Dramatic Improvement or Death Spiral — Two Members of Congress Assess the Medicare Bill

2004 ◽  
Vol 350 (8) ◽  
pp. 747-751 ◽  
Author(s):  
Edward M. Kennedy ◽  
Bill Thomas
Keyword(s):  
Dramatic Improvement ◽  
Death Spiral

Modification of Low ĸ Materials for ULSI Multilevel Interconnects by Ion Implantation

2002 ◽  
Vol 716 ◽  
Author(s):  
Alok Nandini ◽  
U. Roy ◽  
A. Mallikarjunan ◽  
A. Kumar ◽  
J. Fortin ◽  
...  
Keyword(s):  
Dielectric Constant ◽  
Ion Implantation ◽  
Dielectric Materials ◽  
Dramatic Improvement ◽  
Force Microscopy ◽  
Low Dielectric ◽  
Quantitative Measurements ◽  
Hardness Increase ◽  
Xerogel Films ◽  
Ion Species

AbstractThin films of low dielectric constant (κ) materials such as Xerogel (ĸ=1.76) and SilkTM (ĸ=2.65) were implanted with argon, neon, nitrogen, carbon and helium with 2 x 1015 cm -2 and 1 x 1016 cm -2 dose at energies varying from 50 to 150 keV at room temperature. In this work we discuss the improvement of hardness as well as elasticity of low ĸ dielectric materials by ion implantation. Ultrasonic Force Microscopy (UFM) [6] and Nano indentation technique [5] have been used for qualitative and quantitative measurements respectively. The hardness increased with increasing ion energy and dose of implantation. For a given energy and dose, the hardness improvement varied with ion species. Dramatic improvement of hardness is seen for multi-dose implantation. Among all the implanted ion species (Helium, Carbon, Nitrogen, Neon and Argon), Argon implantation resulted in 5x hardness increase in Xerogel films, sacrificing only a slight increase (∼ 15%) in dielectric constant.

Minocycline-Induced Agranulocytosis Presenting as Ecthyma Gangrenosum

2017 ◽  
Vol 1 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Katherine Nolan ◽  
Reema Ishteiwy ◽  
John Alexis ◽  
Martin Zaiac ◽  
Anna Nichols
Keyword(s):  
Care Facility ◽  
Urgent Care ◽  
Severe Neutropenia ◽  
Dramatic Improvement ◽  
Therapy Discontinuation ◽  
Incision And Drainage ◽  
Ecthyma Gangrenosum ◽  
Minimal Improvement ◽  
History Of ◽  
Acute And Chronic Inflammation

A 51-year-old female with a history of rheumatoid arthritis was admitted for progressive fevers, chills and malaise. Five weeks prior, she started minocycline for an RA exacerbation. Two weeks after starting minocycline she developed an abscess on her right ankle that was treated at an urgent care facility with ceftriaxone and trimethoprim-sulfamethoxazole. She had minimal improvement so was switched to clindamycin. She developed additional abscesses on her right ankle and right axilla and spiking fevers so she was treated with incision and drainage under general anesthesia. Routine blood work obtained prior to surgery revealed severe neutropenia (0.74 103/ul) and the patient was urgently referred to the emergency department.  Skin biopsy was obtained on admission and revealed ulceration, necrosis, acute and chronic inflammation, vasculitis with vascular thrombosis and rod-shaped bacteria in blood vessel walls and lumina consistent with ecthyma gangrenosum. The following day tissue and blood cultures confirmed the growth of Pseudomonas aureginosa. Bone-marrow biopsy showed decreased granulopoiesis and hematopoiesis, and a diagnosis of minocycline-induced agranulocytosis presenting as ecthyma gangrenosum was made.  The patient had dramatic improvement with appropriate antibiotic therapy, discontinuation of minocycline and initiation of filgrastrim. She has remained healthy without recurrence for 17 months.    

High-Resolution Backside GMR Magnetic Current Imaging on a Contour-Milled Globally Ultrathin Die

2014 ◽  
Author(s):  
D. Vallett ◽  
J. Gaudestad ◽  
C. Richardson
Keyword(s):  
Quantum Interference ◽  
Flip Chip ◽  
Milling Process ◽  
Dramatic Improvement ◽  
Superconducting Quantum Interference Device ◽  
Density Peak ◽  
Magnetic Current ◽  
Gmr Sensors ◽  
Silicon Thickness ◽  
A Current

Abstract Magnetic current imaging (MCI) using superconducting quantum interference device (SQUID) and giant-magnetoresistive (GMR) sensors is an effective method for localizing defects and current paths [1]. The spatial resolution (and sensitivity) of MCI is improved significantly when the sensor is as close as possible to the current paths and associated magnetic fields of interest. This is accomplished in part by nondestructive removal of any intervening passive layers (e.g. silicon) in the sample. This paper will present a die backside contour-milling process resulting in an edge-to-edge remaining silicon thickness (RST) of < 5 microns, followed by a backside GMR-based MCI measurement performed directly on the ultra-thin silicon surface. The dramatic improvement in resolving current paths in an ESD protect circuit is shown as is nanometer scale resolution of a current density peak due to a power supply shortcircuit defect at the edge of a flip-chip packaged die.

