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https://www.readbyqxmd.com/read/28351118/how-will-repealing-the-aca-affect-medicaid-impact-on-health-care-coverage-delivery-and-payment
#1
Sara Rosenbaum, Sara Rothenberg, Sara Schmucker, Rachel Gunsalus, J. Zoë Beckerman
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...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28351054/drug-delivery-to-the-posterior-segment-of-the-eye
#2
Elad Moisseiev, Anat Loewenstein
Drug delivery into the posterior segment of the eye is complicated by the existence of the blood-ocular barrier. Strategies for delivering drugs to the posterior segment include systemic administration, modification of the barrier, and local drug delivery (including transcorneal, transscleral, and intravitreal). The most commonly used method for drug delivery into the posterior segment is by intravitreal injection. Other routes that can be used to achieve therapeutic drug levels in the posterior segment include topical, iontophoretic, and juxtascleral delivery...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28350837/semaphorin-3f-expression-is-reduced-in-pregnancy-complicated-by-preeclampsia-an-observational-clinical-study
#3
Giovanni Stallone, Maria Matteo, Giuseppe Stefano Netti, Barbara Infante, Adelaide Di Lorenzo, Clelia Prattichizzo, Stefania Carlucci, Federica Trezza, Loreto Gesualdo, Pantaleo Greco, Giuseppe Grandaliano
BACKGROUND AND OBJECTIVE: Preeclampsia is a systemic disorder, affecting 2-10% of pregnancies, characterized by a deregulated pro- and anti-angiogenic balance. Semaphorin 3F is an angiogenesis inhibitor. We aimed to investigate whether semaphorin 3F expression is modulated in preeclampsia. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We performed two observational single center cohort studies between March 2013 and August 2014. In the first we enrolled 110 consecutive women, undergoing an elective cesarean section; in the second we included 150 consecutive women undergoing amniocentesis for routine clinical indications at 16-18 week of gestation...
2017: PloS One
https://www.readbyqxmd.com/read/28350703/rf-safety-analysis-of-a-novel-ultra-wideband-fetal-monitoring-system
#4
Jerrold T Bushberg, J Paul Tupin
The LifeWave Ultra-Wideband RF sensor (LWUWBS) is a monitoring solution for a variety of physiologic assessment applications, including maternal fetal monitoring in both the antepartum and intrapartum periods. The system uses extremely low power radio frequency (RF) ultra-wide band (UWB) signals to provide continuous fetal heart rate and contractions monitoring during labor and delivery. Even with the incorporation of three very conservative assumptions, (1) concentration of the RF energy in 1 cm, (2) minimal (2...
May 2017: Health Physics
https://www.readbyqxmd.com/read/28350627/data-staff-and-money-leadership-reflections-on-the-future-of-public-health-informatics
#5
Jonathon P Leider, Gulzar H Shah, Karmen S Williams, Akrati Gupta, Brian C Castrucci
CONTEXT: Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. OBJECTIVES: Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise...
May 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28350451/ros-switchable-polymeric-nanoplatform-with-stimuli-responsive-release-for-active-targeted-drug-delivery-to-breast-cancer
#6
Yu Zhang, Qin Guo, Sai An, Yifei Lu, Jianfeng Li, Xi He, Lisha Liu, Yujie Zhang, Tao Sun, Chen Jiang
Tumor microenvironment plays a vital role in the process of tumor development, proliferation, invasion, and metastasis. It is well acknowledged that reduction in pH, reactive oxygen species (ROS), and increased level of glucose transporter 1 (GLUT1) have become featured intracellular and extracellular biochemical markers of cancer owing to oncogenic transformation and abnormal metabolism. To establish a distinctive drug delivery system directed against the tumor microenvironment features, we develop a newly engineered polymeric nanoplatform for efficient doxorubicin (DOX) delivery with reduced systemic toxicity and high antitumor efficiency...
March 28, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28350443/monitoring-the-disassembly-of-virus-like-particles-by-19f-nmr
#7
Rogen L C Leung, Matthew D M Robinson, Alaa A A Ajabali, Gogulan Karunanithy, Brian Lyons, Ritu Raj, Saeed Raoufmoghaddam, Shabaz Mohammed, Timothy D W Claridge, Andrew J Baldwin, Benjamin G Davis
Virus-like particles (VLPs) are stable protein cages derived from virus coats. They have been used extensively as biomolecular platforms, e.g. nanocarriers or vaccines, but a convenient in situ technique is lacking for tracking functional status. Here, we present a simple way to monitor disassembly of 19F-labeled VLPs derived from bacteriophage Qβ by 19F NMR. Analysis of resonances, under a range of conditions, allowed determination not only of the particle as fully assembled but also as disas-sembled, as well as detection of a degraded state upon digestion by cells...
