antigens detected by HeLa nuclear extracts. We have identified unusual ACA not associated with Raynaud's disease or SSc.

  12. Neuroprotection by acetoacetate and β-hydroxybutyrate against NMDA-induced RGC damage in rat—possible involvement of kynurenic acid

    PubMed Central

    Thaler, Sebastian; Choragiewicz, Tomasz J.; Rejdak, Robert; Fiedorowicz, Michal; Turski, Waldemar A.; Tulidowicz-Bielak, Maria; Zrenner, Eberhart; Schuettauf, Frank

    2010-01-01

    Purpose This study investigated the effects of systemically administered lithium acetoacetate (ACA) and sodium β-hydroxybutyrate (BHB) in a rat model of N-methyl-D-aspartate (NMDA)-induced damage of retinal ganglion cells (RGC). Additionally, the influence of ACA and BHB on kynurenic acid (KYNA) production was assessed in vitro in bovine retinal slices. Methods Female adult Brown–Norway rats in groups of 5–8 animals were used. ACA and BHB were administered intraperitoneally once a day for 21 consecutive days, and phosphate buffered saline (PBS) was administered to control animals. After 2 weeks, the animals received intraocular NMDA (2 μl of a 10 mM solution in PBS) or intraocular PBS as a control. On day 19, retinal ganglion cells were labeled retrogradely with hydroxystilbamidine. Two days later, RGC density (cells per mm2) was assessed on retinal flatmounts. Additionaly, bovine retinal slices were incubated with NMDA and ACA or BHB at concentrations of 1.0 mM and 3.0 mM, and de novo KYNA production was measured using HPLC. Results Intraperitoneal ACA (250 mg/kg) or BHB (291.2 mg/kg) significantly protected RGC against NMDA-induced neurodegeneration. De novo KYNA production in bovine retinal slices was lowered by NMDA. Both ACA and BHB at a concentration of 3.0 mM significantly reduced the effects of NMDA. Conclusions ACA and BHB had a significant dose-dependent neuroprotective effect on RGC in a rat model of NMDA-induced RGC damage. Both ketone bodies also significantly attenuated NMDA-induced reduction of retinal KYNA production in vitro, suggesting that this mechanism may be essential for the neuroprotective effects of ACA and BHB in vivo. Our results imply that ketone bodies may represent an additional treatment option in chronic neurodegenerative disorders of the eye. PMID:20532550

  13. Critical Care Implications of the Affordable Care Act

    PubMed Central

    Dogra, Anjali P.; Dorman, Todd

    2015-01-01

    Objectives To provide an overview of key elements of the Affordable Care Act (ACA). To evaluate ways in which the ACA will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the ACA. Data Sources and Synthesis Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office (CBO). As all of the ACA's provisions will not be fully implemented until 2019, we also drew upon cost, population and utilization projections as well as the experience of existing state-based healthcare reforms. Conclusion The ACA represents the furthest reaching regulatory changes in the US healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The ACA aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the ACA outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-ACA era. PMID:26565630

  14. Novel X-Linked Genes Revealed by Quantitative Polymerase Chain Reaction in the Green Anole, Anolis carolinensis

    PubMed Central

    Rovatsos, Michail; Altmanová, Marie; Pokorná, Martina Johnson; Kratochvíl, Lukáš

    2014-01-01

    The green anole, Anolis carolinensis (ACA), is the model reptile for a vast array of biological disciplines. It was the first nonavian reptile to have its genome fully sequenced. During the genome project, the XX/XY system of sex chromosomes homologous to chicken chromosome 15 (GGA15) was revealed, and 106 X-linked genes were identified. We selected 38 genes located on eight scaffolds in ACA and having orthologs located on GGA15, then tested their linkage to ACA X chromosome by using comparative quantitative fluorescent real-time polymerase chain reaction applied to male and female genomic DNA. All tested genes appeared to be X-specific and not present on the Y chromosome. Assuming that all genes located on these scaffolds should be localized to the ACA X chromosome, we more than doubled the number of known X-linked genes in ACA, from 106 to 250. While demonstrating that the gene content of chromosome X in ACA and GGA15 is largely conserved, we nevertheless showed that numerous interchromosomal rearrangements had occurred since the splitting of the chicken and anole evolutionary lineages. The presence of many ACA X-specific genes localized to distinct contigs indicates that the ACA Y chromosome should be highly degenerated, having lost a large amount of its original gene content during evolution. The identification of novel genes linked to the X chromosome and absent on the Y chromosome in the model lizard species contributes to ongoing research as to the evolution of sex determination in reptiles and provides important information for future comparative and functional genomics. PMID:25172916

  15. Interactions of Hydrazine and of Hydrazine Derivatives with Soil Constituents and with Soils

    DTIC Science & Technology

    1984-08-23

    hypodermic needles and the pH was measured. The cells were then cleaned by flushing with distilled water. The experiment was repeated interacting metal...of the reaction vessel were removed to a plastic vial by means of a syringe with a hypodermic needle . The supernatant concentration of hydrazine was...colorzretric analysis technique (CFSC - ACA) 9 3.3.3. Procedure for sorption studies 3.3.4 Exmination of errors in the CSC-ACA 20 technique 3.4

  16. Dual mechanism of activation of plant plasma membrane Ca2+-ATPase by acidic phospholipids: evidence for a phospholipid binding site which overlaps the calmodulin-binding site.

    PubMed

    Meneghelli, Silvia; Fusca, Tiziana; Luoni, Laura; De Michelis, Maria Ida

    2008-09-01

    The effect of phospholipids on the activity of isoform ACA8 of Arabidopsis thaliana plasma membrane (PM) Ca2+-ATPase was evaluated in membranes isolated from Saccharomyces cerevisiae strain K616 expressing wild type or mutated ACA8 cDNA. Acidic phospholipids stimulated the basal Ca2+-ATPase activity in the following order of efficiency: phosphatidylinositol 4-monophosphate > phosphatidylserine > phosphatidylcholine approximately = phosphatidylethanolamine approximately = 0. Acidic phospholipids increased V(max-Ca2+) and lowered the value of K(0.5-Ca2+) below the value measured in the presence of calmodulin (CaM). In the presence of CaM acidic phospholipids activated ACA8 by further decreasing its K(0.5-Ca2+) value. Phosphatidylinositol 4-monophosphate and, with lower efficiency, phosphatidylserine bound peptides reproducing ACA8 N-terminus (aa 1-116). Single point mutation of three residues (A56, R59 and Y62) within the sequence A56-T63 lowered the apparent affinity of ACA8 for phosphatidylinositol 4-monophosphate by two to three fold, indicating that this region contains a binding site for acidic phospholipids. However, the N-deleted mutant Delta74-ACA8 was also activated by acidic phospholipids, indicating that acidic phospholipids activate ACA8 through a complex mechanism, involving interaction with different sites. The striking similarity between the response to acidic phospholipids of ACA8 and animal plasma membrane Ca2+-ATPase provides new evidence that type 2B Ca2+-ATPases share common regulatory properties independently of structural differences such as the localization of the terminal regulatory region at the N- or C-terminal end of the protein.

  17. What Physicians from Diverse Specialties Know and Support in Health Care Reform

    PubMed Central

    Ganjian, Sheila; Dowling, Patrick T.; Hove, Jason; Moreno, Gerardo

    2015-01-01

    Background The US is in an unprecedented era of health care reform that is pushing medical professionals and medical educators to evaluate the future of their patients, careers, and the field of medicine. Objectives To describe physician familiarity and knowledge with the Patient Protection and Affordable Care Act (ACA), and to determine if knowledge is associated with support and endorsement of the ACA. Methods Cross-sectional internet-based survey of 559 physicians practicing in California. Primary outcomes were physician support and endorsement of ACA: 1) overall impact on the country (1 item), and 2) perceived impact on physician’s medical practice (1 item). The primary predictor was knowledge of the ACA as measured with 10 questions. Other measures included age, gender, race-ethnicity, specialty, political views, provision of direct care, satisfaction with the practice of medicine, and compensation type. Descriptive statistics and multiple variable regression models were calculated. Results Respondents were 65% females, and the mean age was 54 years (+/− 9.7). Seventy-seven percent of physicians understood the ACA somewhat well/very well, and 59% endorsed the ACA, but 36% of physicians believed that health care reform will most likely hurt their practice. Primary care physicians were more likely to perceive that the new law will help their practice, compared to procedural specialties. Satisfaction with the practice of medicine, political affiliation, compensation type, and more knowledge of the health care law were independently associated with endorsement of the ACA. Conclusions Endorsement of the ACA varied by specialty, knowledge, and satisfaction with the practice of medicine. PMID:25853599

  18. Systemic Sclerosis Sine Scleroderma in Mexican Patients. Case Reports.

    PubMed

    Vera-Lastra, Olga; Sauceda-Casas, Christian Alexis; Domínguez, María Del Pilar Cruz; Alvarez, Sergio Alberto Mendoza; Sepulceda-Delgado, Jesús

    2017-01-03

    Systemic sclerosis sine scleroderma (ssSSc) is a form of systemic sclerosis that is characterized by Raynaud's phenomenon (RP), visceral involvement without thickening of skin and anticentromere antibodies (ACA). We studied 10 ssSsc patients with a prevalence of 2%. The clinical signs were: RP 9/10, esophageal manifestations 8/10, pulmonary arterial hypertension 4/10, interstitial lung disease 4/10, cardiac signs 3/10 and ACA 8/10.

  19. Novel X-linked genes revealed by quantitative polymerase chain reaction in the green anole, Anolis carolinensis.

    PubMed

    Rovatsos, Michail; Altmanová, Marie; Pokorná, Martina Johnson; Kratochvíl, Lukáš

    2014-08-28

    The green anole, Anolis carolinensis (ACA), is the model reptile for a vast array of biological disciplines. It was the first nonavian reptile to have its genome fully sequenced. During the genome project, the XX/XY system of sex chromosomes homologous to chicken chromosome 15 (GGA15) was revealed, and 106 X-linked genes were identified. We selected 38 genes located on eight scaffolds in ACA and having orthologs located on GGA15, then tested their linkage to ACA X chromosome by using comparative quantitative fluorescent real-time polymerase chain reaction applied to male and female genomic DNA. All tested genes appeared to be X-specific and not present on the Y chromosome. Assuming that all genes located on these scaffolds should be localized to the ACA X chromosome, we more than doubled the number of known X-linked genes in ACA, from 106 to 250. While demonstrating that the gene content of chromosome X in ACA and GGA15 is largely conserved, we nevertheless showed that numerous interchromosomal rearrangements had occurred since the splitting of the chicken and anole evolutionary lineages. The presence of many ACA X-specific genes localized to distinct contigs indicates that the ACA Y chromosome should be highly degenerated, having lost a large amount of its original gene content during evolution. The identification of novel genes linked to the X chromosome and absent on the Y chromosome in the model lizard species contributes to ongoing research as to the evolution of sex determination in reptiles and provides important information for future comparative and functional genomics.

  20. A conserved WD40 protein binds the Cajal body localization signal of scaRNP particles.

    PubMed

    Tycowski, Kazimierz T; Shu, Mei-Di; Kukoyi, Abiodun; Steitz, Joan A

    2009-04-10

    Small Cajal body (CB)-specific RNPs (scaRNPs) function in posttranscriptional modification of small nuclear (sn)RNAs. An RNA element, the CAB box, facilitates CB localization of H/ACA scaRNPs. Using a related element in Drosophila C/D scaRNAs, we purified a fly WD40 repeat protein that UV crosslinks to RNA in a C/D CAB box-dependent manner and associates with C/D and mixed domain C/D-H/ACA scaRNAs. Its human homolog, WDR79, associates with C/D, H/ACA, and mixed domain scaRNAs, as well as with telomerase RNA. WDR79's binding to human H/ACA and mixed domain scaRNAs is CAB box dependent, and its association with mixed domain RNAs also requires the ACA motif, arguing for additional interactions of WDR79 with H/ACA core proteins. We demonstrate a requirement for WDR79 binding in the CB localization of a scaRNA. This and other recent reports establish WDR79 as a central player in the localization and processing of nuclear RNPs.

  1. The alternative strategy for designing covalent drugs through kinetic effects of pi-stacking on the self-assembled nanoparticles: a model study with antibiotics

    NASA Astrophysics Data System (ADS)

    Du, Libo; Suo, Siqingaowa; Zhang, Han; Jia, Hongying; Liu, Ke Jian; Zhang, Xue Ji; Liu, Yang

    2016-11-01

    It is still a huge challenge to find a new strategy for rationally designing covalent drugs because most of them are discovered by serendipity. Considering that the effect of covalent drugs is closely associated with the kinetics of the reaction between drug molecule and its target protein, here we first demonstrate an example of the kinetic effect of pi-stacking of drug molecules on covalent antimicrobial drug design. When PEGylated 7-aminocephalosporanic acid (PEG-ACA) is used as a substrate drug, pi-stacking of the ACA group via the self-assembly of PEG-ACA on the surface of gold nanoparticles (i.e. Au@ACA) exhibits antibacterial activity against E. coli fourfold higher than a PEG-ACA monomer does. The reason can be reasonably attributed to the kinetic rate enhancement for the covalent reaction between Au@ACA and penicillin binding proteins. We believe that the self-assembly of functional groups onto the surface of gold nanoparticles represents a new strategy for covalent drug design.

  2. Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs.

    PubMed

    Nowak, Sarah A; Eibner, Christine; Adamson, David M; Saltzman, Evan

    2014-01-01

    This study examines the likely effects of the Affordable Care Act (ACA) on average annual consumer health care spending and the risk of catastrophic medical costs for the United States overall and in two large states that have decided not to expand their Medicaid programs (Texas and Florida). The ACA will have varied impacts on individuals' and families' spending on health care, depending on income level and on estimated 2016 insurance status without the ACA. The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured. People who would otherwise be uninsured who transition to the individual market under the ACA will have higher total health care spending on average after implementation of the ACA because they will now incur the cost of health insurance premiums. The authors also find that risk of catastrophic health care spending will decrease for individuals of all income levels for the insurance transitions considered; decreases will be greatest for those at the lowest income levels. Case studies found that in Texas and Florida, Medicaid expansion would substantially reduce out-of-pocket and total health care spending for those with incomes below 100 percent of the federal poverty level, compared with a scenario in which the ACA is implemented without Medicaid expansion. Expansion would reduce the risk of high medical spending for those covered under Medicaid who would remain uninsured without expansion.

  3. Alterations of MicroRNA Expression Patterns in Human Cervical Carcinoma Cells (Ca Ski) toward 1′S-1′-Acetoxychavicol Acetate and Cisplatin

    PubMed Central

    Phuah, Neoh Hun; In, Lionel LA; Azmi, Mohamad Nurul; Ibrahim, Halijah; Awang, Khalijah

    2013-01-01

    The aims of this study were to investigate the combined effects of a natural compound 1′S-1′-acetoxychavicol acetate (ACA) with cisplatin (CDDP) on HPV-positive human cervical carcinoma cell lines (Ca Ski—low cisplatin sensitivity and HeLa—high cisplatin sensitivity), and to identify microRNAs (miRNAs) modulated in response toward ACA and/or CDDP. It was revealed that both ACA and CDDP induced dose- and time-dependent cytotoxicity when used as a stand-alone agent, while synergistic effects were observed when used in combination with a combination index (CI) value of 0.74 ± 0.01 and 0.85 ± 0.01 in Ca Ski and HeLa cells, respectively. A total of 25 miRNAs were found to be significantly differentially expressed in response to ACA and/or CDDP. These include hsa-miR-138, hsa-miR-210, and hsa-miR-744 with predicted gene targets involved in signaling pathways regulating apoptosis and cell cycle progression. In conclusion, ACA acts as a chemosensitizer which synergistically potentiates the cytotoxic effect of CDDP in cervical cancer cells. The altered miRNA expression upon administration of ACA and/or CDDP suggests that miRNAs play an important role in anticancer drug responses, which can be manipulated for therapeutic purposes. PMID:23012319

  4. [Nicotine abusing in adult children of alcoholics].

    PubMed

    Suwała, Małgorzata

    2010-01-01

    Adult Children of Alcoholics (ACA) are people who were raised in families abusing alcohol where one of the parents (or both) was addicted to alcohol and where alcohol was the main problem affecting all areas of life. It is estimated that in Poland adult population consists of ACA in 35-40%. Those people represent higher risk of addiction to psychoactive substances, most of all alcohol, but also nicotine. Higher addiction propensity among ACA is a result of their personality's features consisting so called "ACA syndrome". The goal of the study was to determine nicotine addiction frequency and assessment of self-propensity to addiction in chosen ACA group, gathered in three abstinent clubs for alcoholics in Warsaw. Nicotine addiction frequency among the study group members was 58.4% and alcohol addiction frequency was 21.2%. Strong nicotine addiction represented 49.2% of smokers. Men more often than women were addicted to nicotine (0.67 vs. 0.52), on the other hand women were more often than men alcohol addicts (0.18 vs. 0.15). All smokers and nicotine addicts (assessment by HIS test) were aware of their addiction. In relation to initial addiction diagnosis by CAGE test regarded higher percentage of people than it resulted from study group self-assessment (21.2% vs. 16.8). Professional psychotherapy for ACA did not influence substantially the nicotine addiction frequency in the study group.

  5. Studies on the HLA-DRB1 genotypes in Japanese women with severe pre-eclampsia positive and negative for anticardiolipin antibody using a polymerase chain reaction-restriction fragment length polymorphism method.

    PubMed

    Takakuwa, K; Honda, K; Ishii, K; Hataya, I; Yasuda, M; Tanaka, K

    1999-12-01

    The human leukocyte antigen (HLA)-DR genotype was determined in 54 Japanese women with severe pre-eclampsia in order to elucidate the relationship between HLA-DR antigen systems and pre-eclampsia. The patients were divided into two groups according to positivity for the anticardiolipin antibody (ACA), i.e. one patient group negative for ACA (n = 41) and the other patient group positive for ACA (n = 13). The frequency of each HLA-DRB1 allele in both groups was compared with that in 81 normally fertile Japanese women who had not experienced pre-eclampsia. The genotypes of HLA-DR antigens were determined using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The frequency of DRB1*04 and DRB1*0403 in the patient group positive for the ACA was significantly higher compared with that in the group of normal fertile women (P< 0.05). The frequency of each HLA-DRB1 allele was not significantly different between patient group with pre-eclampsia negative for ACA and group of normal fertile women. These results suggest a difference in the immunogenetic background between the patient groups with severe pre-eclampsia positive and negative for the ACA.

