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https://www.readbyqxmd.com/read/28324029/vital-directions-for-health-and-health-care-priorities-from-a-national-academy-of-medicine-initiative
#1
Victor J Dzau, Mark B McClellan, J Michael McGinnis, Sheila P Burke, Molly J Coye, Angela Diaz, Thomas A Daschle, William H Frist, Martha Gaines, Margaret A Hamburg, Jane E Henney, Shiriki Kumanyika, Michael O Leavitt, Ruth M Parker, Lewis G Sandy, Leonard D Schaeffer, Glenn D Steele, Pamela Thompson, Elias Zerhouni
Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28323658/changing-face-of-metastatic-prostate-cancer-the-law-of-diminishing-returns-holds-true
#2
Ulka N Vaishampayan
PURPOSE OF REVIEW: Prostate cancer presents with a multitude of faces. It ranges from localized cancers staying quiescent for many years during active surveillance to the raging diffuse liver metastases causing terminal disease. The incidence of metastatic disease is increasing. This review will highlight some of the recent developments as well as ongoing challenges of managing advanced prostate cancer. RECENT FINDINGS: Significant strides are being made in managing metastatic prostate cancer...
March 18, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28323646/endothelial-cells-and-lymphatics-at-the-interface-between-the-immune-and-central-nervous-systems-implications-for-multiple-sclerosis
#3
Céline Meyer, Guillaume Martin-Blondel, Roland S Liblau
PURPOSE OF REVIEW: The central nervous system (CNS) has a unique relationship with the immune system. This review highlights the distinct roles of lymphatic vessels and endothelial cells in the interface between CNS and immune cells and invites to revisit the concept of CNS immune privilege. RECENT FINDINGS: T cells can follow several routes to penetrate the CNS parenchyma but may also benefit, together with antigen-loaded presenting cells, from the newly described lymphatic network to exit the CNS...
March 18, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28319992/organizational-and-community-factors-associated-with-magnet-status-of-u-s-hospitals
#4
Teresa Wai Chi Tai, Sherry I Bame
The Magnet Recognition Program for healthcare organizations promotes excellence in nursing services and professional practices. However, organizational and community characteristics that contribute to the adoption of Magnet status remain unexplained. Investigating organizational and community factors will help determine systematic structural and contextual dimensions of Magnet hospitals previously shown to be more cost-effective in comparison with non-Magnet hospitals. Using the baseline 2005 database of all Magnet hospitals in the United States, the authors selected a matched sample to determine key organizational and community characteristics associated with Magnet adoption while controlling for regional and local factors...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319978/patient-experience-the-new-heart-of-healthcare-leadership
#5
Jason A Wolf
In a healthcare world in which consumerism is no longer a question and value has claimed its place at center stage, leaders are called to think differently about how they operate and manage their organizations. Priorities are curving in new directions with shifts in policy, direction of dollars, and evolution of practice. At the center of this transition is an opportunity for healthcare leaders to recognize that patient experience is the new heart of healthcare leadership.To address quality, safety, service, cost, and population health outcomes, leaders must rethink how they understand and engage in experience efforts overall...
April 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28319854/extremely-thermophilic-energy-metabolisms-biotechnological-prospects
#6
REVIEW
Christopher T Straub, Benjamin M Zeldes, Gerrit J Schut, Michael Ww Adams, Robert M Kelly
New strategies for metabolic engineering of extremely thermophilic microorganisms to produce bio-based fuels and chemicals could leverage pathways and physiological features resident in extreme thermophiles for improved outcomes. Furthermore, very recent advances in genetic tools for these microorganisms make it possible for them to serve as metabolic engineering hosts. Beyond providing a higher temperature alternative to mesophilic platforms, exploitation of strategic metabolic characteristics of high temperature microorganisms grants new opportunities for biotechnological products...
March 16, 2017: Current Opinion in Biotechnology
https://www.readbyqxmd.com/read/28318987/a-clinical-evaluation-of-the-pharmacokinetics-and-pharmacodynamics-of-intravenous-alfaxalone-in-cyclodextrin-in-male-and-female-rats-following-a-loading-dose-and-constant-rate-infusion
#7
Kate L White, Stuart Paine, John Harris
OBJECTIVE: To characterise, as a clinical study, the pharmacokinetics and pharmacodynamics and describe the hypnotic effect of the neurosteroid alfaxalone (3α-hydroxy-5 α-pregnane-11, 20-dione) formulated with 2-hydroxypropyl-β-cyclodextrin in male and female rats. STUDY DESIGN: Prospective, experimental laboratory study. ANIMALS: A total of 12 (six male and six female) adult, aged-matched Sprague Dawley rats. METHODS: Surgery and instrumentation was performed under isoflurane anaesthesia in an oxygen/nitrous oxide mixture (1:2) and local anaesthetic infiltration...
