Availability and financing of CAR-T cell therapies: A cross-country comparative analysis.

Chimeric antigen receptor T-cell therapies (CAR-T therapies) are a type of advanced therapy medicinal product (ATMP) that belong to a new generation of personalised cancer immunotherapies. This paper compares the approval, availability and financing of CAR-T cell therapies in ten countries. It also examines the implementation of this type of ATMP within the health care system, describing the organizational elements of CAR-T therapy delivery and the challenges of ensuring equitable access to all those in need, taking a more systems-oriented view.

Endovascular Repair of Three Concurrent Mycotic Pseudoaneurysms.

Introduction: Mycotic pseudoaneurysm has traditionally been repaired surgically with excision of the infected artery and revascularization via extra-anatomical or in situ bypass. There have been reports of endovascular repair for high-risk patients for formal surgical repair. We present a case of a patient with 3 large pseudoaneurysms arising from the right subclavian artery, descending thoracic aorta, and right popliteal artery treated with endovascular and hybrid intervention.

Effects of dialysate to serum sodium (Na) alignment in chronic hemodialysis (HD) patients: retrospective cohort study from a quality improvement project.

Background: Evidence indicates favorable effects of dialysate (DNa) to serum sodium concentration (SNa) alignment, however, results from larger sample populations are needed. For this reason, we conducted a retrospective propensity score-matched cohort study from a quality improvement project to investigate the effects of alignment on population of maintenance hemodialysis patients.

Methods: At 4 participating hemodialysis (HD) clinics, patients with SNa lower than the standard DNa of 137 mEq/L who received HD with DNa aligned to the average of the last 4 SNa measurements were evaluated (clinicaltrials.

Evidence of a sewer vapor transport pathway at the USEPA vapor intrusion research duplex.

The role of sewer lines as preferential pathways for vapor intrusion is poorly understood. Although the importance of sewer lines for volatile organic compound (VOC) transport has been documented at a small number of sites with vapor intrusion, sewer lines are not routinely sampled during most vapor intrusion investigations. We have used a tracer study and VOC concentration measurements to evaluate the role of the combined sanitary/storm sewer line in VOC transport at the USEPA vapor intrusion research duplex in Indianapolis, Indiana.

Processes, contexts, and rationale for disinvestment: a protocol for a critical interpretive synthesis.

Background: Practical solutions are needed to support the appropriate use of available health system resources as countries are continually pressured to 'do more with less' in health care. Increasingly, health systems and organizations are exploring the reassessment of possibly obsolete, inefficient, or ineffective health system resources and potentially redirecting funds to those that are more effective and efficient. Such processes are often referred to as 'disinvestment'.

Intradialytic hypotension: frequency, sources of variation and correlation with clinical outcome.

Intradialytic hypotension (IH) is a frequent complication of hemodialysis (HD) and is associated with increased patient mortality and cardiovascular events. We studied IH to determine its variability, correlates, and clinical impact in 13 outpatient HD facilities. Blood pressure was captured by machine download.

Predicting nursing home placement among home- and community-based services program participants.

Background: Several states offer publicly funded-care management programs to prevent long-term care placement of high-risk Medicaid beneficiaries. Understanding participant risk factors and services that may prevent long-term care placement can facilitate efficient allocation of program resources.

Objectives: To develop a practical prediction model to identify participants in a home- and community-based services program who are at highest risk for long-term nursing home placement, and to examine participant-level and program-level predictors of nursing home placement.

Factorial validity and invariance of a survey measuring psychosocial correlates of colorectal cancer screening in Ontario, Canada--a replication study.

Psychosocial constructs have been used to predict colorectal cancer screening and are frequently targeted as intermediate outcomes in behavioral intervention studies. Few studies have conducted analyses to adequately test construct validity. The psychometric analyses undertaken with U.

Stakeholder preferences for cancer care performance indicators.

Purpose: The purpose of this paper is to show that performance data use could be promoted with a better understanding of the type of indicators that are important to different stakeholders. This study explored patient, nurse, physician and manager preferences for cancer care quality indicators.

Design/methodology/approach: Interviews were held with 30 stakeholders between March and June 2004.

Managed care's perspective on treatment of plaque psoriasis.

Sullivan discussed the potential for acceptance of biologic drugs for treatment of psoriasis in the context of how managed care organizations currently respond to new therapies. The apparent effectiveness of biologic therapies, compared with conventional treatments, led Sullivan to suggest that traditional methods of evaluating and "tiering" pharmaceutical products may not necessarily prove appropriate for biologic therapies.

Endoscopic follow-up of positive fecal occult blood testing in the Ontario FOBT Project.