  6. Osteoporosis Recovery by Antrodia camphorata Alcohol Extracts through Bone Regeneration in SAMP8 Mice

    PubMed Central

    Liu, Hen-Yu; Huang, Chiung-Fang; Li, Chun-Hao; Tsai, Ching-Yu; Chen, Wei-Hong; Wei, Hong-Jian; Wang, Ming-Fu; Kuo, Yueh-Hsiung; Cheong, Mei-Leng; Deng, Win-Ping

    2016-01-01

    Antrodia camphorata has previously demonstrated the efficacy in treating cancer and anti-inflammation. In this study, we are the first to evaluate Antrodia camphorata alcohol extract (ACAE) for osteoporosis recovery in vitro with preosteoblast cells (MC3T3-E1) and in vivo with an osteoporosis mouse model established in our previous studies, ovariectomized senescence accelerated mice (OVX-SAMP8). Our results demonstrated that ACAE treatment was slightly cytotoxic to preosteoblast at 25 μg/mL, by which the osteogenic gene expression (RUNX2, OPN, and OCN) was significantly upregulated with an increased ratio of OPG to RANKL, indicating maintenance of the bone matrix through inhibition of osteoclastic pathway. Additionally, evaluation by Alizarin Red S staining showed increased mineralization in ACAE-treated preosteoblasts. For in vivo study, our results indicated that ACAE inhibits bone loss and significantly increases percentage bone volume, trabecular bone number, and bone mineral density in OVX-SAMP8 mice treated with ACAE. Collectively, in vitro and in vivo results showed that ACAE could promote osteogenesis and prevent bone loss and should be considered an evidence-based complementary and alternative medicine for osteoporosis therapy through the maintenance of bone health. PMID:27143981

  7. Osteoporosis Recovery by Antrodia camphorata Alcohol Extracts through Bone Regeneration in SAMP8 Mice.

    PubMed

    Liu, Hen-Yu; Huang, Chiung-Fang; Li, Chun-Hao; Tsai, Ching-Yu; Chen, Wei-Hong; Wei, Hong-Jian; Wang, Ming-Fu; Kuo, Yueh-Hsiung; Cheong, Mei-Leng; Deng, Win-Ping

    2016-01-01

    Antrodia camphorata has previously demonstrated the efficacy in treating cancer and anti-inflammation. In this study, we are the first to evaluate Antrodia camphorata alcohol extract (ACAE) for osteoporosis recovery in vitro with preosteoblast cells (MC3T3-E1) and in vivo with an osteoporosis mouse model established in our previous studies, ovariectomized senescence accelerated mice (OVX-SAMP8). Our results demonstrated that ACAE treatment was slightly cytotoxic to preosteoblast at 25 μg/mL, by which the osteogenic gene expression (RUNX2, OPN, and OCN) was significantly upregulated with an increased ratio of OPG to RANKL, indicating maintenance of the bone matrix through inhibition of osteoclastic pathway. Additionally, evaluation by Alizarin Red S staining showed increased mineralization in ACAE-treated preosteoblasts. For in vivo study, our results indicated that ACAE inhibits bone loss and significantly increases percentage bone volume, trabecular bone number, and bone mineral density in OVX-SAMP8 mice treated with ACAE. Collectively, in vitro and in vivo results showed that ACAE could promote osteogenesis and prevent bone loss and should be considered an evidence-based complementary and alternative medicine for osteoporosis therapy through the maintenance of bone health.

  8. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

    PubMed

    Bartels, Stephen J; Gill, Lydia; Naslund, John A

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

  9. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

    PubMed Central

    Abdus, Salam; Mistry, Kamila B.

    2015-01-01

    Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

  10. Evaluating the "Keep Your Health Plan Fix": Implications for the Affordable Care Act Compared to Legislative Alternatives.

    PubMed

    Saltzman, Evan; Eibner, Christine

    2014-01-01

    President Obama's promise that Americans could keep their existing health care plans under the Affordable Care Act (ACA) has received increased scrutiny in the wake of millions of Americans having their plans cancelled. These cancellations primarily occurred in the individual or nongroup market, where individuals purchase health care plans directly from an insurer instead of through an employer. Many such plans do not meet the minimum coverage requirements of the ACA, leading insurers to send plan-cancellation notices to their enrollees. This study describes a comparative analysis of three proposals to remedy the situation: one by the White House, another by Senator Mary Landrieu (D-LA), and a third by Representative Fred Upton (R-MI). The proposals are evaluated based on their potential impact on the ACA-compliant market and the cost and coverage of health insurance. The possibility of each proposal causing a "death spiral," in which rising premiums and decreasing enrollment undermine the viability of the ACA-compliant market, is also addressed. The authors find that the three proposals vary from slight to moderate impact on ACA premiums, enrollment, and federal spending, but none of them would result in the unraveling of the ACA-compliant market.

  11. A Stress-Induced Bias in the Reading of the Genetic Code in Escherichia coli

    PubMed Central

    Oron-Gottesman, Adi; Sauert, Martina; Moll, Isabella

    2016-01-01

    ABSTRACT Escherichia coli mazEF is an extensively studied stress-induced toxin-antitoxin (TA) system. The toxin MazF is an endoribonuclease that cleaves RNAs at ACA sites. Thereby, under stress, the induced MazF generates a stress-induced translation machinery (STM), composed of MazF-processed mRNAs and selective ribosomes that specifically translate the processed mRNAs. Here, we further characterized the STM system, finding that MazF cleaves only ACA sites located in the open reading frames of processed mRNAs, while out-of-frame ACAs are resistant. This in-frame ACA cleavage of MazF seems to depend on MazF binding to an extracellular-death-factor (EDF)-like element in ribosomal protein bS1 (bacterial S1), apparently causing MazF to be part of STM ribosomes. Furthermore, due to the in-frame MazF cleavage of ACAs under stress, a bias occurs in the reading of the genetic code causing the amino acid threonine to be encoded only by its synonym codon ACC, ACU, or ACG, instead of by ACA. PMID:27935840

  12. A Pollen Coat–Inducible Autoinhibited Ca2+-ATPase Expressed in Stigmatic Papilla Cells Is Required for Compatible Pollination in the Brassicaceae[W

    PubMed Central

    Iwano, Megumi; Igarashi, Motoko; Tarutani, Yoshiaki; Kaothien-Nakayama, Pulla; Nakayama, Hideki; Moriyama, Hideki; Yakabe, Ryo; Entani, Tetsuyuki; Shimosato-Asano, Hiroko; Ueki, Masao; Tamiya, Gen; Takayama, Seiji

    2014-01-01

    In the Brassicaceae, intraspecific non-self pollen (compatible pollen) can germinate and grow into stigmatic papilla cells, while self-pollen or interspecific pollen is rejected at this stage. However, the mechanisms underlying this selective acceptance of compatible pollen remain unclear. Here, using a cell-impermeant calcium indicator, we showed that the compatible pollen coat contains signaling molecules that stimulate Ca2+ export from the papilla cells. Transcriptome analyses of stigmas suggested that autoinhibited Ca2+-ATPase13 (ACA13) was induced after both compatible pollination and compatible pollen coat treatment. A complementation test using a yeast Saccharomyces cerevisiae strain lacking major Ca2+ transport systems suggested that ACA13 indeed functions as an autoinhibited Ca2+ transporter. ACA13 transcription increased in papilla cells and in transmitting tracts after pollination. ACA13 protein localized to the plasma membrane and to vesicles near the Golgi body and accumulated at the pollen tube penetration site after pollination. The stigma of a T-DNA insertion line of ACA13 exhibited reduced Ca2+ export, as well as defects in compatible pollen germination and seed production. These findings suggest that stigmatic ACA13 functions in the export of Ca2+ to the compatible pollen tube, which promotes successful fertilization. PMID:24569769

  13. Proceedings of the Seventh Joint Magnetism and Magnetic Materials-Intermag Conference 6-9 January 1998 San Francisco, California Volume 83, Number 11, Part 2.

    DTIC Science & Technology

    2007-11-02

    34’Electronic mail: jgonzalez@pinarl.csic.es b)Also with: Instituto de Magnetismo Aplicado "Salvador Velayos", REN- FEUCM, 28230 Las Rozas, Madrid...Väzquez,a) J. M. Garcia-Beneytez, and J. P. Sinnecker Insitituto de Magnetismo Aplicado-UCM-RENFE and Instituto de Ciencia de Materiales-CSIC, P.O... Magnetismo Aplicado UCM-RENFE and Instituto de Ciencia de Materiales-CSlC, P.O. Box 155, Las Rozas 28230 Madrid, Spain V. A. Lukshina and A. P. Potapov

  14. Infarction in the territory of the anterior cerebral artery: clinical study of 51 patients

    PubMed Central

    Arboix, Adrià; García-Eroles, Luis; Sellarés, Núria; Raga, Agnès; Oliveres, Montserrat; Massons, Joan

    2009-01-01

    Background Little is known about clinical features and prognosis of patients with ischaemic stroke caused by infarction in the territory of the anterior cerebral artery (ACA). This single centre, retrospective study was conducted with the following objectives: a) to describe the clinical characteristics and short-term outcome of stroke patients with ACA infarction as compared with that of patients with ischaemic stroke due to middle cerebral artery (MCA) and posterior cerebral artery (PCA) infarctions, and b) to identify predictors of ACA stroke. Methods Fifty-one patients with ACA stroke were included in the "Sagrat Cor Hospital of Barcelona Stroke Registry" during a period of 19 years (1986–2004). Data from stroke patients are entered in the stroke registry following a standardized protocol with 161 items regarding demographics, risk factors, clinical features, laboratory and neuroimaging data, complications and outcome. The characteristics of these 51 patients with ACA stroke were compared with those of the 1355 patients with MCA infarctions and 232 patients with PCA infarctions included in the registry. Results Infarctions of the ACA accounted for 1.3% of all cases of stroke (n = 3808) and 1.8% of cerebral infarctions (n = 2704). Stroke subtypes included cardioembolic infarction in 45.1% of patients, atherothrombotic infarction in 29.4%, lacunar infarct in 11.8%, infarct of unknown cause in 11.8% and infarction of unusual aetiology in 2%. In-hospital mortality was 7.8% (n = 4). Only 5 (9.8%) patients were symptom-free at hospital discharge. Speech disturbances (odds ratio [OR] = 0.48) and altered consciousness (OR = 0.31) were independent variables of ACA stroke in comparison with MCA infarction, whereas limb weakness (OR = 9.11), cardioembolism as stroke mechanism (OR = 2.49) and sensory deficit (OR = 0.35) were independent variables associated with ACA stroke in comparison with PCA infarction. Conclusion Cardioembolism is the main cause of brain infarction

  15. A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?

    PubMed

    Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

    2017-03-01

    The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access. Health insurance is a financial mechanism for paying for health care, while access refers to the process of actually obtaining that health care. The ACA has widened the gap between providing patients the mechanism of paying for healthcare and actually receiving it. The ACA is applauded for increasing the number of insured, quite appropriately as that has occurred for over 20 million people. Less frequently mentioned are the 6 million who have lost their insurance. Further, in terms of how health insurance is been provided, the majority the expansion was based on Medicaid expansion, with an increase of 13 million. Consequently, the ACA hasn't worked well for the working and middle class who receive much less support, particularly those who earn more than 400% of the federal poverty level, who constitute 40% of the population and don't receive any help. As a result, exchange enrollment has been a disappointment and the percentage of workers obtaining their health benefits from their employer has decreased steadily. Access to health care has been uneven, with those on Medicaid hampered by narrow networks, while those on the exchanges or getting employer benefits have faced high out-of-pocket costs.The second category relates to cost containment. President Obama claimed that the ACA provided significant cost containment, in that costs would have been even much higher if the ACA was not enacted. Further, he attributed

  16. The synergistic effect of 1'-acetoxychavicol acetate and sodium butyrate on the death of human hepatocellular carcinoma cells.

    PubMed

    Kato, Rie; Matsui-Yuasa, Isao; Azuma, Hideki; Kojima-Yuasa, Akiko

    2014-04-05

    It has been suggested that the combined effect of natural products may improve the effect of treatment against the proliferation of cancer cells. In this study, we evaluated the combination of 1'-acetoxychavicol acetate (ACA), obtained from Alpinia galangal, and sodium butyrate, a major short chain fatty acid, on the growth of HepG2 human hepatocellular carcinoma cells and found that treatment had a synergistic inhibitory effect. The number of HepG2 cells was synergistically decreased via apoptosis induction when cells were treated with both ACA and sodium butyrate. In ACA- and sodium butyrate-treated cells, intracellular reactive oxygen species (ROS) levels and NADPH oxidase activities were increased significantly. The decrease in cell number after combined treatment of ACA and sodium butyrate was diminished when cells were pretreated with catalase. These results suggest that an increase in intracellular ROS levels is involved in cancer cell death. AMP-activated protein kinase (AMPK), a cellular energy sensor, plays an essential role in controlling processes related to tumor development. In ACA- and sodium butyrate-treated cells, AMPK phosphorylation was induced significantly, and this induction improved when cells were pretreated with catalase. These results suggest that the increase in intracellular ROS is involved in the increase of AMPK phosphorylation. In normal hepatocyte cells, treatment with ACA and sodium butyrate did not decrease cell numbers or increase ROS levels. In conclusion, combined treatment with ACA and sodium butyrate synergistically induced apoptotic cell death via an increase in intracellular ROS and phosphorylation of AMPK. Our findings may provide new insight into the development of novel combination therapies against hepatocellular carcinoma.

  17. The modernization of American public law: health care reform and popular constitutionalism.

    PubMed

    Super, David A

    2014-04-01

    The Patient Protection and Affordable Care Act (ACA) transformed U.S. public law in crucial ways extending far beyond health care. As important as were the doctrinal shifts wrought by National Federation of Independent Business v. Sebelius, the ACA's structural changes to public law likely will prove far more important should they become entrenched. The struggle over the ACA has triggered the kind of "constitutional moment" that has largely replaced Article V's formal amendment procedure since the Prohibition fiasco. The Court participates in this process, but the definitive and enduring character of these constitutional moments' outcomes springs from broad popular engagement. Despite the Court's ruling and the outcome of the 2012 elections, the battle over whether to implement or shelve the ACA will continue unabated, both federally and in the states, until We the People render a clear decision. Whether the ACA survives or fails will determine the basic principles that guide the development of federalism, social insurance, tax policy, and privatization for decades to come. In each of these areas, the New Deal bequeathed us a delicate accommodation between traditionalist social values and modernizing norms of economic efficiency and interest group liberalism. This balance has come under increasing stress, with individual laws rejecting tradition far more emphatically than the New Deal did. But absent broad popular engagement, no definitive new principles could be established. The ACA's entrenchment would elevate technocratic norms across public law, the first change of our fundamental law since the civil rights revolution. The ACA's failure would rejuvenate individualistic, moralistic, pre-New Deal norms and allow opponents to attempt a counterrevolution against technocracy.

  18. An anti-steroidogenic inhibitory primer pheromone in male sea lamprey (Petromyzon marinus).

    PubMed

    Chung-Davidson, Yu-Wen; Wang, Huiyong; Bryan, Mara B; Wu, Hong; Johnson, Nicholas S; Li, Weiming

    2013-08-01

    Reproductive functions can be modulated by both stimulatory and inhibitory primer pheromones released by conspecifics. Many stimulatory primer pheromones have been documented, but relatively few inhibitory primer pheromones have been reported in vertebrates. The sea lamprey male sex pheromone system presents an advantageous model to explore the stimulatory and inhibitory primer pheromone functions in vertebrates since several pheromone components have been identified. We hypothesized that a candidate sex pheromone component, 7α, 12α-dihydroxy-5α-cholan-3-one-24-oic acid (3 keto-allocholic acid or 3kACA), exerts priming effects through the hypothalamic-pituitary-gonadal (HPG) axis. To test this hypothesis, we measured the peptide concentrations and gene expressions of lamprey gonadotropin releasing hormones (lGnRH) and the HPG output in immature male sea lamprey exposed to waterborne 3kACA. Exposure to waterborne 3kACA altered neuronal activation markers such as jun and jun N-terminal kinase (JNK), and lGnRH mRNA levels in the brain. Waterborne 3kACA also increased lGnRH-III, but not lGnRH-I or -II, in the forebrain. In the plasma, 3kACA exposure decreased all three lGnRH peptide concentrations after 1h exposure. After 2h exposure, 3kACA increased lGnRH-I and -III, but decreased lGnRH-II peptide concentrations in the plasma. Plasma lGnRH peptide concentrations showed differential phasic patterns. Group housing condition appeared to increase the averaged plasma lGnRH levels in male sea lamprey compared to isolated males. Interestingly, 15α-hydroxyprogesterone (15α-P) concentrations decreased after prolonged 3kACA exposure (at least 24h). To our knowledge, this is the only known synthetic vertebrate pheromone component that inhibits steroidogenesis in males.

  19. 1'-Acetoxychavicol acetate ameliorates age-related spatial memory deterioration by increasing serum ketone body production as a complementary energy source for neuronal cells.

    PubMed

    Kojima-Yuasa, Akiko; Yamamoto, Tomiya; Yaku, Keisuke; Hirota, Shiori; Takenaka, Shigeo; Kawabe, Kouichi; Matsui-Yuasa, Isao

    2016-09-25

    1'-Acetoxychavicol acetate (ACA) is naturally obtained from the rhizomes and seeds of Alpinia galangal. Here, we examined the effect of ACA on learning and memory in senescence-accelerated mice prone 8 (SAMP8). In mice that were fed a control diet containing 0.02% ACA for 25 weeks, the learning ability in the Morris water maze test was significantly enhanced in comparison with mice that were fed the control diet alone. In the Y-maze test, SAMP8 mice showed decreased spontaneous alterations in comparison with senescence-accelerated resistant/1 (SAMR1) mice, a homologous control, which was improved by ACA pretreatment. Serum metabolite profiles were obtained by GC-MS analysis, and each metabolic profile was plotted on a 3D score plot. Based upon the diagram, it can be seen that the distribution areas for the three groups were completely separate. Furthermore, the contents of β-hydroxybutyric acid and palmitic acid in the serum of SAMP8-ACA mice were higher than those of SAMP8-control mice and SAMR1-control mice. We also found that SAMR1 mice did not show histological abnormalities, whereas histological damage in the CA1 region of the hippocampus in SAMP8-control mice was observed. However, SAMP8-ACA mice were observed in a similar manner as SAMR1 mice. These findings confirm that ACA increases the serum concentrations of β-hydroxybutyric acid and palmitic acid levels and thus these fuels might contribute to the maintenance of the cognitive performance of SAMP8 mice.

  20. Membrane Targeting of P-type ATPases in Plant Cells

    SciTech Connect

    Jeffrey F. Harper, Ph.D.

    2004-06-30

    How membrane proteins are targeted to specific subcellular locations is a very complex and poorly understood area of research. Our long-term goal is to use P-type ATPases (ion pumps), in a model plant system Arabidopsis, as a paradigm to understand how members of a family of closely related membrane proteins can be targeted to different subcellular locations. The research is divided into two specific aims. The first aim is focused on determining the targeting destination of all 10 ACA-type calcium pumps (Arabidopsis Calcium ATPase) in Arabidopsis. ACAs represent a plant specific-subfamily of plasma membrane-type calcium pumps. In contrast to animals, the plant homologs have been found in multiple membrane systems, including the ER (ACA2), tonoplast (ACA4) and plasma membrane (ACA8). Their high degree of similarity provides a unique opportunity to use a comparative approach to delineate the membrane specific targeting information for each pump. One hypothesis to be tested is that an endomembrane located ACA can be re-directed to the plasma membrane by including targeting information from a plasma membrane isoform, ACA8. Our approach is to engineer domain swaps between pumps and monitor the targeting of chimeric proteins in plant cells using a Green Fluorescence Protein (GFP) as a tag. The second aim is to test the hypothesis that heterologous transporters can be engineered into plants and targeted to the plasma membrane by fusing them to a plasma membrane proton pump. As a test case we are evaluating the targeting properties of fusions made between a yeast sodium/proton exchanger (Sod2) and a proton pump (AHA2). This fusion may potentially lead to a new strategy for engineering salt resistant plants. Together these aims are designed to provide fundamental insights into the biogenesis and function of plant cell membrane systems.

