Science.gov

Sample records for comportamental aplicado aca

  1. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false ACA expenditures. 154....402 ACA expenditures. Link to an amendment published at 78 FR 19412, Apr. 1, 2013. (a) Requirements... revised text is set forth as follows: § 154.402 ACA expenditures. (a) Requirements. Upon approval by the...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  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. 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

  8. 77 FR 65006 - Air Cargo Advance Screening (ACAS) Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... SECURITY U.S. Customs and Border Protection Air Cargo Advance Screening (ACAS) Pilot Program AGENCY: U.S...) pilot program which revises the time frame for transmission by pilot participants of a subset of... States for all other locations. The ACAS pilot is a voluntary test in which participants agree to submit...

  9. 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…

  10. 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…

  11. 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

  12. 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.

  13. Report of the ACA Ethics Committee: 2002-2003

    ERIC Educational Resources Information Center

    Hubert, Robert M.; Freeman, Larry T.

    2004-01-01

    This report summarizes the activities of the American Counseling Association (ACA) Ethics Committee during the period of July 1, 2002, through June 30, 2003. Summary data of the complaints filed and the inquiries received are presented.

  14. 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.

  15. Characterization of an industrial biocatalyst: immobilized glutaryl-7-ACA acylase.

    PubMed

    Monti, D; Carrea, G; Riva, S; Baldaro, E; Frare, G

    2000-10-20

    A batch of the immobilized industrial biocatalyst glutaryl-7-ACA acylase (GA), one of the two enzymes involved in the biotransformation of cephalosporin C (CefC) into 7-aminocephalosporanic acid (7-ACA), was characterized. K(m) value for glutaryl-7-ACA was 5 mM. Enzyme activity was found to be optimal at pH between 7 and 9.5 and to increase with temperature and in buffered solutions. To avoid product degradation, optimal reaction conditions were obtained working at 25 degrees C using a 50-mM phosphate buffer, pH 8.0. Immobilized GA showed good stability at pH value below 9 and at temperature up to 30 degrees C. The inactivation of immobilized GA in the presence of different amounts of H(2)O(2), a side product that might be present in the plant-scale industrial solutions of glutaryl-7-ACA, was also investigated, but the deactivation rates were negligible at H(2)O(2) concentration that might be reached under operative conditions. Finally, biocatalyst performance in the complete two-step enzymatic conversion process from CefC to 7-ACA was determined on a laboratory scale. Following the complete conversion of a 75 mM solution of CefC into glutaryl-7-ACA catalyzed by an immobilized D-amino acid oxidase (DAAO), immobilized GA was used for the transformation of this intermediate into the final product 7-ACA. This reaction was repeated for 42 cycles. An estimation of the residual activity of the biocatalyst showed that 50% inactivation of immobilized GA was reached after approximately 300 cycles, corresponding to an enzyme consumption of 0.4 kU per kg of isolated 7-ACA. Copyright 2000 John Wiley & Sons, Inc.

  16. Medicaid's future: What Might ACA Repeal Mean?

    PubMed

    Rosenbaum, Sara; Rothenberg, Sara; Gunsalus, Rachel; Schmucker, Sara

    2017-01-01

    Issue: Republicans in Congress are expected to repeal portions of the Affordable Care Act (ACA) using a fast-track process known as budget reconciliation. Goals: This issue brief examines how repeal legislation could affect Medicaid, the nation’s health care safety net, which insured 70 million people in 2016. Findings and Conclusions: Partial-repeal legislation that passed Congress but was vetoed by President Obama in 2016 offers some insight but new legislation could go further. It could repeal the ACA’s Medicaid eligibility expansions for adults and children but also roll back other provisions, such as simplified enrollment and improvements in long-term services and supports for beneficiaries with disabilities. Additionally, the Trump Administration could expand use of demonstration authority to introduce deeper structural changes into Medicaid, such as eligibility restrictions tied to work, required premium contributions and lock-out for nonpayment, annual enrollment periods, and coverage limits and exclusions. Together, these changes would have far-reaching implications for Medicaid’s continued role as the nation’s safety-net insurer.

  17. Effects of the ACA on Health Care Cost Containment.

    PubMed

    Weiner, Janet; Marks, Clifford; Pauly, Mark

    2017-02-01

    This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to "bend the cost curve." Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

  18. 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...

  19. 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...

  20. 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 the...

  1. 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.

  2. Medicaid Expansion and ACA Repeal: Evidence From Ohio.

    PubMed

    Seiber, Eric E; Berman, Micah L

    2017-06-01

    To examine the health insurance coverage options for Medicaid expansion enrollees if the Affordable Care Act (ACA) is repealed, using evidence from Ohio, where more than half a million adults have enrolled in the state's Medicaid program through the ACA expansion. The Ohio Medicaid Assessment Survey interviewed 42 000 households in 2015. We report data from a unique battery of questions designed to identify insurance coverage immediately prior to Medicaid enrollment. Ninety-five percent of new Medicaid enrollees in Ohio did not have a private health insurance option immediately before enrollment. These new enrollees are predominantly older, low-income Whites with a high school education or less. Only 5% of new Medicaid enrollees were eligible for an employer-sponsored insurance plan to which they could potentially return in the case of repeal of the ACA. The vast majority of Medicaid expansion enrollees would have no plausible pathway to obtaining private-sector insurance if the ACA were repealed. Demographic similarities between the expansion population and 2016 exit polls suggest that coverage losses would fall disproportionately on members of the winning Republican coalition.

  3. The "ACA Code of Ethics": Articulating Counseling's Professional Covenant

    ERIC Educational Resources Information Center

    Ponton, Richard F.; Duba, Jill D.

    2009-01-01

    The "ACA Code of Ethics" (American Counseling Association, 2005) is an articulation of the ever-changing relationship between counseling professionals and society. It provides clear parameters of behaviors to meet the changing needs of the people counselors are called to serve. This article reviews the 2005 "Code" as both a statement of counselor…

  4. AcaDames: Living and Working towards Tenure

    ERIC Educational Resources Information Center

    Magaldi-Dopman, Danielle; Marshall, Anne Marie; Rivera-McCutchen, Rosa L.; Roberts, Laura A.

    2015-01-01

    This study examined the experiences of the "AcaDames," a faculty support group of five female pre-tenure faculty members, including two women of color. Qualitative analysis of a sample of meeting transcripts suggests that the peer mentorship group afforded accountability, professional and emotional support, collaboration, and…

  5. State Innovation Waivers: Redrawing the Boundaries of the ACA.

    PubMed

    Howard, Heather; Benshoof, Galen

    2015-12-01

    In the federalist spirit of the rest of the Affordable Care Act (ACA), section 1332 of the law authorizes new optional waivers for state innovation. These waivers, 1332 waivers, as they have become known, offer states the flexibility to refashion their coverage systems, provided that their reforms stay within important boundaries set by statute. A year and a half out from the earliest effective date--January 1, 2017--some states have already begun the planning and engagement process required as part of the waiver application. This article discusses possible waiver strategies aimed at exchange sustainability, coverage expansion, delivery system reform, and more. States have the option to make small, targeted fixes or bring more sweeping changes to their health landscapes. Though the application process is involved and states must still accomplish the aims of the ACA, 1332 waivers give them the opportunity to tailor the law to local politics, markets, and health systems. Copyright © 2016 by Duke University Press.

  6. Court ruling demonstrates ACA's power to reduce future medical expenses.

    PubMed

    Jenny, Leslie M

    2016-04-01

    Industry insiders who handle litigation involving catastrophic injury cases have eagerly awaited the first rulings to address the impact, if any, of the Affordable Care Act (ACA), often referred to as Obamacare, on claims for future damages. Before the ACA, it was uncertain whether injured individuals would have health insurance to cover ever-growing health care costs in the future. Consequently, in most jurisdictions, the applicable rule of law has prevented the argument that future damages should be reduced because of the availability of health insurance. Because of this, damages have remained essentially unrebutted, and the law has permitted such unrebutted damage projections to be calculated into the future. These projections, primarily in the form of life care plans, are generally the single largest financial component of damage claims. Such plans often project massive expenses that can drive equally massive jury verdicts. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Revisiting the structure/function relationships of H/ACA(-like) RNAs: a unified model for Euryarchaea and Crenarchaea

    PubMed Central

    Toffano-Nioche, Claire; Gautheret, Daniel; Leclerc, Fabrice

    2015-01-01

    A structural and functional classification of H/ACA and H/ACA-like motifs is obtained from the analysis of the H/ACA guide RNAs which have been identified previously in the genomes of Euryarchaea (Pyrococcus) and Crenarchaea (Pyrobaculum). A unified structure/function model is proposed based on the common structural determinants shared by H/ACA and H/ACA-like motifs in both Euryarchaea and Crenarchaea. Using a computational approach, structural and energetic rules for the guide:target RNA-RNA interactions are derived from structural and functional data on the H/ACA RNP particles. H/ACA(-like) motifs found in Pyrococcus are evaluated through the classification and their biological relevance is discussed. Extra-ribosomal targets found in both Pyrococcus and Pyrobaculum might support the hypothesis of a gene regulation mediated by H/ACA(-like) guide RNAs in archaea. PMID:26240384

  15. Reconstitution and structural analysis of the yeast box H/ACA RNA-guided pseudouridine synthase.

    PubMed

    Li, Shuang; Duan, Jingqi; Li, Dandan; Yang, Bing; Dong, Mengqiu; Ye, Keqiong

    2011-11-15

    Box H/ACA ribonucleoprotein particles (RNPs) mediate pseudouridine synthesis, ribosome formation, and telomere maintenance. The structure of eukaryotic H/ACA RNPs remains poorly understood. We reconstituted functional Saccharomyces cerevisiae H/ACA RNPs with recombinant proteins Cbf5, Nop10, Gar1, and Nhp2 and a two-hairpin H/ACA RNA; determined the crystal structure of a Cbf5, Nop10, and Gar1 ternary complex at 1.9 Å resolution; and analyzed the structure-function relationship of the yeast complex. Although eukaryotic H/ACA RNAs have a conserved two-hairpin structure, isolated single-hairpin RNAs are also active in guiding pseudouridylation. Nhp2, unlike its archaeal counterpart, is largely dispensable for the activity, reflecting a functional adaptation of eukaryotic H/ACA RNPs to the variable RNA structure that Nhp2 binds. The N-terminal extension of Cbf5, a hot spot for dyskeratosis congenita mutation, forms an extra structural layer on the PUA domain. Gar1 is distinguished from the assembly factor Naf1 by containing a C-terminal extension that controls substrate turnover and the Gar1-Naf1 exchange during H/ACA RNP maturation. Our results reveal significant novel features of eukaryotic H/ACA RNPs.

  16. 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

  17. 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.

  18. 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,…

  19. Complete Genome Sequence of the Sourdough Isolate Lactobacillus zymae ACA-DC 3411

    PubMed Central

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

    2017-01-01

    ABSTRACT Lactobacillus zymae is a Gram-positive lactic acid bacterium belonging to the Lactobacillus brevis clade. Here, we report the first complete genome sequence of L. zymae ACA-DC 3411, which was isolated from traditional Greek wheat sourdough. Whole-genome analysis may reveal adaptive traits of strain ACA-DC 3411 in the sourdough ecosystem. PMID:28751400

  20. 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…

  1. 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…

  2. The American Counseling Association Practice Research Network (ACA-PRN): A New Research Tool

    ERIC Educational Resources Information Center

    Bradley, Loretta J.; Sexton, Thomas L.; Smith, Howard B.

    2005-01-01

    This article features the American Counseling Association Practice Research Network (ACA-PRN). Without additional current and ongoing research data, ACA and the counseling profession are seriously hampered when they discuss counseling outcomes. Without a sound, dynamic research base that better articulates the characteristics of practicing…

  3. 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,…

  4. 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.

  5. 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.

  6. Expression and intracellular localization of ACA and TRA-1-81 in smooth muscle cell tumors.

    PubMed

    Sukhikh, G T; Becker-Kojić, Z; Kogan, E A; Demura, T A; Faizullina, N M; Nizyaeva, N V; Schott, A; Ureña-Peralta, J J; Askol'skaya, S I; Popov, Yu V

    2013-08-01

    We studied the expression and intracellular localization of ACA and TRA-1-81 in smooth muscle cell tumors. The study was performed on tissue specimens obtained during surgery from patients with uterine leiomyoma and leiomyosarcoma (mean age 34 and 51 years, respectively). ACA was present in leiomyoma, leiomyosarcoma, and control myometrium. Intracellular expression of ACA varied in different types of tumors and was minimum in normal myometrium and maximum in leiomyosarcoma. Membrane localization of the protein is typical of common and cellular leiomyoma, while in the growth zones of mitotically active leiomyoma and leiomyosarcoma the reaction product was primarily located in tumor cell cytoplasm. TRA was detected in some leiomyosarcoma cells. Thus, ACA dysregulation was revealed in the growth zones of leiomyomas and in leiomyosarcomas, which manifested in enhanced expression of this protein and its detachment from the plasma membrane, which leads ACA translocation into the cytoplasm and nucleus of tumor cells and potentiates their proliferative activity.

  7. 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...

  8. 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.

  9. 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.

  10. [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.

  11. 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

  12. Reconstitution of archaeal H/ACA small ribonucleoprotein complexes active in pseudouridylation.

    PubMed

    Charpentier, Bruno; Muller, Sébastien; Branlant, Christiane

    2005-01-01

    Pseudouridine (Psi) are frequently modified residues in RNA. In Eukarya, their formation is catalyzed by enzymes or by ribonucleoprotein complexes (RNPs) containing H/ACA snoRNAs. H/ACA sRNA and putative ORFs for H/ACA sRNP proteins (L7Ae, aCBF5, aNOP10 and aGAR1) were found in Archaea. Here, by using Pyrococcus abyssi recombinant proteins and an in vitro transcribed P.abyssi H/ACA sRNA, we obtained the first complete in vitro reconstitution of an active H/ACA RNP. Both L7Ae and the aCBF5 RNA:Psi synthase bind directly the sRNA; aCBF5 also interacts directly and independently with aNOP10 and aGAR1. Presence of aCBF5, aNOP10 and a U residue at the pseudouridylation site in the target RNA are required for RNA target recruitment. In agreement, we found that the aCBF5-aNOP10 pair is the minimal set of proteins needed for the formation of a particle active for pseudouridylation. However, particles more efficient in targeted pseudouridylation can be formed with the addition of proteins L7Ae and/or aGAR1. Although necessary for optimal activity, the conserved ACA motif in the sRNA was found to be not essential.

  13. 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.

  14. 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

  15. The analysis of AC/A ratio in nonrefractive accommodative esotropia treated with bifocal glasses.

    PubMed

    Kim, Wook Kyum; Kang, Sung Yong; Rhiu, Soolienah; Chung, Seung Ah; Lee, Jong Bok

    2012-02-01

    To report the long term results of bifocal treatment in nonrefractive accommodative esotropia and to analyze the changes of accommodative convergence to accommodation (AC/A) ratio. Sixteen patients treated with bifocal glasses for at least 5 years were evaluated retrospectively. Angle of deviation at near and distance, refractive error, and AC/A ratio by the lens gradient method were analyzed. The changes of AC/A ratios were also compared after dividing the patients according to continuation or cessation of bifocal therapy. Six patients (38%; bifocal stop group, BSG) were able to stop using bifocal glasses at an average age of 10.8 years (range, 6.5 to 15.4 years) during their follow-up. However, the other ten patients (62%; bifocal continue group, BCG) had to continue using bifocal glasses until the final visit, which was 13.8 years on average (range, 11.3 to 18.5 years). The AC/A ratio decreased from time of bifocal prescription to the last visit in both groups, from 4.4 to 2.7 in the BSG and from 5.9 to 4.5 in the BCG. AC/A ratios were significantly higher (p = 0.03) in the BCG than that of the BSG from the beginning of bifocal treatment and this difference was persistent until the final visit (p = 0.03). The AC/A ratio decreased with age in both groups but was significantly higher throughout the entire follow-up period in the BCG. AC/A ratio at bifocal prescription could be an important factor in predicting response to bifocal treatment.

  16. The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses

    PubMed Central

    Kim, Wook Kyum; Kang, Sung Yong; Rhiu, Soolienah; Chung, Seung Ah

    2012-01-01

    Purpose To report the long term results of bifocal treatment in nonrefractive accommodative esotropia and to analyze the changes of accommodative convergence to accommodation (AC/A) ratio. Methods Sixteen patients treated with bifocal glasses for at least 5 years were evaluated retrospectively. Angle of deviation at near and distance, refractive error, and AC/A ratio by the lens gradient method were analyzed. The changes of AC/A ratios were also compared after dividing the patients according to continuation or cessation of bifocal therapy. Results Six patients (38%; bifocal stop group, BSG) were able to stop using bifocal glasses at an average age of 10.8 years (range, 6.5 to 15.4 years) during their follow-up. However, the other ten patients (62%; bifocal continue group, BCG) had to continue using bifocal glasses until the final visit, which was 13.8 years on average (range, 11.3 to 18.5 years). The AC/A ratio decreased from time of bifocal prescription to the last visit in both groups, from 4.4 to 2.7 in the BSG and from 5.9 to 4.5 in the BCG. AC/A ratios were significantly higher (p = 0.03) in the BCG than that of the BSG from the beginning of bifocal treatment and this difference was persistent until the final visit (p = 0.03). Conclusions The AC/A ratio decreased with age in both groups but was significantly higher throughout the entire follow-up period in the BCG. AC/A ratio at bifocal prescription could be an important factor in predicting response to bifocal treatment. PMID:22323884

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

    PubMed

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

    2017-03-01

    To investigate the ratio of accommodative convergence per diopter of accommodative response (AC/A ratio) before, during, and after myopia onset. 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. 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. 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.

  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. Spectroscopic and structural impact of a stem base-pair change in DNA hairpins: GTTC-ACA-GAAC versus GTAC-ACA-GTAC

    NASA Astrophysics Data System (ADS)

    Lamoureux, Michèle; Patard, Louis; Hernandez, Belen; Couesnon, Thierry; Santini, Guillaume P. H.; Cognet, Jean A. H.; Gouyette, Catherine; Cordier, Christine

    2006-09-01

    Successive investigations over the last decade have revealed and confirmed a stable loop closure in a family of d-[GTAC-5Pur6N7N-GTAC] hairpins, where 5Pur6N7N is a AAA, GAG and AXC loop (X being any nucleotide). The trinucleotide loop is characterized by a well defined 5Pur-7N mispairing mode, and by upfield chemical shifts for three sugar protons of the apical nucleotide 6N. The GTTC-ACA-GAAC DNA hairpin, of interest for its likely involvement in Vibrio cholerae genome mutations, has now been investigated. The GTAC-ACA-GTAC DNA hairpin has also been studied because it is intermediate between the other structures, as it contains the loop of the hairpin under consideration and the stem of the above family. The two hairpins with the ACA loop are stable. They show the same mispairing mode and similar upfield shifts as the previous family, but GTTC-ACA-GAAC seems to be slightly less compact than any other. GTTC-ACA-GAAC is remarkable in that it exhibits a B II character for the phosphate-ester conformation at 8Gp9A, together with a swing of the upper hairpin into the major groove that, in particular, brings 6CH1' roughly as close to 7AH2 as to 6CH6. These unexpected structural features are qualitatively deduced from 1H and 31P NMR spectra, and confirmed by Raman spectroscopy. This comparative study shows that not only the loop sequence but also the stem sequence may control hairpin structures.

  20. 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.

  1. 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.

  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. 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.

  4. 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

    .... Approximately $4,920,000 in ACA funding will be awarded to the grantees for network expansion and enhancement. Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section 4002 [42 U.S.C. 300u-11... Cooperative Agreement. Approximate Total Current Fiscal Year ACA Funding: $4,920,000. Anticipated Number of...

  5. Revisiting the structure/function relationships of H/ACA(-like) RNAs: a unified model for Euryarchaea and Crenarchaea.

    PubMed

    Toffano-Nioche, Claire; Gautheret, Daniel; Leclerc, Fabrice

    2015-09-18

    A structural and functional classification of H/ACA and H/ACA-like motifs is obtained from the analysis of the H/ACA guide RNAs which have been identified previously in the genomes of Euryarchaea (Pyrococcus) and Crenarchaea (Pyrobaculum). A unified structure/function model is proposed based on the common structural determinants shared by H/ACA and H/ACA-like motifs in both Euryarchaea and Crenarchaea. Using a computational approach, structural and energetic rules for the guide:target RNA-RNA interactions are derived from structural and functional data on the H/ACA RNP particles. H/ACA(-like) motifs found in Pyrococcus are evaluated through the classification and their biological relevance is discussed. Extra-ribosomal targets found in both Pyrococcus and Pyrobaculum might support the hypothesis of a gene regulation mediated by H/ACA(-like) guide RNAs in archaea. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

  6. 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.

  7. 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...

  8. 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...

  9. 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

  10. 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.

  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. 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).

  13. Complete Genome Sequence of the Yogurt Isolate Lactobacillus delbrueckii subsp. bulgaricus ACA-DC 87

    PubMed Central

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

    2017-01-01

    ABSTRACT Lactobacillus delbrueckii subsp. bulgaricus is widely used in the production of yogurt and cheese. In this study, we present the complete genome sequence of L. delbrueckii subsp. bulgaricus ACA-DC 87 isolated from traditional Greek yogurt. Whole-genome analysis may reveal desirable technological traits of the strain for dairy fermentations. PMID:28839034

  14. 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.

  15. 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...

