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negligence issue

Martin Holtkamp, William H Theodore
Generic antiepileptic drugs (AED) are significantly cheaper than brand name drugs, and may reduce overall health care expenditures. Regulatory bodies in Europe and North America require bioequivalence between generic and innovator drugs with regard to area under the plasma concentration-time curve (AUC) and peak plasma concentration (Cmax ); strict cutoff values have been defined. The main issue is if bioequivalence ensures therapeutic equivalence. Are switches from brand to generic, or between generic AEDs entirely safe or potentially harmful in patients with epilepsy? We summarized and evaluated the available evidence from bioequivalence, health care utilization, and clinical studies on safety of generic AEDs...
June 12, 2018: Epilepsia
Filip Persson, Pär Söderhjelm, Bertil Halle
Much of biology happens at the protein-water interface, so all dynamical processes in this region are of fundamental importance. Local structural fluctuations in the hydration layer can be probed by 17 O magnetic relaxation dispersion (MRD), which, at high frequencies, measures the integral of a biaxial rotational time correlation function (TCF)-the integral rotational correlation time. Numerous 17 O MRD studies have demonstrated that this correlation time, when averaged over the first hydration shell, is longer than in bulk water by a factor 3-5...
June 7, 2018: Journal of Chemical Physics
Jeremy T Howard, Tom A Rathje, Caitlyn E Bruns, Danielle F Wilson-Wells, Stephen D Kachman, Matthew L Spangler
Simulated and swine industry data sets were utilized to assess the impact of removing older data on the predictive ability of selection candidate estimated breeding values (EBV) when using single-step genomic best linear unbiased prediction (ssGBLUP). Simulated data included thirty replicates designed to mimic the structure of swine data sets. For the simulated data, varying amounts of data were truncated based on the number of ancestral generations back from the selection candidates. The swine data sets consisted of phenotypic and genotypic records for three traits across two breeds on animals born from 2003 to 2017...
June 8, 2018: Journal of Animal Breeding and Genetics, Zeitschrift Für Tierzüchtung und Züchtungsbiologie
Erkki Soini, Ossi Riekkinen, Heikki Kröger, Petri Mankinen, Taru Hallinen, Janne P Karjalainen
Purpose: Osteoporosis is asymptomatic morbidity of the elderly which develops slowly over several years. Osteoporosis diagnosis has typically involved Fracture Risk Assessment (FRAX) followed by dual energy X-ray absorptiometry (DXA) in specialist care. Point-of-care pulse-echo ultrasound (PEUS) was developed to overcome DXA-related access issues and to enable faster fracture prevention treatment (FPT) initiation. The objective of this study was to evaluate the cost-effectiveness of two proposed osteoporosis management (POMs: FRAX→PEUS-if-needed→DXA-if-needed→FPT-if-needed) pathways including PEUS compared with the current osteoporosis management (FRAX→DXA-if-needed→FPT-if-needed)...
2018: ClinicoEconomics and Outcomes Research: CEOR
Gemma Turton
If a patient suffers physical harm during medical treatment when a risk materialises which the doctor failed to warn the patient about, there are two key issues when a negligence claim is brought by the patient. First, it must be shown that the doctor was negligent in failing to warn the patient about the particular risk. Secondly, it must normally be shown that this failure to warn was a cause of the damage suffered, although courts also allow claims to succeed when a patient may still have undergone treatment even if adequately warned...
June 5, 2018: Medical Law Review
Arlene I Ramsingh, Steven J Gray, Andrew Reilly, Michael Koday, Debbie Bratt, Merika Treants Koday, Robert Murnane, Jeremy Smedley, Yuhui Hu, Anne Messer, Deborah Heydenburg Fuller
A critical issue in transgene delivery studies is immune reactivity to the transgene- encoded protein and its impact on sustained gene expression. Here, we test the hypothesis that immunomodulation by rapamycin can decrease immune reactivity after intrathecal AAV9 delivery of a transgene (GFP) in non-human primates, resulting in sustained GFP expression in the CNS. We show that rapamycin treatment clearly reduced the overall immunogenicity of the AAV9/GFP vector by lowering GFP- and AAV9-specific antibody responses, and decreasing T cell responses including cytokine and cytolytic effector responses...
2018: PloS One
Miaomiao Tang, Xiaoyuan Ji, Hua Xu, Lu Zhang, Airui Jiang, Bin Song, Yuanyuan Su, Yao He
Ocular neovascularization can result in devastating diseases that lead to marked vision impairment and eventual visual loss. In clinical implementation, neovascular eye diseases are firstly diagnosed by fluorescein angiography and then treated by multiple intravitreal injections, which nevertheless involves vision-threatening complications, as well as lack of real-time monitoring disease progression and timely assessment of therapeutic outcomes. To address this critical issue, we herein pre-sent a kind of theranostic agents made of peptide-functionalized silicon nanoparticles (SiNPs), suitable for simultaneous ocular neovascularization imaging and therapy...