  1. HIV-Infected Patient Knowledge, Attitudes, and Beliefs Regarding the Affordable Care Act.

    PubMed

    Rozin, Irina; Sayles, Harlan; Anderson, Matthew J; Furl, Renae; Stimpson, Jim P; Swindells, Susan; Bares, Sara H

    2015-06-01

    We evaluated patient knowledge, attitudes, and beliefs regarding changes present with the Affordable Care Act (ACA). HIV-infected adults attending an academic medical center HIV clinic in Omaha, Nebraska were asked to complete a self-administered survey between November 2013 and March 2014. Information collected included demographics, knowledge regarding healthcare reform policies, as well as attitudes and beliefs regarding the potential impact of the ACA on patient access to healthcare. Basic descriptive statistics were used to assess demographic characteristics of respondents and outcomes of interest. Chi-square tests were used for comparisons of interest among participants; some trends were evaluated with Cochran-Armitage trend tests. Four hundred and six patients completed the questionnaire. Of the respondents 90% were between the ages of 27 and 64, 61% were white, 27% had no health insurance, and 21% reported that they felt they had or will eventually benefit from the ACA. The proportion who responded "I don't know" to this question decreased over the study period (p=0.036). Overall, 57% reported they do not believe that they are informed enough to make decisions about the ACA. In answering four knowledge-based questions, only 3% answered all of them correctly. Knowledge about the ACA was significantly associated with perception of benefit (p=0.018). HIV-infected patients are not well informed about the ACA and few perceive that they will benefit from healthcare reform. Targeted education and outreach are necessary to reduce the knowledge gap for this population that stands to benefit greatly from the ACA.

  2. An anti-steroidogenic inhibitory primer pheromone in male sea lamprey (Petromyzon marinus)

    USGS Publications Warehouse

    Chung-Davidson, Yu-Wen; Wang, Huiyong; Bryan, Mara B.; Wu, Hong; Johnson, Nicholas S.; Li, Weiming

    2013-01-01

    Reproductive functions can be modulated by both stimulatory and inhibitory primer pheromones released by conspecifics. Many stimulatory primer pheromones have been documented, but relatively few inhibitory primer pheromones have been reported in vertebrates. The sea lamprey male sex pheromone system presents an advantageous model to explore the stimulatory and inhibitory primer pheromone functions in vertebrates since several pheromone components have been identified. We hypothesized that a candidate sex pheromone component, 7α, 12α-dihydroxy-5α-cholan-3-one-24-oic acid (3 keto-allocholic acid or 3kACA), exerts priming effects through the hypothalamic-pituitary-gonadal (HPG) axis. To test this hypothesis, we measured the peptide concentrations and gene expressions of lamprey gonadotropin releasing hormones (lGnRH) and the HPG output in immature male sea lamprey exposed to waterborne 3kACA. Exposure to waterborne 3kACA altered neuronal activation markers such as jun and jun N-terminal kinase (JNK), and lGnRH mRNA levels in the brain. Waterborne 3kACA also increased lGnRH-III, but not lGnRH-I or -II, in the forebrain. In the plasma, 3kACA exposure decreased all three lGnRH peptide concentrations after 1 h exposure. After 2 h exposure, 3kACA increased lGnRHI and -III, but decreased lGnRH-II peptide concentrations in the plasma. Plasma lGnRH peptide concentrations showed differential phasic patterns. Group housing condition appeared to increase the averaged plasma lGnRH levels in male sea lamprey compared to isolated males. Interestingly, 15α-hydroxyprogesterone (15α-P) concentrations decreased after prolonged 3kACA exposure (at least 24 h). To our knowledge, this is the only known synthetic vertebrate pheromone component that inhibits steroidogenesis in males.

  3. Development of a delivery system for the continuous endogenous release of an anti-idiotypic antibody against ovarian carcinoma.

    PubMed

    Hann, Evelin; Reinartz, Silke; Clare, Susan E; Passow, Sebastian; Kissel, Thomas; Wagner, Uwe

    2005-06-01

    The treatment of several cancers with anti-idiotype antibodies has shown promising results in animals and clinical trials. A common drawback of many anti-idiotypic antibodies is their low immunogenicity. The aim of this work was to construct a new delivery form for the anti-idiotypic antibody ACA125hFc, with the goal of improving its immunogenicity as vaccine against ovarian carcinoma. Designed on bioencapsulation technologies, we generated an in vitro depot that acts as a continuous delivery system for the anti-idiotypic antibody ACA125hFc. C2C12 myoblasts were transfected with the anti-idiotypic chimeric antibody ACA125hFc, which mimics the CA125 tumor antigen and which consists of variable regions of the monoclonal murine antibody ACA125 (currently in clinical trial) and the human IgG Fc domain. Recombinant myoblasts were encapsulated in 1-cm semipermeable, polyethersulfone (PES), or polyvinylidene difluoride (PVDF) hollow fibers, which differ in their molecular weight cutoff (MWCO). Encapsulated cells were evaluated in vitro for viability and antibody secretion over a period of 3 months. PES hollow fibers with a higher MWCO showed a twofold higher secretion rate of chACA125hFc compared to PES devices with a lower MWCO. No remarkable level of ACA125hFc could be detected for PVDF devices. The expression levels of the anti-idiotypic antibody ACA125hFc from capsules with a lower MWCO could be improved substantially, in both PES as well as PVDF, by inserting an internal polyethyleneterephtalate (PET) yarn. We conclude that murine recombinant C2C12 myoblasts encapsulated in PES as well as PVDF hollow fibers containing an internal PET matrix can act as a long-term secretion system for anti-idiotypic antibodies.

  4. Proceedings of the International Workshop on Non-Crystalline Solids (3rd) Held in Matalascanas (Costa de la Luz), Spain on November 5-8, 1991. Trends in Non-Crystalline Solids,

    DTIC Science & Technology

    1992-01-01

    Magnetismo Aplicado, Madrid, Spain) G.R. Strobl (Universitat Freiburg, Germany) A. van den Beukel (Delft University of Technology, The Netherlands...second in San SebastiAn in 1989 - will continue. The fourth will be held in 1994, organized by the "Instituto de Magnetismo Aplicado" of the Complutense...Dpto. Electricidad y Electr6nica, Facultad de Ciencias, UPV/EHU Apdo. 644,48080 Bilbao ABSTRACT:We report 57 Fe MOssbauer Spectroscopy measurements

  5. International Workshop on Non-Crystalline Solids (3rd) Held in Matalascanas, Spain on November 5-8, 1991. Programme and Abstracts

    DTIC Science & Technology

    1991-11-01

    Magnetismo Aplicado. Madrid, Spain) G.R. Strobl (Universitit Freiburg, Germany) A. van den Beukel (Delft University of Technology, The Netherlands...H.T. SAVAGE Instituto Magnetismo Aplicado. Universidad Complutense and RENFE, Apartado 155, Las Rozas, 28230-MADRID (Spain) Amorphous ferromagnetic...ALLOYS I. Orue, J.M.Barandiardn, M.L Ferndndez-Gubieda, F. Plazaola Dpto. Electricidad y Electronica, Facultad de Ciencias, UPV/EHU Aptdo 644, 48080

  6. Recruiting and Retention of Military Personnel (Recrutement et Retention du Personnel Militaire)

    DTIC Science & Technology

    2007-10-01

    metodológicos y aplicados. Madrid, Biblioteca Nueva. [263] Hofstede, G. (1980). Culture’s consequences: International differences in work related...humanos: desarrollos teóricos, metodológicos y aplicados. Madrid, Biblioteca Nueva. [278] Ros, M. (2001). Psicología social de los valores: una... Biblioteca Nueva. [279] Ros, M. and Gouveia, V.V. (2001). Validez de los modelos transculturales sobre los valores. In M. Ros and V.V. Gouveia (Eds

  7. Metal (Fe, Co, Ni) supported on different aluminas as Fischer-Tropsch catalyst

    SciTech Connect

    Dahlan; Marsih, I. Nyoman Ismunandar; Makertihartha, I. G. B. N.; Praserthdam, Piyasan; Panpranot, Joongjai

    2015-09-30

    This research aimed to compare the physico-chemical properties of the same metal M (M = iron, cobalt, nickel) supported on aluminas with different morphology and pore size as Fischer-Tropsch catalyst. The aluminas applied as support were alumina synthesized through hydrothermal process, alumina formed by pretreatment of catapal and commercial alumina which named as Ahy, Aca, and Aco respectively. Ahy has uniform morphology of nanotubes while Aca and Aco showed non-uniform morphology of particle lumps. The particle lumps of Aca were larger than those of Aco. Ahy, Aca, and Aco respectively has average pore diameter of 2.75, 2.86 and 2.9 nm. Metals were deposited on the supports by incipient-wetness impregnation method. The catalysts were characterized by XRD, H{sub 2}-TPR, and H{sub 2} chemisorption. Catalyst acitivity test for Fischer-Tropsch reaction was carried out in a micro reactor at 200 °C and 1 atm, and molar ratio of H{sub 2}/CO = 2:1. The metal oxide particle size increased in the order M/Aco < M/Aca < M/Ahy. The catalysts reducibility also increased according to the order M/Aco < M/Aca < M/Ahy suggesting that the larger metal oxide particles are more reducible. The number of active site was not proportional to the reducibility because during the reduction, larger metal oxide particles were converted into larger metal particles. On the other hand, the number of active sites was inversely proportional to the particle sizes. The number of active site increased in the order M/Ahy < M/Aco < M/Aca. The catalytic activity also increased in the following order M/Ahy < M/Aco < M/Aca. The activity per active site increased according to the order M/Aca < M/Aco < M/Ahy meaning that for M/Ahy, a little increase in active site will lead to a significance increase in catalytic activity. It showed that Ahy has potential for the better support.

  8. Suppression of microRNA-629 enhances sensitivity of cervical cancer cells to 1′S-1′-acetoxychavicol acetate via regulating RSU1

    PubMed Central

    Phuah, Neoh Hun; Azmi, Mohamad Nurul; Awang, Khalijah; Nagoor, Noor Hasima

    2017-01-01

    Background Cervical cancer is the fourth most frequent malignancy affecting women worldwide, but drug resistance and toxicities remain a major challenge in chemotherapy. The use of natural compounds is promising because they are less toxic and able to target multiple signaling pathways. The 1′S-1′-acetoxychavicol acetate (ACA), a natural compound isolated from wild ginger Alpinia conchigera, induced cytotoxicity on various cancer cells including cervical cancer. MicroRNAs (miRNAs) are short noncoding RNAs that regulate numerous biological processes, such as apoptosis and chemosensitivity. Past studies reported that miR-629 is upregulated in many cancers, and its expression was altered in ACA-treated cervical cancer cells. However, the role of miR-629 in regulating sensitivity toward ACA or other anticancer agents has not been reported. Hence, this study aims to investigate the role of miR-629 in regulating response toward ACA on cervical cancer cells. Methods The miR-629 expression following transfection with miR-629 hairpin inhibitor and hairpin inhibitor negative control was measured using quantitative real-time polymerase chain reaction (RT-qPCR). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to investigate sensitivity toward ACA. Apoptosis was detected using Annexin V/propidium iodide and Caspase 3/7 assays. The gene target for miR-629 was identified using miRNA target prediction programs, luciferase reporter assay and Western blots. Gene overexpression studies were performed to evaluate its role in regulating response toward ACA. Results Transfection with miR-629 hairpin inhibitor downregulated its expression in both cervical cancer cell lines. Suppression of miR-629 increased sensitivity toward ACA by reducing cell proliferation and inducing apoptosis. Luciferase reporter assay confirmed RSU1 as a direct target of miR-629. Overexpression of miR-629 decreased RSU1 protein expression, while inhibition of miR-629

  9. The role of interactions between accommodation and vergence in human visual development

    NASA Astrophysics Data System (ADS)

    Teel, Danielle F. W.

    Even in early infancy accommodation and vergence interact through neural coupling such that accommodation drives vergence (AC/A ratio) and vergence drives accommodation (CA/C ratio), to assist coordination and development of clear and single binocular vision. Infants have narrow inter-pupillary distances (IPD) requiring less vergence in angular units (degrees or prism diopters), and are typically hyperopic, requiring larger accommodative responses (diopters) than adults. The relative demands also change with emmetropization (decreasing hyperopia) and head growth (increasing IPD) over time. Therefore, adult-like couplings may not be optimal during development and the couplings may play a role in abnormality such as esotropia. A range of cues can drive accommodation and vergence. In addition to blur and disparity, proximity in the form of looming, size and perceived distance has been shown to influence the interactions between accommodation and vergence in adults. The role of this cue in measures of coupling is also poorly understood and may impact key clinical AC/A estimates in young children. Utilizing principles of eccentric photorefraction and Purkinje image eye tracking, this research examines the AC/A and CA/C ratios in infants, preschoolers and adults as a function of age, refractive error and interpupillary distance, plus the role proximity, specifically looming and size cues, plays in estimating the AC/A ratio in three year olds and adults. The AC/A (PD/D) was significantly higher in adults than three-year-olds or infants but similar across age groups in MA/D units. The CA/C was higher in infants than adults or three-year-olds (D/MA and D/PD). Although, not fully reciprocally related, a significant negative relationship was found between the response AC/A and CA/C. Similarly, higher AC/As (PD/D) and lower CA/Cs (D/PD) were associated with larger IPDs and less hyperopia. Although, not statistically significant the absence of proximity resulted in a trend

  10. Early Pleistocene climate in western arid central Asia inferred from loess-palaeosol sequences

    PubMed Central

    Wang, Xin; Wei, Haitao; Taheri, Mehdi; Khormali, Farhad; Danukalova, Guzel; Chen, Fahu

    2016-01-01

    Arid central Asia (ACA) is one of the most arid regions in the mid-latitudes and one of the main potential dust sources for the northern hemisphere. The lack of in situ early Pleistocene loess/dust records from ACA hinders our comprehensive understanding of the spatio-temporal record of aeolian loess accumulation and long term climatic changes in Asia as a whole. Here, we report the results of sedimentological, chronological and climatic studies of early Pleistocene loess-palaeosol sequences (LPS) from the northeastern Iranian Golestan Province (NIGP) in the western part of ACA. Our results reveal that: 1) Accumulation of loess on the NIGP commenced at ~2.4–1.8 Ma, making it the oldest loess known so far in western ACA; 2) the climate during the early Pleistocene in the NIGP was semi-arid, but wetter, warmer, and less windy than during the late Pleistocene and present interglacial; 3) orbital-scale palaeoclimatic changes in ACA during the early Pleistoceneare in-phase with those of monsoonal Asia, a relationship which was probably related to the growth and decay of northern hemisphere ice sheets. PMID:26839045

  11. Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature

    PubMed Central

    Meguins, Lucas C.; Hidalgo, Raquel C. T.; Spotti, Antônio R.; de Morais, Dionei F.

    2017-01-01

    Background: The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine meningioma. Case Description: A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache. Computed tomography (CT) revealed an intracerebral hematoma and an expansive calcified lesion. AngioCT showed the presence of a large aneurysm in the distal portion of the azygos ACA. During the surgical procedure, it was possible to visualize the aneurysm in contact with an expansive lesion arising from the anterior third of the falx. Microsurgical clipping of the aneurysm was performed uneventfully and partial resection of the tumor was done. Histopathological analysis showed a fibrous meningioma. The patient was discharged home on the seventh postoperative day in good clinical conditions. Conclusion: The association of aneurysm from azygos ACA and falcine meningioma is an extremely rare event and must be remembered when expansive masses are present in the vicinity of vascular lesions. PMID:28303205

  12. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

    PubMed

    Williams, John C

    2015-01-01

    The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.

  13. Structural Characterization of a Human-Type Corrinoid Adenosyltransferase Confirms That Coenzyme B[subscript 12] Is Synthesized through a Four-Coordinate Intermediate

    SciTech Connect

    St. Maurice, Martin; Mera, Paola; Park, Kiyoung; Brunold, Thomas C.; Escalante-Semerena, Jorge C.; Rayment, Ivan

    2008-11-18

    ATP:cob(I)alamin adenosyltransferases (ACAs) catalyze the transfer of the 5{prime}-deoxyadenosyl moiety from ATP to the upper axial ligand position of cobalamin in the synthesis of coenzyme B{sub 12}. For the ACA-catalyzed reaction to proceed, cob(II)alamin must be reduced to cob(I)alamin in the enzyme active site. This reduction is facilitated through the generation of a four-coordinate cob(II)alamin intermediate on the enzyme. We have determined the high-resolution crystal structure of a human-type ACA from Lactobacillus reuteri with a four-coordinate cob(II)alamin bound in the enzyme active site and with the product, adenosylcobalamin, partially occupied in the active site. The assembled structures represent snapshots of the steps in the ACA-catalyzed formation of the cobalt-carbon bond of coenzyme B{sub 12}. The structures define the corrinoid binding site and provide visual evidence for a base-off, four-coordinate cob(II)alamin intermediate. The complete structural description of ACA-mediated catalysis reveals the molecular features of four-coordinate cob(II)alamin stabilization and provides additional insights into the molecular basis for dysfunction in human patients suffering from methylmalonic aciduria.