  16. 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…

  17. Ethical Challenges in a Complex World: Highlights of the 2005 ACA Code of Ethics

    ERIC Educational Resources Information Center

    Kocet, Michael M.

    2006-01-01

    Being an effective counselor includes having knowledge of and the ability to integrate a code of ethics into one's professional practice. This article addresses some of the highlights of the changes in the 2005 ACA [American Counseling Association] Code of Ethics such as end-of-life issues, boundaries and relationships, and multicultural and…

  18. 76 FR 5404 - Notice of Renewal of the Advisory Committee on Apprenticeship (ACA) Charter

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... revisions are intended as a routine updating of the Department's strategic goals and existing procedures.... The ACA's Charter is required to be renewed every two years from the date of the Secretary of Labor's... Secretary's priorities. FOR FURTHER INFORMATION CONTACT: Mr. John V. Ladd, Administrator, Office of...

  19. 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

    ... Committee's original intent. The revisions are a routine updating of the Charter to ensure closer alignment with the Department's strategic goals and priorities. The charter for the ACA will expire on January 31... Renew Charter. SUMMARY: The Secretary of Labor has determined that the renewal of a national advisory...

  20. 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

  1. 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.

  2. 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.

  3. 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...

  4. 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...

  5. 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.

  6. 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.

  7. Enzymatic activity and immunoreactivity of Aca s 4, an alpha-amylase allergen from the storage mite Acarus siro

    PubMed Central

    2012-01-01

    Background Enzymatic allergens of storage mites that contaminate stored food products are poorly characterized. We describe biochemical and immunological properties of the native alpha-amylase allergen Aca s 4 from Acarus siro, a medically important storage mite. Results A. siro produced a high level of alpha-amylase activity attributed to Aca s 4. This enzyme was purified and identified by protein sequencing and LC-MS/MS analysis. Aca s 4 showed a distinct inhibition pattern and an unusual alpha-amylolytic activity with low sensitivity to activation by chloride ions. Homology modeling of Aca s 4 revealed a structural change in the chloride-binding site that may account for this activation pattern. Aca s 4 was recognized by IgE from house dust mite-sensitive patients, and potential epitopes for cross-reactivity with house dust mite group 4 allergens were found. Conclusions We present the first protein-level characterization of a group 4 allergen from storage mites. Due to its high production and IgE reactivity, Aca s 4 is potentially relevant to allergic hypersensitivity. PMID:22292590

  8. 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.

  9. 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. Project HOPE—The People-to-People Health Foundation, Inc.

  10. The H/ACA RNP assembly factor SHQ1 functions as an RNA mimic.

    PubMed

    Walbott, Hélène; Machado-Pinilla, Rosario; Liger, Dominique; Blaud, Magali; Réty, Stéphane; Grozdanov, Petar N; Godin, Kate; van Tilbeurgh, Herman; Varani, Gabriele; Meier, U Thomas; Leulliot, Nicolas

    2011-11-15

    SHQ1 is an essential assembly factor for H/ACA ribonucleoproteins (RNPs) required for ribosome biogenesis, pre-mRNA splicing, and telomere maintenance. SHQ1 binds dyskerin/NAP57, the catalytic subunit of human H/ACA RNPs, and this interaction is modulated by mutations causing X-linked dyskeratosis congenita. We report the crystal structure of the C-terminal domain of yeast SHQ1, Shq1p, and its complex with yeast dyskerin/NAP57, Cbf5p, lacking its catalytic domain. The C-terminal domain of Shq1p interacts with the RNA-binding domain of Cbf5p and, through structural mimicry, uses the RNA-protein-binding sites to achieve a specific protein-protein interface. We propose that Shq1p operates as a Cbf5p chaperone during RNP assembly by acting as an RNA placeholder, thereby preventing Cbf5p from nonspecific RNA binding before association with an H/ACA RNA and the other core RNP proteins.

  11. The ACA's 65th Birthday Challenge: Moving from Medicaid to Medicare.

    PubMed

    Ndumele, Chima D; Sommers, Benjamin D; Trivedi, Amal N

    2015-11-01

    The Affordable Care Act (ACA) expanded Medicaid to millions of low-income near-elderly Americans, facilitating access to health care services, but did not change income eligibility for Medicaid for those 65 years and older. Therefore, following the ACA's coverage expansion, many newly-insured older enrollees will face a complex insurance transition on their 65th birthday: they will lose Medicaid coverage and transition from Medicaid to Medicare as their primary insurer. This transition in primary health insurance coverage includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors. Using data from 2012, we estimate that 1.6 million current Medicaid beneficiaries and an additional 1.6 to 2.9 million low-income individuals who will gain Medicaid coverage under the ACA will be likely to make this transition in the next decade. Primary care physicians and policymakers can help mitigate the potential consequences of this insurance transition by preparing patients for Medicare's more restrictive insurance coverage, encouraging patients to sign up for available low-income subsidies, and understanding how the loss of Medicaid coverage impacts out-of-pocket costs.

  12. Naf1p, an essential nucleoplasmic factor specifically required for accumulation of box H/ACA small nucleolar RNPs.

    PubMed

    Dez, Christophe; Noaillac-Depeyre, Jacqueline; Caizergues-Ferrer, Michèle; Henry, Yves

    2002-10-01

    Box H/ACA small nucleolar ribonucleoprotein particles (H/ACA snoRNPs) play key roles in the synthesis of eukaryotic ribosomes. The ways in which these particles are assembled and correctly localized in the dense fibrillar component of the nucleolus remain largely unknown. Recently, the essential Saccharomyces cerevisiae Naf1p protein (encoded by the YNL124W open reading frame) was found to interact in a two-hybrid assay with two core protein components of mature H/ACA snoRNPs, Cbf5p and Nhp2p (T. Ito, T. Chiba, R. Ozawa, M. Yoshida, M. Hattori, and Y. Sakaki, Proc. Natl. Acad. Sci. USA 98:4569-4574, 2001). Here we show that several H/ACA snoRNP components are weakly but specifically immunoprecipitated with epitope-tagged Naf1p, suggesting that the latter protein is involved in H/ACA snoRNP biogenesis, trafficking, and/or function. Consistent with this, we find that depletion of Naf1p leads to a defect in 18S rRNA accumulation. Naf1p is unlikely to directly assist H/ACA snoRNPs during pre-rRNA processing in the dense fibrillar component of the nucleolus for two reasons. Firstly, Naf1p accumulates predominantly in the nucleoplasm. Secondly, Naf1p sediments in a sucrose gradient chiefly as a free protein or associated in a complex of the size of free snoRNPs, whereas extremely little Naf1p is found in fractions containing preribosomes. These results are more consistent with a role for Naf1p in H/ACA snoRNP biogenesis and/or intranuclear trafficking. Indeed, depletion of Naf1p leads to a specific and dramatic decrease in the steady-state accumulation of all box H/ACA snoRNAs tested and of Cbf5p, Gar1p, and Nop10p. Naf1p is unlikely to be directly required for the synthesis of H/ACA snoRNP components. Naf1p could participate in H/ACA snoRNP assembly and/or transport.

  13. 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.

  14. 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.

  15. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings.

    PubMed

    French, Michael T; Homer, Jenny; Gumus, Gulcin; Hickling, Lucas

    2016-10-01

    To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5 years regarding both the immediate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies. We identified relevant articles from peer-reviewed scholarly journals by performing a comprehensive search of major electronic databases. We also identified reports in the "gray literature" disseminated by government agencies and other organizations. Overall, research shows that the ACA has substantially decreased the number of uninsured individuals through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets. The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been successful in achieving its goals. © Health Research and Educational Trust.

  16. Structure and Functional Studies of the CS Domain of the Essential H/ACA Ribonucleoparticle Assembly Protein SHQ1

    SciTech Connect

    Singh, Mahavir; Gonzales, Fernando A.; Cascio, Duilio; Heckmann, Nathanael; Chanfreau, Guillaume; Feigon, Juli

    2009-03-16

    H/ACA ribonucleoprotein particles are essential for ribosomal RNA and telomerase RNA processing and metabolism. Shq1p has been identified as an essential eukaryotic H/ACA small nucleolar (sno) ribonucleoparticle (snoRNP) biogenesis and assembly factor. Shq1p is postulated to be involved in the early biogenesis steps of H/ACA snoRNP complexes, and Shq1p depletion leads to a specific decrease in H/ACA small nucleolar RNA levels and to defects in ribosomal RNA processing. Shq1p contains two predicted domains as follows: an N-terminal CS (named after CHORD-containing proteins and SGT1) or HSP20-like domain, and a C-terminal region of high sequence homology called the Shq1 domain. Here we report the crystal structure and functional studies of the Saccharomyces cerevisiae Shq1p CS domain. The structure consists of a compact anti-parallel {beta}-sandwich fold that is composed of two {beta}-sheets containing four and three {beta}-strands, respectively, and a short {alpha}-helix. Deletion studies showed that the CS domain is required for the essential functions of Shq1p. Point mutations in residues Phe-6, Gln-10, and Lys-80 destabilize Shq1p in vivo and induce a temperature-sensitive phenotype with depletion of H/ACA small nucleolar RNAs and defects in rRNA processing. Although CS domains are frequently found in co-chaperones of the Hsp90 molecular chaperone, no interaction was detected between the Shq1p CS domain and yeast Hsp90 in vitro. These results show that the CS domain is essential for Shq1p function in H/ACA snoRNP biogenesis in vivo, possibly in an Hsp90-independent manner.

  17. The plasma membrane-localised Ca(2+)-ATPase ACA8 plays a role in sucrose signalling involved in early seedling development in Arabidopsis.

    PubMed

    Zhang, Jie; Zhang, Xudong; Wang, Ruiping; Li, Weiqi

    2014-05-01

    Arabidopsis Ca (2+) -ATPase ACA8 plays a role in sucrose signalling during early seedling development by integrating developmental signals with carbon source availability. Calcium (Ca(2+)) is an essential signal transduction element in eukaryotic organisms. Changes in the levels of intracellular Ca(2+) affect multiple developmental processes in plants, including cell division, polar growth, and organogenesis. Here, we report that the plasma-membrane-localised Arabidopsis Ca(2+)-ATPase ACA8 plays a role in sucrose signalling during early seedling development. Disruption of the ACA8 gene elevated the expression of genes that encode transporters for Ca(2+) efflux. The seedlings that carried a T-DNA insertion mutation in ACA8 experienced water stress during early development. This response was unrelated to inadequate osmoregulatory responses and was most likely caused by disruption of cell membrane integrity and severe ion leakage. In addition, aca8-1 seedlings displayed a significant decline in photosynthetic performance and arrested root growth after removal of sucrose from the growth medium. The two phenomena resulted from impaired photosynthesis, reduced cell proliferation in the root meristem and the sucrose control of cell-cycle events. All of the stress-response phenotypes were rescued when expression of ACA8 was restored in aca8-1 mutant. Taken together, our results indicate that ACA8-mediated Ca(2+) signalling contributes to modulate early seedling development and coordinates root development with nutrient availability.

  18. 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.

  19. 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

  20. 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.

  1. Strains differentiation of Microsporum canis by RAPD analysis using (GACA)4 and (ACA)5 primers.

    PubMed

    Dobrowolska, Anita; Debska, Joanna; Kozłowska, Magdalena; Staczek, Paweł

    2011-01-01

    Molecular analysis of dermatophytes (based on PCR fingerprinting) revealed high clonal differentiation between the genus and species. Microsporum canis (zoophilic dermatophyte, belonging to genus Microsporum), responsible for most cases of tinea capitis in children, tinea corporis in adults and dermatophytoses in cats, is very unique in comparison with other dermatophytes. Results of most molecular studies show that there is no clonal differentiation within M. canis as distinct from other species. The aim of this study was application of (GACA)4 repetitive primer and (ACA)5 primer for typing of M. canis strains isolated from human and animals in Central Poland. Fungal strains: 32 clinical isolates of M. canis, originated from patients from Central Poland; 11 strains isolated from infected cats (6) and dogs (7), reference strains of M. canis (CBS 113480), T rubrum (CBS 120358), T mentagrophytes (CBS 120357) and E. floccosum (CBS 970.95). The genomic DNAs of the strains were used as a template in RAPD reaction. No differentiation was observed for the analyzed M. canis strains using (GACA)4 and (ACA)5 typing.

  2. Sustained Gains In Coverage, Access, And Affordability Under The ACA: A 2017 Update.

    PubMed

    Long, Sharon K; Bart, Lea; Karpman, Michael; Shartzer, Adele; Zuckerman, Stephen

    2017-09-01

    The significant gains in health insurance coverage and improvements in health care access and affordability that followed the implementation of the key coverage provisions of the Affordable Care Act in 2014 have persisted into 2017. Adults in all parts of the country, of all ages, and across all income groups have benefited from a large and sustained increase in the percentage of the US population that has health insurance. The gains have been particularly striking among low- and moderate-income Americans living in states that expanded Medicaid. Our latest survey data from the Urban Institute's 2017 Health Reform Monitoring Survey shows that only 10.2 percent of nonelderly adults are now uninsured-a decline of almost 41 percent from the period before implementation of the ACA. Nonetheless, repealing and replacing the ACA remained under consideration during the summer of 2017, along with more systematic changes to the financing of the Medicaid program. Many people will be at substantial risk if key components of the law are repealed or otherwise changed without carefully considering the health and financial consequences for those projected to lose coverage. Though the politics of health reform are challenging, opportunities exist to create a more equitable and efficient health care system. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Reducing Young Adults' Health Care Spending through the ACA Expansion of Dependent Coverage.

    PubMed

    Chen, Jie; Vargas-Bustamante, Arturo; Novak, Priscilla

    2017-10-01

    To estimate health care expenditure trends among young adults ages 19-25 before and after the 2010 implementation of the Affordable Care Act (ACA) provision that extended eligibility for dependent private health insurance coverage. Nationally representative Medical Expenditure Panel Survey data from 2008 to 2012. We conducted repeated cross-sectional analyses and employed a difference-in-differences quantile regression model to estimate health care expenditure trends among young adults ages 19-25 (the treatment group) and ages 27-29 (the control group). Our results show that the treatment group had 14 percent lower overall health care expenditures and 21 percent lower out-of-pocket payments compared with the control group in 2011-2012. The overall reduction in health care expenditures among young adults ages 19-25 in years 2011-2012 was more significant at the higher end of the health care expenditure distribution. Young adults ages 19-25 had significantly higher emergency department costs at the 10th percentile in 2011-2012. Differences in the trends of costs of private health insurance and doctor visits are not statistically significant. Increased health insurance enrollment as a consequence of the ACA provision for dependent coverage has successfully reduced spending and catastrophic expenditures, providing financial protections for young adults. © Health Research and Educational Trust.

  4. Accurate placement of substrate RNA by Gar1 in H/ACA RNA-guided pseudouridylation

    PubMed Central

    Wang, Peng; Yang, Lijiang; Gao, Yi Qin; Zhao, Xin Sheng

    2015-01-01

    H/ACA RNA-guided ribonucleoprotein particle (RNP), the most complicated RNA pseudouridylase so far known, uses H/ACA guide RNA for substrate capture and four proteins (Cbf5, Nop10, L7Ae and Gar1) for pseudouridylation. Although it was shown that Gar1 not only facilitates the product release, but also enhances the catalytic activity, the chemical role that Gar1 plays in this complicated machinery is largely unknown. Kinetics measurement on Pyrococcus furiosus RNPs at different temperatures making use of fluorescence anisotropy showed that Gar1 reduces the catalytic barrier through affecting the activation entropy instead of enthalpy. Site-directed mutagenesis combined with molecular dynamics simulations demonstrated that V149 in the thumb loop of Cbf5 is critical in placing the target uridine to the right position toward catalytic D85 of Cbf5. The enzyme elegantly aligns the position of uridine in the catalytic site with the help of Gar1. In addition, conversion of uridine to pseudouridine results in a rigid syn configuration of the target nucleotide in the active site and causes Gar1 to pull out the thumb. Both factors guarantee the efficient release of the product. PMID:26206671

  5. 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

    ... partnership. NAPHSIS and its membership (state vital records registrars) will work with CDC to promote... to identify and overcome barriers that limit access to work with CDC, states and local grantees to... Domestic Assistance Number (CFDA): 93.070. Approximately $125,000.00 in ACA funding will be awarded to...

  6. 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....

  7. 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...

  8. 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…

  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. 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...

  11. 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

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

    PubMed

    Coroniti, Roberta; Fario, 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 vascularization

  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.

    PubMed

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

    2015-02-27

    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, 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  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. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. Accommodative ET-High AC/A Ratio Esotropia: The Case for Glasses.

    PubMed

    Raab, Edward L

    2016-01-01

    There is a continuing debate as to whether the patient optically correctable at distance to within 8 prism diopters of perfect alignment requires treatment for persisting overconvergence at near, and if treatment is indicated, what it should be. For the patient whose misalignment at distance is reduced to 8 or fewer prism diopters, my preference is for the full cycloplegic correction plus a bifocal in the first prescription, to discourage virtually all accommodation initially, with pull back later. Review of several reports indicates a continued lack of consensus on whether this causes disuse weakening of accommodation and premature presbyopia. Recent studies found that prolonged convergence tone at near can result in anatomic and physiologic alterations in the medial rectus muscles that threaten a satisfactory distance alignment as well, despite relief of the accommodative demand. Hypoaccommodative esotropia resembles the high AC/A variety. Spontaneously improving over-convergence at near is not likely to occur in the hypoaccommodating patient either with observation alone or with surgery. I reserve surgery for the over-convergence at near for the unusual case of an extremely high distance-near disparity, and for the teenager or adult not showing likelihood that the condition will resolve. © 2016 Board of regents of the University of Wisconsin System, American Orthoptic Journal, Volume 66, 2016, ISSN 0065-955X, E-ISSN 1553-4448.

  9. A role for H/ACA and C/D small nucleolar RNAs in viral replication.

    PubMed

    Murray, James L; Sheng, Jinsong; Rubin, Donald H

    2014-05-01

    We have employed gene-trap insertional mutagenesis to identify candidate genes whose disruption confer phenotypic resistance to lytic infection, in independent studies using 12 distinct viruses and several different cell lines. Analysis of >2,000 virus-resistant clones revealed >1,000 candidate host genes, approximately 20 % of which were disrupted in clones surviving separate infections with 2-6 viruses. Interestingly, there were 83 instances in which the insertional mutagenesis vector disrupted transcripts encoding H/ACA-class and C/D-class small nucleolar RNAs (SNORAs and SNORDs, respectively). Of these, 79 SNORAs and SNORDs reside within introns of 29 genes (predominantly protein-coding), while 4 appear to be independent transcription units. siRNA studies targeting candidate SNORA/Ds provided independent confirmation of their roles in infection when tested against cowpox virus, Dengue Fever virus, influenza A virus, human rhinovirus 16, herpes simplex virus 2, or respiratory syncytial virus. Significantly, eight of the nine SNORA/Ds targeted with siRNAs enhanced cellular resistance to multiple viruses suggesting widespread involvement of SNORA/Ds in virus-host interactions and/or virus-induced cell death.

  10. 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.

  11. 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.

  12. 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.

  13. Analysis of the binding of the N-terminal conserved domain of yeast Cbf5p to a box H/ACA snoRNA.

    PubMed

    Normand, Christophe; Capeyrou, Regine; Quevillon-Cheruel, Sophie; Mougin, Annie; Henry, Yves; Caizergues-Ferrer, Michele

    2006-10-01

    During ribosome biogenesis, the RNA precursor to mature rRNAs undergoes numerous post-transcriptional chemical modifications of bases, including conversions of uridines to pseudouridines. In archaea and eukaryotes, these conversions are performed by box H/ACA small ribonucleoprotein particles (box H/ACA RNPs), which contain a small guide RNA responsible for the selection of substrate uridines and four proteins, including the pseudouridine synthase, Cbf5p. So far, no in vitro reconstitution of eukaryotic box H/ACA RNPs from purified components has been achieved, principally due to difficulties in purifying recombinant eukaryotic Cbf5p. In this study, we present the purification of a truncated derivative of yeast Cbf5p (Cbf5(Delta)p) that retains the highly conserved TRUB and PUA domains. We have used band retardation assays to show that Cbf5(Delta)p on its own binds to box H/ACA small nucleolar (sno)RNAs. We demonstrate that the conserved H and ACA boxes enhance the affinity of the protein for the snoRNA. Furthermore, like its archaeal homologs, Cbf5(Delta)p can bind to a single stem-loop-box ACA RNA. Finally, we report the first enzymatic footprinting analysis of a Cbf5-RNA complex. Our results are compatible with the view that two molecules of Cbf5p interact with a binding platform constituted by the 5' end of the RNA, the single-stranded hinge domain containing the conserved H box, and the 3' end of the molecule, including the conserved ACA box.

  14. 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

  15. Structure of the Shq1-Cbf5-Nop10-Gar1 complex and implications for H/ACA RNP biogenesis and dyskeratosis congenita.

    PubMed

    Li, Shuang; Duan, Jingqi; Li, Dandan; Ma, Shoucai; Ye, Keqiong

    2011-11-25

    Shq1 is a conserved protein required for the biogenesis of eukaryotic H/ACA ribonucleoproteins (RNPs), including human telomerase. We report the structure of the Shq1-specific domain alone and in complex with H/ACA RNP proteins Cbf5, Nop10 and Gar1. The Shq1-specific domain adopts a novel helical fold and primarily contacts the PUA domain and the otherwise disordered C-terminal extension (CTE) of Cbf5. The structure shows that dyskeratosis congenita mutations found in the CTE of human Cbf5 likely interfere with Shq1 binding. However, most mutations in the PUA domain are not located at the Shq1-binding surface and also have little effect on the yeast Cbf5-Shq1 interaction. Shq1 binds Cbf5 independently of the H/ACA RNP proteins Nop10, Gar1 and Nhp2 and the assembly factor Naf1, but shares an overlapping binding surface with H/ACA RNA. Shq1 point mutations that disrupt Cbf5 interaction suppress yeast growth particularly at elevated temperatures. Our results suggest that Shq1 functions as an assembly chaperone that protects the Cbf5 protein complexes from non-specific RNA binding and aggregation before assembly of H/ACA RNA.

