Assessing key cost drivers associated with caring for chronic kidney disease patients.

Background: To examine key factors influencing chronic kidney disease (CKD) patients' total expenditure and offer recommendations on how to reduce total cost of CKD care without compromising quality.

Methods: Using the 2002-2011 Medical Expenditure Panel Survey (MEPS) data, our cross-sectional study analyzed 197 patient records-79 patients with one record and 59 with two entries per patient (138 unique patients). We used three patient groups, based on international statistical classification of diseases version 9 code for condition (ICD9CODX) classification, to focus inference from the analysis: (a) non-dialysis dependent CKD, (b) dialysis and (c) transplant.

Melatonin Regulates Root Meristem by Repressing Auxin Synthesis and Polar Auxin Transport in .

Melatonin (-acetyl-5-methoxytryptamine) plays important roles in regulating both biotic and abiotic stress tolerance, biological rhythms, plant growth and development. Sharing the same substrate (tryptophan) for the biosynthesis, melatonin and auxin also have similar effects in plant development. However, the specific function of melatonin in modulating plant root growth and the relationship between melatonin and auxin as well as underlying mechanisms are still unclear.

Revitalizing Learning Outcomes for Adult Gerontology Advanced Practice Programs.

The implementation of the Consensus Model for Advanced Practice Registered Nurse Regulation has defined the model for advanced practice within the four recognized advanced practice nursing roles. The focus of graduate nursing program focus for care of the adult population has been broadened to include gerontology. The change toward increasing graduate program breadth and focus to a lifespan adult/gerontology population will result in the need for analysis and restructuring of advanced practice programs in order to incorporate gerontologic content.

Correlation between spheno-occipital synchondrosis, dental age, chronological age and cervical vertebrae maturation in Turkish population: is there a link?

Objective: To assess the correlation between third molar mineralization (TMM), spheno-occipital synchondrosis (SOS) fusion, chronologic age and cervical vertebrae maturation (CVM) for skeletal maturation.

Materials And Methods: Radiographs for 116 patients between 8 and 28 years were evaluated for age determination using mandibular TMM, SOS fusion and CVM. Spearman Correlation and Kappa test analyses were used to assess the relationship between variables and for intraobserver reliability.

LPA Gene, Ethnicity, and Cardiovascular Events.

Background: The relationship of LPA single nucleotide polymorphisms (SNPs), apolipoprotein(a) isoforms, and lipoprotein(a) [Lp(a)] levels with major adverse cardiovascular events (MACE) in different ethnic groups is not well known.

Methods: LPA SNPs, apolipoprotein(a) isoforms, Lp(a), and oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) levels were measured in 1792 black, 1030 white, and 597 Hispanic subjects enrolled in the Dallas Heart Study. Their interdependent relationships and prospective association with MACE after median 9.

Ursolic Acid and Chronic Disease: An Overview of UA's Effects On Prevention and Treatment of Obesity and Cancer.

Chronic diseases pose a worldwide problem and are only continuing to increase in incidence. Two major factors contributing to the increased incidence in chronic disease are a lack of physical activity and poor diet. As the link between diet and lifestyle and the increased incidence of chronic disease has been well established in the literature, novel preventive, and therapeutic methods should be aimed at naturally derived compounds such as ursolic acid (UA), the focus of this chapter.

Quantitative assessment of target delineation variability for thymic cancers: Agreement evaluation of a prospective segmentation challenge.

Objectives: We sought to quantitatively determine the inter-observer variability of expert radiotherapy target-volume delineation for thymic cancers, as part of a larger effort to develop an expert-consensus contouring atlas.

Methods: A pilot dataset was created consisting of a standardized case presentation with pre- and post-operative DICOM CT image sets from a single patient with Masaoka-Koga Stage III thymoma. Expert thoracic radiation oncologists delineated tumor targets on the pre- and post-operative scans as they would for a definitive and adjuvant case, respectively.

Characterization of air temperature in modern ion chambers due to phantom geometry and ambient temperature changes.