March 28, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/28350442/engineered-polymer-transferrin-conjugates-as-self-assembling-targeted-drug-delivery-systems
#8
Hiteshri Makwana, Francesca Mastrotto, Johannes Pall Magnusson, Darrell Sleep, Joanna Hay, Karl J Nicholls, Stephanie Allen, Cameron Alexander
Polymer-protein conjugates can be engineered to self-assemble into discrete and well-defined drug delivery systems which combine the advantages of receptor targeting and controlled drug release. We designed specific conjugates of the iron-binding and transport protein, transferrin (Tf), to combine the advantages of this serum-stable protein as a targeting agent for cancer cells with self-assembling polymers to act as carriers of cytotoxic drugs. Tf variants were expressed with cysteine residues at sites spanning different regions of the protein surface and the polymer conjugates grown from these variants were compared with polymer conjugates grown from non-selectively derivatised sites on native Tf...
March 28, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28346926/microbiota-and-obesity
#9
Erika Isolauri
Obesity is globally the most prevalent nutritional disorder. Multifaceted therapeutic approaches are called for to halt the cascade from neonatal adiposity/high birth weight to childhood excessive weight gain/adult obesity with comorbidities. Recent experimental and clinical data provide one new target for interventions aiming to close this vicious circle: the microbiota. An aberrant gut microbiota, dysbiosis, induces immune and metabolic disturbances both locally and, consequent upon impaired gut barrier function, also systemic low-grade inflammation, which is causally linked to insulin resistance...
2017: Nestlé Nutrition Institute Workshop Series
https://www.readbyqxmd.com/read/28346751/d-fructose-modification-enhanced-internalization-of-mixed-micelles-in-breast-cancer-cells-via-glut5-transporters
#10
Xu Zhou, Xianyan Qin, Tao Gong, Zhi-Rong Zhang, Yao Fu
d-Fructose modified poly(ε-caprolactone)-polyethylene glycol (PCL-PEG-Fru) diblock amphiphile is synthesized via Cu(I)-catalyzed click chemistry, which self-assembles with D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) into PCL-PEG-Fru/TPGS mixed micelles (PPF MM). It has been proven that glucose transporter (GLUT)5 is overexpressed in MCF-7 cells other than L929 cells. In this study, PPF MM exhibit a significantly higher uptake efficiency than fructose-free PCL-PEG-N3 /TPGS mixed micelles in both 2D MCF-7 cells and 3D tumor spheroids...
March 27, 2017: Macromolecular Bioscience
https://www.readbyqxmd.com/read/28346653/how-successful-is-the-fitting-of-digital-hearing-aids-implications-for-the-allocation-of-resources-within-national-health-systems
#11
Petros V Vlastarakos, Alastair I Cameron, Thomas P Nikolopoulos
We conducted a retrospective study to determine the success rate of initial fittings in digital hearing aid (DHA) users. We also addressed the implications of national health systems' continuing to provide access to these devices. We identified 1,597 consecutively presenting adults who had undergone a first fitting or a new fitting (i.e., an upgrade from an analogue hearing aid in the first or second ear) of a behind-the-ear DHA during the previous year. We further sought to identify all nominal reprogram appointments that had taken place within 6 months after the first or new fitting; we found 460 such appointments (28...
March 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28346436/detailed-comparison-of-retroviral-vectors-and-promoter-configurations-for-stable-and-high-transgene-expression-in-human-induced-pluripotent-stem-cells
#12
D Hoffmann, J W Schott, F K Geis, L Lange, F-J Müller, D Lenz, D Zychlinski, D Steinemann, M Morgan, T Moritz, A Schambach
Correction of patient-specific induced pluripotent stem cells (iPSC) upon gene delivery through retroviral vectors offers new treatment perspectives for monogenetic diseases. Gene-modified iPSC clones can be screened for safe integration sites and differentiated into transplantable cells of interest. However, the current bottleneck is epigenetic vector silencing. In order to identify the most suitable retroviral expression system in iPSC, we systematically compared vectors from different retroviral genera, different promoters and their combination with ubiquitous chromatin opening elements (UCOE), and several envelope pseudotypes...
March 27, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28346435/aav9-mediated-engineering-of-autotransplanted-kidney-of-non-human-primates
#13
S Tomasoni, P Trionfini, N Azzollini, L Zentilin, M Giacca, S Aiello, L Longaretti, E Cozzi, N Baldan, G Remuzzi, A Benigni
Ex vivo gene transfer to the graft before transplantation is an attractive option for circumventing systemic side effects of chronic anti-rejection therapy. Gene delivery of the immunomodulatory protein CTLA4-Ig prevented chronic kidney rejection in a rat model of allotransplantation without the need for systemic immunosuppression. Here, we generated AAV2 and AAV9 vectors encoding for LEA29Y, an optimized version of CTLA4-Ig. Both LEA29Y vectors were equally efficient for reducing T-cell proliferation in vitro...
March 27, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28346375/liposomal-formulations-in-clinical-use-an-updated-review
#14
REVIEW
Upendra Bulbake, Sindhu Doppalapudi, Nagavendra Kommineni, Wahid Khan
Liposomes are the first nano drug delivery systems that have been successfully translated into real-time clinical applications. These closed bilayer phospholipid vesicles have witnessed many technical advances in recent years since their first development in 1965. Delivery of therapeutics by liposomes alters their biodistribution profile, which further enhances the therapeutic index of various drugs. Extensive research is being carried out using these nano drug delivery systems in diverse areas including the delivery of anti-cancer, anti-fungal, anti-inflammatory drugs and therapeutic genes...