  14. Novel route to chaetomellic acid A and analogues: serendipitous discovery of a more competent FTase inhibitor

    PubMed Central

    Bellesia, Franco; Choi, Seoung-ryoung; Felluga, Fulvia; Fiscaletti, Giuliano; Ghelfi, Franco; Menziani, Maria Cristina; Parsons, Andrew F.; Poulter, C. Dale; Roncaglia, Fabrizio; Sabbatini, Massimo; Spinelli, Domenico

    2013-01-01

    A new practical route to chaetomellic acid A (ACA), based on the copper catalysed radical cyclization (RC) of (Z)-3-(2,2-dichloropropanoyl)-2-pentadecylidene-1,3-thiazinane, is described. Remarkably, the process entailed: i) a one-pot preparation of the intermediate N-α-perchloroacyl-2-(Z)-alkyliden-1,3-thiazinanes starting from N-(3-hydroxypropyl)palmitamide, ii) a two step smooth transformation of the RC products into ACA and iii) only one intermediate chromatographic purification step. The method offers a versatile approach to the preparation of ACA analogues, through the synthesis of an intermediate maleic anhydride with a vinylic group at the end of the aliphatic tail, a function that can be transformed through a thiol-ene coupling. Serendipitously, the disodium salt of 2-(9-(butylthio)nonyl)-3-methylmaleic acid, that we prepared as a representative sulfurated ACA analogue, was a more competent FTase inhibitor than ACA. This behaviour was analysed by a molecular docking study. PMID:23182215

  15. Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery

    PubMed Central

    Martinez Moreno, R; Ganslandt, O; Bäzner, H; Henkes, H; Perez, M Aguilar

    2017-01-01

    Background Few publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA). Objective To determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA. Methods We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016. The aneurysm fundus size, neck size, number and type of flow-diverting stent (FDS), complications, and follow-up data were recorded. Results In total 26 patients, with 27 aneurysms were identified that matched our inclusion criteria (11 male and 15 female). The average age of the patients was 59.3 years (range 27–77 years). All patients, except one, had a single aneurysm affecting the ACA. Fourteen aneurysms were located on the left (51.9%). The average aneurysm fundus size was 2.9 mm (range 2–6 mm). Twenty patients had follow-up angiographic studies. In total, 16 aneurysms were completely excluded, 1 aneurysm showed a very small remnant, and no follow-up angiographic data are available for the remaining patients. One patient had a treatment-related complication. Conclusions Treatment of aneurysms arising from the ACA with flow diverters is technically feasible and carries a high degree of success with low complication rate. PMID:27789789

  16. A selective chromogenic agar that distinguishes Bacillus anthracis from Bacillus cereus and Bacillus thuringiensis.

    PubMed

    Juergensmeyer, Margaret A; Gingras, Bruce A; Restaino, Lawrence; Frampton, Elon W

    2006-08-01

    A selective and differential plating medium, R & F anthracis chromogenic agar (ACA), has been developed for isolating and identifying presumptive colonies of Bacillus anthracis. ACA contains the chromogenic substrate 5-bromo-4-chloro-3-indoxyl-choline phosphate that upon hydrolysis yields teal (blue green) colonies indicating the presence of phosphatidylcholine-specific phospholipase C (PC-PLC) activity. Among seven Bacillus species tested on ACA, only members of the Bacillus cereus group (B. anthracis, B. cereus, and B. thuringiensis) produced teal colonies (PC-PLC positive) having cream rings. Examination of colony morphology in 18 pure culture strains of B. anthracis (15 ATCC strains plus AMES-1-RIID, ANR-1, and AMED-RIID), with one exception, required 48 h at 35 to 37 degrees C for significant color production, whereas only 24 h was required for B. cereus and B. thuringiensis. This differential rate of PC-PLC synthesis in B. anthracis (due to the truncated plcR gene and PlcR regulator in B. anthracis) allowed for the rapid differentiation on ACA of presumptive colonies of B. anthracis from B. cereus and B. thuringiensis in both pure and mixed cultures. Effective recovery of B. anthracis from a variety of matrices having both high (soil and sewage) and low microbial backgrounds (cloth, paper, and blood) spiked with B. anthracis ANR-1 spores suggests the probable utility of ACA plating for B. anthracis recovery in a diversity of applications.

  17. The olfactory system of migratory adult sea lamprey (Petromyzon marinus) is specifically and acutely sensitive to unique bile acids released by conspecific larvae

    PubMed Central

    1995-01-01

    Larval sea lamprey inhabit freshwater streams and migrate to oceans or lakes to feed after a radical metamorphosis; subsequently, mature adults return to streams to spawn. Previous observations suggested that lamprey utilize the odor of conspecific larvae to select streams for spawning. Here we report biochemical and electrophysiological evidence that this odor is comprised of two unique bile acids released by larvae. High performance liquid chromatography and mass spectrometry demonstrated that larval sea lamprey produce and release two unique bile acids, allocholic acid (ACA) and petromyzonol sulfate (PS). Electro-olfactogram (EOG) recording also demonstrated that the olfactory system of migratory adult sea lamprey is acutely and specifically sensitive to ACA and PS; detection thresholds for these compounds were approximately 10(-12) M. ACA and PS were the most potent of 38 bile acids tested and cross-adaptation experiments suggested that adult sea lamprey have specific olfactory receptor sites associated with independent signal transduction pathways for these bile acids. These receptor sites specifically recognize the key substituents of ACA and PS such as a 5 alpha-hydrogen, three axial hydroxyls, and a C-24 sulfate ester or carboxyl. In conclusion, the unique lamprey bile acids, ACA and PS, are potent and specific stimulants of the adult olfactory system, strongly supporting the hypothesis that these unique bile acids function as migratory pheromones in lamprey. PMID:7658193

  18. Removal of chemical oxygen demand from landfill leachate using cow-dung ash as a low-cost adsorbent.

    PubMed

    Kaur, Kamalpreet; Mor, Suman; Ravindra, Khaiwal

    2016-05-01

    The application of cow dung ash was assessed for the removal of organic contamination from the wastewater using landfill leachate of known Chemical Oxygen Demand (COD) concentration in batch mode. The effect of various parameters like adsorbents dose, time, pH and temperature was investigated. Results indicate that upto 79% removal of COD could be achieved using activated cow dung ash (ACA) at optimum temperature of 30 °C at pH 6.0 using 20 g/L dose in 120 min, whereas cow dung ash (CA) shows 66% removal at pH 8.0 using 20 g/L dose, also in 120 min. Data also shows that ACA exhibited 11-13% better removal efficiency than CA. COD removal efficiency of various adsorbents was also compared and it was found that ACA offers significantly higher efficiency. Freundlich and Langmuir adsorption isotherms were also applied, which depicts good correlations (0.921 and 0.976) with the experimental data. Scanning electron microscope (SEM) images shows that after the activation, carbon particles disintegrate and surface of particles become more rough and porous, indicating the reason for high adsorption efficiency of ACA. Hence, ACA offers a cost-effective solution for the removal of organic contaminants from the wastewater and for the direct treatment of landfill leachate.

  19. Plant and animal type 2B Ca2+-ATPases: evidence for a common auto-inhibitory mechanism.

    PubMed

    Bonza, Maria Cristina; Luoni, Laura

    2010-12-01

    Plant auto-inhibited Ca(2+)-ATPase 8 (ACA8) and animal plasma membrane Ca(2+)-ATPase 4b (PMCA4b) are representatives of plant and animal 2B P-type ATPases with a regulatory auto-inhibitory domain localized at the N- and C-terminus, respectively. To check whether the regulatory domain works independently of its terminal localization and if auto-inhibitory domains of different organisms are interchangeable, a mutant in which the N-terminus of ACA8 is repositioned at the C-terminus and chimeras in which PMCA4b C-terminus is fused to the N- or C-terminus of ACA8 were analysed in the yeast mutant K616 devoid of endogenous Ca(2+)-ATPases. Results show that the regulatory function of the terminal domain is independent from its position in ACA8 and that the regulatory domain belonging to PMCA4b is able to at least partially auto-inhibit ACA8.

  20. Early Pleistocene climate in western arid central Asia inferred from loess-palaeosol sequences.

    PubMed

    Wang, Xin; Wei, Haitao; Taheri, Mehdi; Khormali, Farhad; Danukalova, Guzel; Chen, Fahu

    2016-02-03

    Arid central Asia (ACA) is one of the most arid regions in the mid-latitudes and one of the main potential dust sources for the northern hemisphere. The lack of in situ early Pleistocene loess/dust records from ACA hinders our comprehensive understanding of the spatio-temporal record of aeolian loess accumulation and long term climatic changes in Asia as a whole. Here, we report the results of sedimentological, chronological and climatic studies of early Pleistocene loess-palaeosol sequences (LPS) from the northeastern Iranian Golestan Province (NIGP) in the western part of ACA. Our results reveal that: 1) Accumulation of loess on the NIGP commenced at ~2.4-1.8 Ma, making it the oldest loess known so far in western ACA; 2) the climate during the early Pleistocene in the NIGP was semi-arid, but wetter, warmer, and less windy than during the late Pleistocene and present interglacial; 3) orbital-scale palaeoclimatic changes in ACA during the early Pleistoceneare in-phase with those of monsoonal Asia, a relationship which was probably related to the growth and decay of northern hemisphere ice sheets.

  1. Challenges facing the United States of America in implementing universal coverage.

    PubMed

    Rice, Thomas; Unruh, Lynn Y; Rosenau, Pauline; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2014-12-01

    In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features--health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies--remain works in progress. The ACA did not introduce the stringent spending controls found in many European health systems. It also explicitly prohibits the creation of institutes--for the assessment of the cost-effectiveness of pharmaceuticals, health services and technologies--comparable to the National Institute for Health and Care Excellence in the United Kingdom of Great Britain and Northern Ireland, the Haute Autorité de Santé in France or the Pharmaceutical Benefits Advisory Committee in Australia. The ACA was--and remains--weakened by a lack of cross-party political consensus. The ACA's performance and its resulting acceptability to the general public will be critical to the Act's future.

  2. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.

    PubMed

    Quadagno, Jill

    2014-02-01

    On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible.

  3. The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

    PubMed

    Hernandez-Boussard, Tina; Burns, Carson S; Wang, N Ewen; Baker, Laurence C; Goldstein, Benjamin A

    2014-09-01

    The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009-11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19-25 before and after the ACA provision was implemented with changes in the same period for people ages 26-31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group--a relative change of -2.1 percent. The largest relative decreases were found in women (-3.0 percent) and blacks (-3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19-25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (-0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.

  4. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Connecticut, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011-2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).

  5. Surgical flow modification of the anterior cerebral artery-anterior communicating artery complex in the management of giant aneurysms of internal carotid artery bifurcation: An alternative for a difficult clip reconstruction

    PubMed Central

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Beer-Furlan, André Luiz; Rotta, José Marcus

    2016-01-01

    Background: Internal carotid artery bifurcation (ICAb) aneurysms account for about 2–15% of all intracranial aneurysms. In giant and complex cases, treatment may be difficult and dangerous, once some aneurysms have wide neck and anterior cerebral artery (ACA) and middle cerebral artery (MCA) may arise from the aneurysm itself. Clip reconstruction may be difficult in such cases. Whenever possible, the occlusion of ACA transform the bifurcation in a single artery reconstruction (ICA to MCA), much easier than a bifurcation reconstruction. Methods: In patients with giant and complex ICAb aneurysms, we propose routine preoperative angiography with anatomical evaluation of anterior communicating artery (ACoA) patency during cervical common carotid compression with concomitant contralateral carotid artery injection. This allowed visualization of the expected reversal of flow in the A1 segment–ACoA complex. When test is positive, we can perform ipsilateral ACA (A1 segment) clip occlusion and flow modification of the ACA-ACoA complex transforming a three vessel (ICA, ACA, and MCA) reconstruction into a two vessel (ICA and MCA) reconstruction. Results: Two patients were treated, with 100% of occlusion and good outcome. Conclusions: Surgical treatment of giant and complex ICAb may be achieved with acceptable morbidity. PMID:27313968

  6. Cloning and characterization of the genes for two distinct cephalosporin acylases from a Pseudomonas strain.

    PubMed Central

    Matsuda, A; Matsuyama, K; Yamamoto, K; Ichikawa, S; Komatsu, K

    1987-01-01

    Pseudomonas sp. strain SE83 converts cephalosporin C and 7 beta-(4-carboxybutanamido)cephalosporanic acid (GL-7ACA) to 7-aminocephalosporanic acid (7ACA). A DNA library of this strain was constructed in Escherichia coli and screened for the ability to deacylate GL-7ACA to 7ACA. Apparently, two distinct genes, designated acyI and acyII, were cloned on 4.8- and 6.0-kilobase-pair BglII fragments, respectively. The enzymes encoded by the two genes showed different substrate specificities, and the acyII-encoded enzyme was found to yield 7ACA from cephalosporin C by direct deacylation. Expression of the two genes in E. coli was strongly dependent on a promoter of the vector. The coding regions for acyI and acyII were localized on the 2.5- and 2.8-kilobase-pair fragments, respectively, by subcloning experiments, and high expression of both genes was obtained by placing them under the control of the lacUV5 promoter. The acyII-encoded enzyme was purified and shown to be composed of two nonidentical subunits with molecular weights of 26,000 and 57,000. Maxicell analysis revealed three acyII-specific polypeptides, two of which corresponded to the above subunits. The third polypeptide with a molecular weight of 83,000 was suggested to be the precursor of both subunits. Images PMID:2824449

  7. The PI3K-mediated activation of CRAC independently regulates adenylyl cyclase activation and chemotaxis.

    PubMed

    Comer, Frank I; Lippincott, Christopher K; Masbad, Joseph J; Parent, Carole A

    2005-01-26

    The ability of a cell to detect an external chemical signal and initiate a program of directed migration along a gradient comprises the fundamental process called chemotaxis. Investigations in Dictyostelium discoideum and neutrophils have established that pleckstrin homology (PH) domain-containing proteins that bind to the PI3K products PI(3,4)P2 and PI(3,4,5)P3, such as CRAC (cytosolic regulator of adenylyl cyclase) and Akt/PKB, translocate specifically to the leading edge of chemotaxing cells. CRAC is essential for the chemoattractant-mediated activation of the adenylyl cyclase ACA, which converts ATP into cAMP, the primary chemoattractant for D. discoideum. The mechanisms by which CRAC activates ACA remain to be determined. We now show that in addition to its essential role in the activation of ACA, CRAC is involved in regulating chemotaxis. Through mutagenesis, we show that these two functions are independently regulated downstream of PI3K. A CRAC mutant that has lost the capacity to bind PI3K products does not support chemotaxis and shows minimal ACA activation. Finally, overexpression of CRAC and various CRAC mutants show strong effects on ACA activation with little effect on chemotaxis. These findings establish that chemoattractant-mediated activation of PI3K is important for the CRAC-dependent regulation of both chemotaxis and adenylyl cyclase activation.

  8. Anticardiolipin antibodies in HIV infection: association with cerebral perfusion defects as detected by 99mTc-HMPAO SPECT.

    PubMed Central

    Rubbert, A; Bock, E; Schwab, J; Marienhagen, J; Nüsslein, H; Wolf, F; Kalden, J R

    1994-01-01

    Anticardiolipin antibodies (ACA) belong to a heterogeneous group of antibodies directed against negatively charged phospholipids. In patients with rheumatic disorders, their presence has been correlated to the occurrence of thromboembolic complications, thrombocytopenia, abortions and other disease manifestations. Several studies have revealed the detection of mostly high-titre ACA in a significant proportion of HIV-infected patients without any known clinical relationship. In our study, ACA were detected in 17/34 HIV-infected patients, and their presence was significantly associated with the detection of cerebral perfusion abnormalities by 99mTc-HMPAO SPECT. SPECT scans were classified as normal or as focal or diffuse defects in uptake. Most patients (13/16) with cerebral perfusion defects had elevated ACA titres in contrast to 4/18 patients with normal SPECT findings (P = 0.002). Focal uptake defects were always associated with the presence of ACA. No correlation to clinical features or other laboratory parameters was evident. Our results suggest a possible implication of autoimmune mechanisms in the pathogenesis of cerebral perfusion abnormalities detected by SPECT scanning in HIV-infected patients. However, further studies are needed to evaluate the clinical significance and to develop possible therapeutic consequences. Images Fig. 1 Fig. 2 Fig. 3 PMID:7994900

  9. Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

    PubMed

    Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

    2017-04-01

    The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets.

  10. Rural Medicare Advantage Plan Payment in 2015.

    PubMed

    Kemper, Leah; Barker, Abigail R; McBride, Timothy D; Mueller, Keith

    2015-12-01

    Payment to Medicare Advantage (MA) plans was fundamentally altered in the Patient Protection and Affordable Care Act of 2010 (ACA). MA plans now operate under a new formula for county-level payment area benchmarks, and in 2012 began receiving quality-based bonus payments. The Medicare Advantage Quality Bonus Payment Demonstration expanded the bonus payments to most MA plans through 2014; however, with the end of the demonstration bonus payments has been reduced for intermediate quality MA plans. This brief examines the impact that these changes in MA baseline payment are having on MA plans and beneficiaries in rural and urban areas. Key Data Findings. (1) Payments to plans in rural areas were 3.9 percent smaller under ACA payment policies in 2015 than they would have been in the absence of the ACA. For plans in urban areas, the payments were 8.8 percent smaller than they would have been. These figures were determined using hypothetical pre-ACA and actual ACA-mandated benchmarks for 2015. (2) MA plans in rural areas received an average annual bonus payment of $326.77 per enrollee in 2014, but only $63.76 per enrollee in 2015, with the conclusion of the demonstration. (3) In 2014, 92 percent of rural MA beneficiaries were in a plan that received quality-based bonus payments under the demonstration, while in March 2015, 56 percent of rural MA beneficiaries were in a plan that was eligible for quality-based bonus payments.

  11. Necessary health care and basic needs: health insurance plans and essential benefits.

    PubMed

    Ward, Andrew; Johnson, Pamela Jo

    2013-12-01

    According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which "all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs". This does not mean that everyone will have whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an "essential health benefits package". However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA's requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of "essential benefits", arguing that the "essential health benefits package" in the ACA should be one that optimally satisfies the basic needs of the people covered.

  12. Expanding dependent coverage for young adults: lessons from state initiatives.

    PubMed

    Cantor, Joel C; Belloff, Dina; Monheit, Alan C; Delia, Derek; Koller, Margaret

    2012-02-01

    The Patient Protection and Affordable Care Act (ACA) requires that adults up to age twenty-six be permitted to enroll as dependents on their parents' health plans. This article examines the experiences of states that enacted dependent expansion laws. Drawing on public information from thirty-one enacting states and case studies of four diverse reform states, it derives lessons that are pertinent to the implementation of this ACA provision. Dependent coverage laws vary across the states, but most impose residency, marital status, and other restrictions. The federal Employee Retirement Income Security Act further limits the reach of state laws. Eligibility for expanded coverage under the ACA is much broader. Rules in some states requiring or allowing separate premiums for adult dependents may also discourage enrollment compared with rules in other states (and the ACA), where these costs must be factored into family premiums. Business opposition in some states led to more restrictive regulations, especially for how premiums are charged, which in turn raised greater implementation challenges. Case study states did not report substantial young adult dependent coverage take-up, but early enrollment experience under ACA appears to be more positive. Long-term questions remain about the implications of this policy for risk pooling and the distribution of premium costs.

  13. Folding and unfolding of helix-turn-helix motifs in the gas phase.

    PubMed

    Zilch, Lloyd W; Kaleta, David T; Kohtani, Motoya; Krishnan, Ranjani; Jarrold, Martin F

    2007-07-01

    Ion mobility measurements and molecular dynamic simulations have been performed for a series of peptides designed to have helix-turn-helix motifs. For peptides with two helical sections linked by a short loop region: AcA(14)KG(3)A(14)K+2H(+), AcA(14)KG(5)A(14)K+2H(+), AcA(14)KG(7)A(14)K+2H(+), and AcA(14)KSar(3)A(14)K+2H(+) (Ac = acetyl, A = alanine, G = glycine, Sar = sarcosine and K = lysine); a coiled-coil geometry with two anti-parallel helices is the lowest energy conformation. The helices uncouple and the coiled-coil unfolds as the temperature is raised. Equilibrium constants determined as a function of temperature yield enthalpy and entropy changes for the unfolding of the coiled-coil. The enthalpy and entropy changes depend on the length and nature of the loop region. For a peptide with three helical sections: protonated AcA(14)KG(3)A(14)KG(3)A(14)K; a coiled-coil bundle with three helices side-by-side is substantially less stable than a geometry with two helices in an antiparallel coiled-coil and the third helix collinear with one of the other two.

  14. Cloning and nucleotide sequencing of a novel 7 beta-(4-carboxybutanamido)cephalosporanic acid acylase gene of Bacillus laterosporus and its expression in Escherichia coli and Bacillus subtilis.