Purpose: Temperature and pressure corrections are necessary to account for the varying mass of air in the sensitive volume of a vented ionization chamber (IC) when performing absolute dose measurements. Locations commonly used to measure the presumed IC air temperature may not accurately represent the chamber cavity air temperature, and phantoms undergoing temperature changes further compound the problem. Prior studies have characterized thermal equilibrium in separate phantoms for Farmer chambers alone.

Effect of Body Weight on Hemodynamic Response in Patients Receiving Fixed-Dose Vasopressin for Septic Shock.

Background: Fixed-dose vasopressin is an adjunctive therapy to norepinephrine (NE) to raise mean arterial pressure (MAP) and decrease NE requirements in patients with septic shock. It is unknown if weight affects hemodynamic response to vasopressin or if a weight-based vasopressin strategy is superior to fixed dosing.

Objective: The primary objective was to evaluate effect of body weight on response to vasopressin as measured by change in MAP 1 hour post-vasopressin initiation.

Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists.

Objectives: The goal of the present study was to survey the Society of Cardiovascular Angiography and Intervention (SCAI) member cardiologists to evaluate contemporary practice patterns with regards to contrast use, acute kidney injury (AKI) risk assessment, and prevention in patients undergoing invasive angiography. We sought to compare the physician responses against guideline statements and evidence-based data from clinical studies.

Methods: A 20-question online survey based on a modified Likert scale was sent out via email to the Society of Cardiovascular Angiography and Intervention (SCAI) member cardiologists.

Pathology of the Trachea and Central Bronchi.

A wide variety of disorders can affect the trachea and central bronchi. Computed tomography is the imaging modality of choice in the evaluation of tracheobronchial disease. Tracheobronchial abnormalities are sometimes incidentally detected on routine imaging or when imaging is performed for another reason.

Pitfalls in the analysis of the physiological antioxidant glutathione (GSH) and its disulfide (GSSG) in biological samples: An elephant in the room.

Glutathione (GSH) is the most abundant low-molecular-mass thiol within cells and one of the major antioxidant compounds in body fluids. Under pro-oxidant conditions, two GSH molecules donate one electron each and are converted into glutathione disulfide (GSSG). The GSH/GSSG molar ratio is considered a powerful index of oxidative stress and disease risk.

Plasma Levels of Advanced Glycation End Products Are Related to the Clinical Presentation and Angiographic Severity of Symptomatic Lower Extremity Peripheral Arterial Disease.

Evidence implicates a role of advanced glycation end products (AGEs) in the development of atherosclerosis. The present study examined the relationship between plasma levels of AGEs and the clinical and angiographic characteristics of patients with symptomatic peripheral arterial disease (PAD). A total of 40 consecutive patients with symptomatic lower extremity PAD undergoing invasive evaluation were enrolled.

Immediate stabilization of human blood for delayed quantification of endogenous thiols and disulfides.

Endogenous thiols undergo rapid and reversible oxidation to disulfides when exposed to oxidants and are, therefore, suitable biomarkers of oxidative stress. However, accurate analysis of thiols in blood is frequently compromised by their artifactual oxidation during sample manipulation, which spuriously elevates the disulfide levels. Here, we describe a validated pre-analytical procedure that prevents both artifactual oxidation of thiols during sample manipulation and their oxidative decay for months in biosamples that are stored at -80°C.

Age estimation by an analysis of spheno-occipital synchondrosis using cone-beam computed tomography.

The spheno-occipital synchondrosis has a relatively late ossification in comparison with other cranial base synchondroses, which makes it a point of interest for forensic age determination studies. The purpose of the present study was to evaluate the reliability of spheno-occipital synchondrosis development in age determination in a Turkish population and to evaluate the reproducibility and reliability of cone beam computed tomography (CBCT) in an evaluation of the fusion stages of spheno-occipital synchondrosis. CBCT mid-sagittal images of 238 (90 males and 148 females) patients between the ages of 7 and 25, with a mean age of 15.

Dosimetric quantification of dose fall-off in liver SBRT planning using dual photon energy IMRT.