  16. 18S rRNA processing requires base pairings of snR30 H/ACA snoRNA to eukaryote-specific 18S sequences.

    PubMed

    Fayet-Lebaron, Eléonore; Atzorn, Vera; Henry, Yves; Kiss, Tamás

    2009-05-06

    The H/ACA RNAs represent an abundant, evolutionarily conserved and functionally diverse class of non-coding RNAs. Many H/ACA RNAs direct pseudouridylation of rRNAs and snRNAs, while members of the rapidly growing group of 'orphan' H/ACA RNAs participate in pre-rRNA processing, telomere synthesis and probably, in other nuclear processes. The yeast snR30 'orphan' H/ACA snoRNA has long been known to function in the nucleolytic processing of 18S rRNA, but its molecular role remained unknown. Here, we provide biochemical and genetic evidence demonstrating that during pre-rRNA processing, two evolutionarily conserved sequence elements in the 3'-hairpin of snR30 base-pair with short pre-rRNA sequences located in the eukaryote-specific internal region of 18S rRNA. The newly discovered snR30-18S base-pairing interactions are essential for 18S rRNA production and they constitute a complex snoRNA target RNA transient structure that is novel to H/ACA RNAs. We also demonstrate that besides the 18S recognition motifs, the distal part of the 3'-hairpin of snR30 contains an additional snoRNA element that is essential for 18S rRNA processing and that functions most likely as a snoRNP protein-binding site.

  17. 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

    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

    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. 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. 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. 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.

  18. 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.

  19. 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

  20. 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

  1. Functional and Structural Impact of Target Uridine Substitutions on the H/ACA Ribonucleoprotein Particle Pseudouridine Synthase

    SciTech Connect

    Zhou, Jing; Liang, Bo; Li, Hong

    2010-09-17

    Box H/ACA ribonucleoprotein protein particles catalyze the majority of pseudouridylation in functional RNA. Different from stand alone pseudouridine synthases, the RNP pseudouridine synthase comprises multiple protein subunits and an RNA subunit. Previous studies showed that each subunit, regardless its location, is sensitive to the step of subunit placement at the catalytic center and potentially to the reaction status of the substrate. Here we describe the impact of chemical substitutions of target uridine on enzyme activity and structure. We found that 3-methyluridine in place of uridine inhibited its isomerization while 2{prime}-deoxyuridine or 4-thiouridine did not. Significantly, crystal structures of an archaeal box H/ACA RNP bound with the nonreactive and the two postreactive substrate analogues showed only subtle structural changes throughout the assembly except for a conserved tyrosine and a substrate anchoring loop of Cbf5. Our results suggest a potential role of these elements and the subunit that contacts them in substrate binding and product release.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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…

  9. 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…

  10. 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

  11. Long-term outcome of medial rectus recession and pulley posterior fixation in esotropia with high AC/A ratio.

    PubMed

    Wabulembo, Geoffrey; Demer, Joseph L

    2012-09-01

    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). 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. 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. 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. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. Policy commercializing nonprofits in health: the history of a paradox from the 19th century to the ACA.

    PubMed

    Fox, Daniel M

    2015-03-01

    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. 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. 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. 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. The policy paradox that has incentivized the growth and commercialization of nonprofits in

  19. When public health and genetic privacy collide: positive and normative theories explaining how ACA's expansion of corporate wellness programs conflicts with GINA's privacy rules.

    PubMed

    Bard, Jennifer S

    2011-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) contains many provisions intended to increase access to and lower the cost of health care by adopting public health measures. One of these promotes the use of at-work wellness programs by both providing employers with grants to develop these programs and also increasing their ability to tie the price employees pay for health insurance for participating in these programs and meeting specific health goals. Yet despite ACA's specific alteration of three different statues which had in the past shielded employees from having to contribute to the cost of their health insurance based on their achieving employer-designated health markers, it chose to leave alone recently enacted rules implementing the Genetic Non-Discrimination Act (GINA), which prohibits employers from asking employees about their family health history in any context, including assessing their risk for setting wellness targets. This article reviews how both the changes made by ACA and the restrictions recently put place by GINA will affect the way employers are likely to structure Wellness Programs. It also considers how these changes reflect the competing social goals of both ACA, which seeks to expand access to the population by lowering costs, and GINA, which seeks to protect individuals from discrimination. It does so by analyzing both positive theories about how these new laws will function and normative theories explaining the likelihood of future friction between the interests of the population of the United States as a whole who are in need of increased and affordable access to health care, and of the individuals living in this country who risk discrimination, as science and medicine continue to make advances in linking genetic make-up to risk of future illness. © 2011 American Society of Law, Medicine & Ethics, Inc.

  20. 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

  1. A physical interaction between Gar1p and Rnt1pi is required for the nuclear import of H/ACA small nucleolar RNA-associated proteins.

    PubMed

    Tremblay, Annie; Lamontagne, Bruno; Catala, Mathieu; Yam, Yeung; Larose, Stephanie; Good, Liam; Elela, Sherif Abou

    2002-07-01

    During rRNA biogenesis, multiple RNA and protein substrates are modified and assembled through the coordinated activity of many factors. In Saccharomyces cerevisiae, the double-stranded RNA nuclease Rnt1p and the H/ACA snoRNA pseudouridylase complex participate in the transformation of the nascent pre-rRNA transcript into 35S pre-rRNA. Here we demonstrate the binding of a component of the H/ACA complex (Gar1p) to Rnt1p in vivo and in vitro in the absence of other factors. In vitro, Rnt1p binding to Gar1p is mutually exclusive of its RNA binding and cleavage activities. Mutations in Rnt1p that disrupt Gar1p binding do not inhibit RNA cleavage in vitro but slow RNA processing, prevent nucleolar localization of H/ACA snoRNA-associated proteins, and reduce pre-rRNA pseudouridylation in vivo. These results demonstrate colocalization of various components of the rRNA maturation complex and suggest a mechanism that links rRNA pseudouridylation and cleavage factors.

  2. Effectiveness of the 'availability, current issues and anticipation' (ACA) training programme for general practice trainees on communication with palliative care patients: a controlled trial.

    PubMed

    Slort, Willemjan; Blankenstein, Annette H; Schweitzer, Bart P M; Deliens, Luc; van der Horst, Henriëtte E

    2014-04-01

    This study aimed to evaluate the effectiveness of a new palliative care 'availability, current issues and anticipation' (ACA) training programme to improve communication skills of general practice trainees (GPTs). In a controlled trial among third-year GPTs, we videotaped one 20-min consultation between each GPT and a simulated palliative care patient at baseline and at six months follow-up. We measured the number of issues discussed and the quality of communication skills and analysed between-group differences using linear mixed models and logistic regression. Fifty-four GPTs were assigned to the intervention and 64 to the control group. We found no effect of the programme on the number of issues discussed or on the quality of GPT communicative behaviour. GPTs infrequently addressed 'spiritual/existential issues' and 'unfinished business'. In a selection of the consultations, simulated patients brought up more issues than the GPTs did. The ACA training programme was not effective in the way it was carried out and evaluated in this trial. The ACA programme should focus on the issues that scored low in this trial. Future research on GPT-patient communication in palliative care should consider using real patients in a series of consultations to evaluate effectiveness. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. 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

  4. Disruption of the MIG1 gene enhances lipid biosynthesis in the oleaginous yeast Yarrowia lipolytica ACA-DC 50109.

    PubMed

    Wang, Zhi-Peng; Xu, Hong-Mei; Wang, Guang-Yuan; Chi, Zhe; Chi, Zhen-Ming

    2013-04-01

    In this study, the MIG1 gene in the oleaginous yeast Yarrowia lipolytica ACA-DC 50109 (the parent yeast) was disrupted and the disruptant M25 obtained could grow in yeast nitrogen base-N5000 medium without uracil or the medium with 2-deoxy-D-glucose. It was found that the cells of the disruptant M25 had more lipid bodies than those of its parent yeast. The disruptant M25 contained 48.7% (w/w) of oil based on its cell weight while the parent yeast only contained 36.0% (w/w) of oil. Transcript levels of many genes relevant to lipid biosynthesis in the disruptant M25 were enhanced compared to those of the same genes in the parent yeast. However, transcript level of the MFE1 gene, one of the genes relevant to fatty acid degradation was reduced in the disruptant M25 compared to that of the same gene in the parent yeast. Such changes in gene expression profile may cause the increased lipid biosynthesis in the disruptant M25. Biosynthesis of C18:1 fatty acid in the disruptant M25 was greatly enhanced compared to that in the parent yeast. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. 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. Project HOPE—The People-to-People Health Foundation, Inc.

  6. 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

  7. 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.

  8. Effectiveness of the ACA (Availability, Current issues and Anticipation) training programme on GP-patient communication in palliative care; a controlled trial.

    PubMed

    Slort, Willemjan; Blankenstein, Annette H; Schweitzer, Bart P M; Knol, Dirk L; Deliens, Luc; Aaronson, Neil K; van der Horst, Henriëtte E

    2013-07-02

    Communicating effectively with palliative care patients has been acknowledged to be somewhat difficult, but little is known about the effect that training general practitioners (GPs) in specific elements of communication in palliative care might have. We hypothesized that GPs exposed to a new training programme in GP-patient communication in palliative care focusing on availability of the GP for the patient, current issues the GP should discuss with the patient and anticipation by the GP of various scenarios (ACA), would discuss more issues and become more skilled in their communication with palliative care patients. In this controlled trial among GPs who attended a two-year Palliative Care Peer Group Training Course in the Netherlands only intervention GPs received the ACA training programme. To evaluate the effect of the programme a content analysis (Roter Interaction Analysis System) was performed of one videotaped 15-minute consultation of each GP with a simulated palliative care patient conducted at baseline, and one at 12 months follow-up. Both how the GP communicated with the patient ('availability') and the number of current and anticipated issues the GP discussed with the patient were measured quantitatively. We used linear mixed models and logistic regression models to evaluate between-group differences over time. Sixty-two GPs were assigned to the intervention and 64 to the control group. We found no effect of the ACA training programme on how the GPs communicated with the patient or on the number of issues discussed by GPs with the patient. The total number of issues discussed by the GPs was eight out of 13 before and after the training in both groups. The ACA training programme did not influence how the GPs communicated with the simulated palliative care patient or the number of issues discussed by the GPs in this trial. Further research should evaluate whether this training programme is effective for GPs who do not have a special interest in

  9. The impact of the affordable care Act (ACA) on favorable risk selection and Beneficiaries' health status in Medicare advantage: a preliminary assessment.

    PubMed

    Natafgi, Nabil; Nattinger, Matthew; Ugwi, Patience; Ullrich, Fred; Wolinsky, Fredric D

    2016-08-18

    In response to increasing fiscal pressures, the Affordable Care Act (ACA) sought to reduce Medicare Advantage plan expenses by restructuring the bidding and payment processes. The purpose of this study is to assess the effects of the ACA's payment freeze and restructuring of the bidding and payment processes on favorable risk selection in Medicare Advantage plan enrollment (objective 1) and changes in the health status of beneficiaries enrolled in Medicare Advantage plans over time (objective 2). We used the Medicare Health Outcome Survey baseline data (2007→2013) for analyses of the first objective (7 cohorts, 1.7 million beneficiaries) and the linked baseline and follow-up data (2007-2009→2011-2013) for analyses of the second objective (5 cohorts, 0.5 million beneficiaries). To examine favorable risk selection we used the following outcomes: self-rated health, falls, balance problems, falls management, frailty, and morbidity. To examine changes in beneficiary health status over time, we examined changes (over time) in these same outcomes. The focal independent variable is the policy implementation measure, which is time dependent and measures the accumulation of changes to Medicare Advantage payment policies resulting from the ACA. Multiple regression models were developed to examine the relationship between ACA implementation and outcomes of interest. In terms of favorable selection, individuals enrolled in Medicare Advantage plans post-ACA have, on average, better self-rated health (b = 0.003, p < 0.01), lower odds of falls (AOR = 0.981, p < 0.001), higher odds of falls management (AOR = 1.040, p < 0.001), lower frailty risks (IRR = 0.983, p < 0.001), and lower risks of comorbidities (IRR = 0.989, p < 0.001). In terms of health status changes over time, the results indicate that in the post-ACA period, beneficiaries reported better self-rated health (b = 0.028, p < 0.001), lower odds of falls (AOR = 0

  10. 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.

  11. Expanding the clinicopathological spectrum of late cutaneous Lyme borreliosis (acrodermatitis chronica atrophicans [ACA]): A prospective study of 20 culture- and/or polymerase chain reaction (PCR)-documented cases.

    PubMed

    Lenormand, Cédric; Jaulhac, Benoît; Debarbieux, Sébastien; Dupin, Nicolas; Granel-Brocard, Florence; Adamski, Henri; Barthel, Cathy; Cribier, Bernard; Lipsker, Dan

    2016-04-01

    The diagnosis of acrodermatitis chronica atrophicans (ACA), the late cutaneous manifestation of Lyme borreliosis, can be challenging. Histologic changes in ACA have been described in a few studies from endemic countries, relying on cases documented by serology only. We sought to reassess the clinicopathological spectrum of ACA in a series of thoroughly documented cases. Patients prospectively included in a national prospective study were selected on the basis of positive culture and/or polymerase chain reaction of a skin biopsy sample. The diagnosis of ACA was confirmed by reviewing the clinical and serologic data. Histopathological samples were carefully reviewed. Twenty patients were included. Unusual clinical features (ie, numerous small violaceous patches and equidistant small spinous papules with background faint erythema) were observed in 2 patients. Histopathological examination revealed a classic plasma cell-rich perivascular and interstitial pattern with telangiectases in 16 of 25 samples, whereas strikingly prominent granuloma annulare-like or lichenoid features were observed in 4 and 2 of 25 cases, respectively, and discrete nonspecific minor changes in 3 of 25 cases. The small number of patients was a limitation. Genuine culture- and/or polymerase chain reaction-proven ACA can rarely present as numerous violaceous patches or cluster of spinous papules clinically, and as a granuloma annulare-like or lichenoid dermatosis histologically. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Conserved composition of mammalian box H/ACA and box C/D small nucleolar ribonucleoprotein particles and their interaction with the common factor Nopp140.

    PubMed

    Yang, Y; Isaac, C; Wang, C; Dragon, F; Pogacic, V; Meier, U T

    2000-02-01

    Small nucleolar ribonucleoprotein particles (snoRNPs) mainly catalyze the modification of rRNA. The two major classes of snoRNPs, box H/ACA and box C/D, function in the pseudouridylation and 2'-O-methylation, respectively, of specific nucleotides. The emerging view based on studies in yeast is that each class of snoRNPs is composed of a unique set of proteins. Here we present a characterization of mammalian snoRNPs. We show that the previously characterized NAP57 is specific for box H/ACA snoRNPs, whereas the newly identified NAP65, the rat homologue of yeast Nop5/58p, is a component of the box C/D class. Using coimmunoprecipitation experiments, we show that the nucleolar and coiled-body protein Nopp140 interacts with both classes of snoRNPs. This interaction is corroborated in vivo by the exclusive depletion of snoRNP proteins from nucleoli in cells transfected with a dominant negative Nopp140 construct. Interestingly, RNA polymerase I transcription is arrested in nucleoli depleted of snoRNPs, raising the possibility of a feedback mechanism between rRNA modification and transcription. Moreover, the Nopp140-snoRNP interaction appears to be conserved in yeast, because depletion of Srp40p, the yeast Nopp140 homologue, in a conditional lethal strain induces the loss of box H/ACA small nucleolar RNAs. We propose that Nopp140 functions as a chaperone of snoRNPs in yeast and vertebrate cells.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  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. 68Ga-NOTA-Aca-BBN(7-14) PET/CT in Healthy Volunteers and Glioma Patients.

    PubMed

    Zhang, Jingjing; Li, Deling; Lang, Lixin; Zhu, Zhaohui; Wang, Ling; Wu, Peilin; Niu, Gang; Li, Fang; Chen, Xiaoyuan

    2016-01-01

    This work was designed to study the safety, biodistribution, and radiation dosimetry of a gastrin-releasing peptide receptor (GRPR)-targeting, (68)Ga-labeled bombesin (BBN) peptide derivative PET tracer, NOTA-Aca-BBN(7-14) (denoted as (68)Ga-BBN) in healthy volunteers and to assess the level of receptor expression in glioma patients. Four healthy volunteers (2 male and 2 female) underwent whole-body PET/CT at multiple time points after a bolus injection of (68)Ga-BBN (111 ± 148 MBq). Regions of interest were drawn manually over major organs, and time-activity curves were obtained. Dosimetry was calculated using the OLINDA/EXM software. Twelve patients with glioma diagnosed by contrast-enhanced MRI underwent PET/CT at 30-45 min after (68)Ga-BBN injection. Within 1 wk afterward, the tumor was surgically removed and immunohistochemical staining of tumor samples against GRPR was performed and correlated with the PET/CT results. (68)Ga-BBN was well tolerated in all healthy volunteers, with no adverse symptoms being noticed or reported. (68)Ga-BBN cleared rapidly from the circulation and was excreted mainly through the kidneys and urinary tract. The total effective dose equivalent and effective dose were 0.0335 ± 0.0079 and 0.0276 ± 0.0066 mSv/MBq, respectively. In glioma patients, all MRI-identified lesions showed high signal intensity on (68)Ga-BBN PET/CT. SUVmax and SUVmean were 2.08 ± 0.58 and 1.32 ± 0.37, respectively. With normal brain tissue as background, tumor-to-background ratios were 24.0 ± 8.85 and 13.4 ± 4.54 based on SUVmax and SUVmean, respectively. The immunohistochemical staining confirmed a positive correlation between SUV and GRPR expression level (r(2) = 0.71, P < 0.001). (68)Ga-BBN is a PET tracer with favorable pharmacokinetics and a favorable dosimetry profile. It has the potential to evaluate GRPR expression in glioma patients and guide GRPR-targeted therapy of glioma. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  1. 68Ga-NOTA-Aca-BBN(7–14) PET/CT in Healthy Volunteers and Glioma Patients

    PubMed Central

    Zhang, Jingjing; Li, Deling; Lang, Lixin; Zhu, Zhaohui; Wang, Ling; Wu, Peilin; Niu, Gang; Li, Fang; Chen, Xiaoyuan

    2017-01-01

    This work was designed to study the safety, biodistribution, and radiation dosimetry of a gastrin-releasing peptide receptor (GRPR)– targeting, 68Ga-labeled bombesin (BBN) peptide derivative PET tracer, NOTA-Aca-BBN(7–14) (denoted as 68Ga-BBN) in healthy volunteers and to assess the level of receptor expression in glioma patients. Methods Four healthy volunteers (2 male and 2 female) underwent whole-body PET/CT at multiple time points after a bolus injection of 68Ga-BBN (111 ± 148 MBq). Regions of interest were drawn manually over major organs, and time–activity curves were obtained. Dosimetry was calculated using the OLINDA/EXM software. Twelve patients with glioma diagnosed by contrast-enhanced MRI underwent PET/CT at 30–45 min after 68Ga-BBN injection. Within 1 wk afterward, the tumor was surgically removed and immunohistochemical staining of tumor samples against GRPR was performed and correlated with the PET/CT results. Results 68Ga-BBN was well tolerated in all healthy volunteers, with no adverse symptoms being noticed or reported. 68Ga-BBN cleared rapidly from the circulation and was excreted mainly through the kidneys and urinary tract. The total effective dose equivalent and effective dose were 0.0335 ± 0.0079 and 0.0276 ± 0.0066 mSv/MBq, respectively. In glioma patients, all MRI-identified lesions showed high signal intensity on 68Ga-BBN PET/CT. SUVmax and SUVmean were 2.08 ± 0.58 and 1.32 ± 0.37, respectively. With normal brain tissue as background, tumor-to-background ratios were 24.0 ± 8.85 and 13.4 ± 4.54 based on SUVmax and SUVmean, respectively. The immunohistochemical staining confirmed a positive correlation between SUV and GRPR expression level (r2 = 0.71, P < 0.001). Conclusion 68Ga-BBN is a PET tracer with favorable pharmacokinetics and a favorable dosimetry profile. It has the potential to evaluate GRPR expression in glioma patients and guide GRPR-targeted therapy of glioma. PMID:26449838

  2. The box H/ACA RNP assembly factor Naf1p contains a domain homologous to Gar1p mediating its interaction with Cbf5p.

    PubMed

    Leulliot, Nicolas; Godin, Katherine S; Hoareau-Aveilla, Coralie; Quevillon-Cheruel, Sophie; Varani, Gabriele; Henry, Yves; Van Tilbeurgh, Herman

    2007-08-31

    Naf1 is an essential protein involved in the maturation of box H/ACA ribonucleoproteins, a group of particles required for ribosome biogenesis, modification of spliceosomal small nuclear RNAs and telomere synthesis. Naf1 participates in the assembly of the RNP at transcription sites and in the nuclear trafficking of the complex. The crystal structure of a domain of yeast Naf1p, Naf1Delta1p, reveals a striking structural homology with the core domain of archaeal Gar1, an essential protein component of the mature RNP; it suggests that Naf1p and Gar1p have a common binding site on the enzymatic protein component of the particle, Cbf5p. We propose that Naf1p is a competitive binder for Cbf5p, which is replaced by Gar1p during maturation of the H/ACA particle. The exchange of Naf1p by Gar1p might be prompted by external factors that alter the oligomerisation state of Naf1p and Gar1p. The structural homology with Gar1 suggests that the function of Naf1 involves preventing non-cognate RNAs from being loaded during transport of the particle by inducing a non-productive conformation of Cbf5.

