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This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions)...
October 13, 2016: Federal Register
P Meimoun, J Clerc, D Ardourel, U Djou, S Martis, T Botoro, F Elmkies, H Zemir, A Luycx-Bore, J Boulanger
To test the usefulness of non-invasive coronary flow reserve (CFR) by transthoracic Doppler echocardiography by comparison to invasive fractional flow reserve (FFR) and instantaneous wave-free ratio (IFR), a new vasodilator-free index of coronary stenosis severity, in patients with left anterior descending artery (LAD) stenosis of intermediate severity (IS) and stable coronary artery disease. 94 consecutive patients (mean age 68 ± 10 years) with angiographic LAD stenosis of IS (50-70 % diameter stenosis), were prospectively studied...
October 17, 2016: International Journal of Cardiovascular Imaging
Zhen-Yuan Zhu, Fei Liu, Hui Gao, Huiqing Sun, Meng Meng, Yong-Min Zhang
A purified selenium-containing derivatives of Cordyceps militaris polysaccharide synthesized using H2SeO3/HNO3 and BaCl2 as a catalyst was investigated in this paper. The reaction condition was optimized by selecting different reaction temperature and period. Afterward, the one with the highest Se content was purified by ultra-filtration device with a molecular cut off size of 10KDa. Followed by its structural characterizations. Results of IFR and (13)C NMR spectroscopy indicated that C-6 substitution was predominant in selenized polysaccharide...
September 22, 2016: International Journal of Biological Macromolecules
G G Shi, L Shi, Z Y Zhang, Y Z Wan, B Li, L Yu, E P Zhang, H S Ju, M Q He, H Z Ji
OBJECTIVE: Through the retrospective analysis of the clinical data in 14 cases of invasive fungal rhinosinusitis (IFRS), the clinical characteristics, diagnosis and treatment of this disease were evaluated. METHODS: Fourteen clinically confirmed cases of IFRS since January 2008 to October 2015 were evaluated.collected, the clinical features, diagnosis, treatment and prognosis were analyzed to obtain a more comprehensive understanding for clinical reference. Fourteen patients were confirmed by pathological examination as IFRS, including 9 cases of aspergillus, 4 cases of mucor, and 1 case of rhinocerebral zygomycosis; including 5 cases of acute IFRS, 9 cases of chronic IFRS...
August 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Wanrong Man, Jianqiang Hu, Zhijing Zhao, Mingming Zhang, Tingting Wang, Jie Lin, Yu Duan, Ling Wang, Haichang Wang, Dongdong Sun, Yan Li
BACKGROUND: The instantaneous wave-free ratio (iFR) is a new vasodilator-free index of coronary stenosis severity. The aim of this meta-analysis is to assess the diagnostic performance of iFR for the evaluation of coronary stenosis severity with fractional flow reserve as standard reference. METHODS: We searched PubMed, EMBASE, CENTRAL, ProQuest, Web of Science, and International Clinical Trials Registry Platform (ICTRP) for publications concerning the diagnostic value of iFR...
September 2016: Medicine (Baltimore)
T Härle, S Meyer, W Bojara, F Vahldiek, A Elsässer
INTRODUCTION: Intracoronary pressure measurements have improved assessment of angiographic intermediate coronary stenoses. Methodically, pressure equalization and actual measurements are frequently performed at different height levels, depending on the particular coronary territory analyzed. Considering a hypothetical influence of hydrostatic pressure and the supine position of the patient, differences in the results of intracoronary measurements between anterior and posterior vessels seem likely...
August 31, 2016: Herz
Gunnar M Buyse, Thomas Voit, Ulrike Schara, Chiara S M Straathof, Maria Grazia D'Angelo, Günther Bernert, Jean-Marie Cuisset, Richard S Finkel, Nathalie Goemans, Christian Rummey, Mika Leinonen, Oscar H Mayer, Paolo Spagnolo, Thomas Meier, Craig M McDonald
Assessment of dynamic inspiratory function may provide valuable information about the degree and progression of pulmonary involvement in patients with Duchenne muscular dystrophy (DMD). The aims of this study were to characterize inspiratory function and to assess the efficacy of idebenone on this pulmonary function outcome in a large and well-characterized cohort of 10-18 year-old DMD patients not taking glucocorticoid steroids (GCs) enrolled in the phase 3 randomized controlled DELOS trial. We evaluated the effect of idebenone on the highest flow generated during an inspiratory FVC maneuver (maximum inspiratory flow; V'I,max(FVC)) and the ratio between the largest inspiratory flow during tidal breathing (tidal inspiratory flow; V'I,max(t)) and the V'I,max(FVC)...
