Protein delivery to the back of the eye: barriers, carriers and stability of anti-VEGF proteins.

Utilization of the full clinical potential of many novel therapeutic proteins designed for diseases affecting the posterior segment of the eye has often been limited because of their inherent instability and the difficulty in overcoming various ocular barriers. Intravitreal injection is currently the only approved mode of administration, although it is suboptimal because it is painful and has to be done every 1-2 months as a result of high protein clearance rates from the vitreous humor. In this review, we discuss the status of protein drug delivery to back of the eye in terms of novel protein drugs developed, physiological barriers encountered, strategies for carrier design to overcome these limitations, and protein stability.

Cost-Effective In-House Neutralization Assay for the Confirmation of HBeAg.

Background & Aim: Hepatitis B virus-e-antigen (HBeAg) is an affordable viral marker to assess viral replication kinetics and response to antiviral therapy. In the absence of confirmatory assays, discrepant or false-positive HBeAg results are resolved by screening for other HBV markers. We standardized an in-house HBeAg neutralization assay (HBeAg-NT) to confirm HBeAg in clinical samples.

A cross-sectional study of problem gambling and its correlates among college students in South India.

Background: In the Western world, a significant portion of college students have gambled. College gamblers have one of the highest rates of problem gambling. To date, there have been no studies on gambling participation or the rates of problem gambling in India.

Studying Associations Between Heart Failure Self-Management and Rehospitalizations Using Natural Language Processing.

This study developed an innovative natural language processing algorithm to automatically identify heart failure (HF) patients with ineffective self-management status (in the domains of diet, physical activity, medication adherence, and adherence to clinician appointments) from narrative discharge summary notes. We also analyzed the association between self-management status and preventable 30-day hospital readmissions. Our natural language system achieved relatively high accuracy ( F-measure = 86.

The Knowing-Doing Gap in Advance Directives in Asian Americans: The Role of Education and Acculturation.

Objectives: The purposes of the present study were (1) to explore the completion rate of advance directives (ADs) in a sample of Asian Americans and (2) to examine the direct and moderating effects of knowledge of AD, education, and acculturation in predicting AD completion. Education and acculturation were conceptualized as moderators in the link between knowledge and completion of ADs.

Methods: Using data from 2609 participants in the 2015 Asian American Quality of Life survey (aged 18-98), logistic regression analyses on AD completion were conducted, testing both direct and moderating effects.

Study of stability and biophysical characterization of ranibizumab and aflibercept.

The anti-vascular endothelial growth factor (VEGF) agents such as ranibizumab (Lucentis®) and aflibercept (EyLea®) are currently used as monthly or bimonthly intravitreal injections to treat potentially retinal diseases such as wet age-related macular degeneration (AMD) or diabetic macular edema (DME). Because of the complications associated with repeated intra-vitreal injections, there is considerable interest in developing a sustained delivery system. The purpose of this study was to examine the stability of both therapeutic proteins under physiological conditions as well as when incorporated into drug delivery systems (DDS).

The Impact of Race and Neighborhood Racial Composition on Preventable Readmissions for Diabetic Medicare Home Health Beneficiaries.

Background: The recommended home health financial penalty program for preventable readmission does not factor race/ethnicity and neighborhood racial compositions into the determination of preventable readmission rates. Home health agencies may avoid beneficiaries from certain racial/ethnic groups and neighborhoods if these two factors have an effect on preventable readmissions. We examined the association between preventable readmissions with race/ethnicity and neighborhood racial composition.

Visual Analytics for Pattern Discovery in Home Care. Clinical Relevance for Quality Improvement.

Background: Visualization can reduce the cognitive load of information, allowing users to easily interpret and assess large amounts of data. The purpose of our study was to examine home health data using visual analysis techniques to discover clinically salient associations between patient characteristics with problem-oriented health outcomes of older adult home health patients during the home health service period.

Methods: Knowledge, Behavior and Status ratings at discharge as well as change from admission to discharge that was coded using the Omaha System was collected from a dataset on 988 de-identified patient data from 15 home health agencies.

Perceptions of Older Adults with Heart Failure on Playing an Interactive Digital e-Health Game (IDEG) for Learning About Heart Failure (HF): Prototype Development and Usability Testing.

Effective self-management can decrease up to 50% of heart failure (HF) hospitalizations. However, self-management by patients with HF remains poor. We describe the development and usability testing of an interactive digital e-health game (IDEG) for older patients with HF in Central Texas, USA.

Mining Clinicians' Electronic Documentation to Identify Heart Failure Patients with Ineffective Self-Management: A Pilot Text-Mining Study.

Effective self-management can decrease up to 50% of heart failure hospitalizations. Unfortunately, self-management by patients with heart failure remains poor. This pilot study aimed to explore the use of text-mining to identify heart failure patients with ineffective self-management.

Autoimmune Regulator (AIRE) Is Expressed in Spermatogenic Cells, and It Altered the Expression of Several Nucleic-Acid-Binding and Cytoskeletal Proteins in Germ Cell 1 Spermatogonial (GC1-spg) Cells.

Autoimmune regulator (AIRE) is a gene associated with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). AIRE is expressed heavily in the thymic epithelial cells and is involved in maintaining self-tolerance through regulating the expression of tissue-specific antigens. The testes are the most predominant extrathymic location where a heavy expression of AIRE is reported.

Size-isolation of ultrasound-mediated phase change perfluorocarbon droplets using differential centrifugation.