  3. Elucidating the role of H/ACA-like RNAs in trans-splicing and rRNA processing via RNA interference silencing of the Trypanosoma brucei CBF5 pseudouridine synthase.

    PubMed

    Barth, Sarit; Hury, Avraham; Liang, Xue-Hai; Michaeli, Shulamit

    2005-10-14

    Most pseudouridinylation in eukaryotic rRNA and small nuclear RNAs is guided by H/ACA small nucleolar RNAs. In this study, the Trypanosoma brucei pseudouridine synthase, Cbf5p, a snoRNP protein, was identified and silenced by RNAi. Depletion of this protein destabilized all small nucleolar RNAs of the H/ACA-like family. Following silencing, defects in rRNA processing, such as accumulation of precursors and inhibition of cleavages to generate the mature rRNA, were observed. snR30, an H/ACA RNA involved in rRNA maturation, was identified based on prototypical conserved domains characteristic of this RNA in other eukaryotes. The silencing of CBF5 also eliminated the spliced leader-associated (SLA1) RNA that directs pseudouridylation on the spliced leader RNA (SL RNA), which is the substrate for the trans-splicing reaction. Surprisingly, the depletion of Cbf5p not only eliminated the pseudouridine on the SL RNA but also abolished capping at the fourth cap-4 nucleotide. As a result of defects in the SL RNA and decreased modification on the U small nuclear RNA, trans-splicing was inhibited at the first step of the reaction, providing evidence for the essential role of H/ACA RNAs and the modifications they guide on trans-splicing.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Acquisition through horizontal gene transfer of plasmid pSMA198 by Streptococcus macedonicus ACA-DC 198 points towards the dairy origin of the species.

    PubMed

    Papadimitriou, Konstantinos; Anastasiou, Rania; Maistrou, Eleni; Plakas, Thomas; Papandreou, Nikos C; Hamodrakas, Stavros J; Ferreira, Stéphanie; Supply, Philip; Renault, Pierre; Pot, Bruno; Tsakalidou, Effie

    2015-01-01

    Streptococcus macedonicus is an intriguing streptococcal species whose most frequent source of isolation is fermented foods similarly to Streptococcus thermophilus. However, S. macedonicus is closely related to commensal opportunistic pathogens of the Streptococcus bovis/Streptococcus equinus complex. We analyzed the pSMA198 plasmid isolated from the dairy strain Streptococcus macedonicus ACA-DC 198 in order to provide novel clues about the main ecological niche of this bacterium. pSMA198 belongs to the narrow host range pCI305/pWV02 family found primarily in lactococci and to the best of our knowledge it is the first such plasmid to be reported in streptococci. Comparative analysis of the pSMA198 sequence revealed a high degree of similarity with plasmids isolated from Lactococcus lactis strains deriving from milk or its products. Phylogenetic analysis of the pSMA198 Rep showed that the vast majority of closely related proteins derive from lactococcal dairy isolates. Additionally, cloning of the pSMA198 ori in L. lactis revealed a 100% stability of replication over 100 generations. Both pSMA198 and the chromosome of S. macedonicus exhibit a high percentage of potential pseudogenes, indicating that they have co-evolved under the same gene decay processes. We identified chromosomal regions in S. macedonicus that may have originated from pSMA198, also supporting a long co-existence of the two replicons. pSMA198 was also found in divergent biotypes of S. macedonicus and in strains isolated from dispersed geographic locations (e.g. Greece and Switzerland) showing that pSMA198's acquisition is not a recent event. Here we propose that S. macedonicus acquired plasmid pSMA198 from L. lactis via an ancestral genetic exchange event that took place most probably in milk or dairy products. We provide important evidence that point towards the dairy origin of this species.

  17. 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).

  18. 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.

  19. 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

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

    PubMed

    Papadimitriou, Konstantinos; Anastasiou, Rania; Mavrogonatou, Eleni; Blom, Jochen; Papandreou, Nikos C; Hamodrakas, Stavros J; Ferreira, Stéphanie; Renault, Pierre; Supply, Philip; Pot, Bruno; Tsakalidou, Effie

    2014-04-08

    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. 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, similar findings were

  1. Acquisition through Horizontal Gene Transfer of Plasmid pSMA198 by Streptococcus macedonicus ACA-DC 198 Points towards the Dairy Origin of the Species

    PubMed Central

    Papadimitriou, Konstantinos; Anastasiou, Rania; Maistrou, Eleni; Plakas, Thomas; Papandreou, Nikos C.; Hamodrakas, Stavros J.; Ferreira, Stéphanie; Supply, Philip; Renault, Pierre; Pot, Bruno; Tsakalidou, Effie

    2015-01-01

    Background Streptococcus macedonicus is an intriguing streptococcal species whose most frequent source of isolation is fermented foods similarly to Streptococcus thermophilus. However, S. macedonicus is closely related to commensal opportunistic pathogens of the Streptococcus bovis/Streptococcus equinus complex. Methodology/Principal Findings We analyzed the pSMA198 plasmid isolated from the dairy strain Streptococcus macedonicus ACA-DC 198 in order to provide novel clues about the main ecological niche of this bacterium. pSMA198 belongs to the narrow host range pCI305/pWV02 family found primarily in lactococci and to the best of our knowledge it is the first such plasmid to be reported in streptococci. Comparative analysis of the pSMA198 sequence revealed a high degree of similarity with plasmids isolated from Lactococcus lactis strains deriving from milk or its products. Phylogenetic analysis of the pSMA198 Rep showed that the vast majority of closely related proteins derive from lactococcal dairy isolates. Additionally, cloning of the pSMA198 ori in L. lactis revealed a 100% stability of replication over 100 generations. Both pSMA198 and the chromosome of S. macedonicus exhibit a high percentage of potential pseudogenes, indicating that they have co-evolved under the same gene decay processes. We identified chromosomal regions in S. macedonicus that may have originated from pSMA198, also supporting a long co-existence of the two replicons. pSMA198 was also found in divergent biotypes of S. macedonicus and in strains isolated from dispersed geographic locations (e.g. Greece and Switzerland) showing that pSMA198’s acquisition is not a recent event. Conclusions/Significance Here we propose that S. macedonicus acquired plasmid pSMA198 from L. lactis via an ancestral genetic exchange event that took place most probably in milk or dairy products. We provide important evidence that point towards the dairy origin of this species. PMID:25584532

  2. 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

  3. Spin-density-wave-induced anomalies in the optical conductivity of AFe2As2, (A=Ca, Sr, Ba) single-crystalline iron pnictides

    NASA Astrophysics Data System (ADS)

    Charnukha, A.; Pröpper, D.; Larkin, T. I.; Sun, D. L.; Li, Z. W.; Lin, C. T.; Wolf, T.; Keimer, B.; Boris, A. V.

    2013-11-01

    We report the complex dielectric function of high-quality AFe2As2, (A=Ca, Sr, Ba) single crystals with TN≈150K, 200K, and 138K, respectively, determined by broadband spectroscopic ellipsometry at temperatures 10≤T≤300K and wave numbers from 100cm-1 to 52000cm-1. In CaFe2As2 we identify the optical spin-density-wave gap 2ΔSDW≈1250cm-1. The 2ΔSDW/(kBTN) ratio, characterizing the strength of the electron-electron coupling in the spin-density-wave state, amounts to ≈12 in CaFe2As2, significantly larger than the corresponding values for the SrFe2As2 and BaFe2As2 compounds: 8.7 and 5.3, respectively. We further show that, similarly to the Ba-based compound, two characteristic SDW energy gaps can be identified in the infrared-conductivity spectra of both SrFe2As2 and CaFe2As2 and investigate their detailed temperature dependence in all three materials. This analysis reveals the existence of an anomaly in CaFe2As2 at a temperature T*≈80K, well below the Néel temperature of this compound, which implies weak coupling between the two SDW subsystems. The coupling between the two subsystems evolves to intermediate in the Sr-based and strong in the Ba-based material. The temperature dependence of the infrared phonons reveals clear anomalies at the corresponding Néel temperatures of the investigated compounds. In CaFe2As2, the phonons exhibit signatures of SDW fluctuations above TN and some evidence for anomalies at T*. Investigation of all three materials in the visible spectral range reveals a spin-density-wave-induced suppression of two absorption bands systematically enhanced with decreasing atomic number of the intercalant. A dispersion analysis of the data in the entire spectral range clearly shows that CaFe2As2 is significantly more metallic than the other two compounds. Our results single out CaFe2As2 in the class of ThCr2Si2-type iron-based materials by demonstrating the existence of two weakly coupled and extremely metallic electronic subsystems.

  4. 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.

  5. 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

  6. 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.

  7. Influence of valence electron concentration on elastic, electronic and optical properties of the alkaline-earth tin oxides A 3SnO (A=Ca, Sr and Ba): A comparative study with ASnO 3 compounds

    NASA Astrophysics Data System (ADS)

    Cherrad, Djellal; Maouche, M.; Maamache, M.; Krache, L.

    2011-07-01

    By employing first principles method of the plane wave pseudo potential calculations (PP-PW), based on the density functional theory (DFT), within the local density approximation (LDA), the correlation between valence electron concentration and structural, elastic, electronic as well as optical properties of A 3SnO and ASnO 3 compounds where A=Ca, Sr and Ba are investigated. The elastic constants and their pressure dependence are calculated using the static finite strain technique. We derived the bulk, shear and Young's moduli for ideal monocrystalline and for polycrystalline A 3SnO and ASnO 3 aggregates. Band structures reveal that alkaline-earth tin oxides A 3SnO are direct energy band gap (G-G) materials. The hardness of these compounds was explained using chemical bonding properties and Milliken charges transfer. The optical constants, including the dielectric function, optical reflectivity, refractive index and electron energy loss, are calculated for radiation up to 20 eV. We have found that the static dielectric constants of all these compounds are in good agreement with Penn model.

  8. Synthesis and Eu{sup 3+} luminescence in new oxysilicates, ALa{sub 3}Bi(SiO{sub 4}){sub 3}O and ALa{sub 2}Bi{sub 2}(SiO{sub 4}){sub 3}O [A=Ca, Sr and Ba] with apatite-related structure

    SciTech Connect

    Lakshminarasimhan, N.; Varadaraju, U.V. . E-mail: varada@iitm.ac.in

    2005-11-15

    New oxysilicates with the general formula ALa{sub 3}Bi(SiO{sub 4}){sub 3}O and ALa{sub 2}Bi{sub 2}(SiO{sub 4}){sub 3}O [A=Ca, Sr and Ba] are synthesized and characterized. Powder X-ray diffraction of these silicates show that they are isostructural with BiCa{sub 4}(VO{sub 4}){sub 3}O which has an apatite-related structure. Eu{sup 3+} luminescence in the newly synthesized oxysilicates show broad emission lines due to disorder of cations. The relatively high intense magnetic dipole transition {sup 5}D{sub 0}->{sup 7}F{sub 1} points to a more symmetric environment. The photoluminescence results confirm that the compounds have apatite-related crystal structure.

  9. 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.

  10. Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

    PubMed

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S; Steffel, Jan; Marín, Francisco; de Oliveira Figueiredo, Márcio Jansen; de Simone, Giovanni; Tzou, Wendy S; Chiang, Chern-En; Williams, Bryan; Dan, Gheorghe-Andrei; Gorenek, Bulent; Fauchier, Laurent; Savelieva, Irina; Hatala, Robert; van Gelder, Isabelle; Brguljan-Hitij, Jana; Erdine, Serap; Lovic, Dragan; Kim, Young-Hoon; Salinas-Arce, Jorge; Field, Michael

    2017-06-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available evidence to publish a joint consensus document on hypertension and cardiac arrhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and the patient in light of all of the circumstances presented by that patient. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  11. Crystal structure determination and site-directed mutagenesis of the Pyrococcus abyssi aCBF5–aNOP10 complex reveal crucial roles of the C-terminal domains of both proteins in H/ACA sRNP activity

    PubMed Central

    2006-01-01

    In archaeal rRNAs, the isomerization of uridine into pseudouridine (Ψ) is achieved by the H/ACA sRNPs and the minimal set of proteins required for RNA:Ψ-synthase activity is the aCBF5–aNOP10 protein pair. The crystal structure of the aCBF5–aNOP10 heterodimer from Pyrococcus abyssi was solved at 2.1 Å resolution. In this structure, protein aNOP10 has an extended shape, with a zinc-binding motif at the N-terminus and an α-helix at the C-terminus. Both motifs contact the aCBF5 catalytic domain. Although less efficiently as does the full-length aNOP10, the aNOP10 C-terminal domain binds aCBF5 and stimulates the RNA-guided activity. We show that the C-terminal domain of aCBF5 (the PUA domain), which is wrapped by an N-terminal extension of aCBF5, plays a crucial role for aCBF5 binding to the guide sRNA. Addition of this domain in trans partially complement particles assembled with an aCBF5ΔPUA truncated protein. In the crystal structure, the aCBF5–aNOP10 complex forms two kinds of heterotetramers with parallel and perpendicular orientations of the aNOP10 terminal α-helices, respectively. By gel filtration assay, we showed that aNOP10 can dimerize in solution. As both residues Y41 and L48 were needed for dimerization, the dimerization likely takes place by interaction of parallel α-helices. PMID:16456033

  12. Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

    PubMed

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S; Steffel, Jan; Marín, Francisco; de Oliveira Figueiredo, Márcio Jansen; de Simone, Giovanni; Tzou, Wendy S; En Chiang, Chern; Williams, Bryan

    2017-10-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesaemia), contributing further to arrhythmias, while effective blood pressure control may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between HTN and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence and publishing a joint consensus document on HTN and cardiac arrhythmias, and providing up-to-date consensus recommendations for use in clinical practice. The ultimate judgment on the care of a specific patient must be made by the healthcare provider and the patient in light of all individual factors presented. This is an executive summary of the full document co-published by EHRA in EP-Europace. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  13. 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…

  14. 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…

  15. 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,…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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,…

  2. 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…

  3. 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.…

  4. 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…

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

    DTIC Science & Technology

    1990-01-18

    dive histogirams of fluore -scence variations hiuk,-i (Cutm ofM & ~ %op U* W concentrations ý%.ithin cell populatuins I ~I N.S u) e Detect tluoresocence...out the analyses in Figure S. Fluore •cent imagee of rat liver WB cello exposed te no attached monolayers of cel. rather than cell (left panel) or...1 2Toshio Morin’ , Tsukasa Matsunaga , Chia -Cheng Chang James E. Trosko2 , and Osamu Nikaido, IDivision of Radiation Biology, Faculty of

  6. 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…

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Networks In ACA Marketplaces Are Narrower For Mental Health Care Than For Primary Care.

    PubMed

    Zhu, Jane M; Zhang, Yuehan; Polsky, Daniel

    2017-09-01

    There is increasing concern about the extent to which narrow-network plans, generally defined as those including fewer than 25 percent of providers in a given health insurance market, affect consumers' choice of and access to specialty providers-particularly in mental health care. Using data for 2016 from 531 unique provider networks in the Affordable Care Act Marketplaces, we evaluated how network size and the percentage of providers who participate in any network differ between mental health care providers and a control group of primary care providers. Compared to primary care networks, participation in mental health networks was low, with only 42.7 percent of psychiatrists and 19.3 percent of nonphysician mental health care providers participating in any network. On average, plan networks included 24.3 percent of all primary care providers and 11.3 percent of all mental health care providers practicing in a given state-level market. These findings raise important questions about provider-side barriers to meeting the goal of mental health parity regulations: that insurers cover mental health services on a par with general medical and surgical services. Concerted efforts to increase network participation by mental health care providers, along with greater regulatory attention to network size and composition, could improve consumer choice and complement efforts to achieve mental health parity. Project HOPE—The People-to-People Health Foundation, Inc.

  12. 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.

  13. 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

    ...: Pursuant to section 10 of the Federal Advisory Committee Act (Pub. L. 92 463; 5 U.S.C. APP. 1), notice is... (FACA), as amended 5 U.S.C., App. 2, and its implementing regulations (41 CFR 101-6 and 102-3). All...

  14. 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. Copyright © 2016 by Duke University Press.

  15. 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.

  16. 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.

  17. 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.…

  18. Early Experience of Financial Performance and Solvency of Medicaid-Focused Insurers Under ACA Expansion.

    PubMed

    McCue, Michael J

    2016-08-16

    To allow for greater coverage of the uninsured, the Affordable Care Act expanded Medicaid coverage in 2014. Accessing financial data of state health insurers from the National Association of Insurance Commissioners, this data trend study compares the financial performance and solvency of Medicaid-focused health insurers prior to and after the first year expansion of Medicaid coverage. After the first year of Medicaid expansion, there was a significant increase in operating profit margin ratio for Medicaid-focused health insurers within expansion states. Lower medical loss ratio as well as no change in administrative costs contributed to this profitable position. The risk-based capital ratio for solvency increased significantly for health insurers in nonexpansion states while there was no change in this ratio for health insurers in expansion states. Conversely, the other important solvency ratio of cash flow margin increased significantly for health insurers in expansion states but not for insurers in nonexpansion states. © The Author(s) 2016.

  19. 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...

  20. 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

    ... of Labor, Frances Perkins Building, 200 Constitution Avenue NW., Washington, DC 20210. (Please consult the Security Instructions for the Frances Perkins Building below). The second first day of the meeting will take place at the Department of Labor, Frances Perkins Building, 200 Constitution Avenue NW...

  1. 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.

  2. 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.

  3. 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

    ... cameras, PDAs, blackberries, laptops, etc.) and tobacco products. You are encouraged to leave these items.... 4. Laptops and other electronic devices may be inspected and logged for identification purposes....

  4. ACA-mandated elimination of cost sharing for preventive screening has had limited early impact.

    PubMed

    Mehta, Shivan J; Polsky, Daniel; Zhu, Jingsan; Lewis, James D; Kolstad, Jonathan T; Loewenstein, George; Volpp, Kevin G

    2015-07-01

    The Affordable Care Act eliminated patient cost sharing for evidence-based preventive care, yet the impact of this policy on colonoscopy and mammography rates is unclear. We examined the elimination of cost sharing among small business beneficiaries of Humana, a large national insurer. This was a retrospective interrupted time series analysis of whether the change in cost-sharing policy was associated with a change in screening utilization, using grandfathered plans as a comparison group. We compared beneficiaries in small business nongrandfathered plans that were required to eliminate cost sharing (intervention) with those in grandfathered plans that did not have to change cost sharing (control). There were 63,246 men and women aged 50 to 64 years eligible for colorectal cancer screening, and 30,802 women aged 50 to 64 years eligible for breast cancer screening. The primary outcome variables were rates of colonoscopy and mammography per person-month, with secondary analysis of colonoscopy rates coded as preventive only. There was no significant change in the level or slope of colonoscopy and mammography utilization for intervention plans relative to the control plans. There was also no significant relevant change among those colonoscopies coded as preventive. The results suggest that the implementation of the policy is not having its intended effects, as cost sharing rates for colonoscopy and mammography did not change substantially, and utilization of colonoscopy and mammography changed little, following this new policy approach.

  5. Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply.

    PubMed

    Kaestner, Robert; Garrett, Bowen; Chen, Jiajia; Gangopadhyaya, Anuj; Fleming, Caitlyn

    We examined the effect of the expansion of Medicaid eligibility under the Affordable Care Act on health insurance coverage and labor supply of low-educated and low-income adults. We found that the Medicaid expansions were associated with large increases in Medicaid coverage, for example, 50 percent among childless adults, and corresponding decreases in the proportion uninsured. There was relatively little change in private insurance coverage, although the expansions tended to decrease such coverage slightly. In terms of labor supply, estimates indicated that the Medicaid expansions had little effect on work effort despite the substantial changes in health insurance coverage. Most estimates suggested that the expansions increased work effort, although not significantly.

  6. 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.

  7. Long-term durability of CCA and ACA : how is 0.4 doing?

    Treesearch

    Stan T. Lebow; Cherilyn A. Hatfield; Bessie Woodward

    2010-01-01

    For decades the phrase “point 4” was synonymous with wood treated for use in contact with the ground. In this paper we review how and why the 0.4 lb/ft3 (6.4 kg/m3) retention became such an accepted standard, and then evaluate how well this retention has performed in long term stake testing. Data from plots near Saucier,...

  8. 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.…

  9. 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…

  10. 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.

  11. The Challenge To Reform Arts Education: What Role Can Research Play? ACA Arts Research Seminar Series.

    ERIC Educational Resources Information Center

    Pankratz, David B., Ed.; Mulcahy, Kevin V., Ed.