August 29, 2016: Pediatric Pulmonology
Mayara Tabai, Igor Moreira Hazboun, Emerson Taro Inoue Sakuma, Marcelo Hamilton Sampaio, Eulalia Sakano
Introduction. A range of traumatic, vascular, inflammatory, infectious, and neoplastic processes can affect the orbit and its structures. In the area of otolaryngology, the rhino-orbital-cerebral involvement of invasive fungal rhinosinusitis can affect the orbit, which may look like initially a rhinosinusitis or even mimic malignancy. Case Presentation. Female patient, 32 years old, with headache and ocular proptosis. She was using prednisone in immunosuppressive doses for a year and had breast cancer treated three years earlier...
2016: Case Reports in Otolaryngology
Luigi Di Serafino, Gabriella Scognamiglio, Maurizio Turturo, Giovanni Esposito, Riccardo Savastano, Saverio Lanzone, Bruno Trimarco, Carlo D'Agostino
BACKGROUND: Coronary angiography has poor predictive value for functionally significant coronary artery stenosis. The Fractional Flow Reserve (FFR) currently represents the gold standard to define the ischemic potential of epicardial stenosis and, recently, the instantaneous wave-free ratio (iFR), has also been introduced as alternative to the FFR, but it still remains an invasive procedure. We aimed this study in order to evaluate the accuracy of the "Angiography-DeriveD hEmoDynamic index" (ADDED index) to predict the FFR as compared with the iFR...
November 15, 2016: International Journal of Cardiology
Kazeem Olalekan, Andy Fox, Rodney Gilbert
BACKGROUND: Unlicensed medications are used all the time in the management of diseases in childhood. Tolvaptan (Jinarc®) is a vasopressin V2-receptor antagonist licensed for use to slow the progression of cyst development and renal insufficiency of ADPKD in adults with CKD stage 1 to 3 with evidence of rapidly progressing disease. Studies of animal models implicate the antidiuretic hormone arginine vasopressin and its messenger cyclic adenosine monophosphate (cAMP) as promoters of kidney-cyst cell proliferation and luminal fluid secretion...
September 2016: Archives of Disease in Childhood
Yongrui Li, Ye Li, Alan Jackson, Xiaodong Li, Ning Huang, Chunjie Guo, Huimao Zhang
OBJECTIVE: To assess the effect of varying iodine flow rate (IFR) and iodine concentration on the quality of virtual unenhanced (VUE) images of the abdomen obtained with dual-energy CT. METHODS: 94 subjects underwent unenhanced and triphasic contrast-enhanced CT scan of the abdomen, including arterial phase, portal venous phase, and delayed phase using dual-energy CT. Patients were randomized into 4 groups with different IFRs or iodine concentrations. VUE images were generated at 70 keV...
July 28, 2016: Abdominal Radiology
Ashkan Javadzadegan, Andy S C Yong, Michael Chang, Martin K C Ng, Masud Behnia, Leonard Kritharides
: Abnormal haemodynamic parameters are associated with atheroma plaque progression and instability in coronary arteries. Flow recirculation, shear stress and pressure gradient are understood to be important pathogenic mediators in coronary disease. The effect of freedom of coronary artery movement on these parameters is still unknown. Fluid-structure interaction (FSI) simulations were carried out in 25 coronary artery models derived from authentic human coronaries in order to investigate the effect of degree of freedom of movement of the coronary arteries on flow recirculation, wall shear stress (WSS) and wall pressure gradient (WPG)...
July 28, 2016: Computer Methods in Biomechanics and Biomedical Engineering
Jong-Wan Kim, Nam-Ki Lee, Hye-Young Sim, Pil-Young Yun, Jong-Ho Lee
This study aimed to analyze and compare the failure rate of orthodontic mini-implants (OMIs) in terms of the number of implants (implant failure rate [IFR]) and patients (patient failure rate [PFR]) according to the age, sex, and arch of the patients, the number of primary insertions, and frequency of reinsertions after failure. A total of 394 OMIs (1.2 mm in diameter; 7.0 mm in length) were inserted in 125 patients (24 male and 101 female, mean age 21.95 ± 7.60 years). IFR and PFR were evaluated according to the age and sex of the patient, the number of primary insertions, and the frequency of reinsertions after failure...