Barriers to antiretroviral therapy adherence among prisoners in one prison in Iran

2019 ◽  
Vol 19 ◽  
Author(s):  
Behnam Farhoudi ◽  
Seyed Ahmad Seyedalinaghi ◽  
Masoud Jafarinasab ◽  
Seyed Mohammad Ghavam ◽  
Omid Dadras ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Patient Adherence ◽  
Social Stigma ◽  
Group Discussion ◽  
Life Quality ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Dramatic Improvement ◽  
Art Adherence ◽  
Opium Addiction

Background: Antiretroviral medications have improved the survival and life quality of people living with HIV and turned HIV into a chronic controllable disease. However, the success of HIV treatment depends on many factors; the patient adherence is one the most important indicators which. In this study, we explored the potential barriers to an effective adherence antiretroviral therapy (ART) among the HIV-positive prisoners of Ghezelhesar prison, Iran. Methods: To explore and identify the barriers toward ART adherence, a focus group discussion was held with six prisoners eligible for ART but rejected to be treated or did not retain on ART. The prisoners were recruited through purposive sampling method. All the words, behaviors and even body languages were precisely recorded and analyzed to reach the final results. Results: The most reported obstacles toward ART adherence were the lack of trust in effectiveness of medications and drug complications. Other reasons were inadequate nutrition, lack of amenities, social stigma, lack of economic and psychological support, misbehavior of prison staff and inadequate methadone prescription for those with opium addiction. Conclusion: Due to the results and the fact that adequate Methadone prescription for opium addiction, improving life quality and receiving emotional and medical support from staff could improve adherence to HIV medication in prisoners, comprehensive education of prisoners about their health condition along with staff education may improve the life condition of HIV infected prisoners and may cause dramatic improvement in ART adherence and prisoners health.

scholarly journals LGG-23. EXCELLENT CLINICAL / RADIOLOGICAL RESPONSE TO BRAF INHIBITION IN A YOUNG CHILD WITH IN-OPERABLE SUPRA-SELLAR PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii370-iii371
Author(s):  
Stacy Chapman ◽  
Demitre Serletis ◽  
Colin Kazina ◽  
Mubeen Rafay ◽  
Sherry Krawitz ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Pilocytic Astrocytoma ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Braf V600e Mutation ◽  
Braf V600e ◽  
Low Grade ◽  
Dramatic Improvement ◽  
Chemotherapeutic Regimen ◽  
Response To Chemotherapy

Abstract In-operable low grade gliomas (LGG) in the pediatric population continue to present a treatment dilemma. Due to the low-grade nature of these tumors, and variable response to chemotherapy / radiation, the choice of adjuvant treatment is difficult. Overall survival is directly related to the degree of surgical resection, adding complexity to these inoperable tumors. Current chemotherapeutic regimen for these inoperable tumors includes vincristine (VCR) and carboplatin (Carbo). With advancements in the molecular characterization of gliomas, the role of targeted therapy has come into question. We present a 2-year-old female with biopsy proven Pilocytic Astrocytoma (positive BRAF-V600E mutation) involving the hypothalamic/optic chiasm region. She presented with ataxic gait, bi-temporal hemianopia, obstructive hydrocephalus and central hypothyroidism, which progressed to altered consciousness, and right hemiparesis due to location/mass effect of the tumor. She was initially treated with chemotherapy (VCR/Carbo) but her tumor progressed at 6 weeks of treatment. As her tumor was positive for BRAF-V600E mutation, she was started on Dabrafenib monotherapy, resulting in dramatic improvement in her clinical symptoms (able to stand, improved vision), and a 60% reduction in tumor size at 3-months. At 6-months, follow up MRI showed slight increase in the solid portion of the tumor, with no clinical symptoms. We plan to add MEK inhibitor (Trametinib) and continue with Dabrafenib. Our experience and literature review suggests that LGG with BRAF-V600E mutations may benefit from upfront targeted therapy. Prospective clinical trials comparing the efficacy of BRAF inhibitors versus standard chemotherapy in LGG with BRAF mutations are urgently needed.

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