    This collection of papers examines the role of research in efforts to reform art education. The essays include: "Arts Education Research: Issues, Constraints, and Opportunities" by David B. Pankratz; "Characterizing Civilization: Research Strategies, Findings, and Implications from the National Endowment for the Arts' Report on Arts Education" by…

  12. Effects of Expanded California Health Coverage on Hospitals: Implications for ACA Medicaid Expansions.

    PubMed

    Bazzoli, Gloria J

    2016-08-01

    To assess the effects on hospitals of early California actions to expand insurance coverage for low-income uninsured adults after passage of the Affordable Care Act. Data from the California Office of Statewide Health Planning and Development and the California Department of Health were merged with U.S. census data for 294 short-term general hospitals during the period 2009-2012. A difference-in-difference analysis was conducted with hospitals in counties that did not implement insurance expansions used as a comparison group. Variables examined included payer mix, costs of unreimbursed care, and hospital operating margin. Sensitivity analyses were conducted as well as a triple difference analysis. Effects were estimated for hospitals overall and by ownership type. California insurance expansions primarily benefited for-profit hospitals, with these facilities experiencing significant decreases in self-pay patients, increases in county-covered patients, and reductions in charity care. Most models yielded no significant change in payer mix and conflicting changes in unreimbursed care for nonprofit hospitals. California hospitals that treated the most uninsured prior to insurance expansions did not as a group experience substantial benefit in terms of reduced uninsured burden or better financial performance after program expansions occurred. © Health Research and Educational Trust.

  13. 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.

  14. 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

  15. 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.

  16. 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…

  17. 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.

  18. 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...

  19. 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.

  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. 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.

  2. State Regulations and the ACA Code of Ethics and Standards of Practice: Oil and Water for the Substance Abuse Counselor.

    ERIC Educational Resources Information Center

    West, Paul L.; Mustaine, Beverly L.; Wyrick, Barry

    1999-01-01

    Reviews state regulations responsible for determining the minimum qualifications for counselors, clinical supervisors, or client assessors in the substance abuse treatment field. Few of the 34 states surveyed required treatment outcome studies or referenced licensed professional counselors. Discusses implications new counselors may face when their…

  3. 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.

  4. 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.

  5. Effect of stereochemistry on the transport of Aca-linked beta-turn peptidomimetics across a human intestinal cell line.

    PubMed

    Tamura, K; Agrios, K A; Vander Velde, D; Aubé, J; Borchardt, R T

    1997-09-01

    Transcellular transport is one of the most important barriers facing the development of new therapeutic agents. However, little is known about the specific effects of structure and particularly stereochemistry on cell permeability. An attractive in vitro model has been developed for the direct assessment of cell transport, using the immortalized human epithelial cell line, Caco-2. The present study assesses the effects of stereochemistry on transport in a commonly used beta-turn model system. Thus, L,L- and L,D-Ala-Ala were cyclized with aminocaproic acid, resulting in macrocycles in which the dipeptides correspond to the i + 1 and i + 2 positions of a beta-turn. The transport of these dipeptides across a Caco-2 cell monolayer was determined, along with corresponding acyclic models (L,L- and L,D-CH3CH2C(O)-Ala-Ala-n-Pr). The transport studies were carried out in the presence and absence of verapamil, a known inhibitor of the apically polarized efflux system present in Caco-2 cells. Both apical-->basolateral and basolateral-->apical transport were measured. Measurements made in the presence of verapamil showed that the cyclic peptides experienced a ca. 4-5-fold difference in intrinsic flux depending on stereochemistry, with the L,D isomer being transported at a higher rate. These differences disappeared in the acyclic cases examined (permeability coefficient ratios of the L,D/L,L isomers were 1.04-1.13). These observations are discussed in terms of the conformations and hydrogen-bonding characteristics of the compounds as determined by NMR spectroscopy.

  6. The Impact of the ACA's Medicaid Expansion on Hospitals' Uncompensated Care Burden and the Potential Effects of Repeal.

    PubMed

    Dranove, David; Gartwaite, Craig; Ody, Christopher

    2017-05-01

    ISSUE: By increasing health insurance coverage, the Affordable Care Act's Medicaid eligibility expansion was also expected to lessen the uncompensated care burden on hospitals. The expansion currently faces an uncertain future. GOAL: To compare the change in hospitals' uncompensated care burden in the 31 states (plus the District of Columbia) that chose to expand Medicaid to the changes in states that did not, and to estimate how these expenses would be affected by repeal or further expansion. METHODS: Analysis of uncompensated care data from Medicare Hospital Cost Reports from 2011 to 2015. FINDINGS AND CONCLUSIONS: Uncompensated care burdens fell sharply in expansion states between 2013 and 2015, from 3.9 percent to 2.3 percent of operating costs. Estimated savings across all hospitals in Medicaid expansion states totaled $6.2 billion. The largest reductions in uncompensated care were found for hospitals in expansion states that care for the highest proportion of low-income and uninsured patients. Legislation that scales back or eliminates Medicaid expansion is likely to expose these safety-net hospitals to large cost increases. Conversely, if the 19 states that chose not to expand Medicaid were to adopt expansion, their uncompensated care costs also would decrease by an estimated $6.2 billion.

  7. 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.

  8. 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…

  9. 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…

  10. 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...

  11. 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.

  12. 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.

  13. The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.

    PubMed

    Aliu, Oluseyi; Auger, Katherine A; Sun, Gordon H; Burke, James F; Cooke, Colin R; Chung, Kevin C; Hayward, Rodney A

    2014-09-01

    Critics argue that expanding health insurance coverage through Medicaid may not result in improved access to care. The Affordable Care Act provides reimbursement incentives aimed at improving access to primary care services for new Medicaid beneficiaries; however, there are no such incentives for specialty services. Using the natural experiment of Medicaid expansion in New York (NY) State in October 2001, we examined whether Medicaid expansion increased access to common musculoskeletal procedures for Medicaid beneficiaries. From the State Inpatient Database for NY State, we identified 19- to 64-year-old patients who underwent lower extremity large joint replacement, spine procedures, and upper/lower extremity fracture/dislocation repair from January 1998 to December 2006. We used interrupted time series analysis to evaluate the association between Medicaid expansion and trends in the relative and absolute number of Medicaid beneficiaries who underwent these musculoskeletal procedures. Before Medicaid expansion, we observed a slight but steady temporal decline in the proportion of musculoskeletal surgical patients who were Medicaid beneficiaries. After expansion, this trend reversed, and by 5 years after Medicaid expansion, the proportion of musculoskeletal surgical patients who were Medicaid beneficiaries was 4.7 percentage points [95% confidence interval, 3.9-5.5] higher than expected, based on the preexpansion time trend. Medicaid expansion in NY State significantly improved access to common musculoskeletal procedures for Medicaid beneficiaries.

  14. 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

  15. 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.

  16. 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.

  17. Effectiveness of the palliative care 'Availability, Current issues and Anticipation' (ACA) communication training programme for general practitioners on patient outcomes: a controlled trial.

    PubMed

    Slort, Willemjan; Blankenstein, Annette H; Schweitzer, Bart P M; Knol, Dirk L; van der Horst, Henriëtte E; Aaronson, Neil K; Deliens, Luc

    2014-09-01

    Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients' quality of life. Little is known about the effect of training general practitioners in palliative care-specific communication. We hypothesized that palliative care patients of general practitioners exposed to the 'Availability, Current issues and Anticipation' communication training programme would report better outcomes than patients of control general practitioners. To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes. In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire-III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. ISRCTN56722368. General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands. Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire-III and Availability, Current issues and Anticipation Scale. General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care. © The Author(s) 2014.

  18. 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.

  19. 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.

  20. Induction of Microglia Activation after Infection with the Non-Neurotropic A/CA/04/2009 H1N1 Influenza Virus

    PubMed Central

    Sadasivan, Shankar; Zanin, Mark; O’Brien, Kevin; Schultz-Cherry, Stacey; Smeyne, Richard J.

    2015-01-01

    Although influenza is primarily a respiratory disease, it has been shown, in some cases, to induce encephalitis, including people acutely infected with the pandemic A/California/04/2009 (CA/09) H1N1 virus. Based on previous studies showing that the highly pathogenic avian influenza (HPAI) A/Vietnam/1203/2004 H5N1 virus was neurotropic, induced CNS inflammation and a transient parkinsonism, we examined the neurotropic and inflammatory potential of the CA/09 H1N1 virus in mice. Following intranasal inoculation, we found no evidence for CA/09 H1N1 virus neurotropism in the enteric, peripheral or central nervous systems. We did, however, observe a robust increase in microglial activity in the brain characterized by an increase in the number of activated Iba-1-positive microglia in the substantia nigra (SN) and the hippocampus, despite the absence of virus in the brain. qPCR analysis in SN tissue showed that the induction of microgliosis was preceded by reduced gene expression of the neurotrophic factors bdnf, and gdnf and increases in the immune modulatory chemokine chemokine (C-C motif) ligand 4 (ccl4). We also noted changes in the expression of transforming growth factor-1 (tgfβ1) in the SN starting at 7 days post-infection (dpi) that was sustained through 21 dpi, coupled with increases in arginase-1 (arg1) and csf1, M2 markers for microglia. Given that neuroinflammation contributes to generation and progression of a number of neurodegenerative disorders, these findings have significant implications as they highlight the possibility that influenza and perhaps other non-neurotropic viruses can initiate inflammatory signals via microglia activation in the brain and contribute to, but not necessarily be the primary cause of, neurodegenerative disorders. PMID:25861024

  1. The ACA's Zero Cost-Sharing Mandate and Trends in Out-of-Pocket Expenditures on Well-Child and Screening Mammography Visits.

    PubMed

    Kirby, James B; Davidoff, Amy J; Basu, Jayasree

    2016-12-01

    Starting in September of 2010, the Patient Protection and Affordable Care Act required most health insurance policies to cover evidence-based preventive care with no cost-sharing (no copays, coinsurance, or deductibles). It is unknown, however, whether declines in out-of-pocket costs for preventive services are large enough to prompt increases in utilization, the ultimate goal of the policy. In this study, we use a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. Estimates are made using 2-part interrupted time-series models, with well-woman visits serving as the control group because they were not covered under the zero cost-sharing mandate until after our study period. Results indicate a substantial reduction in out-of-pocket costs attributable to the Affordable Care Act. Between January 2011 and September 2012, the zero cost-sharing mandate reduced per-visit out-of-pocket costs for well-child visits from $18.46 to $8.08 (56%) and out-of-pocket costs for screening mammography visits from $25.43 to $6.50 (74%). No reduction was apparent for well-woman visits. The Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits. To increase preventive service use, research is needed to better understand barriers to obtaining preventive care that are not directly related to cost.

  2. Single-ion properties of the Seff = 1/2 XY antiferromagnetic pyrochlores Na A'Co2F7 (A'=Ca2 + , Sr2 +)

    NASA Astrophysics Data System (ADS)

    Ross, K. A.; Brown, J. M.; Cava, R. J.; Krizan, J. W.; Nagler, S. E.; Rodriguez-Rivera, J. A.; Stone, M. B.

    2017-04-01

    The antiferromagnetic pyrochlore material NaCaCo2F7 is a thermal spin liquid over a broad temperature range (≈140 K down to TF=2.4 K), in which magnetic correlations between Co2 + dipole moments explore a continuous manifold of antiferromagnetic XY states [K. A. Ross et al., Phys. Rev. B 93, 014433 (2016), 10.1103/PhysRevB.93.014433]. The thermal spin liquid is interrupted by spin freezing at a temperature that is ˜2 % of the mean-field interaction strength, leading to short-range static XY clusters with distinctive relaxation dynamics. Here we report the low-energy inelastic neutron scattering response from the related compound NaSrCo2F7 , confirming that it hosts the same static and dynamic spin correlations as NaCaCo2F7 . We then present the single-ion levels of Co2 + in these materials as measured by inelastic neutron scattering. An intermediate spin-orbit coupling model applied to an ensemble of trigonally distorted octahedral crystal fields accounts for the observed transitions. The single-ion ground state of Co2 + is a Kramers doublet with a strongly XY-like g tensor (gx y/gz˜3 ). The local disorder inherent from the mixed pyrochlore A sites (Na+/Ca2 + and Na+/Sr2 +) is evident in these measurements as exaggerated broadening of some of the levels. A simple model that reproduces the salient features of the single-ion spectrum produces approximately 8.4% and 4.1% variation in the z and x y components of the g tensor, respectively. This study confirms that an Seff=1/2 model with XY antiferromagnetic exchange and weak exchange disorder serves as a basic starting point in understanding the low-temperature magnetic behavior of these strongly frustrated magnets.

  3. 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.

  4. Mn K-edge XANES studies of La1-xAxMnO3 systems (A=Ca, Ba, Pb)

    NASA Astrophysics Data System (ADS)

    Bridges, F.; Booth, C. H.; Anderson, M.; Kwei, G. H.; Neumeier, J. J.; Snyder, J.; Mitchell, J.; Gardner, J. S.; Brosha, E.

    2001-06-01

    We present Mn K-edge x-ray absorption near-edge structure (XANES) data for a number of manganite systems as a function of temperature. The 1s absorption edge for the Ca-substituted samples is very sharp, almost featureless, and shifts uniformly upwards with increasing Ca content. The interpretation of this result is controversial because the lack of structure appears difficult to reconcile with a mixture of Mn+3 and Mn+4 ions or with several different Mn-O bond lengths at high T. We propose a possible solution in terms of covalency and considerable overlap of the Mn p states (mostly Mn 4p). The manganite preedge structure is quite similar to that for a large number of other Mn compounds, with two or three small peaks that are ascribed to 1s-3d weakly allowed dipole transitions plus possibly a small quadrupole component. The weak dipole transitions are explained as arising from a hybridization of the Mn 4p state of the excited atom with an odd symmetry combination of Mn 3d states on adjacent Mn atoms. The first preedge peak A1 has a small shift to higher energy with increasing valence while the next peak A2 is nearly independent of dopant concentration at 300 K. However, for the colossal magnetoresistance (CMR) samples the A2 preedge peak shifts to a lower energy below the ferromagnetic transition temperature Tc, resulting in a decrease in the A2-A1 splitting by ~0.4 eV. This indicates a change in the higher-energy 3d bands, most likely the minority spin eg, plus some change in covalency. In addition, the amplitudes are temperature dependent for the CMR materials, with the change in A1, A2 correlated with the change in sample magnetization. For the charge ordered (CO) sample, the analysis suggests that the change in the preedge is produced by a distortion that increases below TCO. We discuss these results in terms of some of the theoretical models that have been proposed and other recent XANES studies.

  5. 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.

  6. Effects of prayer on the vital signs of patients with chronic kidney disease: randomized controlled trial.

    PubMed

    Brasileiro, Thaila Oliveira Zatiti; Prado, Andressa Anunciação de Oliveira; Assis, Bianca Bacelar de; Nogueira, Denismar Alves; Lima, Rogério Silva; Chaves, Erika de Cassia Lopes

    2017-07-20

    To assess the effect of prayer on blood pressure, heart rate and respiratory rate in patients with chronic kidney disease and learn their perception of the intervention. A randomized controlledtrial, double blind with a sample of volunteers, randomized into an intervention group (n=42) and a control group (n=37). Questionnaires addressing socio-demographic, clinical and spiritual characteristics and the Duke University Religious Index were applied. Blood pressure, heart rate and respiratory rate were measured. The prayer was conducted at three different moments on alternating weeks. The qualitative data were organized and analyzed through Thematic Analysis. The sample consisted of 95 randomized volunteers. In the intra-group analysis, a statistically significant reduction (P<0001) of blood pressure, heart rate and respiratory rate was observed in all evaluations of the people who were prayed for. The qualitative analysis resulted in the themes Prayer in a "Place of Suffering" and Positive Evaluation and in the sub-themes Relief from Suffering, Hope for Improvement, and Coping with Hemodialysis. CONCLUSIONPrayer reduced blood pressure, heart rate and respiratory rate in patients who suffer from chronic kidney disease, and the volunteers' evaluation of the intervention was positive.BrazilianClinicalTrials Registry: RBR-2zv39y. Avaliar o efeito da prece sobre a pressão arterial, a frequência cardíaca e respiratória em paciente com insuficiência renal crônica e conhecer sua percepção a respeito da intervenção. Ensaio clínico controlado, randomizado, duplo cego com uma amostra de voluntários, randomizados em grupo intervenção (n=42) e grupo controle (n=37). Foram aplicados, por meio de entrevista, um questionário de características sociodemográficas, clínicas e espirituais e o Índice de Religiosidade da Universidade de Duke, além da mensuração da pressão arterial, frequência cardíaca e respiratória. A prece foi ministrada em três momentos

  7. 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...

  8. 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.

  9. Following the ACA Repeal-and-Replace Effort, Where Does the U.S. Stand on Insurance Coverage? Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--June 2017.

    PubMed

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

    2017-09-01

    After Congress's failure to repeal and replace the Affordable Care Act, some policy leaders are calling for bipartisan approaches to address weaknesses in the law’s coverage expansions. To do this, policymakers will need data about trends in insurance coverage, reasons why people remain uninsured, and consumer perceptions of affordability. To examine U.S. trends in insurance coverage and the demographics of the remaining uninsured population, as well as affordability and satisfaction among adults with marketplace and Medicaid coverage. Analysis of the Commonwealth Fund Affordable Care Act Tracking Survey, March–June 2017 The uninsured rate among 19-to-64-year-old adults was 14 percent in 2017, or an estimated 27 million people, statistically unchanged from one year earlier. Uninsured rates ticked up significantly in three subgroups: 35-to-49-year-olds, adults with incomes of 400 percent of poverty or more (about $48,000 for an individual), and adults living in states that had not expanded Medicaid. Half of uninsured adults, or an estimated 13 million, are likely eligible for marketplace subsidies or the Medicaid expansion in their state. Four of 10 uninsured adults are unaware of the marketplaces. Adults in marketplace plans with incomes below 250 percent of poverty are much more likely to view their premiums as easy to afford compared with people with higher incomes. Policies to improve coverage include a federal commitment to supporting the marketplaces and the 2018 open enrollment period, expansion of Medicaid in 19 remaining states, and enhanced subsidies for people with incomes of 250 percent of poverty or more.

  10. 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,...

  11. 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...

  12. 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...

  13. 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...

  14. 78 FR 41960 - Notice of Permits Issued Under the Antarctic Conservation Act of 1978

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... Support Contract (ASC) ACA 2013-012 and ACA 2013-014 were replaced by permit ACA. 2014-002 issued to the ASC on June 12, 2013. Nadene G. Kennedy, Division of Polar Programs. BILLING CODE 7555-01-P ...

  15. 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).

  16. 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…

  17. 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…

  18. 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).

  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. [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.

  1. 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…

  2. The 10 Hounsfield units unenhanced computed tomography attenuation threshold does not apply to cortisol secreting adrenocortical adenomas.

    PubMed

    Chambre, Claire; McMurray, Emily; Baudry, Camille; Lataud, Marine; Guignat, Laurence; Gaujoux, Sébastien; Lahlou, Najiba; Guibourdenche, Jean; Tissier, Frédérique; Sibony, Mathilde; Dousset, Bertrand; Bertagna, Xavier; Bertherat, Jérôme; Legmann, Paul; Groussin, Lionel

    2015-09-01

    Computed tomography (CT) unenhanced attenuation value of <10 Hounsfield units (HU) has an excellent specificity (98%) to diagnose lipid-rich adrenocortical adenomas (ACAs) with a weaker sensitivity (71%). To determine from a routine clinical perspective if unenhanced attenuation value is influenced by cortisol secretion in ACAs. This was a retrospective study of cases collected between 2009 and 2012. This study was conducted in a tertiary-care university hospital. Seventy-two patients operated on for an ACA (Weiss score ≤ 2) were analysed. Thirty-four patients had an ACA oversecreting cortisol (Cush-ACA). Thirty-eight patients had an ACA without cortisol oversecretion (Non Hyper-ACA). CT unenhanced attenuation value was correlated with the functional status. The Weiss score items were analysed. Among the 34 patients with a Cush-ACA a minority (n = 7) had an unenhanced attenuation value under 10 HU. Among the high precontrast density (> 10 HU) Cush-ACAs, washout analysis after contrast administration was consistent with the benign nature of the tumor in ∼ 60% of the cases. Less than 25% clear cells (lipid-rich cells), a Weiss score item, was present in 50% of the Cush-ACAs in favour of a lipid-poor content. Unenhanced attenuation value has a poor sensitivity to diagnose an ACA in case of cortisol oversecretion due to poor lipid content. Nevertheless, the accuracy of washout analysis was preserved in the group of Cush-ACAs. © 2015 European Society of Endocrinology.

  3. 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…

  4. Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act.

    PubMed

    Wharam, J Frank; Zhang, Fang; Landon, Bruce E; LeCates, Robert; Soumerai, Stephen; Ross-Degnan, Dennis

    2016-05-01

    Little is known about the effect of the Affordable Care Act's (ACA) elimination of out-of-pocket costs for preventive services. This policy likely reduced out-of-pocket colonoscopy costs most for high-deductible health plan (HDHP) members. Determine the ACA's impact on colorectal cancer screening among HDHP members. Pre-post with comparison group, constructed before and after the ACA. We studied 2003-2012 administrative claims data of a large national health insurer. HDHP members had 1 year of low-deductible (≤$500) plan enrollment followed by 1 year of HDHP (≥$1000) enrollment after an employer-mandated switch; HDHP enrollment occurred fully after the ACA for 21,605 members and fully before the ACA for 106,609 members. We propensity score-matched contemporaneous low-deductible (≤$500) control group members to both the before-ACA and after-ACA HDHP groups. We examined the 1-year impact of the HDHP switch separately in the before-ACA and after-ACA study cohorts, then compared these changes to estimate ACA effects. Overall colorectal cancer screening, colonoscopy, and fecal-occult blood testing annual rates. Before the ACA, colorectal cancer screening tests declined by 37/10,000 (-71, -4) among HDHP members versus controls; after the ACA, HDHP members experienced a nonsignificant increase in screening [+52/10,000 (-19,124)]. Corresponding changes in colonoscopy were -55/10,000 (-81, -29) before and +20/10,000 (-38, 78) after the ACA. Thus, the ACA was associated with increased colorectal cancer screening rates [+89/10,000 (11, 168); relative: +9.1% (0.5-17.8)] and screening colonoscopies [+75/10,000 (12-139); relative: +16.4% (2.5-30.3)] among HDHP members. The ACA was associated with improved colorectal cancer screening among HDHP members.