Perfluorocarbon droplets that are capable of an ultrasound-mediated phase transition have applications in diagnostic and therapeutic ultrasound. Techniques to modify the droplet size distribution are of interest because of the size-dependent acoustic response of the droplets. Differential centrifugation has been used to isolate specific sizes of microbubbles.

Dexmedetomidine as an adjuvant to bupivacaine in caudal analgesia in children.

Context: Postoperative pain management is becoming an integral part of anesthesia care. Various techniques of pediatric pain relief have been designed among which the most commonly practiced is caudal epidural block. Several adjuvants have been used to prolong the duration of caudal analgesia such as clonidine, neostigmine, ketamine, opioids, and ephedrine.

Drug, delivery and devices for diabetic retinopathy (3Ds in DR).

Diabetic Retinopathy (DR) is one of the most common causes of blindness among the working population worldwide. Clearly, there is an unmet clinical need to find better treatment options for DR. Areas covered: The literature search was conducted on PubMed with no limitation on language or year of publication.

Scavenging dissolved oxygen via acoustic droplet vaporization.

Acoustic droplet vaporization (ADV) of perfluorocarbon emulsions has been explored for diagnostic and therapeutic applications. Previous studies have demonstrated that vaporization of a liquid droplet results in a gas microbubble with a diameter 5-6 times larger than the initial droplet diameter. The expansion factor can increase to a factor of 10 in gassy fluids as a result of air diffusing from the surrounding fluid into the microbubble.

Lewis Acid Catalyzed Regioselective Hydroheteroarylation of Pentafulvenes.

A diverse approach toward the catalytic regioselective nucleophilic addition of nitrogen heterocycles to Lewis acid activated pentafulvenes has been established. The developed protocol introduces pentafulvenes as nonsymmetrical alkenes for the hydroheteroarylation reaction, providing alkylidenecyclopentenylation at the C-3 position of indoles and the C-2 position of pyrrole.

Effective Teaching-Learning Strategies for the Omaha System.

Home healthcare clinicians can benefit from the use of interprofessional standardized terminologies to more efficiently document and assess patient problems, describe and present clinician interventions, and measure the outcomes of care. The Omaha System is a research-based, comprehensive standardized terminology that can enable users to describe and measure the impact of nursing and healthcare services on patient care and outcomes. In this article, we (1) describe effective strategies for teaching the Omaha System to home healthcare agency staff, and (2) illustrate those strategies' effectiveness by presenting an example from an Omaha System Basic Workshop conducted in 2015.

Velocity and doubling time of prostate-specific antigen: mathematics can matter.

Changes in prostate-specific antigen (PSA) values are often reported as velocity or doubling time. We compared the association of these two calculations-at the time of PSA failure after primary treatment for prostate cancer-with prostate cancer mortality. From a source population of 1313 US Veterans with prostate cancer, including 623 treated with curative intent, the study population included 242 men experiencing biochemical failure, 81 after surgery and 161 after radiation therapy.

Effect of Structured and Unstructured Physical Activity Training on Cognitive Functions in Adolescents - A Randomized Control Trial.

Background: Regular physical activity in children and adolescents promotes not only their physical health but also improves their cognition. Paper and pencil Neurocognitive tests (NCT) are commonly used to assess the various cognitive domains of a person and can be used as simple tests to assess improvements, if any, in the cognitive abilities of growing adolescents who practice regular physical activity.

Aim: To study the effect of six months of structured and unstructured physical activity on cognitive functions in adolescents.

Titanium and Zirconium Hydride-Catalyzed Regioselective Isomerization of 1,4-Dihydrofulvenes: Access to 1-Substituted 1,2-Dihydrofulvenes.

Zirconium hydride-catalyzed C═C double bond migration from nonconjugated to conjugated dienes is described. Applied to 1-substituted 1,4-dihydrofulvenes, the migration leads selectively to 1-substituted 1,2-dihydrofulvenes. The C═C double bond migration can also be catalyzed by titanium hydride, allowing a one-pot procedure to provide 1-substituted 1,2-dihydrofulvenes from pentafulvenes via two titanium-catalyzed steps.

Auditory and visual reaction times in school going adolescents: effect of structured and unstructured physical training - a randomized control trial.

Background: Cognitive development of adolescents is influenced by their physical activity status. Exercises requiring greater cognitive engagement are likely to have a stronger effect on their executive cognitive functions than simpler exercises.

Materials And Methods: In our randomized, single blinded, parallel group, active controlled trial (CTRI/ 2013/08/003897) the recruited healthy student volunteers, aged 12-17 years (n=439), were allocated into structured physical activity (SPA) and unstructured physical activity (USPA) groups by age and gender stratified block randomization.

Trans-Stent B-Mode Ultrasound and Passive Cavitation Imaging.

Angioplasty and stenting of a stenosed artery enable acute restoration of blood flow. However, restenosis or a lack of re-endothelization can subsequently occur depending on the stent type. Cavitation-mediated drug delivery is a potential therapy for these conditions, but requires that particular types of cavitation be induced by ultrasound insonation.

Improving diabetic patient transition to home healthcare: leading risk factors for 30-day readmission.

Objectives: To identify risk factors of 30-day readmissions due to ambulatory care-sensitive conditions (ACSCs) for diabetic Medicare home healthcare beneficiaries in order to improve transition from hospital-based care to home healthcare.

Study Design: We analyzed diabetic Medicare beneficiaries who received home healthcare within 14 days of hospital discharges in 2009. The unit of analysis is the home health episode for post acute care.