Introduction: The purpose of this study was to dosimetrically compare 6 MV, 10 MV and a hybrid of 6 and 10 MV photon beam energies in liver stereotactic body radiotherapy (SBRT) patients using a fixed-field IMRT technique. The objectives of the study were to evaluate dosimetric differences in the target volume and investigate if dose fall-off could be improved with 10MV beam energy.

Methods And Materials: Sixteen (n=16) liver SBRT patients previously treated using a non-coplanar, fixed-field IMRT technique with 6 MV were replanned using 10 MV and dual photon energy (DE).

Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial.

Background: Isavuconazole is a novel triazole with broad-spectrum antifungal activity. The SECURE trial assessed efficacy and safety of isavuconazole versus voriconazole in patients with invasive mould disease.

Methods: This was a phase 3, double-blind, global multicentre, comparative-group study.

Dosimetric effect of photon beam energy on volumetric modulated arc therapy treatment plan quality due to body habitus in advanced prostate cancer.

Purpose: The purpose of this study was to dosimetrically compare 6- and 10-MV photon beam energies in high-risk prostate cancer patients of various body habitus using a volumetric modulated arc therapy (VMAT) radiation delivery technique. The objectives of the study were to evaluate whether dosimetric differences exist and to investigate whether differences are dependent on patient body habitus.

Methods And Materials: Forty patients with various body habitus who had previously received treatment to the prostate and pelvic lymph nodes with VMAT techniques were chosen.

The contribution of opiate analgesics to the development of infectious complications in trauma patients.

Trauma-related pain is a natural consequence of injury and its surgical management; however, the relationship between opiates and complications in trauma patients is unknown. To study this a retrospective chart review of selected subjects following traumatic injury with admission to the SICU for > 3 days was performed, and opiate administration data was collected for the first 3 days of admission. Associated data from each subject's chart was also collected.

Rose Bengal Photothrombosis by Confocal Optical Imaging In Vivo: A Model of Single Vessel Stroke.

In vivo imaging techniques have increased in utilization due to recent advances in imaging dyes and optical technologies, allowing for the ability to image cellular events in an intact animal. Additionally, the ability to induce physiological disease states such as stroke in vivo increases its utility. The technique described herein allows for physiological assessment of cellular responses within the CNS following a stroke and can be adapted for other pathological conditions being studied.

An evaluation of the stability of image-quality parameters of Varian on-board imaging (OBI) and EPID imaging systems.

Quality assurance (QA) of the image quality for image-guided localization systems is crucial to ensure accurate visualization and localization of regions of interest within the patient. In this study, the temporal stability of selected image parameters was assessed and evaluated for kV CBCT mode, planar radiographic kV, and MV modes. The motivation of the study was to better characterize the temporal variability in specific image-quality parameters.

Novel therapeutic approaches for recurrent nonmuscle invasive bladder cancer.

This article summarizes strategies being investigated in patients with nonmuscle invasive bladder cancer. Progress has been made toward improving the delivery method of intravesical agents. Intravesical therapy is limited by the amount of time that the agent remains in contact with the bladder.

Transcriptomal changes and functional annotation of the developing non-human primate choroid plexus.

The choroid plexuses are small organs that protrude into each brain ventricle producing cerebrospinal fluid that constantly bathes the brain. These organs differentiate early in development just after neural closure at a stage when the brain is little vascularized. In recent years the plexus has been shown to have a much more active role in brain development than previously appreciated thereby it can influence both neurogenesis and neural migration by secreting factors into the CSF.

Treatment of vitamin D deficiency/insufficiency with ergocalciferol is associated with reduced vascular access dysfunction in chronic hemodialysis patients.

Vitamin D deficiency or insufficiency is highly prevalent among patients with chronic kidney disease (CKD). This study aims to determine the relationship between vitamin D and frequency of vascular access dysfunction (VAD) in hemodialysis (HD) patients. We reviewed medical records of all HD patients who had serum 25-hydroxyvitamin D (25OHD) levels at 4 outpatient dialysis facilities between January 2011 and January 2012.