July 2016: International Journal of Periodontics & Restorative Dentistry
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The Department of Health and Human Services is issuing a final regulation that adopts, without change, the interim final rule (IFR) entitled ``State Health Insurance Assistance Program (SHIP).'' This final rule implements a provision enacted by the Consolidated Appropriations Act of 2014 and reflects the transfer of the State Health Insurance Assistance Program (SHIP) from the Centers for Medicare & Medicaid Services (CMS), in the Department of Health and Human Services (HHS) to the Administration for Community Living (ACL) in HHS...
June 3, 2016: Federal Register
Tim P van de Hoef, Ricardo Petraco, Martijn A van Lavieren, Sukhjinder Nijjer, Froukje Nolte, Sayan Sen, Mauro Echavarria-Pinto, José P S Henriques, Karel T Koch, Jan Baan, Robbert J de Winter, Maria Siebes, Jos A E Spaan, Jan G P Tijssen, Martijn Meuwissen, Javier Escaned, Justin E Davies, Jan J Piek
AIMS: Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses...
June 12, 2016: EuroIntervention
Hitoshi Matsuo, Yoshiaki Kawase
Fractional flow reserve (FFR) is an invasive physiologic index measured in the cardiac catheterization laboratory to assess the functional significance of a coronary stenosis. It is now accepted as the reference standard to indicate whether a stenosis is likely to be responsible for ischemia. It is generally accepted that a stenosis with an ischemic value of FFR is responsible for symptom and a worse outcome and should be revascularized, whereas lesions with a non-ischemic FFR have a more favorable prognosis and can be treated medically...
July 2016: Cardiovascular Intervention and Therapeutics
F Picard, V X Tadros, M Pighi, V Spagnoli, Q De Hemptinne, H Q Ly
In recent years, a large body of evidence has revealed the limitations of angiographic evaluation in determining the physiological significance of coronary stenosis, particularly when these are intermediate lesions. Percutaneous coronary interventions (PCI) guided by physiological assessment using fractional flow reserve (FFR) have been shown to reduce cardiovascular events when compared to angiography alone. Recently, another coronary physiologic parameter has been introduced: the "instantaneous wave-free ratio" (iFR)...
May 19, 2016: Annales de Cardiologie et D'angéiologie
Arash Aryana, Padraig Gearoid O'Neill, Deep K Pujara, Steve K Singh, Mark R Bowers, Shelley L Allen, André d'Avila
BACKGROUND: The optimal irrigation flow rate (IFR) during epicardial radiofrequency (RF) ablation has not been established. OBJECTIVE: This study specifically examined the impact of IFR and intrapericardial fluid (IPF) accumulation during epicardial RF ablation. METHODS: Altogether, 452 ex vivo RF applications (10 g for 60 seconds) delivered to the epicardial surface of bovine myocardium using 3 open-irrigated ablation catheters (ThermoCool SmartTouch, ThermoCool SmartTouch-SF, and FlexAbility) and 50 in vivo RF applications delivered (ThermoCool SmartTouch-SF) in 4 healthy adult swine in the presence or absence of IPF were examined...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Eric Abadie, Alexia Muguet, Tom Berteaux, Nicolas Chomérat, Philipp Hess, Emmanuelle Roque D'OrbCastel, Estelle Masseret, Mohamed Laabir
Vulcanodinium rugosum, a recently described species, produces pinnatoxins. The IFR-VRU-01 strain, isolated from a French Mediterranean lagoon in 2010 and identified as the causative dinoflagellate contaminating mussels in the Ingril Lagoon (French Mediterranean) with pinnatoxin-G, was grown in an enriched natural seawater medium. We tested the effect of temperature and salinity on growth, pinnatoxin-G production and chlorophyll a levels of this dinoflagellate. These factors were tested in combinations of five temperatures (15, 20, 25, 30 and 35 °C) and five salinities (20, 25, 30, 35 and 40) at an irradiance of 100 µmol photon m(-2) s(-1)...
2016: Toxins
Heikki Mansikka, Kai Virtanen, Don Harris, Petteri Simola
Increased task demand will increase the pilot mental workload (PMWL). When PMWL is increased, mental overload may occur resulting in degraded performance. During pilots' instrument flight rules (IFR) proficiency test, PMWL is typically not measured. Therefore, little is known about workload during the proficiency test and pilots' potential to cope with higher task demands than those experienced during the test. In this study, fighter pilots' performance and PMWL was measured during a real IFR proficiency test in an F/A-18 simulator...
September 2016: Applied Ergonomics
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