February 1, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28318522/prognostic-stratification-and-healthcare-approach-in-patients-with-multiple-pathologies
#8
M Bernabeu-Wittel, B Barón-Franco, D Nieto-Martín, L Moreno-Gaviño, N Ramírez-Duque, M Ollero-Baturone
Polypathological patients constitute a prevalent, fairly homogeneous population, which is characterised by high clinical complexity, substantial vulnerability and significant resource consumption, in addition to high mortality and the need for comprehensive, coordinated care. It is particularly important to establish a reliable prognosis in these patients. It is also extremely useful for professionals involved in the decision-making process for patients and their families in vital planning and their preferences, for strategic health planning in management fields, and for clinical research, by facilitating their incorporation into clinical trials and other intervention studies...
March 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28317644/the-biomarker-based-diagnosis-of-alzheimer-s-disease-1-ethical-and-societal-issues
#9
REVIEW
Corinna Porteri, Emiliano Albanese, Charles Scerri, Maria C Carrillo, Heather M Snyder, Birgitta Martensson, Mark Baker, Ezio Giacobini, Marina Boccardi, Bengt Winblad, Giovanni B Frisoni, Samia Hurst
There is great interest in the use of biomarkers to assist in the timely identification of Alzheimer's disease (AD) in individuals with mild symptoms. However, the inclusion of AD biomarkers in clinical criteria poses socioethical challenges. The Geneva Task Force for the Roadmap of Alzheimer's Biomarkers was established to deliver a systematic strategic research agenda (aka roadmap) to promote efficient and effective validation of AD biomarkers and to foster their uptake in clinical practice. In this article, we summarize the workshop discussion of the Geneva Task Force "ethical and societal issues" working group, which comprised bioethicists, clinicians, health economists, and representatives of those affected by AD...
April 2017: Neurobiology of Aging
https://www.readbyqxmd.com/read/28317390/failing-to-protect-humanitarian-workers-lessons-from-britain-and-voluntary-aid-detachments-in-the-second-world-war
#10
Amol A Verma
This paper draws on official records of international and British organizations, newspaper reports, and volunteer memoirs to study the failure to protect humanitarian workers in the Second World War. The Second World War saw a significant expansion in the use of air warfare and flying missiles and these technological advances posed a grave threat to civilians and humanitarian workers. In this context, the International Committee of the Red Cross advocated unsuccessfully to restrict air warfare and create safe hospital zones...
March 19, 2017: Medicine, Conflict, and Survival
https://www.readbyqxmd.com/read/28316895/interacting-effects-of-early-dietary-conditions-and-reproductive-effort-on-the-oxidative-costs-of-reproduction
#11
Jose Carlos Noguera
The hypothesis that oxidative damage accumulation can mediate the trade-off between reproduction and lifespan has recently been questioned. However, in captive conditions, studies reporting no evidence in support of this hypothesis have usually provided easy access to food which may have mitigated the cost of reproduction. Here, I test the hypothesis that greater investment in reproduction should lead to oxidative damage accumulation and telomere loss in domestic zebra finches Taeniopygia guttata. Moreover, since the change or fluctuation in diet composition between early and late postnatal period can impair the ability to produce antioxidant defences in zebra finches, I also tested if early nutritional conditions (constant vs fluctuating early diet) influenced the magnitude of any subsequent costs of reproduction (e...
2017: PeerJ
https://www.readbyqxmd.com/read/28316263/individualised-dietary-strategies-for-olympic-combat-sports-acute-weight-loss-recovery-and-competition-nutrition
#12
Reid Reale, Gary Slater, Louise M Burke
Olympic combat sports separate athletes into weight divisions, in an attempt to reduce size, strength, range and/or leverage disparities between competitors. Official weigh-ins are conducted anywhere from 3 and up to 24 h prior to competition ensuring athletes meet weight requirements (i.e. have 'made weight'). Fighters commonly aim to compete in weight divisions lower than their day-to-day weight, achieved via chronic and acute manipulations of body mass (BM). Although these manipulations may impair health and absolute performance, their strategic use can improve competitive success...
March 19, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/28315052/spatiotemporal-variability-in-salinity-and-hydraulic-relationship-with-salt-intrusion-in-the-tidal-reaches-of-the-minjiang-river-fujian-province-china
#13
Rongrong Xie, Yong Pang, Bingrong Luo, Jiabing Li, Chunshan Wu, Yuyi Zheng, Qiyuan Sun, Peng Zhang, Feifeng Wang
Salinity is one of the most important factors for tidal-affected water bodies including estuaries and tidal river reaches. However, due to the limitations of simultaneous manual monitoring in long-distance areas, studies of estuaries are preferred to tidal reaches. Hence, in this study, we investigated the tidal reach of the Minjiang River and five sets of field observations were used to determine the influence of saltwater intrusion in different seasons. During the dry and wet season with low discharge, the longitudinal salinity profiles showed that a station located about 45 km from the river mouth still suffered from saltwater intrusion especially when the upstream discharge was under 754 m(3) s(-1), where the periodical fluctuation in the salinity remained the same with the water level, but there was a time lag of approximately 4 h compared with the discharge process...