    PubMed

    Aramori, I; Fukagawa, M; Tsumura, M; Iwami, M; Ono, H; Kojo, H; Kohsaka, M; Ueda, Y; Imanaka, H

    1991-12-01

    A strain of Bacillus species which produced an enzyme named glutaryl 7-ACA acylase which converts 7 beta-(4-carboxybutanamido)cephalosporanic acid (glutaryl 7-ACA) to 7-amino cephalosporanic acid (7-ACA) was isolated from soil. The gene for the glutaryl 7-ACA acylase was cloned with pHSG298 in Escherichia coli JM109, and the nucleotide sequence was determined by the M13 dideoxy chain termination method. The DNA sequence revealed only one large open reading frame composed of 1,902 bp corresponding to 634 amino acid residues. The deduced amino acid sequence contained a potential signal sequence in its amino-terminal region. Expression of the gene for glutaryl 7-ACA acylase was performed in both E. coli and Bacillus subtilis. The enzyme preparations purified from either recombinant strain of E. coli or B. subtilis were shown to be identical with each other as regards the profile of sodium dodecyl sulfate-polyacrylamide gel electrophoresis and were composed of a single peptide with the molecular size of 70 kDa. Determination of the amino-terminal sequence of the two enzyme preparations revealed that both amino-terminal sequences (the first nine amino acids) were identical and completely coincided with residues 28 to 36 of the open reading frame. Extracellular excretion of the enzyme was observed in a recombinant strain of B. subtilis.

  15. Cloning and nucleotide sequencing of a novel 7 beta-(4-carboxybutanamido)cephalosporanic acid acylase gene of Bacillus laterosporus and its expression in Escherichia coli and Bacillus subtilis.

    PubMed Central

    Aramori, I; Fukagawa, M; Tsumura, M; Iwami, M; Ono, H; Kojo, H; Kohsaka, M; Ueda, Y; Imanaka, H

    1991-01-01

    A strain of Bacillus species which produced an enzyme named glutaryl 7-ACA acylase which converts 7 beta-(4-carboxybutanamido)cephalosporanic acid (glutaryl 7-ACA) to 7-amino cephalosporanic acid (7-ACA) was isolated from soil. The gene for the glutaryl 7-ACA acylase was cloned with pHSG298 in Escherichia coli JM109, and the nucleotide sequence was determined by the M13 dideoxy chain termination method. The DNA sequence revealed only one large open reading frame composed of 1,902 bp corresponding to 634 amino acid residues. The deduced amino acid sequence contained a potential signal sequence in its amino-terminal region. Expression of the gene for glutaryl 7-ACA acylase was performed in both E. coli and Bacillus subtilis. The enzyme preparations purified from either recombinant strain of E. coli or B. subtilis were shown to be identical with each other as regards the profile of sodium dodecyl sulfate-polyacrylamide gel electrophoresis and were composed of a single peptide with the molecular size of 70 kDa. Determination of the amino-terminal sequence of the two enzyme preparations revealed that both amino-terminal sequences (the first nine amino acids) were identical and completely coincided with residues 28 to 36 of the open reading frame. Extracellular excretion of the enzyme was observed in a recombinant strain of B. subtilis. Images FIG. 2 FIG. 5 FIG. 6 PMID:1744041

  16. A look behind the arms control agenda at the US-Russian and Sino-US summits

    SciTech Connect

    1995-11-01

    When President Bill Clinton met in New York with Russian President Boris Yeltsin on October 23 and Chinese President Jiang Zemin the following day, the leaders discussed a broad spectrum of arms control issues-including START II ratification, limits on Russian conventional weapons in the Caucasus, the nuclear test ban treaty, nuclear exports to Iran and NATO expansion. The crisis in Bosnia, however, dominated the administration`s pre- and post-summit briefings as well as the media`s coverage of the meetings. On October 20, the Arms Control Association (ACA) held a news conference to highlight the key arms control issues involved in the two sets of talks. Because these vital national security issues were virtually ignored by the press, the ACA press briefing remains the most comprehensive coverage of the full range of issues that were, in fact, addressed at the mini-summits. Panel speakers included Spurgeon M. Keeny, Jr., ACA president and executive director and former deputy director of the Arms Control and Disarmament Agency; Jack Mendelsohn, ACA deputy director and a former member of the US SALT II and START I delegations; Stanley Resor, ACA board chairman and former chief US delegate to the Mutual and Balanced Force Reduction talks, former defense undersecretary for policy and former secretary of the Army; and William Dircks, director of the Atlantic Council`s Program on Nuclear Policy and former deputy director general of the International Atomic Energy Agency. Extended excerpts from their remarks follow.

  17. Implementing the Affordable Care Act in North Carolina: the rubber hits the road.

    PubMed

    Silberman, Pam

    2013-01-01

    The health insurance mandate, perhaps the best-known provision of the Patient Protection and Affordable Care Act of 2010 (ACA), is slated to go into effect on January 1, 2014. Yet most people do not know how the ACA will affect them. More than one-third of people in a recent national poll were unaware that new health insurance marketplaces will make it easier to purchase coverage or that some people will qualify for subsidies to help them purchase coverage. The ACA includes many other provisions that will have a profound impact on our health care delivery system. Some changes are already helping to break down silos in the delivery of care. Groups of health care professionals are working together to manage the health of populations. The ACA places a much greater emphasis on measuring quality and on paying health professionals and health care institutions based on the value of the services they provide. In addition, the ACA makes greater investments in prevention and in population health management. This issue brief highlights some of the health system changes that have taken place over the past 3 years, as well as some of the potential changes that are yet to come relating to insurance coverage, access to care, quality of care, rising health care costs, and overall population health.

  18. Is the swiss health care system a model for the United States?

    PubMed

    Chaufan, Claudia

    2014-01-01

    Both supporters and critics of the Patient Protection and Affordable Care Act (ACA) have argued that it is similar to Switzerland's Federal Law on Health Insurance (LAMal), which currently governs Swiss health care, and have either praised or condemned the ACA on the basis of this alleged similarity. I challenge these observers on the grounds that they overlook critical problems with the Swiss model, such as its inequities in access, and critical differences between it and the ACA, such as the roots in, and continuing commitment to, social insurance of the Swiss model. Indeed, the daunting challenge of attempting to impose the tightly regulated model of operation of the Swiss model on mega-corporations like UnitedHealth, WellPoint, or Aetna is likely to trigger no less ferocious resistance than a fully public, single-payer system would. I also conclude that the ACA might unravel in ways unintended or even opposed by its designers and supporters, as employers, confronted with ever-rising costs, retreat from sponsoring insurance, and workers react in outrage as they confront the unaffordable underinsurance mandated by the ACA. A new political and ideological landscape may then ensue that finally ushers in a truly national health program.

  19. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

    PubMed Central

    Corman, Juliane; Levin, David

    2016-01-01

    Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309

  20. A case of anterior cerebral artery dissection caused by scuba diving.

    PubMed

    Fukuoka, Takuya; Kato, Yuji; Ohe, Yasuko; Deguchi, Ichiro; Maruyama, Hajime; Hayashi, Takeshi; Tanahashi, Norio

    2014-08-01

    A 51-year-old man was admitted with right hemiparesis during scuba diving, without headache. Brain magnetic resonance (MR) imaging depicted high-intensity areas in the left superior frontal and cingulate gyri on diffusion-weighted imaging. Dissection of the anterior cerebral artery (ACA) was detected using axial MR angiography and 3-dimensional MR cisternography. Dissection of the ACA during and after scuba diving has not been reported before. Dissection of the arteries should be included in the differential diagnosis when neurologic symptoms occur both during and after scuba diving, even if the patient does not experience headache. Furthermore, the combination of MR cisternography and MR angiography is useful to detect ACA dissection.

  1. D-amino acid oxidase: its potential in the production of 7-aminocephalosporanic acid.

    PubMed

    Mujawar, S K

    1999-01-01

    D-Amino acid oxidase (DAAO) used in the preparation of alpha-keto acids, in the determination of D-amino acids and in the resolution of racemic mixture of amino acids is produced by a wide range of microorganisms. In the recent past this enzyme is being recognized for its potential in the commercial production of 7-aminocephalosporanic acid (7-ACA), a starting material for various semisynthetic cephalosporins. Though this enzyme is widespread among microorganisms, very few microbial species have been explored for the production of 7-ACA; this is because cephalosporin C is quantitatively deaminated by limited microbial DAAOs. Comparison of physico-chemical properties of enzyme preparations indicate wide variations, however in general DAAOs are specific for D-configuration of amino acids. Both immobilized enzyme and cell preparations are developed for its various applications. The advantages of DAAO in the production of 7-ACA are discussed.

  2. Automatic anterior chamber angle structure segmentation in AS-OCT image based on label transfer.

    PubMed

    Huazhu Fu; Yanwu Xu; Wong, Damon Wing Kee; Jiang Liu; Baskaran, Mani; Perera, Shamira A; Tin Aung

    2016-08-01

    The anterior chamber angle (ACA) plays an important role for diagnosis and treatment of angle-closure glaucoma. Anterior Segment Optical Coherence Tomography (AS-OCT) imaging is qualitative and quantitative assessment for the ACA structure. In this paper, we propose a novel fully automatic segmentation method for anterior chamber angle structure in AS-OCT. In our method, the initial labels are obtained by using label transfer from the AS-OCT reference dataset. Then, these labels are refined and utilized as the landmarks to support the structure segmentation. Finally, the major clinical structures: corneal boundary, iris region, and trabecular-iris contact, are extracted as the segmentation result. Experiments show that our proposed method achieve the satisfactory segmentation performance on the clinical AS-OCT dataset. Our proposed method has potential in the applications of clinical ACA parameter measurement and automatic glaucoma classification.

  3. The Affordable Care Act's payment and delivery system reforms: a progress report at five years.

    PubMed

    Abrams, Melinda; Nuzum, Rachel; Zezza, Mark; Ryan, Jamie; Kiszla, Jordan; Guterman, Stuart

    2015-05-01

    In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars.

  4. Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

    PubMed

    Zhang, Shuang Qin; Polite, Blase N

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

  5. The Affordable Care Act: the ethical call for value-based leadership to transform quality.

    PubMed

    Piper, Llewellyn E

    2013-01-01

    Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.

  6. Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

    PubMed

    Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

    2013-10-01

    The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment.

  7. Persistent primitive olfactory artery connected with middle cerebral artery: case report.

    PubMed

    Kim, Myoung Soo

    2013-11-01

    A persistent primitive olfactory artery (PPOA) is an extremely rare variation of the proximal anterior cerebral artery (ACA). The PPOA is connected to the distal ACA, ethmoidal artery, or both. I describe one patient with a PPOA connected to the middle cerebral artery (MCA). I analyzed the radiological characteristics of this anomalous vessel in this patient, who presented with headache. Computed tomography-angiography revealed an abnormal vessel in the patient, which originated from the distal ACA and ran anteromedially along the olfactory tract; it then made an abrupt turn and became the MCA. A PPOA connected to the MCA has been described in only two patients, including my own, in the English-language literature.

  8. Experimental aluminum pathology in rabbits: effects of hydrophilic and lipophilic compounds.

    PubMed Central

    Bombi, G G; Corain, B; Favarato, M; Giordano, R; Nicolini, M; Perazzolo, M; Tapparo, A; Zatta, P

    1990-01-01

    Aluminum lactate [Al(lact)3] (hydrophilic, hydrolytically unstable) and aluminum acetylacetonate [Al(acae)3] (lipophilic, hydrolytically stable) were tested as potential toxicants to rabbits upon IV administration both as aqueous solutions and as liposome suspensions. Both chemicals behaved as cardiotoxic agents when administered as aqueous solutions, but Al(acae)3 was at least two orders of magnitude more active than Al(lact)3. Al(acae)3, but not Al(lact)3, caused myocardial infarcts resembling those in humans (with contraction bands) at doses as low as 0.24 mg/kg body weight, as well as a prominent acanthocytosis. Al(lact)3, when administered as a liposome suspension, was about 300 times more toxic than in aqueous solution, although cardiac damage was not infarctual in character. Both chemical and physical speciation of aluminum(III) thus play an essential role in determining the toxicity of the metal. Images FIGURE 2. FIGURE 3. PMID:2088750

  9. Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act

    PubMed Central

    Collins, Lydia N.

    2015-01-01

    This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn’t know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA. PMID:25798077

  10. Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act.

    PubMed

    Collins, Lydia N

    This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn't know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA.

  11. Why a national high-risk insurance pool is not a workable alternative to the marketplace.

    PubMed

    Hall, Jean P

    2014-12-01

    The Pre-Existing Condition Insurance Plan (PCIP) was a national high-risk pool established under the Affordable Care Act (ACA) to provide coverage for individuals with preexisting conditions who had been uninsured for at least six months. It was intended to be a temporary program: PCIPs opened in 2010 and closed in April 2014. At that point, those with preexisting conditions could shop for health insurance in the marketplaces, where plans are prevented from using applicants' health status to deny coverage or charge more. This issue brief draws on the PCIP experience to outline why national high-risk pools, which continue to be proposed as policy alternatives to ACA coverage expansions, are expensive to enrollees as well as their administrators and ultimately unsustainable. The key lesson--and the principle on which the ACA is built--is that insurance works best when risk is evenly spread across a broad population.

  12. Ionic changes during experimentally induced seizure activity.

    PubMed

    Lux, H D; Heinemann, U

    1978-01-01

    Changes in intra- and extracellular ionic activity and their relation to generation and termination of seizure phenomena can be studied with the help of ion-selective microelectrodes. Transient changes in extracellular potassium activity (aK) of the cortex regularly accompany paroxysmal activity induced by electrical stimulation and pentylenetetrazol injections or occur within active penicillin and aluminum foci. A rise of aK from baseline levels of about 3 mmoles/l up to ceiling levels of 8--12 mmoles/l, followed by subnormal K activity, is typically found during seizure discharge. Extracellular K accumulation during seizures facilitates the spread into extrafocal regions. Ceiling levels of extracellular aK are characterized by pronounced K reabsorption which is probably a limiting mechanism for the rise in extracellular aK. It may be a consequence of a simultaneous rise in intracellular Na activity that an electrogenic Na--K exchange process is involved in the termination of ictal activity. Seizures are also accompanied by significant reductions in extracellular Ca2+ activity (aCa) to as low as 0.7 mmoles/l (resting aCa 1.25 mmoles/l). There is no critical level of lowered aCa at which a seizure ultimately results. However, unlike changes in aK reductions in aCa can precede ictal activity. Thus, a fall of aCa occurs before the onset of paroxysmal periods during cyclical spike driving in a penicillin focus and before seizures induced by pentylenetetrazol. Ca2+-dependent mechanisms may contribute to seizure generation. In addition to changes in aK and aCa, intracellular chloride activity (aCl) can increase during seizure activity, as a result of an impaired chloride extrusion mechanism, which would lead to a reduced efficacy of inhibitory synaptic transmission and, therefore, to facilitation of seizure generation.

  13. Multiple developmental roles for CRAC, a cytosolic regulator of adenylyl cyclase.

    PubMed

    Wang, B; Shaulsky, G; Kuspa, A

    1999-04-01

    Receptor-mediated activation of adenylyl cyclase (ACA) in Dictyostelium requires CRAC protein. Upon translocation to the membrane, this pleckstrin homology (PH) domain protein stimulates ACA and thereby mediates developmental aggregation. CRAC may also have roles later in development since CRAC-null cells can respond to chemotactic signals and participate in developmental aggregation when admixed with wild-type cells, but they do not complete development within such chimeras. To test whether the role of CRAC in postaggregative development is related to the activation of ACA, chemotactic aggregation was bypassed in CRAC-null cells by activating the cAMP-dependent protein kinase (PKA). While such strains formed mounds, they did not complete fruiting body morphogenesis or form spores. Expression of CRAC in the prespore cells of these strains rescued sporulation and fruiting body formation. This later function of CRAC does not appear to require its PH domain since the C-terminal portion of the protein (CRAC-DeltaPH) can substitute for full-length CRAC in promoting spore cell formation and morphogenesis. No detectable ACA activation was observed in any of the CRAC-null strains rescued by PKA activation and expression of CRAC-DeltaPH. Finally, we found that the development of CRAC-null ACA-null double mutants could be rescued by the activation of PKA together with the expression of CRAC-DeltaPH. Thus, there appears to be a required function for CRAC in postaggregative development that is independent of its previously described function in the ACA activation pathway.

  14. NOX2 amplifies acetaldehyde-mediated cardiomyocyte mitochondrial dysfunction in alcoholic cardiomyopathy

    PubMed Central

    Brandt, Moritz; Garlapati, Venkata; Oelze, Matthias; Sotiriou, Efthymios; Knorr, Maike; Kröller-Schön, Swenja; Kossmann, Sabine; Schönfelder, Tanja; Morawietz, Henning; Schulz, Eberhard; Schultheiss, Heinz-Peter; Daiber, Andreas; Münzel, Thomas; Wenzel, Philip

    2016-01-01

    Alcoholic cardiomyopathy (ACM) resulting from excess alcohol consumption is an important cause of heart failure (HF). Although it is assumed that the cardiotoxicity of the ethanol (EtOH)-metabolite acetaldehyde (ACA) is central for its development and progression, the exact mechanisms remain obscure. Murine cardiomyocytes (CMs) exposed to ACA or EtOH showed increased superoxide (O2•−) levels and decreased mitochondrial polarization, both being normalized by NADPH oxidase (NOX) inhibition. C57BL/6 mice and mice deficient for the ACA-degrading enzyme mitochondrial aldehyde dehydrogenase (ALDH-2−/−) were fed a 2% EtOH diet for 5 weeks creating an ACA-overload. 2% EtOH-fed ALDH-2−/− mice exhibited a decreased cardiac function, increased heart-to-body and lung-to-body weight ratios, increased cardiac levels of the lipid peroxidation product malondialdehyde (MDA) as well as increased NOX activity and NOX2/glycoprotein 91phox (NOX2/gp91phox) subunit expression compared to 2% EtOH-fed C57BL/6 mice. Echocardiography revealed that ALDH-2−/−/gp91phox−/− mice were protected from ACA-overload-induced HF after 5 weeks of 2% EtOH-diet, demonstrating that NOX2-derived O2•− contributes to the development of ACM. Translated to human pathophysiology, we found increased gp91phox expression in endomyocardial biopsies of ACM patients. In conclusion, ACM is promoted by ACA-driven mitochondrial dysfunction and can be improved by ablation of NOX2/gp91phox. NOX2/gp91phox therefore might be a potential pharmacological target to treat ACM. PMID:27624556

  15. The Master Activator of IncA/C Conjugative Plasmids Stimulates Genomic Islands and Multidrug Resistance Dissemination

    PubMed Central

    Luo, Peng; Rodrigue, Sébastien; Burrus, Vincent

    2014-01-01

    Dissemination of antibiotic resistance genes occurs mostly by conjugation, which mediates DNA transfer between cells in direct contact. Conjugative plasmids of the IncA/C incompatibility group have become a substantial threat due to their broad host-range, the extended spectrum of antimicrobial resistance they confer, their prevalence in enteric bacteria and their very efficient spread by conjugation. However, their biology remains largely unexplored. Using the IncA/C conjugative plasmid pVCR94ΔX as a prototype, we have investigated the regulatory circuitry that governs IncA/C plasmids dissemination and found that the transcriptional activator complex AcaCD is essential for the expression of plasmid transfer genes. Using chromatin immunoprecipitation coupled with exonuclease digestion (ChIP-exo) and RNA sequencing (RNA-seq) approaches, we have identified the sequences recognized by AcaCD and characterized the AcaCD regulon. Data mining using the DNA motif recognized by AcaCD revealed potential AcaCD-binding sites upstream of genes involved in the intracellular mobility functions (recombination directionality factor and mobilization genes) in two widespread classes of genomic islands (GIs) phylogenetically unrelated to IncA/C plasmids. The first class, SGI1, confers and propagates multidrug resistance in Salmonella enterica and Proteus mirabilis, whereas MGIVmi1 in Vibrio mimicus belongs to a previously uncharacterized class of GIs. We have demonstrated that through expression of AcaCD, IncA/C plasmids specifically trigger the excision and mobilization of the GIs at high frequencies. This study provides new evidence of the considerable impact of IncA/C plasmids on bacterial genome plasticity through their own mobility and the mobilization of genomic islands. PMID:25340549

  16. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability.