  5. 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.

  6. 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.

  7. 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.

  8. AMPK synergizes with the combined treatment of 1'-acetoxychavicol acetate and sodium butyrate to upregulate phase II detoxifying enzyme activities.

    PubMed

    Yaku, Keisuke; Matsui-Yuasa, Isao; Konishi, Yotaro; Kojima-Yuasa, Akiko

    2013-07-01

    Phase II enzymes play important roles in detoxifying xenobiotics. We previously reported that both 1'-acetoxychavicol acetate (ACA) and sodium butyrate individually increased phase II enzyme activities. Here, we determined the combined action of ACA and sodium butyrate on phase II enzyme activities in intestinal epithelial cells (IEC 6). ACA and sodium butyrate synergistically increased phase II enzyme activities. Protein levels of intranuclear transcription factor NF-E2-related factor 2 (Nrf2) were increased by ACA or sodium butyrate treatment, but treatment with both did not produce a synergistic effect. Intranuclear p53 protein levels were increased by ACA but decreased by sodium butyrate alone or combined treatment with ACA and sodium butyrate. In contrast, p53 acetylation was promoted by sodium butyrate and the ACA and sodium butyrate combination. Inhibition of AMPK activity decreased phase II enzyme activities that were upregulated by treatment with ACA plus sodium butyrate or other phytochemicals, including kaempferol, quercetin, and epigallocatechin-3-gallate. Combined treatment with ACA and sodium butyrate increased phosphorylated AMPK levels. These results suggest that ACA and sodium butyrate synergistically contribute to xenobiotics metabolism. The combined ACA and sodium butyrate treatment synergistically upregulated phase II enzyme activities through AMPK activation and p53 acetylation. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. 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.

  10. The value of antinuclear antibodies in primary biliary cirrhosis.

    PubMed

    Gao, Lixia; Tian, Xinping; Liu, Bin; Zhang, Fengchun

    2008-03-01

    Although autoantibodies have been used for the diagnosis of primary biliary cirrhosis (PBC), their role has not been clarified. In this study, we try to explore the value of gp210 antibody and anti-centromere antibodies (ACA) in PBC. Anti-gp210 and ACA were tested in 140 PBC patients by ELISA and indirect immunofluorescence respectively. Their association with clinical, pathological data and prognosis was analysed. 30.5% of PBC patients had positive anti-gp210 antibody and 29.2% had ACA. The anti-gp210 antibody positive group had higher Mayo risk scores and lower serum albumin levels compared to the negative one. Patients with positive anti-gp210 antibody were more likely to develop hepatic failure (p<0.05, OR=9.8460, 95% CI: 1.067-90.901) than patients with negative anti-gp210 antibody. More patients with positive ACA developed portal hypertension than patients with negative ACA (p<0.05, OR=9.259; 95% CI: 1.027-88.410). Furthermore, concurrent Sjögren's syndrome (SjS) and PBC was significantly more likely in the ACA positive group than in the negative ones (68.4% in ACA positive group, 20.7% in ACA negative group p<0.001). Both anti-gp210 antibody and ACA are related to severe disease course and poor prognosis. For PBC patients with positive ACA, further examinations should be made to detect underlying SjS.

  11. Health Care Sharing Ministries and Their Exemption From the Individual Mandate of the Affordable Care Act.

    PubMed

    Galarneau, Charlene

    2015-06-01

    The U.S. 2010 Patient Protection and Affordable Care Act (ACA) exempts members of health care sharing ministries (HCSMs) from the individual mandate to have minimum essential insurance coverage. Little is generally known about these religious organizations and even less critical attention has been brought to bear on them and their ACA exemption. Both deserve close scrutiny due to the exemption's less than clear legislative justification, their potential influence on the ACA's policy and ethical success, and their salience to current religious liberty debates surrounding the expansion of religious exemptions from ACA responsibilities for both individuals and corporations. Analyzing documents of the United States' three largest health care sharing ministries and related material, I examine these organizations and their ACA exemption with particular consideration of their ethical dimensions. Here a thick description of the nature and workings of health care sharing ministries precedes a similar account of the ACA exemption. From these empirical analyses, five ethical and policy concerns emerge: (1) the charity versus insurance status of these ministries; (2) the conflation of two ACA religious exemptions; (3) the tension between the values of religious liberty and of justice; (4) the potential undermining of ACA policy goals; and (5) the questionable compliance of health care sharing ministries with ACA exemption requirements.  An accurate and informed understanding of HCSMs is required for policymakers and others to justify the ACA exemption of health care sharing ministry members. A sufficient justification would address at least the five ethical and policy concerns raised here.

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

    PubMed

    Hall, Kelli Stidham; Nadella, Samantha Paturu; Zochowski, Melissa K; Patel, Divya; Dalton, Vanessa K

    2015-09-01

    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. 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. 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. 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.

  13. 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

  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. Copyright © 2016 by Duke University Press.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Methodologic evaluation of adaptive conjoint analysis to assess patient preferences: an application in oncology.

    PubMed

    Pieterse, Arwen H; Stiggelbout, Anne M; Marijnen, Corrie A M

    2010-12-01

    Adaptive conjoint analysis (ACA) is an individually tailored preferences elicitation technique that mimics actual decision-making processes by asking participants to make trade-offs between the various dimensions that underlie decision problems. ACA is increasingly applied in patient preferences assessments but formal evaluation of its validity and reliability is lacking. To investigate ACA's validity and reliability in elicitation of treatment outcome preferences. Sixty-eight disease-free rectal cancer patients, treated with surgery with or without preoperative radiotherapy were asked to complete exercises to assess their preferences for radiotherapy [using the treatment trade-off method (TTM)] and for key outcomes associated with radiotherapy (using ACA). We assessed (i) rank ordering of ACA-derived outcome-probability utilities, (ii) compensatory decision making, (iii) ACA test-retest reliability, and (iv) concordance of ACA- and TTM-based preferences. All participants completed the TTM and 66 completed the ACA questionnaire, in 15 min on average. Outcome utilities were rank ordered in agreement with probabilities from best to worst in most participants, except for sexual dysfunction. Most participants were willing to trade survival and their most important outcome. Mean importance ratings were similar at retest. ACA- and TTM-based preferences differed. TTM-based preferences were related to past treatment, ACA-based preferences were not. ACA assesses group-level preferences reliably over time and captures individual preferences independently from treatment experience in treated cancer patients. ACA seems a valid treatment outcome preference elicitation method in a context in which trade-offs between cure and quality of life need to be considered. © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd.

  1. 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.

  2. 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)...

  3. 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.

  4. Atmospheric centers of action and their relations with the northern hemisphere macrocirculation processes

    NASA Astrophysics Data System (ADS)

    Perevedentsev, Yu. P.; Ismagilov, N. V.; Shantalinskij, K. M.

    1994-03-01

    Considered are statistical characteristics of the parameters of the Icelandic, Azores, Aleutian, and Honolulu atmospheric centers of action (ACA) for 1891-1990. Long-term trends in variations of the geographical position and intensity of the Atlantic and Pacific circulation pairs and implicit periodicities are found in the series of mean monthly pressure in ACA. Presented is the analysis of correlations between the ACA parameters and Katz's circulation indices, the Vangengeim-Girs circulation types. It is shown that the most informative are the ACA indices.

  5. 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.

  6. 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.

  7. 1'-acetoxychavicol acetate inhibits adipogenesis in 3T3-L1 adipocytes and in high fat-fed rats.

    PubMed

    Ohnishi, Rie; Matsui-Yuasa, Isao; Deguchi, Yohei; Yaku, Keisuke; Tabuchi, Masaki; Munakata, Hiroshi; Akahoshi, Yasumitsu; Kojima-Yuasa, Akiko

    2012-01-01

    Alpinia galanga and Languas galanga, which are plants belonging to the ginger family, are frequently used for cooking, especially in Thai and Indonesian cuisine. The compound 1'-acetoxychavicol acetate (ACA), which is naturally obtained from the rhizomes and seeds of these gingers, has antioxidant and anti-inflammatory properties. We investigated the anti-obesity effects of ACA in 3T3-L1 adipocytes and in high fat diet (HFD)-induced rat models of obesity. ACA caused a significant decrease in the activity of GPDH in 3T3-L1 adipocytes without eliciting cell cytotoxicity, and it inhibited cellular lipid accumulation through the down-regulation of transcription factors such as PPARγ and C/EBPα. ACA also induced a dose-dependent phosphorylation of AMP-activated protein kinase (AMPK). In the animal model, rats fed an HFD containing 0.05% ACA gained less weight than rats fed an HFD alone. The visceral fat mass in rats fed an HFD containing 0.05% ACA tended to be lower than that in rats fed an HFD alone. Furthermore, a histological examination of livers from rats fed an HFD showed steatohepatitis. However, rats fed an HFD containing 0.05% ACA showed no histopathological changes in the liver tissue. Our results show that ACA exerts anti-obesity activities both in vitro and in vivo and suggests that ACA may have a novel preventive activity against obesity and possibly other metabolic diseases.

  8. 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

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

    PubMed

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

    2015-12-01

    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. 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. 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. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. 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 ...

  11. 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......

  12. 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…

  13. Celiac Disease

    MedlinePlus

    ... es una condicion grave en la que su sistema inmunológico ataca sus órganos cuando se comes gluten. Es más probable llegar a tener enferme- dad celíaca si alguien en la familia la tiene. Si usted tiene enfermedad celíaca, es ...

  14. 77 FR 65508 - Annual Charge Filing Procedures for Natural Gas Pipelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... Energy Regulatory Commission 18 CFR Part 154 Annual Charge Filing Procedures for Natural Gas Pipelines... filing requirements for natural gas pipelines that choose to recover Commission-assessed annual charges through an annual charge adjustment (ACA) clause. Currently, natural gas pipelines utilizing an ACA clause...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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....

  20. 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...

  1. 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,…

  2. 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...

  3. 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,...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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…

  11. 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...

  12. 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...

  13. [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.

  14. 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.

  15. Differences in Distress among Adult Children of Alcoholics.

    ERIC Educational Resources Information Center

    Kashubeck, Susan; Christensen, Sue A.

    1992-01-01

    Investigated psychological distress, social support, and hardiness among 79 adult children of alcoholics (ACAs) compared to 67 ACAs not involved in support groups. Group members reported higher levels of psychological distress, lower levels of hardiness, and less satisfaction with perceived social support than did nonmembers. For both groups,…

  16. 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.

  17. 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…

  18. 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

  19. How the Affordable Care Act will affect access to health care in North Carolina.

    PubMed

    Ricketts, Thomas C

    2013-01-01

    Reforming health care in the United States often focuses on improving access to care by removing financial barriers and bringing practitioners closer to patients. This article reviews the provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) that are intended to improve access and discusses how the ACA will change access to care for Americans.

  20. 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. Copyright © 2017 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  1. 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

  2. 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.

  3. 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,…

  4. Lost in the Health Care Reform Discussion: Health Care as a Right or Privilege

    ERIC Educational Resources Information Center

    O'Rourke, Thomas W.

    2017-01-01

    Health care has been an ongoing issue of public concern for decades, well before President Obama took office. Passage of the Affordable Care Act (ACA), also known as Obamacare, in March 2010 and upheld by a Supreme Court in June 2012. With Republicans now in control of both the House and Senate as well as the presidency, the ACA in its current…

  5. 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…

  6. 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…

  7. Supporting IAAOC Members: Potential Localized Services

    ERIC Educational Resources Information Center

    Lambert, Simone F.

    2010-01-01

    For the past 37 years, the International Association of Addictions and Offender Counselors (IAAOC), a division of the American Counseling Association (ACA), has provided a home for offender counselors and eventually addictions counselors. Throughout that time, the organization's structure has mirrored that of ACA. For instance, the IAAOC (2004)…

  8. The Vital Role of Administrative Cost Allowances to Student Financial Aid Offices: Key Findings from NASFAA's Administrative Cost Allowance Survey, July 2011

    ERIC Educational Resources Information Center

    National Association of Student Financial Aid Administrators (NJ1), 2011

    2011-01-01

    The National Association of Student Financial Aid Administrators (NASFAA) recently conducted a survey on the 2009-10 award year Administrative Cost Allowances (ACA), which are funds used by colleges and universities to support operations and professional development. Specifically, ACA is often used in essential areas that support the day-to-day…

  9. Requirements for a Cocitation Similarity Measure, with Special Reference to Pearson's Correlation Coefficient.

    ERIC Educational Resources Information Center

    Ahlgren, Per; Jarneving, Bo; Rousseau, Ronald

    2003-01-01

    Criticizes the use of Pearson's correlation coefficient in author cocitation analysis (ACA), a technique used to analyze the intellectual structure of a given scientific field, and sets forth two natural requirements that a similarity measure applied in ACA should satisfy. Uses real and hypothetical data to obtain counterexamples to both…

  10. Steroidogenic Acute Regulatory Protein Overexpression Correlates with Protein Kinase A Activation in Adrenocortical Adenoma

    PubMed Central

    Xie, Jing; Su, Tingwei; Jiang, Lei; Jiang, Yiran; Cao, Yanan; Liu, Jianmin; Ning, Guang; Wang, Weiqing

    2016-01-01

    The association of pathological features of cortisol-producing adrenocortical adenomas (ACAs) with somatic driver mutations and their molecular classification remain unclear. In this study, we explored the association between steroidogenic acute regulatory protein (StAR) expression and the driver mutations activating cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signaling to identify the pathological markers of ACAs. Immunohistochemical staining for StAR and mutations in the protein kinase cAMP-activated catalytic subunit alpha (PRKACA), protein kinase cAMP-dependent type I regulatory subunit alpha (PRKAR1A) and guanine nucleotide binding protein, alpha stimulating (GNAS) genes were examined in 97 ACAs. The association of StAR expression with the clinical and mutational features of the ACAs was analyzed. ACAs with mutations in PRKACA, GNAS, and PRKAR1A showed strong immunopositive staining for StAR. The concordance between high StAR expression and mutations activating cAMP/PKA signaling in the ACAs was 99.0%. ACAs with high expression of StAR had significantly smaller tumor volume (P < 0.001) and higher urinary cortisol per tumor volume (P = 0.032) than those with low expression of StAR. Our findings suggest that immunohistochemical staining for StAR is a reliable pathological approach for the diagnosis and classification of ACAs with cAMP/PKA signaling-activating mutations. PMID:27606678

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

    DTIC Science & Technology

    2013-11-22

    Public Health Sciences Track, pursuant to ACA Section 5315. • Removed the maintenance of effort requirement for use of monies in the Community Health...Office (GAO) study of the costs and processes of ACA implementation, and a Medicare actuarial analysis of the impact of the ACA’s private insurance

  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. 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…

  14. 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

  15. 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…

  16. 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

  17. OGLE-IV Transient Search report 25 September 2017 part 2

    NASA Astrophysics Data System (ADS)

    Wyrzykowski, L.; Gromadzki, M.; Hamanowicz, A.; Rybicki, K.; Klencki, J.; Kozlowski, S.; Udalski, A.; Poleski, R.; Szymanski, M. K.; Skowron, J.; Ulaczyk, K.; Pawlak, M.; Mroz, P.; Soszynski, I.; Pietrukowicz, P.; Sitek, M.; Ihanec, N.

    2017-09-01

    The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 49 new on-going and recently finished transients discovered since Jan 2017.

  18. OGLE-IV Transient Search report 25 September 2017 part 1

    NASA Astrophysics Data System (ADS)

    Wyrzykowski, L.; Gromadzki, M.; Hamanowicz, A.; Rybicki, K.; Klencki, J.; Kozlowski, S.; Udalski, A.; Poleski, R.; Szymanski, M. K.; Skowron, J.; Ulaczyk, K.; Pawlak, M.; Mroz, P.; Soszynski, I.; Pietrukowicz, P.; Sitek, M.; Ihanec, N.

    2017-09-01

    The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 50 new on-going and recently finished transients discovered since Jan 2017.

  19. Celebrations: American Camping Association Annual Report 1986.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    The 1986 American Camping Association (ACA) annual report reviews the year's achievements and outlines goals for the future. An introductory message from ACA President Jean McMullan notes successful fund raising to improve the association's national headquarters, passage of federal legislation exempting camps from paying federal unemployment…

  20. 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.

  1. 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…

  2. Acquisition of Cytogenetic Abnormalities in Patients with IPSS defined Lower-Risk Myelodysplastic Syndrome Is Associated with Poor Prognosis and Transformation to Acute Myelogenous Leukemia

    PubMed Central

    Jabbour, Elias; Takahashi, Koichi; Wang, Xuemei; Cornelison, A Megan; Abruzzo, Lynne; Kadia, Tapan; Borthakur, Gautam; Estrov, Zeev; O’Brien, Susan; Mallo, Mar; Wierda, William; Pierce, Sherry; Wei, Yue; Sole, Francisco; Chen, Rui; Kantarjian, Hagop; Garcia-Manero, Guillermo

    2014-01-01

    We hypothesized that the dynamic acquisition of cytogenetic abnormalities (ACA) during the follow up of myelodysplastic syndromes (MDS) could be associated with poor prognosis. We conducted a retrospective analysis of 365 patients with IPSS low or intermediate-1 risk MDS who had at least two consecutive cytogenetic analyses during the follow up. Acquisition of cytogenetic abnormalities was detected in 107 patients (29%). The most frequent alteration involved chromosome 7 in 21% of ACA cases. Median transformation-free and overall survival for patients with and without ACA were 13 vs. 52 months (P =0.01) and 17 vs. 62 months (P =0.01), respectively. By fitting ACA as a time-dependent covariate, multivariate Cox regression analysis showed that patients with ACA had increased risk of transformation (HR=1.40; P = 0.03) or death (HR=1.45; P = 0.02). Notably, female patients with therapy-related MDS (t-MDS) had an increased risk of developing ACA (OR= 5.26; P<0.0001), although subgroup analysis showed that prognostic impact of ACA was not evident in t-MDS. In conclusion, ACA occurs in close to one third of patients with IPSS defined lower risk MDS, more common among patients with t-MDS, but has a significant prognostic impact on de novo MDS. PMID:23760779

  3. Childhood cancer survivors' familiarity with and opinions of the Patient Protection and Affordable Care Act.

    PubMed

    Warner, Echo L; Park, Elyse R; Stroup, Antoinette; Kinney, Anita Y; Kirchhoff, Anne C

    2013-09-01

    The Patient Protection and Affordable Care Act (ACA) offers avenues to increase insurance options and access to care; however, it is unknown whether populations with pre-existing conditions, such as cancer survivors, will benefit from the expanded coverage options. We explored childhood cancer survivors' familiarity with and opinion of the ACA to understand how survivors' insurance coverage may be affected. From April to July 2012 we conducted in-depth, semistructured telephone interviews with 53 adult survivors recruited from the Utah Cancer SEER Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at time of diagnosis. Interviews were recorded, transcribed, and analyzed with NVivo 9 by two coders (kappa=0.94). We report on the 49 participants who had heard of the ACA. Most survivors were unaware of ACA provisions beyond the insurance mandate. Few knew about coverage for children up to age 26 or pre-existing insurance options. Although one third believed the ACA could potentially benefit them via expanded insurance coverage, many were concerned that the ACA would lead to rising health care costs and decreasing quality of care. Survivors had concerns specific to their cancer history, including fears of future health care rationing if they developed subsequent health problems. Childhood cancer survivors have a low level of familiarity with the ACA and are unaware of how it may affect them given their cancer history. These survivors require targeted education to increase knowledge about the ACA.

  4. 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…

  5. 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…

  6. 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…

  7. 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.

  8. 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…

  9. Clinical Behaviors for Addressing Religious/Spiritual Issues: Do We Practice What We Preach?

    ERIC Educational Resources Information Center

    Cashwell, Craig S.; Young, J. Scott; Fulton, Cheryl L.; Willis, Ben T.; Giordano, Amanda; Daniel, Laura Wyatt; Crockett, Jamie; Tate, B. Nicole; Welch, Metoka L.

    2013-01-01

    To determine if counselors integrate clinical behaviors for addressing religious/spiritual issues in counseling consistent with their ratings of the importance of such behaviors, the authors conducted a national survey of American Counseling Association (ACA) members. Seventy-eight ACA members rated the importance of and frequency with which they…

  10. 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…

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  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 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.

  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 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.

  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 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.

  1. 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.

  2. 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.

  3. 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.

  4. Material and tableting properties of Azadirachta indica gum with reference to official acacia gum.

    PubMed

    Ogunjimi, Abayomi T; Alebiowu, Gbenga

    2014-01-01

    This study determined the material and tableting properties of Azadirachta indica gum (NMG) relative to acacia gum (ACA). The morphological properties were assessed with size and shape factors of aspect ratio, roundness, irregularity and equivalent-circle-diameter. The tableting properties of the gums were determined using compressional characteristics, tensile strength (TS), brittle fracture index (BFI) and crushing-strength-friability/disintegration-time ratio (CSFR/DT). The results suggest that NMG possesses larger, irregular and more elongated particles than ACA. The onset and amount of plastic deformation occurring in NMG was faster and higher, respectively, than in ACA. The result shows that, although ACA tablets were stronger, their tendency to cap/laminate was higher than in NMG tablets. The NMG tablets possess lower DT than those of ACA, while the CSFR/DT result suggests that a better balance exists between the strength and weakness of NMG tablets. The study concluded that NMG can be a useful excipient in tablet formulation.