March 17, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28314790/selinexor-kpt-330-induces-tumor-suppression-through-nuclear-sequestration-of-i%C3%AE%C2%BAb-and-down-regulation-of-survivin
#14
Jayasree S Nair, Elgilda Musi, Gary K Schwartz
PURPOSE: Selinexor, a small molecule that inhibits nuclear export protein XPO1 has demonstrated efficacy in solid tumors and hematologic malignancies with the evidence of clinical activity in sarcoma as a single agent. Treatment options available are very few and hence the need to identify novel targets and strategic therapies is of utmost importance. EXPERIMENTAL DESIGN: The mechanistic effects of selinexor in sarcomas as a monotherapy and in combination with proteasome inhibitor, carfilzomib, across a panel of cell lines in vitro and few in xenograft mouse models were investigated...
March 17, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28314428/nanostructuring-biomaterials-with-specific-activities-towards-digestive-enzymes-for-controlled-gastrointestinal-absorption-of-lipophilic-bioactive-molecules
#15
REVIEW
Paul Joyce, Catherine P Whitby, Clive A Prestidge
This review describes the development of novel lipid-based biomaterials that modulate fat digestion for the enhanced uptake of encapsulated lipophilic bioactive compounds (e.g. drugs and vitamins). Specific focus is directed towards analysing how key material characteristics affect the biological function of digestive lipases and manipulate lipolytic digestion. The mechanism of lipase action is a complex, interfacial process, whereby hydrolysis can be controlled by the ability for lipase to access and adsorb to the lipid-in-water interface...
November 2016: Advances in Colloid and Interface Science
https://www.readbyqxmd.com/read/28314131/indicators-role-how-do-they-influence-strategic-environmental-assessment-and-sustainable-planning-the-chinese-experience
#16
Jingjing Gao, Per Christensen, Lone Kørnøv
As an information carrier and communication medium, indicators provide useful decision-making assistance in setting process goals and effectively reaching the goals. The main focus of this article is to investigate indicators' role in influencing planning through Strategic Environmental Assessment (SEA) especially related to Chinese experiences. From the perspective of planning and decision-making theory, the influence on planning is studied as influence of planning structure and influence of planning actors...
March 14, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28314059/deterrence-and-risk-preferences-in-sequential-attacker-defender-games-with-continuous-efforts
#17
Vineet M Payappalli, Jun Zhuang, Victor Richmond R Jose
Most attacker-defender games consider players as risk neutral, whereas in reality attackers and defenders may be risk seeking or risk averse. This article studies the impact of players' risk preferences on their equilibrium behavior and its effect on the notion of deterrence. In particular, we study the effects of risk preferences in a single-period, sequential game where a defender has a continuous range of investment levels that could be strategically chosen to potentially deter an attack. This article presents analytic results related to the effect of attacker and defender risk preferences on the optimal defense effort level and their impact on the deterrence level...
March 17, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28306563/antimicrobial-resistant-gram-negative-infections-in-neonates-burden-of-disease-and-challenges-in-treatment
#18
Laura Folgori, Julia Bielicki, Paul T Heath, Mike Sharland
PURPOSE OF REVIEW: This review summarizes the main challenges of antimicrobial resistance (AMR) in the neonatal population with a special focus on multidrug-resistant (MDR) Gram-negative pathogens. RECENT FINDINGS: MDR-Gram-negative bacteria are a great concern in the neonatal population, with a worldwide rise in the reported incidence and with very limited therapeutic options. Extended-spectrum β-lactamase and carbapenem-resistant Enterobacteriaceae (CRE) have been reported as responsible for neonatal ICU outbreaks...
March 16, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28306191/biomechanical-markers-and-theoretical-concepts-related-to-haemophilic-ankle-and-subtalar-joint-arthropathy-introducing-the-term-haemophilic-tarsal-pan-arthropathy
#19
REVIEW
S Lobet, A McCarthy, C Hermans, K Peerlinck, G A Matricali, F Staes, K Deschamps
BACKGROUND: Although regular factor replacement can reduce the incidence of joint bleeds and slow down the development of haemophilic arthropathy, the ankle joint remains particularly vulnerable even in children with haemophilia on primary or secondary prophylaxis and is now the primary joint affected. The heterogeneity in the pathoaetiology of haemophilic ankle arthropathy means that the functional consequences of early stage of ankle arthropathy are difficult to define as early morphological and structural changes can be observed in clinically asymptomatic ankles...
March 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28304307/logopenic-aphasia-due-to-a-strategic-stroke-new-evidence-from-a-single-case
#20
Javier Riancho, Ana Pozueta, Miguel Santos, Carmen Lage, José M Carril, Ignacio Banzo, Isabel Martínez-Rodriguez, Marilu Gorno-Tempini, Pascual Sánchez-Juan
Among primary progressive aphasias (PPAs), logopenic variant PPA (lv-PPA) is usually related to Alzheimer's disease. Although it has been widely clinically and pathologically evaluated, the topography in LPA is still controversial. We report a patient presenting with a logopenic syndrome due to a strategic lesion located in the superior and middle temporal gyrus and compare our findings with those of a PiB-PET positive lv-PPA patient matched by age, gender, and education. We consider that our study provides new anatomical clues to better understand the cognitive mechanisms underlying the logopenic syndrome...
March 10, 2017: Journal of Alzheimer's Disease: JAD
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