  17. The Role of Pharmacomechanical Endovascular Intervention for Iliofemoral Vein Thrombosis Compared to Conventional Anticoagulation Therapy

    PubMed Central

    2017-01-01

    Although anticoagulation therapy is the primary treatment for deep vein thrombosis (DVT), it has not been associated with the rapid recanalization of the venous occlusion. Moreover, it is associated with long-term disability due to post-thrombotic syndrome (PTS). In contrast, pharmacomechanical endovascular intervention (PMI) results in more rapid clinical improvement in DVT patients, but there are few reports on its long-term outcomes. This retrospective study evaluated the clinical effectiveness of PMI compared to conventional anticoagulation therapy (ACA) for acute and subacute iliofemoral DVT. We reviewed the medical records of 102 patients with iliofemoral DVT. A total of 46 patients for ACA and 56 patients for PMI were enrolled. We analyzed the clinical differences between the PMI and ACA groups by comparing the clinical signs, residual DVT free-rate, and PTS-free rate. There were no statistically significant differences in the demographic characteristics and risk factors except age between the groups (age: ACA, 52.0 ± 18.0 years; PMI, 59.0 ± 17.0 years; P = 0.035). The 1-, 3-, and 5-year residual DVT-free rate (ACA = 84.7%, 71.6%, and 46.0%; PMI = 82.1%, 76.8%, and 76.8%, respectively; P = 0.235) was not significantly different. However, the 1-, 3-, and 5-year PTS-free rate was significantly different (ACA = 93.5%, 74.0%, and 55.7%; PMI = 92.9%, 90.0%, and 90.0%, respectively; P = 0.019). There was no significant difference in the rate of other complications. PMI showed a lower incidence of PTS during the follow-up period. Therefore, PMI should be considered as an effective therapeutic modality for patients with iliofemoral DVT. PMID:27914131

  18. The master activator of IncA/C conjugative plasmids stimulates genomic islands and multidrug resistance dissemination.

    PubMed

    Carraro, Nicolas; Matteau, Dominick; Luo, Peng; Rodrigue, Sébastien; Burrus, Vincent

    2014-10-01

    Dissemination of antibiotic resistance genes occurs mostly by conjugation, which mediates DNA transfer between cells in direct contact. Conjugative plasmids of the IncA/C incompatibility group have become a substantial threat due to their broad host-range, the extended spectrum of antimicrobial resistance they confer, their prevalence in enteric bacteria and their very efficient spread by conjugation. However, their biology remains largely unexplored. Using the IncA/C conjugative plasmid pVCR94ΔX as a prototype, we have investigated the regulatory circuitry that governs IncA/C plasmids dissemination and found that the transcriptional activator complex AcaCD is essential for the expression of plasmid transfer genes. Using chromatin immunoprecipitation coupled with exonuclease digestion (ChIP-exo) and RNA sequencing (RNA-seq) approaches, we have identified the sequences recognized by AcaCD and characterized the AcaCD regulon. Data mining using the DNA motif recognized by AcaCD revealed potential AcaCD-binding sites upstream of genes involved in the intracellular mobility functions (recombination directionality factor and mobilization genes) in two widespread classes of genomic islands (GIs) phylogenetically unrelated to IncA/C plasmids. The first class, SGI1, confers and propagates multidrug resistance in Salmonella enterica and Proteus mirabilis, whereas MGIVmi1 in Vibrio mimicus belongs to a previously uncharacterized class of GIs. We have demonstrated that through expression of AcaCD, IncA/C plasmids specifically trigger the excision and mobilization of the GIs at high frequencies. This study provides new evidence of the considerable impact of IncA/C plasmids on bacterial genome plasticity through their own mobility and the mobilization of genomic islands.

  19. Ultrastructural findings in adrenal cortical adenomas clinically mimicking pheochromocytoma: a comparison with other adrenal tumors and tissue preparation techniques.

    PubMed

    Perrino, Carmen M; Prall, David N; Calomeni, Edward P; Nadasdy, Tibor; Zynger, Debra L

    2012-10-01

    Adrenal cortical tumors clinically mimicking pheochromocytomas are extremely rare, with 14 cases in the literature. The authors describe 2 patients with adrenal cortical adenoma (ACA) and catecholamine elevations. The impact of tissue preparation methods on electron microscopy (EM) images was assessed in ACA mimicking pheochromocytoma, pheochromocytoma, and ACA lacking pheochromocytoma-like symptoms. Ten adrenal cortical tumors were examined using EM after a variety of tissue preparation techniques, including fixation with glutaraldehyde, formalin for varying lengths of time followed by glutaraldehyde, and/or formalin followed by paraffin embedding. Electron micrographs were assessed for image quality and the presence of dense secretory granules and eccentric, norepinephrine (NE)-type granules. Images created from tissue fixed in glutaraldehyde and/or formalin and embedded in resin were of good quality, while those derived from paraffin-embedded specimens were poor with disrupted cellular architecture. When pheochromocytoma was fixed in glutaraldehyde for 24 h or in formalin for 8 days, eccentric granules were identified. These granules were absent when tissue was fixed in formalin for 20 days or was obtained from a paraffin block. ACA without pheochromocytoma-like symptoms and ACA mimicking pheochromocytoma both had noneccentric dense-core granules on EM regardless of tissue preparation, and eccentric NE-type granules were absent. ACA is a rare cause of pheochromocytoma-like symptoms. These tumors lack eccentric, NE-type dense-core granules present in pheochromocytoma. Glutaraldehyde alone or formalin fixation followed by glutaraldehyde produces electron micrographs that may aid in the diagnosis of adrenal cortical tumors, whereas formalin-fixed, paraffin-embedded tissue results in images that are inadequate.

  20. Distal anterior cerebral artery aneurysms: endovascular or surgical treatment? A case report.

    PubMed

    Saponiero, R; Toriello, A; Locatelli, G; Pugliese, N D; Napoli, A N; Napoli, M; Siani, A; Cuomo, G; Panza, M P; Narciso, N; Posteraro, L

    2008-04-07

    Cerebral aneurysms are occasionally associated with anomalies of the cerebral arteries. Most reports on anomalies of the anterior cerebral artery have been concerned with hypoplasia, fenestration and the infra-optic course of the A1, variant A1 perforators or Heubner's artery, multi-channeled anterior communicating artery, and azygos anterior cerebral artery. Distal anterior cerebral artery (ACA) aneurysms are known to have a poor clinical course and prognosis compared to other supratentorial aneurysms. The presence of the unpaired, distal, postcommunicating (A2) segment of the ACA is very rare in adults. We describe a patient with a ruptured aneurysm arising from the proximal end of the azygos ACA, first surgically treated with clipping and then with endovascular coiling. A 37-year-old woman at 34 weeks' gestation was transferred to our emergency room with sudden onset of severe headache and vomiting. Computed tomography (CT) revealed subarachnoid hemorrhage in the basal cisterna and the sylvian and interhemispheric fissures. Cerebral angiography showed an azygos ACA, a saccular aneurysm at the junction of the azygos ACA and the right A1 segment. A right fronto-temporal craniotomy was performed in the day of admission, and the neck of the aneurysm was clipped. One year later, an angiographic control examination revealed a regrowth of the aneurysm. The patient underwent endovascular treatment with coiling. Aneurysms of the azygos ACA are rare and their pathogenesis and course are still a matter of discussion. Developmental abnormalities or dynamic vessel wall stresses can explain the high incidence of aneurysms in these cases. The association of a rare anatomical variant with an aneurysm in the same location may suggest an embryogenesis alteration in the Willis circulation.

  1. Self-assembled large-area annular cavity arrays with tunable cylindrical surface plasmons for sensing.

    PubMed

    Ni, Haibin; Wang, Ming; Shen, Tianyi; Zhou, Jing

    2015-02-24

    Surface plasmons that propagate along cylindrical metal/dielectric interfaces in annular apertures in metal films, called cylindrical surface plasmons (CSPs), exhibit attractive optical characteristics. However, it is challenging to fabricate these nanocoaxial structures. Here, we demonstrate a practical low-cost route to manufacture highly ordered, large-area annular cavity arrays (ACAs) that can support CSPs with great tunability. By employing a sol-gel coassembly method, reactive ion etching and metal sputtering techniques, regular, highly ordered ACAs in square-centimeter-scale with a gap width tunable in the range of several to hundreds of nanometers have been produced with good reproducibility. Ag ACAs with a gap width of 12 nm and a gap height of 635 nm are demonstrated. By finite-difference time-domain simulation, we confirm that the pronounced dips in the reflectance spectra of ACAs are attributable to CSP resonances excited in the annular gaps. By adjusting etching time and Ag film thickness, the CSP dips can be tuned to sweep the entire optical range of 360 to 1800 nm without changing sphere size, which makes them a promising candidate for forming integrated plasmonic sensing arrays. The high tunability of the CSP resonant frequencies together with strong electric field enhancement in the cavities make the ACAs promising candidates for surface plasmon sensors and SERS substrates, as, for example, they have been used in liquid refractive index (RI) sensing, demonstrating a sensitivity of 1505 nm/RIU and a figure of merit of 9. One of the CSP dips of ACAs with a certain geometry size is angle- (0-70 degrees) and polarization-independent and can be used as a narrow-band absorber. Furthermore, the nano annular cavity arrays can be used to construct solar cells, nanolasers and nanoparticle plasmonic tweezers.

  2. Distinct Expression Patterns of Glycoprotein Hormone Subunits in the Lophotrochozoan Aplysia: Implications for the Evolution of Neuroendocrine Systems in Animals

    PubMed Central

    Plachetzki, David; Donelly, Evonne; Gunaratne, Dinuka; Bobkova, Yelena; Jacobson, John; Kohn, Andrea B.; Moroz, Leonid L.

    2012-01-01

    Glycoprotein hormones (GPHs) comprise a group of signaling molecules critical for major metabolic and reproductive functions. In vertebrates they include chorionic gonadotropin, LH, FSH, and TSH. The active hormones are characterized by heterodimerization between a common α and hormone-specific β subunit, which activate leucine-rich repeat-containing G protein coupled receptors. To date, genes referred to as GPHα2 and GPHβ5 have been the only glycoprotein hormone subunits identified in invertebrates, suggesting that other GPHα and GPHβ subunits diversified during vertebrate evolution. Still the functions of GPHα2 and GPHβ5 remain largely unknown for both vertebrates and invertebrates. To further understand the evolution and putative function of these subunits, we cloned and analyzed phylogenetically two glycoprotein subunits, AcaGPHα and AcaGPHβ, from the sea hare Aplysia californica. Model based three-dimensional predictions of AcaGPHβ confirm the presence of a complete cysteine knot, two hairpin loops, and a long loop. As in the human GPHβ5 subunit the seatbelt structure is absent in AcaGPHβ. We also found that AcaGPHα and AcaGPHβ subunits are expressed in larval stages of Aplysia, and we present a detailed expression map of the subunits in the adult central nervous system using in situ hybridizations. Both subunits are expressed in subpopulations of pleural and buccal mechanosensory neurons, suggesting a neuronal modulatory function of these subunits in Aplysia. Furthermore it supports the model of a relatively diffuse neuroendocrine-like system in molluscs, where specific primary sensory neurons release peptides extrasynaptically (paracrine secretion). This is in contrast to vertebrates and insects, in which releasing and stimulating factor from centralized sensory regions of the central nervous system ultimately regulate hormone release in peripheral glands. PMID:22977258

  3. Distinct expression patterns of glycoprotein hormone subunits in the lophotrochozoan Aplysia: implications for the evolution of neuroendocrine systems in animals.

    PubMed

    Heyland, Andreas; Plachetzki, David; Donelly, Evonne; Gunaratne, Dinuka; Bobkova, Yelena; Jacobson, John; Kohn, Andrea B; Moroz, Leonid L

    2012-11-01

    Glycoprotein hormones (GPHs) comprise a group of signaling molecules critical for major metabolic and reproductive functions. In vertebrates they include chorionic gonadotropin, LH, FSH, and TSH. The active hormones are characterized by heterodimerization between a common α and hormone-specific β subunit, which activate leucine-rich repeat-containing G protein coupled receptors. To date, genes referred to as GPHα2 and GPHβ5 have been the only glycoprotein hormone subunits identified in invertebrates, suggesting that other GPHα and GPHβ subunits diversified during vertebrate evolution. Still the functions of GPHα2 and GPHβ5 remain largely unknown for both vertebrates and invertebrates. To further understand the evolution and putative function of these subunits, we cloned and analyzed phylogenetically two glycoprotein subunits, AcaGPHα and AcaGPHβ, from the sea hare Aplysia californica. Model based three-dimensional predictions of AcaGPHβ confirm the presence of a complete cysteine knot, two hairpin loops, and a long loop. As in the human GPHβ5 subunit the seatbelt structure is absent in AcaGPHβ. We also found that AcaGPHα and AcaGPHβ subunits are expressed in larval stages of Aplysia, and we present a detailed expression map of the subunits in the adult central nervous system using in situ hybridizations. Both subunits are expressed in subpopulations of pleural and buccal mechanosensory neurons, suggesting a neuronal modulatory function of these subunits in Aplysia. Furthermore it supports the model of a relatively diffuse neuroendocrine-like system in molluscs, where specific primary sensory neurons release peptides extrasynaptically (paracrine secretion). This is in contrast to vertebrates and insects, in which releasing and stimulating factor from centralized sensory regions of the central nervous system ultimately regulate hormone release in peripheral glands.

  4. Quantifying interactions between accommodation and vergence in a binocularly normal population.

    PubMed

    Sweeney, Laura E; Seidel, Dirk; Day, Mhairi; Gray, Lyle S

    2014-12-01

    Stimulation of the accommodation system results in a response in the vergence system via accommodative vergence cross-link interactions, and stimulation of the vergence system results in an accommodation response via vergence accommodation cross-link interactions. Cross-link interactions are necessary in order to ensure simultaneous responses in the accommodation and vergence systems. The crosslink interactions are represented most comprehensively by the response AC/A (accommodative vergence) and CA/C (vergence accommodation) ratios, although the stimulus AC/A ratio is measured clinically, and the stimulus CA/C ratio is seldom measured in clinical practice. The present study aims to quantify both stimulus and response AC/A and CA/C ratios in a binocularly normal population, and determine the relationship between them. 25 Subjects (mean ± SD age 21.0 ± 1.9 years) were recruited from the university population. A significant linear relationship was found between the stimulus and response ratios, for both AC/A (r² = 0.96, p < 0.001) and CA/C ratios (r² = 0.40, p < 0.05). Good agreement was found between the stimulus and response AC/A ratios (95% CI -0.06 to 0.24 MA/D). Stimulus and response CA/C ratios are linearly related. Stimulus CA/C ratios were higher than response ratios at low values, and lower than response ratios at high values (95% CI -0.46 to 0.42 D/MA). Agreement between stimulus and response CA/C ratios is poorer than that found for AC/A ratios due to increased variability in vergence responses when viewing the Gaussian blurred target. This study has shown that more work is needed to refine the methodology of CA/C ratio measurement.

  5. Repeal and Replace of Affordable Care: A Complex, but Not an Impossible Task.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2016-01-01

    The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson's great society. It has been claimed that many of the law's reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers. In addition, public opinion has been slowly climbing against ObamaCare with 54% of Americans now opposing the law.President Obama has indicated that the law has accomplished many of its goals, including increasing accessibility, affordability, and quality of health care. However, others have contradicted these assertions and described the ACA as "insurance for many with coverage for few." Some believe that the ACA might be more appropriately labeled the "Medicaid Expansion Act."There are multiple plans developed over the years by republican members of the congress; however, of significant consequence and importance are President-elect Trump's proposals and the plan developed by Speaker Paul Ryan to repeal and replace the ACA. The President-elect has described the problems he perceives with the ACA; rapidly rising premiums and deductibles, narrow networks, and limits of coverage imposed by health insurance companies. The President-elect has indicated that his goal will be to create a patient-centered health care system that promotes choice, quality, and affordability with health insurance and health care, and take any needed action to alleviate the burdens imposed on American families and businesses by law.Key words: Affordable Care Act, ObamaCare, Medicaid, exchanges, Trump plan, repeal

  6. Influence of cyanide on diauxic oscillations in yeast.

    PubMed

    Hald, Bjørn O; Smrcinova, Miroslava; Sørensen, Preben G

    2012-12-01

    Coherent glycolytic oscillations in Saccharomyces cerevisiae are a multicellular property induced by addition of glucose to a starved cell population of sufficient density. However, initiation of oscillations requires an additional perturbation, usually addition of cyanide. The fate of cyanide during glycolytic oscillations has not previously been studied, and is the subject of the present paper. Using a cyanide electrode, a substantial decrease in cyanide concentration was observed. In the pH range 6-7, we found experimentally that the electrode behaves reasonably well, provided changes in pH are taken into account. To our knowledge, use of a cyanide electrode to study cyanide dynamics in living biological systems is new. Cyanide was found to enter starving yeast cells in only negligible amounts, and did not react significantly with glucose. Thus, cyanide consumption must be explained by reactions with glycolytic intermediates and evaporation. Evaporation and reaction with the signalling substance, extracellular acetaldehyde (ACA(x)) only explains the observed cyanide removal if [ACA(x)] is improbably high. Furthermore, differences in NADH traces upon cyanide addition before or after glucose addition strongly suggest that cyanide also reacts with intracellular carbonyl-containing metabolites. We show that cyanide reacts with pyruvate (Pyr) and dihydroxyacetone phosphate in addition to ACA, and estimate their rate constants. Our results strongly suggest that the major routes of cyanide removal during glycolysis are reactions with pyruvate and ACA. Cyanide removal by all carbonyl-containing intermediates led to a lower mean [ACA(x) ], thereby increasing the amplitude of [ACA(x) ] oscillations.

  7. Health Insurance Marketplaces: Premium Trends in Rural Areas.

    PubMed

    Barker, Abigail R; Kemper, Leah M; McBride, Timothy D; Meuller, Keith J

    2016-05-01

    Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (ACA) were implemented, considerable premium changes have been observed in the marketplaces across the 50 states and the District of Columbia. This policy brief assesses the changes in average HIM plan premiums from 2014 to 2016, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places. Since this brief focuses on premiums without accounting for subsidies, this is not intended to be an analysis of the "affordability" of ACA premiums, as that would require assessment of premiums, cost-sharing adjustments, and other factors.

  8. A window of opportunity: maximizing the effectiveness of new HCV regimens in the United States with the expansion of the Affordable Care Act.