  5. 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.

  6. 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.

  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 and structural characterization of A3In 2Ge 4 and A5In 3Ge 6 ( A=Ca, Sr, Eu, Yb)—New intermetallic compounds with complex structures, exhibiting Ge-Ge and In-In bonding

    NASA Astrophysics Data System (ADS)

    You, Tae-Soo; Bobev, Svilen

    2010-06-01

    Reported are the synthesis and the structural characterization of four new polar intermetallic phases, which exist only with mixed alkaline-earth and rare-earth metal cations in narrow homogeneity ranges. (Sr 1-xCa x) 5In 3Ge 6 and (Eu 1-xYb x) 5In 3Ge 6 ( x≈0.7) crystallize in the orthorhombic space group Pnma with two formula units per unit cell (own structure type, Pearson symbol oP56). The lattice parameters are as follows: a=13.109(3)-13.266(3) Å, b=4.4089(9)-4.4703(12) Å, and c=23.316(5)-23.557(6) Å. (Sr 1-xCa x) 3In 2Ge 4 and (Sr 1-xYb x) 3In 2Ge 4 ( x≈0.4-0.5) adopt another novel monoclinic structure-type (space group C2 /m, Z=4, Pearson symbol mS36) with lattice parameters in the range a=19.978(2)-20.202(2) Å, b=4.5287(5)-4.5664(5) Å, c=10.3295(12)-10.3447(10) Å, and β=98.214(2)-98.470(2)°, depending on the metal cations and their ratio. The polyanionic sub-structures in both cases are based on chains of InGe 4 corner-shared tetrahedra. The A5In 3Ge 6 structure ( A=Sr/Ca or Sr/Yb) also features Ge 4 tetramers, and isolated In atoms in nearly square-planar environment, while the A3In 2Ge 4 structure ( A=Sr/Ca or Eu/Yb) contains zig-zag chains of In and Ge strings with intricate topology of cis- and trans-bonds. The experimental results have been complemented by tight-binding linear muffin-tin orbital (LMTO) band structure calculations.

  9. Novel purification of 1'S-1'-Acetoxychavicol acetate from Alpinia galanga and its cytotoxic plus antiproliferative activity in colorectal adenocarcinoma cell line SW480.

    PubMed

    Baradwaj, R G; Rao, M V; Senthil Kumar, T

    2017-07-01

    Alpinia galanga (L.) Willd. is a valuable medicinal crop found in specific tropical regions of southeast Asia. Its crude extracts are well known for their wide medicinal properties and many compounds identified from these extracts are of great interest currently. 1'S-1'-Acetoxychavicol acetate (ACA) obtained from rhizomes of A.galanga is one such well-illustrated compound. This study strives to progress and simplifies the purification protocol for ACA from A.galanga rhizomes. It also studies the cytotoxicity and antiproliferative activity of ACA against Dukes' type B, colorectal adenocarcinoma (SW480). HPLC standardisation was carried out for purification of ACA from rhizomes of Alpinia galanga. MTT assay was executed to estimate the IC50 value of ACA against SW480 cell line. This value was used to study the apoptosis, nuclear morphological changes and mitochondrial membrane permeability using Acridine orange/ethidium bromide, DAPI, and JC-1 staining. The DNA fragmentation assay was used to substantiate the nuclear fragmentation of DNA observed in the DAPI staining. Further, cell cycle analysis was performed using flow cytometry to study the exact stage of the cell cycle where SW480 cells are arrested due to ACA, western blot analysis of relevant genes were done to further understand at molecular level. A comprehensive 1.89g of 1'S-1'-Acetoxychavicol acetate (ACA) was recovered from 500g of A.galanga rhizomes. ACA significantly suppressed the proliferation of SW480 cells at an IC50 of 80μM (48h). The mode of SW480 cell death due to ACA was initially identified as apoptosis and cell cycle halted at G0/G1 checkpoint with considerable DNA damage and mitochondrial depolarization. The expression of p21 was increased and concomitantly Cyclin D was downregulated in ACA treated in comparison to control. This study suggests that 1'S-1'-Acetoxychavicol acetate has potent anti-colorectal adenocarcinoma activity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. 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.

  11. 1'-Acetoxychavicol Acetate Increases Proteasome Activity by Activating cAMP-PKA Signaling.

    PubMed

    Yaku, Keisuke; Matsui-Yuasa, Isao; Kojima-Yuasa, Akiko

    2017-08-31

    Protein degradation systems are critical pathways for the maintenance of protein homeostasis. The age-dependent attenuation of the proteasome activity contributes to age-related neurodegenerative processes. The molecule 1'-acetoxychavicol acetate (ACA) is naturally obtained from the rhizomes and seeds of Zingiberaceae plants, such as Languas galangal and Alpinia galangal, and exhibits anti-carcinogenic effects. Recently, we have shown that ACA protected the age-related learning and memory impairments in senescence-accelerated mice and maintained cognitive performance. Therefore, we here examined the effects of ACA on the protein degradation systems and cell protection against neurotoxicity in differentiated PC12 cells. ACA increased proteasome activity in PC12 cells. Increased proteasome activity occurred during the initial stages of ACA treatment and lasted at least 9 h. The activity returned to control levels within 24 h. The increase in proteasome activity by ACA was suppressed by H-89, which is a cAMP-dependent protein kinase A inhibitor. ACA increased the adenylate cyclase activity and therefore the intracellular cAMP levels. Furthermore, ACA recovered the initial cell viability, which was reduced after the addition of the amyloid β-protein fragment to neuronally differentiated PC12 cells. The effects of ACA on amyloid toxicity were reduced after treatment with MG132, a proteasome inhibitor. These results demonstrated a neuroprotective effect of ACA via activation of cAMP/cAMP-dependent protein kinase A signaling in neuronally differentiated PC12 cells. Georg Thieme Verlag KG Stuttgart · New York.

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

    PubMed

    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

    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. 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. 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. By working through trade-offs, patients actively clarified their preferences, learning about CAT risks, benefits, and

  13. 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

  14. 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

  15. Are Press Depictions of Affordable Care Act Beneficiaries Favorable to Policy Durability?

    PubMed

    Chattopadhyay, Jacqueline

    2015-01-01

    If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability--meaning both avoidance of outright retrenchment and fidelity to its policy aims--is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability. This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary "deservingness" in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Using manual and automated methods, this paper analyzes newspaper text from August 2013 through January 2014 to trace portrayals of two ACA "target populations" before and during the new law's first open-enrollment period: those newly eligible for Medicaid, and those eligible for subsidies to assist in the purchase of private health insurance under the ACA. This paper also studies newspaper text portrayals of two groups informally crafted by the ACA in this timeframe: those gaining health insurance and those losing it. The text data uncover the following answers to the three descriptive questions for the timeframe studied: (1) Portrayals may underplay beneficiaries' economic heterogeneity. (2) Portrayals pay little attention to young adults. (3) Portrayals emphasize themes of workforce participation, economic self-sufficiency, and insider status. Health

  16. New York City Taxi Drivers' Knowledge and Perceptions of the Affordable Care Act.

    PubMed

    Gany, Francesca; Flores, Cristina; Winkel, Gary; Alam, Ishtiaq; Genoff, Margaux; Leng, Jennifer

    2015-12-01

    This study was conducted to assess New York City taxi drivers' knowledge and perceptions of the Affordable Care Act (ACA). A cross-sectional street-intercept study design was used to assess drivers' knowledge about the ACA. A 146-item questionnaire was administered from September 12 to December 6, 2013 to 175 yellow taxi and for-hire vehicle drivers. 91 % of drivers were foreign-born; 50 % were uninsured. Mean knowledge about the ACA was quite low; 78 % of the sample either knew nothing or only a little bit about the ACA. 77 % wanted more information about the ACA. Greater English proficiency, more years driving a taxi, and knowledge of having or not having a pre-existing health condition (vs. not knowing) were related to higher ACA knowledge levels. Knowledge of a pre-existing condition (whether they had one or not) compared to those who lacked such knowledge was also an important predictor of the perception of whether the ACA would have a positive impact. To facilitate enrollment, efforts should focus on occupationally-focused initiatives that educate drivers at their places of work and leisure, to raise the overall knowledge levels and enrollment of the community.

  17. 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.

  18. 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.

  19. 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. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. New York City taxi drivers’ knowledge and perceptions of the Affordable Care Act

    PubMed Central

    Gany, Francesca; Flores, Cristina; Winkel, Gary; Alam, Ishtiaq; Genoff, Margaux

    2015-01-01

    Objectives This study was conducted to assess New York City taxi drivers’ knowledge and perceptions of the Affordable Care Act (ACA). Methods A cross-sectional street-intercept study design was used to assess drivers’ knowledge about the ACA. A 146-item questionnaire was administered from September 12 to December 6, 2013 to 175 yellow taxi and for-hire vehicle drivers. Results 91% of drivers were foreign-born; 50% were uninsured. Mean knowledge about the ACA was quite low; 78% of the sample either knew nothing or only a little bit about the ACA. 77% wanted more information about the ACA. Greater English proficiency, more years driving a taxi, and knowledge of having or not having a pre-existing health condition (versus not knowing) were related to higher ACA knowledge levels. Knowledge of a pre-existing condition (whether they had one or not) compared to those who lacked such knowledge was also an important predictor of the perception of whether the ACA would have a positive impact. Conclusions To facilitate enrollment, efforts should focus on occupationally-focused initiatives that educate drivers at their places of work and leisure, to raise the overall knowledge levels and enrollment of the community. PMID:25976215

  5. Involvement of protein tyrosine phosphorylation and reduction of cellular sulfhydryl groups in cell death induced by 1' -acetoxychavicol acetate in Ehrlich ascites tumor cells.

    PubMed

    Moffatt, Jerry; Kennedy, David Opare; Kojima, Akiko; Hasuma, Tadayoshi; Yano, Yoshihisa; Otani, Shuzo; Murakami, Akira; Koshimizu, Koichi; Ohigashi, Hajime; Matsui-Yuasa, Isao

    2002-02-20

    Elucidation of the mechanisms underlying potential anticancer drugs continues and unraveling these mechanisms would not only provide a conceptual framework for drug design but also promote use of natural products for chemotherapy. To further evaluate the efficacy of the anticancer activity of 1'-acetoxychavicol acetate (ACA), this study investigates the underlying mechanisms by which ACA induces death of Ehrlich ascites tumor cells. ACA treatment induced loss of cell viability, and Western blotting analysis revealed that the compound stimulated tyrosine phosphorylation of several proteins with 27 and 70 kDa proteins being regulated in both dose- and time-dependent manner prior to loss of viability. Protein tyrosine kinase inhibitor herbimycin A moderately protected cells from ACA-induced toxicity. In addition, cellular glutathione and protein sulfydryl groups were also significantly reduced both dose- and time-dependently during evidence of cell death. Replenishing thiol levels by antioxidant, N-acetylcysteine (NAC), an excellent supplier of glutathione and precursor of glutathione, substantially recovered the viability loss, but the recovery being time-dependent, as late addition of NAC (at least 30 min after ACA addition to cultures) was, however, ineffective. Addition of NAC to ACA treated cultures also abolished tyrosine phosphorylation of the 27 kDa protein. These results, at least partly, identify cellular sulfhydryl groups and protein tyrosine phosphorylation as targets of ACA cytotoxicity in tumor cells.

  6. 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.

  7. 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

  8. Lower expression of ATM and gene deletion is more frequent in adrenocortical carcinomas than adrenocortical adenomas.

    PubMed

    Ye, Junna; Qi, Yan; Wang, Weiqing; Sun, Fukang; Wei, Qin; Su, Tingwei; Zhou, Weiwei; Jiang, Yiran; Yuan, Wenqi; Cai, Jianfei; Cui, Bin; Ning, Guang

    2012-06-01

    Adrenocortical carcinoma (ACC) is a rare endocrine malignancy accounting for approximately 0.02-0.2% of all cancer deaths. The molecular pathogenesis of ACC has been the hot topic of recent reviews but it is still poorly understood. It is imperative to have a better understanding on the pathophysiology of ACC so as to establish precise diagnosis and effective treatment. This study aims to identify the molecular markers between ACCs and adrenocortical adenomas (ACAs). With MLPA, we checked on 10 ACA and 9 ACC tissue samples. The MLPA results showed deletion on chromosomes 18q, 11q, 11p, and 13q and duplication on chromosomes 3q, 4q, 6p, and 19p. There was a significant difference in the number of aberration copies of the ataxia telangiectasia-mutated (ATM) gene located on chromosome 11q22-q23 between ACCs and ACAs. Five out of 9 (56%) ACC specimens had deletion of ATM (P = 0.011). RT-PCR result then demonstrated that ATM mRNA level is lower in ACCs than in ACAs (P < 0.001). In addition, immunohistochemistry (IHC) study of the 19 ACA and 18 ACC samples confirmed lower expression of ATM protein in ACCs than in ACAs (P < 0.001). The study demonstrated that ATM expression was diminished in ACC than in ACA, suggesting an important role of ATM in the tumorigenesis of ACC.

  9. 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.

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

    PubMed Central

    2015-01-01

    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. PMID:25897065

  11. 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.

  12. Biomarkers in lung adenocarcinoma: a decade of progress.

    PubMed

    Sholl, Lynette M

    2015-04-01

    The analysis of molecular biomarkers in lung adenocarcinoma (ACA) is now a central component of pathologic diagnosis and oncologic care. The identification of an EGFR mutation or ALK rearrangement in advanced-stage lung ACA will dictate a change in first-line treatment from standard chemotherapy to targeted inhibition of these oncogenic alterations. Viable approaches to therapeutic targeting of KRAS-mutated ACA are now under investigation, raising the possibility that this too will become an important predictive marker in this tumor type. The recognized array of less common oncogenic alterations in lung ACA, including in the ROS1, RET, BRAF, and ERBB2 genes, is growing rapidly. The therapeutic implications of these findings are, in many cases, still under investigation. To focus on the major molecular biomarkers in lung ACA, recommended testing strategies, the implications for targeted therapies, and the mechanisms that drive development of resistance. Our current understanding of predictive and prognostic markers in lung ACA is derived from a decade of technical advances, clinical trials, and epidemiologic studies. Many of the newest discoveries have emerged from application of high-throughput next-generation sequencing and gene expression analyses in clinically and pathologically defined cohorts of human lung tumors. Best practices require a solid understanding of relevant biomarkers for diagnosis and treatment of patients with lung ACA.

  13. Expected and Unexpected Consequences of the Affordable Care Act: The Impact on Patients and Surgeons-Pro and Con Arguments.

    PubMed

    Rudnicki, Marek; Armstrong, John H; Clark, Clancy; Marcus, Stuart G; Sacks, Lee; Moser, A James; Reid-Lombardo, K Marie

    2016-02-01

    The Patient Protection and Affordable Care Act (PPACA), called the Affordable Care Act (ACA) or "ObamaCare" for short, was enacted in 2010. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract (SSAT) hosted a debate with an expert panel to discuss the ACA and its impact on surgical care after the first year of patient enrollment. The purpose of this debate was to focus on the impact of ACA on the public and surgeons. At the core of the ACA are insurance industry reforms and expanded coverage, with a goal of improved clinical outcomes and reduced costs of care. We have observed supportive and opposing views on ACA. Nonetheless, we will witness major shifts in health care delivery as well as restructuring of our relationship with payers, institutions, and patients. With the rapidly changing health care landscape, surgeons will become key members of health systems and will likely need to lead transition from solo-practice to integrated care systems. The full effects of the ACA remain unrealized, but its implementation has begun to change the map of the American health care system and will surely impact the practice of surgery. Herein, we provide a synopsis of the "pro" and "con" arguments for the expected and unexpected consequences of the ACA on society and surgeons.

  14. The Perceived Impact of the Patient Protection and Affordable Care Act on North Carolina's Free Clinics.

    PubMed

    Swan, Greg A; Foley, Kristie L

    2016-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) may dramatically affect the demographics of the uninsured population and the funding prospects for free health clinics. We conducted a cross-sectional survey of 64 of 80 free clinics (80.0% response rate) in North Carolina to assess free clinic directors' knowledge of the ACA and their perceptions of how the ACA would affect clinic operations. Free clinic directors were knowledgeable about well publicized aspects of the ACA (eg, lack of Medicaid expansion in North Carolina), but they were less knowledgeable about provisions such as the Federal Tort Claims Act and high-risk pools, which may have direct and indirect effects on free clinics. Directors expressed concern over the unintended consequences of the ACA, such as reduced funding and reduced volunteerism. Anticipated clinic changes as a result of the ACA include initiation of electronic medical records and, to a lesser extent, a move to become "hybrid" clinics (federally qualified health center look-alikes). This study is focused on North Carolina free clinics that are members of the North Carolina Association of Free Clinics (NCAFC). Findings cannot be generalized to non-NCAFC free clinics or to free clinic networks outside the state. Despite its effort to expand health insurance coverage, the ACA may have unintended consequences to low-cost free clinics that serve uninsured populations. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  15. 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

  16. 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.

  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. 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.

  19. 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.

  20. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    PubMed

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  1. In Vitro Activities of Enantiopure and Racemic 1′-Acetoxychavicol Acetate against Clinical Isolates of Mycobacterium tuberculosis

    PubMed Central

    Warit, Saradee; Rukseree, Kamolchanok; Prammananan, Therdsak; Hongmanee, Poonpilas; Billamas, Pamaree; Jaitrong, Sarinya; Chaiprasert, Angkana; Jaki, Birgit U.; Pauli, Guido F.; Palittapongarnpim, Prasit

    2017-01-01

    In the process of evaluating the effect of several plant extracts against Mycobacterium tuberculosis using the Microplate Alamar Blue Assay (MABA), an extract of Thai herb Alpinia galanga rhizome and its major component, 1′-acetoxychavicol acetate (ACA), exhibited marked anti-tuberculosis activity. The minimal inhibition concentrations (MICs) of the S-enantiomer of ACA (S-ACA) against M. tuberculosis H37Ra ATCC 25177 and H37Rv ATCC 27294 strains were 0.2 µg/mL and 0.7 µg/mL, respectively. More than 95% of 100 drug-sensitive and 50 drug-resistant mycobacterial clinical isolates were inhibited by extracted S-ACA at 1.0 µg/mL. All of the remaining isolates were inhibited at 2.0 µg/mL. In contrast to the S-enantiomer, synthetic racemic 1′-R,S-ACA (rac-ACA) showed MICs of 0.5 µg/mL and 2.7 µg/mL for M. tuberculosis H37Ra ATCC 25177 and H37Rv ATCC 27294, respectively, suggesting that the anti-tuberculosis effect might be primarily due to the S-form. These observations were in line with the MICs of rac-ACA against 98% of 93 drug-resistant clinical isolates, which showed the effective inhibitory dose at 2.0 µg/mL. After exposure to 2.7 µg/mL of rac-ACA for at least 3 h, the tubercle bacilli were completely killed. These demonstrated that ACA had potent anti-TB activity. PMID:28927024

  2. In Vitro Activities of Enantiopure and Racemic 1'-Acetoxychavicol Acetate against Clinical Isolates of Mycobacterium tuberculosis.

    PubMed

    Warit, Saradee; Rukseree, Kamolchanok; Prammananan, Therdsak; Hongmanee, Poonpilas; Billamas, Pamaree; Jaitrong, Sarinya; Chaiprasert, Angkana; Jaki, Birgit U; Pauli, Guido F; Franzblau, Scott G; Palittapongarnpim, Prasit

    2017-09-18

    In the process of evaluating the effect of several plant extracts against Mycobacterium tuberculosis using the Microplate Alamar Blue Assay (MABA), an extract of Thai herb Alpinia galanga rhizome and its major component, 1'-acetoxychavicol acetate (ACA), exhibited marked anti-tuberculosis activity. The minimal inhibition concentrations (MICs) of the S-enantiomer of ACA (S-ACA) against M. tuberculosis H37Ra ATCC 25177 and H37Rv ATCC 27294 strains were 0.2 µg/mL and 0.7 µg/mL, respectively. More than 95% of 100 drug-sensitive and 50 drug-resistant mycobacterial clinical isolates were inhibited by extracted S-ACA at 1.0 µg/mL. All of the remaining isolates were inhibited at 2.0 µg/mL. In contrast to the S-enantiomer, synthetic racemic 1'-R,S-ACA (rac-ACA) showed MICs of 0.5 µg/mL and 2.7 µg/mL for M. tuberculosis H37Ra ATCC 25177 and H37Rv ATCC 27294, respectively, suggesting that the anti-tuberculosis effect might be primarily due to the S-form. These observations were in line with the MICs of rac-ACA against 98% of 93 drug-resistant clinical isolates, which showed the effective inhibitory dose at 2.0 µg/mL. After exposure to 2.7 µg/mL of rac-ACA for at least 3 h, the tubercle bacilli were completely killed. These demonstrated that ACA had potent anti-TB activity.