June 6, 2018: Analytical Chemistry
Gerardo Peláez, Joshua Vaugan, Pablo Izquierdo, Higinio Rubio, Juan Carlos García-Prada
Input shaping is an Optimal Control feedforward strategy whose ability to define how and when a flexible dynamical system defined by Ordinary Differential Equations (ODEs) and computer controlled would move into its operative space, without command induced unwanted dynamics, has been exhaustively demonstrated. This work examines the issue of Embedded Internet of Things (IoT) Input Shaping with regard to real time control of multibody oscillatory systems whose dynamics are better described by differential algebraic equations (DAEs)...
June 4, 2018: Sensors
Mahmoud M Gabr, Mahmoud M Zakaria, Ayman F Refaie, Amani M Ismail, Sherry M Khater, Sylvia A Ashamallah, Maha M Azzam, Mohamed A Ghoneim
Ten mongrel dogs were used in this study. Diabetes was chemically induced in 7 dogs, and 3 dogs served as normal controls. For each diabetic dog, 5 million human bone marrow-derived mesenchymal stem cells/kg were differentiated to form insulin-producing cells using a trichostatin-based protocol. Cells were then loaded in 2 TheraCyte capsules which were transplanted under the rectus sheath. One dog died 4 d postoperatively from pneumonia. Six dogs were followed up with for 6 to 18 mo. Euglycemia was achieved in 4 dogs...
January 1, 2018: Cell Transplantation
Bahar Darsazan, Alireza Shafaati, Afshin Zarghi, Seyed Alireza Mortazavi
PURPOSE: Adefovir is an antiviral drug that exhibits high hydrophilic properties and negligible bioavailability (less than 12%). It is only applied in the form of the ester prodrug adefovir dipivoxil (ADV). The oral bioavailability of ADV is limited (32% to 45%) by its low permeability (Class 3) and biological conversion of the prodrug to adefovir. Ion-pair formation is considered as an alternative approach to a covalent prodrug (ADV) to enhance intestinal permeation of adefovir. METHODS: The effect of various counter-ions (anionic, cationic and two quaternary ammonium salts) on the lipophilicity of adefovir was investigated by means of the n-octanol/buffer partitioning system, an in vitro transport model (PAMPA) and a biological membrane (everted gut sac)...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Jingjing Chen, Rui Liu, Changxiao Liu, Xin Jin, Qinghua Zhang, Jialu Wang, Fang Zhao, Ze Wang, Haiyan Qiu, Yazhuo Li, Xiulin Yi
BACKGROUND: As society has developed and living standards have improved, diabetes has become a severe public health issue. Insulin plays a crucial role in managing hyperglycemia caused by type I diabetes and particular type II diabetes. Many researchers are seeking alternative, more acceptable methods of insulin delivery, such as oral insulin. An oral formulation has become a new goal for insulin delivery in recent years. METHODS: The PubMed and CNKI databases were searched for "oral insulin, " "drug delivery systems, " and "pharmacokinetics, " and 85 relevant articles were selected from the results as material for this review...
May 22, 2018: Current Drug Metabolism
Athanasios Theofilatos, Apostolos Ziakopoulos, Eleonora Papadimitriou, George Yannis
INTRODUCTION: Conversation and other interactions with passengers while driving induce a level of distraction to the person driving. METHOD: This paper conducts a qualitative literature review on the effect of passenger interaction on road safety and then extends it by using meta-analysis techniques. RESULTS: The literature review indicates that the distraction due to passengers is a very frequent risk factor, with detrimental effects to various driving behavior and safety measures (e...
June 2018: Journal of Safety Research
John Phair, Eric B Trestman, Eddie Skripochnik, Evan C Lipsitz, Issam Koleilat, Larry A Scher
OBJECTIVE: To analyze causes and outcomes of malpractice claims against vascular surgeons in the United States. METHODS: Cases entered into the Westlaw database from January 1st 1999 to December 31st 2014 were reviewed. Search terms "vascular" and "surgeon" were used. Data was compiled on the allegation, subject matter and outcome of each case. Additional data including demographics of the defendant was obtained from U.S. News Health Reports on practicing physicians...