    PubMed

    Haley, Sean J; Kreek, Mary Jeanne

    2015-03-01

    Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen.

  9. Paleoenvironmental changes recorded in a luminescence dated loess/paleosol sequence from the Tianshan Mountains, arid central Asia, since the Penultimate Glaciation

    NASA Astrophysics Data System (ADS)

    Li, Guoqiang; Rao, Zhiguo; Duan, Yanwu; Xia, Dunsheng; Wang, Leibin; Madsen, David B.; Jia, Jia; Wei, Haitao; Qiang, Mingrui; Chen, Jianhui; Chen, Fahu

    2016-08-01

    Mid-latitude arid central Asia (ACA) is one of the driest regions in the world and is a key source area of global atmospheric dust. Loess records of paleoclimatic changes in ACA are complex and interpretations are problematic due primarily to the lack of robust chronologies. Quartz OSL and K-feldspar pIRIR dating methods were employed to date 8 quartz and 30 K-feldspar samples from a 30 m loess sequence (BYH10 section) on the northern slope of the Tianshan Mountains, central ACA, northwest China. The reliability of quartz and K-feldspar ages was monitored by internal checks of luminescence characteristics and by comparison of the quartz and K-feldspar ages. The section lithology, proxy indexes of grain size and magnetic susceptibility, and the high resolution OSL chronology together indicate: (1) Quartz OSL dating can be used to date ACA loess samples less than 40 ka, while K-feldspar pIRIR dating is reliable for loess samples at least as old as ∼150 ka from ACA; (2) Aeolian loess began to be deposited on the northern slope of Tianshan Mountains beginning at least ∼145 ka ago, and was deposited primarily during the penultimate and last glaciation periods; (3) Rapid loess deposition occurred during MIS 6, MIS 4 to early-mid MIS 3, and MIS 2, but little or no loess deposition occurred during MIS 5, MIS 3a and MIS 1; (4) This loess depositional sequence is comparable to previously published stalagmite growth records in the region on glacial-interglacial cycles. Rapid dust deposition and lack of stalagmite growth during glacials, and lack of loess deposition and stalagmite growth during interglacials, indicate a climatic pattern of wet-warm (interglacial) and dry-cold (glacial) climatic regimes on orbital cycles in ACA; (5) Variation in the loess deposition rates in ACA was much larger than in the central loess plateau during the last glaciation; (6) Depositional hiatuses of >50 kyr occur in ACA loess sequences, and high resolution chronologies are needed when

  10. Health Care Reform: Impact on Total Joint Replacement.

    PubMed

    Chambers, Monique C; El-Othmani, Mouhanad M; Saleh, Khaled J

    2016-10-01

    The US health care system has been fragmented for more than 40 years; this model created a need for modification. Sociopoliticomedical system-related factors led to the Affordable Care Act (ACA) and a restructuring of health care provision/delivery. The ACA increases access to high-quality "affordable care" under cost-effective measures. This article provides a comprehensive review of health reform and the motivating factors that drive policy to empower arthroplasty providers to effectively advocate for the field of orthopedics as a whole, and the patients served.

  11. VizieR Online Data Catalog: I light curves of RR Lyrae from OGLE II (Bernhard+, 2009)

    NASA Astrophysics Data System (ADS)

    Bernhard, K.; Wils, P.

    2010-05-01

    We present the discovery of ten RR Lyrae variables. They were found in a search for new variables in the OGLE II Photometric Database (Szymanski 2005AcA....55...43S, Udalski et al. 1997AcA....47..319U). Suitable parameters (e.g. Isig>0.1, e_Imed

  12. Breastfeeding and the Affordable Care Act.

    PubMed

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding.

  13. The value of a safety-net hospital case example: Denver Health.

    PubMed

    Krantz, Mori J; Brown, Carrie A; Mehler, Philip S

    2013-01-01

    Mergers in the health care are common. The safety nets are being left out, because the operating margins of these hospitals are too thin. The Accountable Care Act (ACA) may increase the financial challenges of safety nets. This is because uncompensated care disbursements such as funding of the disproportionate share hospitals are scheduled to phase down as ACA implementation proceeds. If the safety nets became financially unstable, this would destabilize the local hospital market. Denver Health has gained national recognition for its innovations and excellent quality of care. This article will promote an awareness that safety-net hospitals should be considered for collaborations.

  14. Hepatitis, cholangitis, pulmonary hypertension, digital gangrene, and conjunctivitis sicca in a woman with anticentromere antibodies.

    PubMed

    Tsai, Chang-Youh; Huo, An-Ping; Chou, Chung-Tei; Wu, Tsai-Hung; Tsai, Ying-Yang

    2006-08-01

    A 46-year-old woman presented with chronic fluctuated liver function impairment, Raynaud's phenomenon, digital gangrene, pulmonary hypertension, and intense pruritus within a period of 2 years. Laboratory investigations revealed antinuclear antibodies, anticentromere antibodies (ACA), hypergammaglobulinemia, lymphocytic infiltration of the liver parenchyma, and mild cholangitis. The associated symptoms included thyroiditis, conjunctivitis sicca, xerostomia, and polyarthralgia. There was no conspicuous sclerodactyly, calcinosis, or dysphagia. The symptoms were relieved with intravenous, as well as oral, methylprednisolone. This constellation of presentations, including chronic autoimmune hepatitis with mild cholangitis and pulmonary hypertension, suggested that the presence of serum ACA might indicate relentless visceral organ damage.

  15. [Preliminary results of the heparin treatment in anticardiolipin and antihistone antibodies seropositive pregnant women].

    PubMed

    Horák, S; Grettka, K; Ogrodnik, M

    2000-06-01

    The presence of elevated titres of anticardiolipin antibodies (ACA) and antihistone antibodies (AHA) in the blood serum is considered as one of serious reasons of repeated pregnancy losses. According to some reports, heparin significantly improves live birth rates in these cases. The aim of the work is an evaluation of the results of the heparin therapy in pregnant women with elevated titres of ACA and/or AHA in blood and bad obstetric anamnesis, or after sterility treatment. Our material consisted of three groups: the first one was composed of 25 ACA- and/or AHA-seropositive pregnant women 30.0 +/- 4.1 years old with 1-5 early miscarriages in past, the second one of six seropositive patients 31.3 +/- 2.8 years old, actually pregnant after the treatment of unexplained sterility (two of them after assisted reproduction) and, finally, in the third group were placed five pregnant ACA- and AHA-seronegative pregnant women 30.8 +/- 2.2 years old with 2-4 abortions of unexplained etiology in past. The ACA IgA, IgM and IgG and AHA IgG levels in blood sera were determined by ELISA. As a positive titre ACA in the class IgA was considered > 7 APL/ml, in the class IgM > 4 MPL/ml, IgG > 7 GPL/ml and in case of AHA IgG > 25 GPL/ml. The patients were treated by heparin 7500-30,000 units daily during all the pregnancy under the control of kaolin-kephalin time. In the first group, where 53 pregnancies from 56 were miscarried (94.6%), after the heparin therapy in 10 women 9 pregnancies of 11 (81.8%) were terminated by live birth (p < 0.001). One of the patients died three days after cesarean section because of myocardial infarction, probably due to sudden stopping of heparin. In the second group three women after heparin treatment delivered live babies, but three untreated aborted. In the last group only two women treated by heparin delivered live babies and three, despite treatment, miscarried. It should be concluded, that heparin therapy in ACA- and/or AHA-positive pregnant women

  16. Educational Effectiveness Review

    DTIC Science & Technology

    2010-08-01

    the Advanced Education Review Board (the Navy’s bi- annual higher education review body). The plan frames aca - demic planning and resource allocation...that, the fact that I’m the first woman selected to flag rank as an IW officer is significant to those coming up in the ranks and I am grateful to have...explain why some unique academic roles/positions exist at NPS (e.g., Director of Programs, Program Officers, Aca - demic Associates), while other academic

  17. Prevalence of various antiphospholipid antibodies in pregnant women.

    PubMed

    Fialová, L; Mikulíková, L; Matous-Malbohan, I; Benesová, O; Zwinger, A

    2000-01-01

    Antiphospholipid antibodies (APAs) are characterized as a heterogeneous population of autoantibodies directed against different target antigens, predominantly anionic phospholipids or phospholipid-containing structures. The presence of APAs has been strongly associated with a variety of clinical disorders including adverse pregnancy complications such as spontaneous abortions, pregnancy-induced hypertension, preeclampsia and intrauterine growth retardation. The purpose of this study was to compare the prevalence of anticardiolipin antibodies (ACAs), which are routinely examined, with APAs directed against phosphatidylserine (APS), phosphatidylinositol (API), phosphatidylethanolamine (APE) and phosphatidylcholine (APC) in the sera of pregnant women. We examined 410 serum samples of pregnant women hospitalized in the department for pathological pregnancies. They underwent prenatal biochemical screening of fetal congenital abnormalities in the first and the second trimester of gravidity. Anticardiolipin IgG and IgM were measured using commercial ELISA kits (ImmuLisa Anti-Cardiolipin Antibody), whereas APS, APE, API and APC were determined by our modified ELISA kit. Among 410 pregnant women we found 21 patients (5.1%) positive for ACA IgG (>20 GPL) and 30 patients (7.3%) positive for ACA IgM (>10 MPL). It was found that 7.8% of pregnant women had at least one high-titer APA IgG and 9.8% high-titer APA IgM. One third of ACA IgG or IgM positive sera contained polyspecific autoantibodies reactive to at least two various phospholipids. In the group of IgG ACA positive women, 28.6% patients were positive for APS, 28.6% were positive or moderately positive for API, 23.8% for APC and 19% for APE. In the group of IgM ACA positive women, 33.3% were also positive for APS, 26.7% for APE, 26.7% for API and 23.3% for APC were present. IgG and IgM ACA negative patients exhibited a significantly lower incidence of other APA than the group of ACA positive pregnant women. It still

  18. Anterior clinoidal meningioma coincidental with bilateral intracranial aneurysms

    PubMed Central

    Paraskevopoulos, D; Magras, I; Balogiannis, I; Polyzoidis, K

    2011-01-01

    Coexistence of aneurysms and brain tumors is a rare occurrence. Coincidence is highest in patients with meningiomas rather than other types of tumors. We report a case in which a meningioma of the left anterior clinoid process was coexisting with a right middle cerebral artery (MCA) and a left anterior cerebral artery (ACA) aneurysm. While the right MCA aneurysm was detected preoperatively, the left ACA aneurysm was not detectable, being concealed by the major finding of the region. This report focuses on pitfalls of diagnosis and questions the surgical planning in aneurysms concealed by coincidental brain tumors. PMID:24391419

  19. Anterior clinoidal meningioma coincidental with bilateral intracranial aneurysms.

    PubMed

    Paraskevopoulos, D; Magras, I; Balogiannis, I; Polyzoidis, K

    2011-10-01

    Coexistence of aneurysms and brain tumors is a rare occurrence. Coincidence is highest in patients with meningiomas rather than other types of tumors. We report a case in which a meningioma of the left anterior clinoid process was coexisting with a right middle cerebral artery (MCA) and a left anterior cerebral artery (ACA) aneurysm. While the right MCA aneurysm was detected preoperatively, the left ACA aneurysm was not detectable, being concealed by the major finding of the region. This report focuses on pitfalls of diagnosis and questions the surgical planning in aneurysms concealed by coincidental brain tumors.

  20. Formation of quaternary stereogenic centers by copper-catalyzed asymmetric conjugate addition reactions of alkenylaluminums to trisubstituted enones.

    PubMed

    Müller, Daniel; Alexakis, Alexandre

    2013-11-04

    Alkenylaluminums undergo asymmetric copper-catalyzed conjugate addition (ACA) to β-substituted enones allowing the formation of stereogenic all-carbon quaternary centers. Phosphinamine-copper complexes proved to be particularly active and selective compared with phosphoramidite ligands. After extensive optimization, high enantioselectivities (up to 96% ee) were obtained for the addition of alkenylalanes to β-substituted enones. Two strategies for the generation of the requisite alkenylaluminums were explored allowing for the introduction of aryl- and alkyl-substituted alkenyl nucleophiles. Moreover, alkyl-substituted phosphinamine (SimplePhos) ligands were identified for the first time as highly efficient ligands for the Cu-catalyzed ACA.

  1. A Window of Opportunity: Maximizing the Effectiveness of New HCV Regimens in the United States With the Expansion of the Affordable Care Act

    PubMed Central

    Kreek, Mary Jeanne

    2015-01-01

    Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen. PMID:25602859

  2. Women’s Health and the Affordable Care Act: High Hopes Versus Harsh Realities?

    PubMed Central

    Fendrick, A. Mark; Zochowski, Melissa; Dalton, Vanessa K.

    2014-01-01

    Our population-based survey of 1078 randomly sampled US women, aged 18 to 55 years, sought to characterize their understanding of and attitudes toward the Affordable Care Act (ACA). Most women, especially socially disadvantaged groups, had negative or uncertain attitudes toward the ACA and limited understanding of its health benefits, including its relevance for their own health service coverage and utilization. Our findings are important for continued research, policy, and practice, with implications for whether, when, and how improved coverage will translate to improved access and outcomes for US women. PMID:24922171

  3. State discretion over Medicaid coverage for mental health and addiction services.

    PubMed

    Burns, Marguerite E

    2015-03-01

    Approximately one-third of adults who enroll in Medicaid because of a disability have a serious mental illness. Arguably, this population stands to benefit from insurance coverage that complies with the Mental Health Parity and Addiction Equity Act (MHPAEA). The MHPAEA and the Affordable Care Act (ACA) do not guarantee such coverage for this beneficiary group; however, they provide a variety of mechanisms by which states may provide parity-compliant coverage for mental health and substance use disorder treatment. This column explains key interactions between the MHPAEA, the ACA, and the Medicaid program that permit states to determine whether and how to provide parity-consistent coverage to beneficiaries with disabilities.

  4. The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals

    PubMed Central

    Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh

    2016-01-01

    American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665

  5. Perceived Leadership Preparation in Counselor Education Doctoral Students Who Are Members of the American Counseling Association in CACREP-Accredited Programs: A Survey Examining the Next Generation of Leaders in the Profession

    ERIC Educational Resources Information Center

    Lockard, Fred W., III.

    2010-01-01

    The purpose of this investigation was to examine the perceived leadership development, training, and education of counselor education doctoral students enrolled in CACREP-accredited universities and colleges. Participants of this study were 228 members of the American Counseling Association (ACA) who were doctoral students enrolled in…

  6. Counselors and the Legalization of Physician-Assisted Suicide.

    ERIC Educational Resources Information Center

    Kiser, Jerry D.

    1996-01-01

    With the shift in Americans' beliefs regarding legalizing physician-assisted suicide for the terminally ill, counselors must be prepared to counsel clients who have decided to end their lives. For counselors to avoid violating the ethical guidelines established by the American Counseling Association (ACA) regarding these clients, a reevaluation of…

  7. Identification of aberrantly expressed glycans in gastric cancer by integrated lectin microarray and mass spectrometric analyses

    PubMed Central

    Li, Xiang; Guan, Feng; Li, Dongliang; Tan, Zengqi; Yang, Ganglong; Wu, Yanli; Huang, Zhaohui

    2016-01-01

    Cancer progression is usually associated with alterations of glycan expression patterns. Little is known regarding global glycomics in gastric cancer, the most common type of epithelial cancer. We integrated lectin microarray and mass spectrometry (MS) methods to profile glycan expression in three gastric cancer cell lines (SGC-7901, HGC-27, and MGC-803) and one normal gastric epithelial cell line (GES-1). Significantly altered glycans were confirmed by lectin staining and MALDI-TOF/TOF-MS. The three cancer cell lines showed increased levels of core-fucosylated N-glycans, GalNAcα-Ser/Thr (Tn antigen), and Sia2-6Galβ1-4GlcNAc N-glycans, but reduced levels of biantennary N-glycans, Galβ1-3GalNAcα-Ser/Thr (T antigen), and (GlcNAc)n N-glycans. Lectin histochemistry was used to validate aberrant expression of four representative glycans (core-fucosylation, Sia2-6Galβ1-4GlcNAc, biantennary N-glycans, T antigen, recognized respectively by lectins LCA, SNA, PHA-E+L, and ACA) in clinical gastric cancer samples. Lower binding capacity for ACA was correlated with significantly poorer patient prognosis. Our findings indicate for the first time that glycans recognized by LCA, ACA, and PHA-E+L are aberrantly expressed in gastric cancer, and suggest that ACA is a potential prognostic factor for gastric cancer. PMID:27895315

  8. Crystal structure of a 2:1 co-crystal of meloxicam with acetyl­endi­carb­oxy­lic acid

    PubMed Central

    Tantardini, Christian; Arkhipov, Sergey G.; Cherkashina, Ksenya A.; Kil’met’ev, Alexander S.; Boldyreva, Elena V.

    2016-01-01

    The pharmaceutical 2:1 co-crystal of meloxicam [MXM; systematic name: 4-hy­droxy-2-methyl-N-(5-methyl­thia­zol-2-yl)-2H-1,2-benzo­thia­zine-3-carboxamide 1,1-dioxide] with acetyl­enedi­carb­oxy­lic acid (ACA; systematic name: but-2-ynedioic acid), crystallizes with one MXM mol­ecule and half an ACA mol­ecule in the asymmetric unit, C14H13N3O4S2·0.5C4H2O4. The mid-point of the triple bond of ACA is located on an inversion centre. In the crystal, the two stereoisomers of MXM with respect to the N atom of the sulfonamide group are related by the inversion centre. The carbonyl and hy­droxy groups belonging to the MXM mol­ecule are involved in an intra­molecular O—H⋯O hydrogen bond. The structure-forming motif includes two MXM mol­ecules linked via an ACA conformer through N—H⋯O and O—H⋯N hydrogen bonds, similar to MXM co-crystals with other di­carb­oxy­lic acids. PMID:27980849

  9. Determination of tricyclic antidepressants for ED analysis.

    PubMed

    Schwartz, J G; Hurd, I L; Carnahan, J J

    1994-09-01

    Both the Biosite Triage (Biosite Diagnostics, San Diego, CA) method and the Du Pont aca (Du Pont Company, Wilmington, DE) method give qualitative tricyclic antidepressant (TCA) results to aid in the diagnosis of a TCA overdose. The Triage method uses urine samples and the aca uses serum samples. Although the cutoff values vary considerably between the two methods, the Triage results agreed well with the aca results. The Triage test has an advantage in instrument maintenance and time savings, allowing a reduction in turn-around time for our emergency department. Both urine and serum samples were obtained from 44 patients who were admitted to the emergency department with a diagnosis of "possible tricyclic overdose." Discrepancies between the two methods were resolved by thin layer chromatography (Toxi-Lab, Ansys, Inc, Irvine, CA). Both methods were in agreement with the exception of five patients' samples. In this study, the Triage method allowed for detection of TCA using urine that is simple for the user and yielded higher sensitivity and specificity results compared with the Du Pont aca method.

  10. Counselor Education Student Perceptions of the American Counseling Association Ethical Code as It Pertains to the Use of Facebook

    ERIC Educational Resources Information Center

    Babb, Tanner A.