  3. Early Impact of the Affordable Care Act on Uptake of Long-acting Reversible Contraceptive Methods.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The Affordable Care Act (ACA) required most private insurance plans to cover contraceptive services without patient cost-sharing as of January 2013 for most plans. Whether the ACA's mandate has impacted long-acting reversible contraceptives (LARC) use is unknown. The aim of this article is to assess trends in LARC cost-sharing and uptake before and one year after implementation of the ACA's contraceptive mandate. A retrospective cohort study using Truven Health MarketScan claims data from January 2010 to December 2013. Women aged 18-45 years with continuous insurance coverage with claims for oral contraceptive pills, patches, rings, injections, or LARC during 2010-2013 (N=3,794,793). Descriptive statistics were used to assess trends in LARC cost-sharing and uptake from 2010 through 2013. Interrupted time series models were used to assess the association of time, ACA, and time after the ACA on LARC cost-sharing and initiation rates, adjusting for patient and plan characteristics. The proportion of claims with $0 cost-sharing for intrauterine devices and implants, respectively, rose from 36.6% and 9.3% in 2010 to 87.6% and 80.5% in 2013. The ACA was associated with a significant increase in these proportions and in their rate of increase (level and slope change both P<0.001). LARC uptake increased over time with no significant change in level of LARC use after ACA implementation in January 2013 (P=0.44) and a slightly slower rate of growth post-ACA than previously reported (β coefficient for trend, -0.004; P<0.001). The ACA has significantly decreased LARC cost-sharing, but during its first year had not yet increased LARC initiation rates.

  4. 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.

  5. Public Response to Obamacare on Twitter

    PubMed Central

    Zheng, Kai; Liu, Yang; Levy, Helen

    2017-01-01

    Background The Affordable Care Act (ACA), often called “Obamacare,” is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative. Objective The aim of our study was to examine the extent to which Twitter data can be used to measure public opinion of the ACA over time. Methods We prospectively collected a 10% random sample of daily tweets (approximately 52 million since July 2011) using Twitter’s streaming application programming interface (API) from July 10, 2011 to July 31, 2015. Using a list of key terms and ACA-specific hashtags, we identified tweets about the ACA and examined the overall volume of tweets about the ACA in relation to key ACA events. We applied standard text sentiment analysis to assign each ACA tweet a measure of positivity or negativity and compared overall sentiment from Twitter with results from the Kaiser Family Foundation health tracking poll. Results Public opinion on Twitter (measured via sentiment analysis) was slightly more favorable than public opinion measured by the Kaiser poll (approximately 50% vs 40%, respectively) but trends over time in both favorable and unfavorable views were similar in both sources. The Twitter-based measures of opinion as well as the Kaiser poll changed very little over time: correlation coefficients for favorable and unfavorable public opinion were .43 and .37, respectively. However, we found substantial spikes in the volume of ACA-related tweets in response to key events in the law’s implementation, such as the first open enrollment period in October 2013 and the Supreme Court decision in June 2012. Conclusions Twitter may be useful for tracking public opinion of health care reform as it appears to be comparable with conventional polling results. Moreover, in contrast with conventional polling, the overall amount of tweets also provides a potential indication of public interest of a particular

  6. The capacity of the Medical Expenditure Panel Survey to inform the Affordable Care Act.

    PubMed

    Cohen, Steven B; Cohen, Joel W

    2013-05-01

    The Affordable Care Act (ACA) was enacted with major provisions to expand health insurance coverage, control health care costs, and improve the health care delivery system. Essential data resources will be required for effective program planning, administration, and management, in addition to facilitating evaluations of program performance. The Medical Expenditure Panel Survey (MEPS) is one of the core data resources that has been used to inform several provisions of the ACA. This paper provides a summary of the capacity of the MEPS to inform program planning, implementation, and evaluations of program performance for several components of the ACA.

  7. [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.

  8. 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

  9. 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.

  10. 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

  11. Peripheral neuropathy in acrodermatitis chronica atrophicans - effect of treatment.

    PubMed

    Kindstrand, E; Nilsson, B Y; Hovmark, A; Pirskanen, R; Asbrink, E

    2002-11-01

    Forty-seven patients with the late borrelial manifestation acrodermatitis chronica atrophicans (ACA) and with objective neurological and/or neurophysiological findings were followed up after antibiotic treatment with dermatological, serological, neurological and neurophysiological controls. Despite a good therapeutic effect on ACA lesions, specific antibody values and symptoms of irritative nerve lesions, the objective neurological and neurophysiological findings of nerve deficit remained unchanged. There was no progress of neuropathy findings during the follow-up time. Our interpretation of the results is that the remaining neuropathy signs after treatment of ACA are neurological sequelae and not manifestations of persisting Borrelia infection.

  12. Towards Verification and Validation for Increased Autonomy

    NASA Technical Reports Server (NTRS)

    Giannakopoulou, Dimitra

    2017-01-01

    This presentation goes over the work we have performed over the last few years on verification and validation of the next generation onboard collision avoidance system, ACAS X, for commercial aircraft. It describes our work on probabilistic verification and synthesis of the model that ACAS X is based on, and goes on to the validation of that model with respect to actual simulation and flight data. The presentation then moves on to identify the characteristics of ACAS X that are related to autonomy and to discuss the challenges that autonomy pauses on VV. All work presented has already been published.

  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. 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...

  15. 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.

  16. 76 FR 54460 - Combined Notice of Filings; Filings Instituting Proceedings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ... Numbers: RP11-2414-000. Applicants: Pine Needle LNG Company, LLC. Description: Pine Needle LNG Company, LLC submits tariff filing per 154.402: Pine Needle LNG Company 2011 ACA Filing to be effective 10/1...

  17. 76 FR 55899 - Combined Notice of Filings No. 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    .... Eastern Time on Monday, September 12, 2011. Docket Numbers: RP11-2481-001. Applicants: Dauphin Island Gathering Partners. Description: Dauphin Island Gathering Partners submits tariff filing per 154.205(b): ACA...

  18. Agrobacterium-mediated transformation in Alpinia galanga (Linn.) Willd. for enhanced acetoxychavicol acetate production.

    PubMed

    Rao, Kiranmayee; Chodisetti, Bhuvaneswari; Mangamoori, Lakshmi Narasu; Giri, Archana

    2012-09-01

    Agrobacterium-mediated transformations ensure elevated amounts of secondary metabolite accumulation with genetic and biosynthetic stability. In the present study, Alpinia galanga rich in bioactive compounds was genetically transformed using different strains of Agrobacterium rhizogenes viz. LBA 9402, A(4), 532, 2364 and PRTGus. Even though a higher growth rate was obtained with the LBA 9402 strain, maximum acetoxychavicol acetate accumulation (ACA) was seen in the PRTGus transformant. PRTGus root line has shown 10.1 fold higher ACA content in comparison to the control roots. The lowest ACA production was shown by the A(4) transformant (4.9 fold). The quantification of ACA in the transformed roots was carried out by using HPLC, which was found to be in the order of PRTGus > LBA 9402 > 2364 > 532 > A(4). The fast growth rate of hairy roots, genetic stability and their ability to synthesize more than one metabolite offer a promising system for the production of valuable secondary metabolites.

  19. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 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

  4. Head trauma and distal anterior cerebral artery aneurysm: potential role of an adhesion to the falx.

    PubMed

    Scholtes, Felix; Henroteaux, Adrienne; Otto, Bernard; Martin, Didier

    2015-01-01

    Proximity of the distal anterior cerebral artery (dACA) and the edge of the falx has been hypothetically implicated in the pathogenesis of traumatic dACA aneurysms. A 57-year-old patient presented with posttraumatic intracranial hemorrhage and an A3-bifurcation aneurysm that increased in size over the following 2 weeks. Because of higher endovascular risk, surgical clipping was preferred. Surgery revealed a fibrous adhesion between the falx and the dACA at the aneurysm site. This adhesion could provide an anatomical reason for the formation of a traumatic dACA aneurysm at the edge of the falx or rupture of a preexisting aneurysm. Georg Thieme Verlag KG Stuttgart · New York.

  5. Seasonally transported aerosol layers over southeast Atlantic are closer to underlying clouds than previously reported

    NASA Astrophysics Data System (ADS)

    Rajapakshe, Chamara; Zhang, Zhibo; Yorks, John E.; Yu, Hongbin; Tan, Qian; Meyer, Kerry; Platnick, Steven; Winker, David M.

    2017-06-01

    From June to October, low-level clouds in the southeast (SE) Atlantic often underlie seasonal aerosol layers transported from African continent. Previously, the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) 532 nm lidar observations have been used to estimate the relative vertical location of the above-cloud aerosols (ACA) to the underlying clouds. Here we show new observations from NASA's Cloud-Aerosol Transport System (CATS) lidar. Two seasons of CATS 1064 nm observations reveal that the bottom of the ACA layer is much lower than previously estimated based on CALIPSO 532 nm observations. For about 60% of CATS nighttime ACA scenes, the aerosol layer base is within 360 m distance to the top of the underlying cloud. Our results are important for future studies of the microphysical indirect and semidirect effects of ACA in the SE Atlantic region.

  6. 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.

  7. Statistical theory of wetting of liquid drops on superhydrophobic randomly rough surfaces.

    PubMed

    Afferrante, L; Carbone, G

    2015-10-01

    It is well known that hydrophobic surfaces may become superhydrophobic when their surface is properly roughened. However, the role of roughness is not yet very clear, notwithstanding several theoretical and experimental investigations. In the present paper, we propose a relatively simple theory aiming at calculating the apparent contact angle (ACA) and the contact area occurring in the case of drops gently deposited on two-dimensional randomly rough surfaces. Our theory applies both to isotropic and anisotropic rough surfaces, although in the latter case the predicted ACA has to be interpreted as the average contact angle at the triple line. We assume large separation of scales, i.e., that the spectral content of the surface lies in a range of wavelengths much smaller than the size of the apparent liquid-solid contact area. Results show that anisotropy negligibly affects the ACA, and a very reasonable agreement is obtained between theoretical ACA values and experimental data.

  8. Effects of the tropical ginger compound,1’-acetoxychavicol acetate, against tumor promotion in K5.Stat3C transgenic mice

    PubMed Central

    2012-01-01

    The purpose of the current study was to determine whether a tropical ginger derived compound 1’-acetoxychavicol acetate (ACA), suppresses skin tumor promotion in K5.Stat3C mice. In a two-week study in which wild-type (WT) and K5.Stat3C mice were co-treated with either vehicle, ACA, galanga extract, or fluocinolone acetonide (FA) and tetradecanoyl phorbol acetate (TPA), only the galanga extract and FA suppressed TPA-induced skin hyperproliferation and wet weight. None of these agents were effective at suppressing p-Tyr705Stat3 expression. However, ACA and FA showed promising inhibitory effects against skin tumorigenesis in K5.Stat3C mice. ACA also suppressed phospho-p65 NF-κB activation, suggesting a potential mechanism for its action. PMID:22704648

  9. Anti-diabetic activity of alcoholic extract of Celosia argentea Linn. seeds in rats.

    PubMed

    Vetrichelvan, Thangarasu; Jegadeesan, Maniappan; Devi, Bangaru Adigalar Uma

    2002-04-01

    Celosia argentea Linn. commonly known as "Cocks Comb" and its seeds are widely used in Indian folk medicine for the treatment of diabetes mellitus. This study was undertaken to evaluate the effect of an alcoholic extract of Celosia argentea seeds (ACAS) on blood glucose and body weight in alloxan-induced diabetic rats. ACAS was found to reduce the increase of blood glucose in alloxan-induced diabetic rats (27.8% at 250 mg/kg and 38.8% at 500 mg/kg body weight). Chronic administration of ACAS significantly (p<0.01) reduced the blood glucose in alloxan-induced diabetic rats for two weeks. Also the extract prevented a decrease in body weight in alloxan-induced diabetic rats. These results suggest that the ACAS possesses anti-diabetic activity in alloxan-induced diabetic rats.

  10. 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.

  11. Association of acute cerebellar ataxia and human papilloma virus vaccination: a case report.

    PubMed

    Yonee, Chihiro; Toyoshima, Mitsuo; Maegaki, Yoshihiro; Kodama, Yuichi; Hayami, Hiroshi; Takahashi, Yukitoshi; Kusunoki, Susumu; Uchibori, Ayumi; Chiba, Atsuro; Kawano, Yoshifumi

    2013-10-01

    We report the case of a patient who developed symptoms of acute cerebellar ataxia (ACA) after administration of the human papilloma virus (HPV)-16/18 vaccine. This patient developed symptoms of ACA, including nausea, vertigo, severe limb and truncal ataxia, and bilateral spontaneous continuous horizontal nystagmus with irregular rhythm, 12 days after administration of the HPV-16/18 AS04-adjuvanted cervical cancer vaccine. After this, the patient received methylprednisolone pulse and intravenous immunoglobulin (IVIG) therapies as well as immunoadsorption plasmapheresis. Severe ACA symptoms did not improve after methylprednisolone pulse and IVIG therapies, but the patient recovered completely after immunoadsorption plasmapheresis. This temporal association strongly suggests that ACA was induced by the vaccination. Georg Thieme Verlag KG Stuttgart · New York.

  12. 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

  13. Participatory evaluation of a community mobilization effort to enroll Wyandotte County, Kansas, residents through the Affordable Care Act.

    PubMed

    Fawcett, Stephen B; Sepers, Charles E; Jones, Jerry; Jones, Lucia; McKain, Wesley

    2015-07-01

    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).

  14. 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...

  15. 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.

  16. Azetidine-2-carboxylic acid resistant mutants of Arabidopsis thaliana with increased salt tolerance

    SciTech Connect

    Lehle, F.R.; Murphy, M.A.; Khan, R.A. )

    1989-04-01

    Nineteen mutant Arabidopsis families resistant to the proline analog azetidine-2-carboxylic acid (ACA) were characterized in terms of NaCl tolerance and proline content. Mutants were selected from about 64,000 progeny of about 16,000 self-pollinated Columbia parents which had been mutated with ethyl methane sulfonate during seed imbibition. Selections were performed during seed germination on aseptic agar medium containing 0.2 to 0.25 mM ACA. Nineteen mutant families, 12 clearly independent, retained resistance to ACA in the M{sub 4} generation. Based on germination on 150 mM NaCl, 13 of the mutant families were more tolerant than the wild type. Two mutants of intermediate resistance to ACA were markedly more salt tolerant than the others. Four mutant families appeared to overproduce proline. Of these, only 3 showed slight increases in salt tolerance.

  17. Henry J. Kaiser Family Foundation

    MedlinePlus

    ... Eases Up On Premium Hikes After State Scrutiny Trump’s Order Advances GOP Go-To Ideas To Broaden ... Wildfire. California Slaps Surcharge On ACA Plans As Trump Remains Coy On Subsidies Visit Kaiser Health News ...

  18. 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,...

  19. 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.

  20. 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.

  1. 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)

  2. 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)

  3. 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)

  4. 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)

  5. 78 FR 46935 - Combined Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ...: 20130725-5032. Comments Due: 5 p.m. ET 8/6/13. Docket Numbers: RP13-1098-000. Applicants: Bison Pipeline LLC. Description: Bison Pipeline LLC submits tariff filing per 154.203: ACA Filing 2013 to...

  6. 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...

  7. 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.

  8. 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.

  9. The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces.

    PubMed

    Saltzman, Evan; Eibner, Christine

    2015-07-15

    In this study, RAND Corporation researchers assess the expected change in enrollment and premiums in the Patient Protection and Affordable Care Act (ACA)-compliant individual market in federally facilitated marketplace (FFM) states if the U.S. Supreme Court decides to eliminate subsidies in FFM states. The analysis used the Comprehensive Assessment of Reform Efforts (COMPARE) microsimulation model, an economic model developed by RAND researchers, to assess the impact of proposed health reforms. The authors found that enrollment in the ACA-compliant individual market, including plans sold in the marketplaces and those sold outside of the marketplaces that comply with ACA regulations, would decline by 9.6 million, or 70 percent, in FFM states if subsidies were eliminated. They also found that unsubsidized premiums in the ACA-compliant individual market would increase 47 percent in FFM states. This corresponds to a $1,610 annual increase for a 40-year-old nonsmoker purchasing a silver plan.

  10. 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.

  11. 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.

  12. Up-to-Date on Preventive Care Services Under Affordable Care Act: A Trend Analysis From MEPS 2007-2014.

    PubMed

    Hong, Young-Rock; Jo, Ara; Mainous, Arch G

    2017-08-01

    The utilization of preventive care services has been less than optimal. As part of an effort to address this, the Affordable Care Act (ACA) mandated that private health insurance plans cover evidence-based preventive services. To evaluate whether the provisions of ACA have increased being up-to-date on recommended preventive care services among privately insured individuals aged 18-64. Multivariate linear regression models were used to examine trends in prevalence of being up-to-date on selected preventive services, diagnosis of health conditions, and health expenditures between pre-ACA (2007-2010) and post-ACA (2011-2014). Adjusted difference-in-difference analyses were used to estimate changes in those outcomes in the privately insured that differed from changes in the uninsured (control group). After the passage of ACA, up-to-date rates of routine checkup (2.7%; 95% confidence interval, 0.8%-4.7%; P=0.007) and flu vaccination (5.9%; 95% confidence interval, 4.2%-7.6%; P<0.001) increased among those with private insurance, as compared with the control group. Changes in blood pressure check, cholesterol check and cancer screening (pap smear test, mammography, and colorectal cancer screening) were not associated with the ACA. Prevalence in diagnosis of health conditions remained constant. Slower uptrends in adjusted total health care expenditures and downtrends in adjusted out-of-pocket costs were observed during the study period. The provisions of the ACA have resulted in trivial increases in being up-to-date on selected preventive care services. Additional efforts may be required to take full advantage of the elimination of cost-sharing under the ACA.

  13. 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

    ...On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA), Public Law 111-148. Section 5201 of the ACA changes the Primary Care Loan (PCL) program by: (1) Reducing the number of years for the primary health care service requirement; (2) lowering the interest rate for service default; and (3) eliminating the HHS requirement that parental financial information be submitted for independent students.

  14. 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.

  15. Claudin 3, 4, and 15 expression in solid tumors of lung adenocarcinoma versus malignant pleural mesothelioma.

    PubMed

    Chaouche-Mazouni, Siham; Scherpereel, Arnaud; Zaamoum, Rima; Mihalache, Adriana; Amir, Zine-Charaf; Lebaïli, Nemcha; Delaire, Baptiste; Gosset, Pierre

    2015-08-01

    Epithelioid malignant pleural mesothelioma (MPM) can easily be confused with lung adenocarcinomas (ACAs). In serous effusion, claudin (cldn) 3 is shown to be useful in the diagnosis of mesothelioma vs ACAs. Cldn15 is reported to be overexpressed in epithelioid mesothelioma and absent in human airway epithelium. The aim was to assess the value of cldn3 and cldn4 compared to that of BerEp4 and thyroid transcription factor-1 (TTF1) in differentiating lung ACA from epithelioid MPM and to examine the expression of cldn15 in these tumors. The expression of cldn3, cldn4, cldn15, BerEp4, and TTF1 was examined by immunohistochemistry in a total of 62 human specimen including 28 epithelioid MPMs and 34 ACAs of the lung. In lung ACA, cldn4 was strongly expressed in all 34 (100%) specimens followed by cldn3 in 33 (97%) of 34. BerEp4 was expressed in 32 (94.1%) of 34. TTF1 reacted for only 20 (58.82%) of 34 cases of lung ACA. In MPM specimens, the expression of cldn3 and4 as well as that of TTF1 was completely absent. In contrast, BerEp4 was focally expressed in 5 (17.85%) of 28 cases of epithelioid MPM. Cldn15 was strongly expressed in 53% pf epithelioid MPMs but also in 50% of lung ACAs. Its expression was moderate in normal pleura and limited in normal lung. Cldn3 and cldn4 appear to be the best performing carcinoma markers in discriminating lung ACA from mesothelioma compared with BerEp4 and TTF1. There is no differential expression of cldn15 between the 2 pathologies. However, the limited cldn15 expression in normal tissues and high expression in tumors make it an attractive candidate for cancer therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  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. 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

  18. How Would Rural Hospitals Be Affected by Loss of the Affordable Care Act's Medicare Low-Volume Hospital Adjustment?

    PubMed

    Whitaker, Rebecca Garr; Holmes, G Mark; Pink, George H

    2017-04-01

    The low-volume hospital (LVH) payment adjustment established in the Patient Protection and Affordable Care Act (ACA) of 2010 is scheduled to sunset on October 1, 2017. The purpose of this analysis was: (1) to estimate the effect of the ACA LVH adjustment on qualifying hospitals' profitability margins; and (2) to examine hospital and market characteristics of the hospitals that would be most adversely affected by the loss of the ACA LVH adjustment. 2004-2015 data from the Hospital Cost Report Information System, Hospital Market Service Area File and Nielsen-Claritas Pop-Facts file were used to estimate difference-in-difference regression models with hospital-level random effects in order to determine whether the ACA LVH adjustment improved qualifying rural hospitals' profitability margins. Recycled predictions estimated the effect of losing the ACA LVH adjustment on profitability margins. Bivariate analyses explored associations between the predicted profitability margins and hospital and market characteristics. The ACA LVH adjustment significantly improved Sole Community Hospitals' Medicare inpatient margins in the year they received the adjustment, and it had a large but statistically insignificant effect on the profitability margins of other rural hospitals. Hospitals that would be the most adversely affected by loss of the ACA LVH adjustment were more likely to be small, located in the South, and in high-poverty markets with higher proportions of black and uninsured individuals. Elimination of the ACA LVH adjustment would have differential effects on subgroups of hospitals, and those located in markets serving historically underserved populations would be the most adversely affected. © 2016 National Rural Health Association.

  19. 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.

  20. 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.