May 11, 2018: Annals of Vascular Surgery
Haoxiang Li, Xiaoqing Zhou, Thomas Nummy, Junjie Zhang, Victor Pardo, Warren E Pickett, J F Mitchell, D S Dessau
The original version of this Article contained errors in Fig. 2, Fig. 3a-c and Supplementary Fig. 2. In Fig. 2g and Supplementary Fig. 2, the band structure plot calculated from density function theory (DFT) had a missing band of mainly z2 character that starts at about - 0.25 eV at the Y point and disperses downwards towards the Γ point. This band was inadvertently neglected when transferring the lines from the original band plot to the enhanced version for publication. Also in Fig. 2g, the points labelled M and Y were not exactly at (1/2 1/2 0) and (0 1/2 0), but rather (0...
May 11, 2018: Nature Communications
Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza
BACKGROUND: Pakistan has the second highest fertility rate in South Asia and its increasing population growth presents a significant challenge for country's path to progress and development. Modern contraceptive methods only account for a slow-rising 26% of use in Pakistan which is further lowest in the underserved areas (< 20%), with a high unmet need for family planning (20%). The David and Lucile Packard Foundation USA and Pakistan funded two operational research projects from 2012 to 2015, that employed a Demand-side Financing (DSF) approach testing the effectiveness of single and multi-purpose voucher schemes in increasing access and uptake of FP services and products among the women of two-lowest income quintiles in the Punjab province of Pakistan...
May 11, 2018: BMC Health Services Research
Seyedeh Narjes Mousavizadeh, Tahereh Ashktorab, Fazlollah Ahmadi, Mitra Zandi
Background: Poor adherence of patients with type 2 diabetes to treatment is one of the most complex and important clinical concerns. It is the main issue of the present decade and acknowledged as a challenge to control and treat diabetes. This study was carried out to explore and understand how adherence to treatment process occurs among Iranian patients with type 2 diabetes. Methods: The present study is qualitative with grounded theory approach. The data were collected from December 2015 to July 2016 in Tehran (Iran) through individual semi-structured in-depth interviews, field notes, and memos from 21 patients with type 2 diabetes; combined with two members of their families and a healthcare professional...
March 2018: Iranian Journal of Medical Sciences
Manasi Kumar, Keng-Yen Huang, Caleb Othieno, Dalton Wamalwa, Beatrice Madeghe, Judith Osok, Simon Njuguna Kahonge, Joyce Nato, Mary McKernon McKay
Objective: The key objective of this paper is to provide a phenomenological account of the mental health challenges and experiences of adolescent new mothers. We explore the role of social support and the absence of empathy plays in depression among pregnant adolescents. The project also collected data on the adolescents' caregiving environment which includes the adolescents' mothers, their partners, the community, and health care workers, as well as feedback from staff nurses at the maternal and child health centers...
March 2018: Global Social Welfare: Research, Policy & Practice
Mohamed El Kassas, Yusuke Shimakawa, Zainab Ali-Eldin, Anna-Louise Funk, Mohamed Naguib Wifi, Samy Zaky, Fathiya El-Raey, Gamal Esmat, Arnaud Fontanet
BACKGROUND & AIMS: Hepatitis B virus (HBV) reactivation in chronic hepatitis C (CHC) patients treated with direct acting antivirals (DAAs) became an issue. However, its frequency has been poorly estimated, due to the varying definitions used and evaluation of heterogeneous study populations, including those concurrently treated for HBV. METHODS: We prospectively followed HBV surface antigen (HBsAg)-positive Egyptians undergoing interferon-free DAAs, to estimate the risk of HBV reactivation and HBV-related hepatitis...
May 8, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
G Peri, P Ferrante, M La Gennusa, C Pianello, G Rizzo
Municipal solid waste (MSW) management constitutes a highly challenging issue to cope with in order of moving towards more sustainable urban policies. Despite new Standards call for recycling and reusing materials contained in the urban waste, several municipalities still use landfilling as a waste disposal method. Other than the environmental pressure exerted by these plants, waste transportation from the collection points to the landfill needs a specific attention to correctly assess the whole burden of the waste management systems...
May 3, 2018: Journal of Environmental Management
Gediminas Valkiūnas, Mikas Ilgūnas, Dovilė Bukauskaitė, Karin Fragner, Herbert Weissenböck, Carter T Atkinson, Tatjana A Iezhova
BACKGROUND: Microscopic research has shown that Plasmodium relictum is the most common agent of avian malaria. Recent molecular studies confirmed this conclusion and identified several mtDNA lineages, suggesting the existence of significant intra-species genetic variation or cryptic speciation. Most identified lineages have a broad range of hosts and geographical distribution. Here, a rare new lineage of P. relictum was reported and information about biological characters of different lineages of this pathogen was reviewed, suggesting issues for future research...
May 2, 2018: Malaria Journal
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