    2012-01-01

    Student use of online social networks has increased exponentially in the past five years. Facebook is one of the largest and most utilized by students. Many counseling students use Facebook on a regular basis to keep in touch with friends, family, and acquaintances. (Lenhart & Madden, 2007). Current American Counseling Association (ACA)…

  11. E-Therapy: Scope, Concerns, Ethical Standards, and Feasibility

    ERIC Educational Resources Information Center

    Santhiveeran, Janaki

    2004-01-01

    This article briefly presents a historical overview of e-therapy and the current state of the art as it relates to social work. The article evaluates the research available on the subject and considers several practical issues and ethical concerns based on the ethical standards of NASW, APA, and ACA. The article considers the potential benefits…

  12. Research and Statistical Techniques Used in the Journal of Counseling & Development: 1990-2001

    ERIC Educational Resources Information Center

    Bangert, Arthur W.; Baumberger, Julie P.

    2005-01-01

    The "Journal of Counseling & Development" ("JCD") is the principal journal of the American Counseling Association (ACA) and is considered as the premier counseling journal in the world. The Research section of JCD is devoted primarily to publishing empirical investigations related to counseling theory and methods, counselor training and education,…

  13. Conceptualizing Group Dynamics from Our Clients' Perspective: Development of the Conceptualization of Group Dynamics Inventory

    ERIC Educational Resources Information Center

    Tate, Kevin A.; Rivera, Edil Torres; Conwill, William L.; Miller, M. David; Puig, Ana

    2013-01-01

    There is a clear call in group counseling practice and training for evidence-based practice (ACA, 2005; ASGW, 2008; CACREP, 2009). At the same time, group counselors also are asked to keep clients' experience at the center of their work (ASGW, 2012). This article outlines the authors' effort to develop and study an instrument designed to measure…

  14. Hospital Mergers May Go on Whoever Wins in November.

    PubMed

    Calandra, Robert

    2016-09-01

    Passage of the ACA in 2010 led to some merger mania. Proponents of mergers and acquisitions say they can lower costs by creating economies of scale and smoothing the way for all kinds of clinical integration. But others say the fact that they can doesn't mean they do.

  15. Impairments in Brain Perfusion, Metabolites, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients: An Integrated MRI Study

    PubMed Central

    Wang, Tao

    2017-01-01

    Carotid artery stenosis without transient ischemic attack (TIA) or stroke is considered as “asymptomatic.” However, recent studies have demonstrated that these asymptomatic carotid artery stenosis (aCAS) patients had cognitive impairment in tests of executive function, psychomotor speed, and memory, indicating that “asymptomatic” carotid stenosis may not be truly asymptomatic. In this study, when 19 aCAS patients compared with 24 healthy controls, aCAS patients showed significantly poorer performance on global cognition, memory, and executive function. By utilizing an integrated MRI including pulsed arterial spin labeling (pASL) MRI, Proton MR Spectroscopy (MRS), and resting-state functional MRI (R-fMRI), we also found that aCAS patients suffered decreased cerebral blood flow (CBF) mainly in the Left Frontal Gyrus and had decreased NAA/Cr ratio in the left hippocampus and decreased connectivity to the posterior cingulate cortex (PCC) in the anterior part of default mode network (DMN). PMID:28255464

  16. Internships in Organizational Communication

    ERIC Educational Resources Information Center

    Downs, Cal W.

    1975-01-01

    Considers the present status of intern programs for students of organizational communication and suggests possible future developments. (JW) Published by the Association for Communication Administration Bulletin, Staff Coordinator, ACA 5202 Leesburg Pike, Falls Church, VA 22041, $25.00 annual dues.

  17. Graduate Degree Programs in Speech Communication: Description and Assessment

    ERIC Educational Resources Information Center

    LaBan, Frank K.

    1977-01-01

    Contends that the current status of job opportunities in speech versus the number of graduate degrees awarded on a regular basis warrant a moratorium on new graduate M.A. and Ph.D. programs and a reduction in graduate admissions to existing programs. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg…

  18. Forensics and Speech Communication

    ERIC Educational Resources Information Center

    McBath, James H.

    1975-01-01

    Focuses on the importance of integrating forensics programs into the speech communication curriculum. Maintains that debating and argumentation skills increase the probability of academic success. Published by the Association for Communication Administration Bulletin, Staff Coordinator, ACA 5205 Leesburg Pike, Falls Church, VA 22041, $25.00 annual…

  19. Some Practical Criteria for Developing Courses for Community Colleges

    ERIC Educational Resources Information Center

    Corley, Diana

    1977-01-01

    Examines speech communication course development at the community college level and offers suggestions for dealing with problems of transferring course work to the four-year college and serving the career student enrolled in a two-year program. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg Pike,…

  20. What a Strong Speech Communication Curricular Offering Should Be at a Community College

    ERIC Educational Resources Information Center

    Graham, Jo-Ann

    1977-01-01

    Suggests methods of curriculum development in the speech communication discipline that would offer students opportunities to acquire information and master skills that will enhance academic success and career development. Available from: ACA Bulletin, Robert Hall, Editor, Speech Communication Association, 5205 Leesburg Pike, Suite 1001, Falls…

  1. "Journal for Specialists in Group Work" ("JSGW") Publication Pattern Review: A Meta-Study of Author and Article Characteristics from 1981-2010

    ERIC Educational Resources Information Center

    Byrd, Rebekah; Crockett, Stephanie A.; Erford, Bradley T.

    2012-01-01

    "The Journal for Specialists in Group Work" ("JSGW") is the journal of the Association for Specialists in Group Work (ASGW), a division of the American Counseling Association (ACA). "JSGW" publishes articles related to "group work theory, interventions, training, current issues, and research" (ASGW, 2011). "JSGW" was first published in 1976 and is…

  2. Reproductive Effects on JP-8 Jet Fuel on Male and Female Sprague-Dawley Rats after Exposure by Oral Gavage

    DTIC Science & Technology

    2000-03-01

    700XR chemistry analyzer (Eastman Kodak, Rochester, NY). The dams were transferred to metabolism cages upon weaning and urine was collected for 24...Research Inc., Cambridge, MA). Urine protein assays were performed on 3 an automated chemistry analyzer (Model ACA IV, DuPont, Wilmington, DE). Urine

  3. Westerly jet stream and past millennium climate change in Arid Central Asia simulated by COSMO-CLM model

    NASA Astrophysics Data System (ADS)

    Fallah, Bijan; Sodoudi, Sahar; Cubasch, Ulrich

    2016-05-01

    This study tackles one of the most debated questions around the evolution of Central Asian climate: the "Puzzle" of moisture changes in Arid Central Asia (ACA) throughout the past millennium. A state-of-the-art Regional Climate Model (RCM) is subsequently employed to investigate four different 31-year time slices of extreme dry and wet spells, chosen according to changes in the driving data, in order to analyse the spatio-temporal evolution of the moisture variability in two different climatological epochs: Medieval Climate Anomaly (MCA) and Little Ice Age (LIA). There is a clear regime behavior and bimodality in the westerly Jet phase space throughout the past millennium in ACA. The results indicate that the regime changes during LIA show a moist ACA and a dry East China. During the MCA, the Kazakhstan region shows a stronger response to the westerly jet equatorward shift than during the LIA. The out-of-phase pattern of moisture changes between India and ACA exists during both the LIA and the MCA. However, the pattern is more pronounced during the LIA.

  4. Multiple functions of a multi-component mating pheromone in sea lamprey Petromyzon marinus

    USGS Publications Warehouse

    Johnson, N.S.; Yun, S.-S.; Buchinger, T.J.; Li, W.

    2012-01-01

    The role of the C24 sulphate in the mating pheromone component, 7α,12α,24-trihydroxy-5α-cholan-3-one 24-sulphate (3kPZS), to specifically induce upstream movement in ovulated female sea lampreys Petromyzon marinus was investigated. 7α,12α-dihydroxy-5α-cholan-3-one 24-oic acid (3kACA), a structurally similar bile acid released by spermiated males, but lacking the C24 sulphate ester, was tested in bioassays at concentrations between 10−11 and 10−14 molar (M). 3kACA did not induce upstream movement in females or additional reproductive behaviours. In contrast, spermiated male washings induced upstream movement, prolonged retention on a nest and induced an array of nesting behaviours. Differential extraction and elution by solid-phase extraction resins showed that components other than 3kPZS + 3kACA are necessary to retain females on nests and induce nest cleaning behaviours. All pheromone components, including components in addition to 3kPZS + 3kACA that retain females and induce nest cleaning behaviours were released from the anterior region of the males, as had been reported for 3kPZS. It is concluded that the sea lamprey male mating pheromone has multiple functions and is composed of multiple components.

  5. Learning More about Those Who Play in Session: The National Play Therapy in Counseling Practices Project (Phase I)

    ERIC Educational Resources Information Center

    Lambert, Simone F.; LeBlanc, Michael; Mullen, Jodi Ann; Ray, Dee; Baggerly, Jennifer; White, JoAnna; Kaplan, David

    2007-01-01

    Through a joint research committee sponsored by the Association for Play Therapy (APT) and the American Counseling Association (ACA), The National Play Therapy in Counseling Practices Project conducted the first phase of investigation. Findings offered a snapshot of mental health providers of play therapy, regarding the nature of who they are and…

  6. [Abdominal cavity adhesions. Some issues of pathogenesis, prophylaxis and treatment].

    PubMed

    Tishchenko, V V

    2010-07-01

    The abdominal cavity adhesions (ACA) constitute frequent consequence of various abdominal cavity diseases and traumas and frequent cause of the abdominal adhesive disease and its complications. In spite of the known pathogenesis of ACA, the surgeons had failed throughout the decades of years to find out the measures and methods of its prophylaxis. There are several causes of such a situation and the main of them is that ACA in its origin constitutes a philogenetically developed defense biologic reaction of organism. Because of the fact, that an organism constitutes the self-regulated biological system, any external inputs (including the treatment), directed on qualitative or quantitative signs of these reactions, meet systemic counteraction and become annihilated. The forced overcome of such a counteraction may cause the development of severe systemic disorders in organism. The only prophylactic measures against ACA, which were already tested throughout the time, are the tactical and technical methods, promoting the reduction of severity of morphological changes in peritoneum and abdominal organs, thus causing reduction of natural reaction of organism. When the adhesions formation is inevitable it is necessary to apply surgical methods of governing such a process, and omentoparietopexy may constitutes one of such methods.

  7. 75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... Program Authorized Under Title VII of the Public Health Service Act AGENCY: Health Resources and Services... allopathic or osteopathic medicine. Below are details on how the ACA changes Section 723 of the Public Health... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

  8. Education in the Wake of Healthcare Reform: Increasing Primary Care Usage by Individuals Currently Reliant upon Emergency Departments for Care

    ERIC Educational Resources Information Center

    Tannebaum, Michael; Wilkin, Holley A.; Keys, Jobia

    2014-01-01

    Background: The Affordable Care Act (ACA) was introduced, in part, to increase access to primary care, which has been shown to provide patients with myriad health benefits. Objective: To increase primary care usage by understanding the beliefs about primary and emergency care most salient to those whose healthcare-seeking practices may be impacted…

  9. Support for National Health Insurance Seven Years Into Massachusetts Healthcare Reform: Views of Populations Targeted by the Reform.

    PubMed

    Saluja, Sonali; Zallman, Leah; Nardin, Rachel; Bor, David; Woolhandler, Steffie; Himmelstein, David U; McCormick, Danny

    2016-01-01

    Before the Affordable Care Act (ACA), many surveys showed majority support for national health insurance (NHI), also known as single payer; however, little is currently known about views of the ACA's targeted population. Massachusetts residents have had seven years of experience with state health care reform that became the model for the ACA. We surveyed 1,151 adults visiting safety-net emergency departments in Massachusetts in late 2013 on their preference for NHI or the Massachusetts reform and on their experiences with insurance. Most of the patients surveyed were low-income and non-white. The majority of patients (72.0%) preferred NHI to the Massachusetts reform. Support for NHI among those with public insurance, commercial insurance, and no insurance was 68.9%, 70.3%, and 86.3%, respectively (p < .001). Support for NHI was higher among patients dissatisfied with their insurance plan (83.3% vs. 68.9%, p = .014), who delayed medical care (81.2% vs. 69.6%, p < .001) or avoided purchasing medications due to cost (87.3% vs. 71.4%; p = .01). Majority support for NHI was observed in every demographic subgroup. Given the strong support for NHI among disadvantaged Massachusetts patients seven years after state health reform, a reappraisal of the ACA's ability to meet the needs of underserved patients is warranted.

  10. 77 FR 48986 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... Collection Request: Revision of a currently approved collection; Title: Health Care Reform Insurance Web..., 2010. The original 60-day comment period began on June 5, 2012 and pertained to the Health Care Reform... organizations providing private health care insurance. In accordance with the provisions of the ACA...

  11. Robust Controller Design: Minimizing Peak-to-Peak Gain

    DTIC Science & Technology

    1992-09-01

    Optimality of Feedback Control Systems: The SISO Discrete-Time Case", IEEE Trans. A-C, 35, 1082- 1085, 1990. [18] C.A. Desoer and M. Vidyasagar, Feedback...Systems: Input-Output Properties, Aca- demic Press, Inc, N.Y., 1975. [19] C.A. Desoer , R-W. Liu, J. Murray and R. Saeks. "Feedback System Design: The

  12. Long-Wave Infrared Semiconductor Negative Refraction Metamaterials for High-Resolution Imaging

    DTIC Science & Technology

    2011-02-14

    Press, 1992). 23. E. Palik , ed., The Handbook of Optical Constants of Solids (Academic, 1997). 24. For details see COMSOL Multiphysics User’s Guide and...SIAM, Philadelphia, 1999. 22The Handbook of Optical Constants of Solids, edited by E. D. Palik Aca- demic, New York, 1997. FIG. 4. Color online a

  13. Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

    PubMed Central

    Ortega, Alexander N.; Rodriguez, Hector P.; Bustamante, Arturo Vargas

    2016-01-01

    The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers. PMID:25581154

  14. Predictors of anonymous cyber aggression: the role of adolescents' beliefs about anonymity, aggression, and the permanency of digital content.

    PubMed

    Wright, Michelle F

    2014-07-01

    Little attention has been given to whether adolescents' beliefs about anonymity and their normative beliefs about cyber aggression jointly increase their perpetration of cyber aggression. To this end, the present longitudinal study examined the moderating influence of these variables on the relationships among adolescents' attitudes toward the permanency of digital content, confidence with not getting caught, and anonymous cyber aggression (ACA) assessed 1 year later (Time 2). These associations were examined among 274 7th and 8th graders and through five technologies, including social networking sites (SNS), e-mail, instant messenger (IM), mobile phones, and chatrooms. Findings indicated that increases in Time 2 ACA and attitudes toward the permanency of digital content were more strongly related when adolescents reported greater confidence with not getting caught and higher normative beliefs concerning cyber aggression through SNS and mobile phones. In addition, higher levels of attitudes toward the permanency of digital content, confidence with not getting caught, beliefs about anonymity, and normative beliefs regarding cyber aggression were related to greater Time 2 ACA through e-mail, IM, and chatrooms. All findings are discussed in the context of adolescents' positive attitudes toward ACA, and an appeal for additional research is made to understand more about anonymity in cyberspace.

  15. Media Messages and Perceptions of the Affordable Care Act during the Early Phase of Implementation.

    PubMed

    Fowler, Erika Franklin; Baum, Laura M; Barry, Colleen L; Niederdeppe, Jeff; Gollust, Sarah E

    2017-02-01

    Public opinion about the Affordable Care Act (ACA) has been polarized since the law's passage. Past research suggests these conditions would make any media influence on the public limited at best. However, during the early phase of implementation, locally broadcast ACA-related media messages-in the form of paid health insurance and political advertisements and news media stories-abounded as advocates, insurance marketers, and politicians sought to shape the public's perceptions of the law. To what extent did message exposure affect ACA perceptions during the first open enrollment period? We merge data on volumes of messaging at the media market level with nationally representative survey data to examine the relationship between estimated exposure to media messaging and the public's perceptions of how informed they were about and favorable toward the ACA in October 2013. We find that higher volumes of insurance advertising and local news coverage are associated with participants' perceptions of being informed about the law. Volumes of insurance advertising and of local news coverage are also associated with participants' favorability toward the law, but the relationship varies with partisanship, supporting the growing body of research describing partisan perceptual bias.

  16. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... test for Mycoplasma gallisepticum (MGLP ReTi). (a) DNA extraction. Use Qiagen Qiamp Mini Kit for DNA extraction or equivalent validated technique/procedure. This kit utilizes the following methods: 100 µl of... extraction kit recommendations. (b) Primer selection. A forward primer mglpU26 (5′-CTA GAG GGT TGG ACA...

  17. When worlds collide: medicine, business, the Affordable Care Act and the future of health care in the U.S.

    PubMed

    Wicks, Andrew C; Keevil, Adrian A C

    2014-01-01

    The dialogue about the future of health care in the US has been impeded by flawed conceptions about medicine and business. The present paper re-examines some of the underlying assumptions about both medicine and business, and uses more nuanced readings of both terms to frame debates about the ACA and the emerging health care environment.

  18. 77 FR 45366 - Advisory Committee on Commercial Operations of Customs and Border Protection (COAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-31

    ... May 22, 2012 meeting: The National Strategy for Global Supply Chain Security as it relates to an... Terrorism (C- TPAT) Program Internet survey and the National Strategy for Global Supply Chain Security to... National Strategy. The Air Cargo Security Subcommittee work on the Air Cargo Advance Screening (ACAS)...

  19. The Relationships among School Counselors' Multicultural Competence, Demographic Data and Ethical Decision-Making

    ERIC Educational Resources Information Center

    Strong, Laura A.

    2010-01-01

    The purpose of this study was to determine the relationships, if any, among school counselors' multicultural competence, demographic data and ethical decision-making ability. The participants (N=160) for this study were members of the American Counseling Association (ACA) who designated their area of practice as school counseling. Participant's…

  20. Brewhouse-Resident Microbiota Are Responsible for Multi-Stage Fermentation of American Coolship Ale

    PubMed Central

    Bokulich, Nicholas A.; Bamforth, Charles W.; Mills, David A.

    2012-01-01

    American coolship ale (ACA) is a type of spontaneously fermented beer that employs production methods similar to traditional Belgian lambic. In spite of its growing popularity in the American craft-brewing sector, the fermentation microbiology of ACA has not been previously described, and thus the interface between production methodology and microbial community structure is unexplored. Using terminal restriction fragment length polymorphism (TRFLP), barcoded amplicon sequencing (BAS), quantitative PCR (qPCR) and culture-dependent analysis, ACA fermentations were shown to follow a consistent fermentation progression, initially dominated by Enterobacteriaceae and a range of oxidative yeasts in the first month, then ceding to Saccharomyces spp. and Lactobacillales for the following year. After one year of fermentation, Brettanomyces bruxellensis was the dominant yeast population (occasionally accompanied by minor populations of Candida spp., Pichia spp., and other yeasts) and Lactobacillales remained dominant, though various aerobic bacteria became more prevalent. This work demonstrates that ACA exhibits a conserved core microbial succession in absence of inoculation, supporting the role of a resident brewhouse microbiota. These findings establish this core microbial profile of spontaneous beer fermentations as a target for production control points and quality standards for these beers. PMID:22530036