Background: The Ontario FOBT Project is a pilot study of fecal occult blood testing (FOBT) for colorectal cancer screening conducted among age-eligible volunteers (50 to 75 years) in 12 of 37 public health regions in Ontario.

Methods: Volunteers responded to invitations from primary care practitioners (PCPs) in six regions, and from public health programs in the remaining regions. FOBT collection kits were distributed from routine laboratory specimen collection sites, to which completed kits were returned.

Global gene expression profiling reveals similarities and differences among mouse pluripotent stem cells of different origins and strains.

Pluripotent stem cell lines with similar phenotypes can be derived from both blastocysts (embryonic stem cells, ESC) and primordial germ cells (embryonic germ cells, EGC). Here, we present a compendium DNA microarray analysis of multiple mouse ESCs and EGCs from different genetic backgrounds (strains 129 and C57BL/6) cultured under standard conditions and in differentiation-promoting conditions by the withdrawal of Leukemia Inhibitory Factor (LIF) or treatment with retinoic acid (RA). All pluripotent cell lines showed similar gene expression patterns, which separated them clearly from other tissue stem cells with lower developmental potency.

Factors that influence cancer patients' overall perceptions of the quality of care.

Objective: This study outlines predictors of cancer patients' overall perceptions of the quality of care.

Design And Setting: Our sample included 2790 patients who received cancer care services during 2004 in 15 comprehensive cancer programmes across Ontario, Canada. Patients were classified into three groups: those receiving both chemotherapy and radiotherapy (n = 752), those receiving only chemotherapy (n = 1044), and those receiving only radiotherapy (n = 994).

Loss of emerin at the nuclear envelope disrupts the Rb1/E2F and MyoD pathways during muscle regeneration.

Emery-Dreifuss muscular dystrophy (EDMD1) is caused by mutations in either the X-linked gene emerin (EMD) or the autosomal lamin A/C (LMNA) gene. Here, we describe the derivation of mice lacking emerin in an attempt to derive a mouse model for EDMD1. Although mice lacking emerin show no overt pathology, muscle regeneration in these mice revealed defects.

Methylmercury, fish consumption, and the precautionary principle.

This paper considers several broad issues in the context of probabilistic assessment of the benefits of curtailing mercury (Hg) emissions from U.S. coal-fired power plants, based on information developed from recent literature and epidemiology studies of health effects of methylmercury.

Mutations in the mouse Lmna gene causing progeria, muscular dystrophy and cardiomyopathy.

At least ten different diseases have been linked to mutations in proteins associated with the nuclear envelope (NE). Eight of these diseases are associated with mutations in the lamin A gene (LMNA). These diseases include the premature ageing or progeric diseases Hutchinson-Gilford progeria and atypical Werner's syndrome, diseases affecting striated and cardiac muscle including muscular dystrophies and dilated cardiomyopathies, lipodystrophies affecting white fat deposition and skeletal development and a peripheral neuropathy resulting in motor neuron demyelination.

Heterozygosity for Lmna deficiency eliminates the progeria-like phenotypes in Zmpste24-deficient mice.

Zmpste24 is a metalloproteinase required for the processing of prelamin A to lamin A, a structural component of the nuclear lamina. Zmpste24 deficiency results in the accumulation of prelamin A within cells, a complete loss of mature lamin A, and misshapen nuclear envelopes. Zmpste24-deficient (Zmpste24(-/-)) mice exhibit retarded growth, alopecia, micrognathia, dental abnormalities, osteolytic lesions in bones, and osteoporosis, which are phenotypes shared with Hutchinson-Gilford progeria syndrome, a human disease caused by the synthesis of a mutant prelamin A that cannot undergo processing to lamin A.

Reconstructing cancer services in Ontario.

This paper draws upon experience gained in the recent restructuring of cancer services in Ontario that can provide insights for broader regionalization efforts. Although Ontario is the only province in Canada not to regionalize its healthcare system, the Ontario cancer services system, like most others in Canada, is based on a regionalized system. However, the growing burden of cancer and predictable crises in cancer services in Ontario necessitated a rethinking of how the cancer system should be structured and how services should be delivered.

Declining trends in work-related morbidity and disability, 1993-1998: a comparison of survey estimates and compensation insurance claims.

Objectives: This study compared trends in the incidence of work-related morbidity and disability across 3 sources of surveillance data in a Canadian province.

Methods: Time series estimates of workplace injuries and work-related disability based on 2 panel surveys in the province of Ontario, Canada, for the period 1993-1998 were compared with rates of work-related injury and illness compensation claims during the same period.

Results: Lost-time compensation claims declined by 28.