March 27, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28346198/basics-of-sterile-compounding-biopharmaceutics-of-injectable-dosage-forms
#15
Michael J Akers
Biopharmaceutics studies the relationship between the drug product and what happens after the product is administered. Since the majority of injectables are administered by the intravenous route, thus avoiding the need for drug absorption, not many articles are published compared to other routes of drug administration. However, other routes of administration for drug injection are becoming more frequent because of greater commercial availability of sustained- and controlled-release drug delivery systems. This article reviews basic principles of drug absorption, distribution, metabolism, and elimination of injectable drugs and certain physicochemical and physiological factors affecting injectable drug biopharmaceutics...
January 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28346102/phage-display-derived-ligand-for-mucosal-transcytotic-receptor-gp-2-promotes-antigen-delivery-to-m-cells-and-induces-antigen-specific-immune-response
#16
Inam Ullah Khan, Jiansheng Huang, Rui Liu, Jingbo Wang, Jun Xie, Naishuo Zhu
Successful oral immunization depends on efficient delivery of antigens (Ags) to the mucosal immune induction site. Glycoprotein-2 (GP-2) is an integral membrane protein that is expressed specifically on M cells within follicle-associated epithelium (FAE) and serves as transcytotic receptor for luminal Ags. In this study, we selected peptide ligands against recombinant human GP-2 by screening a phage display library and evaluated their interaction with GP-2 in vitro and ex vivo. Selected peptides were conjugated to the C-terminal of enhanced green fluorescence protein (EGFP) and evaluated for their ability to induce an immune response in mice...
February 1, 2017: SLAS Discov
https://www.readbyqxmd.com/read/28345880/detecting-proteins-glycosylation-by-a-homogeneous-reaction-system-with-zwitterionic-gold-nanoclusters
#17
Jinan Li, Jing Liu, Zheyi Liu, Yuan Tan, Xiaoyan Liu, Fangjun Wang
Homogeneous gold nanoclusters (Au NCs) have been widely utilized in drug delivery, chemical sensing, bioassays and bio-labeling due to their unique physical and chemical properties. However, little attention has been paid to their application in detecting protein post-translational modifications. Herein, we describe development of a homogeneous reaction system with water-soluble zwitterionic Au NCs to capture glycopeptides from complex biological samples. The unique characteristics of Au NCs, such as their molecular-like properties, the excellent homogeneity in aqueous solution, the organic solvent respon-sive precipitation, and the easy preparation in only 4...
March 27, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28345745/in-vitro-and-in-vivo-assessment-of-the-abuse-potential-of-pf614-a-novel-bio-md%C3%A2-prodrug-of-oxycodone
#18
D Lynn Kirkpatrick, William K Schmidt, Ricardo Morales, John Cremin, Julie Seroogy, Craig Husfeld, Thomas Jenkins
OBJECTIVE: The need for pain medication which will not lead to abuse is well recognized. Ensysce has designed prodrug analogs of the commonly used pain medications including hydromorphone, oxycodone (OC), hydrocodone, and morphine that limit their use to oral delivery, two of which are in clinical development. This study was undertaken to demonstrate that PF614, an extended-release prodrug of OC, allows the release of OC as designed when delivered orally, yet it resists ex vivo extraction with household chemicals and is pharmacologically inactive when administered by nonoral routes (nasal and parenteral), thereby substantially reducing its intravenous (IV) and intranasal abuse potential...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345435/predicting-adherence-and-persistence-with-oral-bisphosphonate-therapy-in-an-integrated-health-care-delivery-system
#19
Rita L Hui, Annette L Adams, Fang Niu, Bruce Ettinger, David K Yi, Malini Chandra, Joan C Lo
BACKGROUND: Examining drug exposure is essential to pharmacovigilance, especially for bisphosphonate (BP) therapy. OBJECTIVE: To examine differences in 4 measures of oral BP exposure: treatment discontinuation, adherence, persistence, and nonpersistence. METHODS: Among women aged ≥ 50 years who initiated oral BP therapy during 2002-2007 with at least 3 years of health plan membership follow-up, discontinuation was defined by evidence of no further treatment during the study observation period...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345144/adapting-evaluations-of-alternative-payment-models-to-a-changing-environment
#20
Thomas W Grannemann, Randall S Brown
OBJECTIVE: To identify the most robust methods for evaluating alternative payment models (APMs) in the emerging health care delivery system environment. STUDY DESIGN (APPROACH): We assess the impact of widespread testing of alternative payment models on the ability to find credible comparison groups. We consider the applicability of factorial research designs for assessing the effects of these models. PRINCIPAL FINDINGS: The widespread adoption of alternative payment models could effectively eliminate the possibility of comparing APM results with a "pure" control or comparison group unaffected by other interventions...
March 27, 2017: Health Services Research
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