scholarly journals Tipranavir (TPV) Genotypic Inhibitory Quotient Predicts Virological Response at 48 Weeks to TPV-Based Salvage Regimens

2007 ◽  
Vol 52 (3) ◽  
pp. 1066-1071 ◽  
Author(s):  
Daniel Gonzalez de Requena ◽  
Stefano Bonora ◽  
Andrea Calcagno ◽  
Antonio D'Avolio ◽  
Marco Siccardi ◽  
...  
Keyword(s):  
Virological Response ◽  
Protease Gene ◽  
Reverse Transcriptase Inhibitors ◽  
Cutoff Value ◽  
Multiple Drugs ◽  
The Relationship ◽  
Cell Count Increase ◽  
Better Than

ABSTRACT The virological response (VR) to a tipranavir-ritonavir (TPV-RTV)-based regimen had been shown to be associated with a number of mutations in the protease gene, the use of enfuvirtide (T20), and the TPV phenotypic inhibitory quotient (IQ). The role of the TPV genotypic IQ (gIQ) has not yet been fully investigated. The aim of our study was to evaluate the relationship between the TPV gIQ and the VR at 48 weeks to TPV-based salvage regimens. Patients placed on regimens containing two nucleoside reverse transcriptase inhibitors plus TPV-RTV 500/200 mg twice a day with or without T20 were prospectively studied. Regular follow-up was performed over the study period. VR, considered a viral load (VL) decrease of ≥1 log unit and/or the achievement of <50 copies/ml with no VL rebound of >0.5 log unit compared to the maximal VL decrease at week 48, was assessed. Thirty-eight patients who had received multiple drugs were included. At week 48 the VL decrease was −1.48 (interquartile range [IQR], −2.88 to −0.48), 15 patients (39.5%) had VLs of <50 copies/ml, and the CD4+ cell count increase was 37 cells/mm3 (IQR, −30 to +175). Twenty subjects (52.6%) achieved VRs. The TPV gIQ and optimized background score (OBS) were independently associated with higher VL decreases. The TPV gIQ and OBS were also independent predictors of a VR at week 48. TPV gIQ and OBS cutoff values of 14,500 and 2, respectively, were associated with a higher rate of VR. The TPV gIQ was shown to be able to predict the VR at 48 weeks to TPV-containing salvage regimens better than the TPV trough concentration or TPV-associated mutations alone. A possible TPV gIQ cutoff value of 14,500 for reaching a VR at week 48 was suggested. Further studies are needed in order to evaluate the calculation of TPV gIQ as a new tool for the optimization of TPV-based salvage therapy.

External Investigators' Follow-Up Intentions When Whistleblowers Report Healthcare Fraud: The Effects of Report Anonymity and Previous Confrontation

2020 ◽  
Vol 32 (2) ◽  
pp. 91-101
Author(s):  
Steven E. Kaplan ◽  
Danny Lanier ◽  
Kelly R. Pope ◽  
Janet A. Samuels
Keyword(s):  
Experimental Study ◽  
Early Detection ◽  
Data Availability ◽  
Medical Provider ◽  
Perceived Credibility ◽  
The Relationship ◽  
Critical Investigation

ABSTRACT Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical, investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions. Data Availability: Data are available upon request.

Equity and the Right to Do Wrong

2020 ◽  
pp. 72-91
Author(s):  
Andrew S Gold
Keyword(s):  
The State ◽  
The Self ◽  
Role Of The State ◽  
The Right ◽  
The Relationship ◽  
Private Litigation ◽  
Better Than

This chapter discusses how the ‘stickler-enjoining’ account of equity has important limits. While many distinctive doctrines of equity can be understood to limit stickler behaviour, equity in fact often turns a blind eye to, and sometimes even enables, stickler behaviour. One can sort cases in which equity restrains sticklers from those in which it is indifferent to stickler behaviour if one attends to the role of the state in private litigation. Sometimes the state’s responsibilities require it to protect plaintiffs against sticklers. Other times, it requires it to protect the stickler, as a means, for example, of keeping as open as possible each person’s sphere of choices. Ultimately, the self-regarding account of equity sheds light on the question of the relationship between equity and justice: from the distinct perspective of the judgment, sometimes equitable justice is better than legal justice and sometimes legal justice is better than equitable justice.

scholarly journals Role of Blossom Colonization in Pepper Seed Infestation by Xanthomonas euvesicatoria

2014 ◽  
Vol 104 (3) ◽  
pp. 232-239 ◽  
Author(s):  
B. Dutta ◽  
R. Gitaitis ◽  
H. Sanders ◽  
C. Booth ◽  
S. Smith ◽  
...  
Keyword(s):  
Separate Experiment ◽  
Inoculum Concentration ◽  
Pepper Fruit ◽  
Polymerase Chain ◽  
Xanthomonas Euvesicatoria ◽  
The Relationship ◽  
Pepper Seed ◽  
Seed Infestation ◽  
Better Than

Colonization of Xanthomonas euvesicatoria was investigated in pepper blossoms and the relationship between inoculum concentrations and seed infestation was determined. Inoculation of blossoms resulted in asymptomatic pepper fruit. However, real-time polymerase chain reaction detected X. euvesicatoria in 39% of the seed lots assayed and viable colonies were recovered from 35% of them. Successful transmission occurred in 16% of the seed lots tested. In a separate experiment, X. euvesicatoria reached populations of up to 1 × 105 CFU/blossom on stigmas 96 h after inoculation. Bacteria colonized stylar and ovary tissues with populations ranging from 1 × 105 to 1 × 106 CFU/blossom 96 h after inoculation. A positive correlation existed between inoculum concentration and percentage of infested seedlots. Blossoms inoculated with Acidovorax citrulli also resulted in infested pepper seedlots. Furthermore, A. citrulli colonized pepper blossoms significantly better than X. euvesicatoria by 96 h postinoculation. It was concluded that pepper blossoms can be a potential site of ingress for X. euvesicatoria into seed, and blossom colonization may be involved in pepper seed infestation. Data also indicated that seed infestation via blossoms may be nonspecific because nonhost plants can be colonized by incompatible pathogens. Thus, host–pathogen interactions may not be important for bacterial ingress through blossoms.

scholarly journals ROLE OF THE BUDGET IN RAISING THE EFFICIENCY OF FINANCIAL ‎ PERFORMANCE IN THE DIRECTORATE OF EDUCATION IN THE NORTHERN ‎GOVERNORATES

2021 ◽  
Vol 03 (06) ◽  
pp. 366-383
Author(s):  
Wafaa Mohammad ASHOUR ◽  
Narmeen Ismat ZATARA
Keyword(s):  
Financial Performance ◽  
Preparation Process ◽  
Ministry Of Education ◽  
Open Questions ◽  
Study Population ◽  
Training Courses ◽  
The Relationship ◽  
Academic Year

The study aimed to identify the role of the budget in raising the efficiency of financial ‎performance in the Directorate of Education in the northern governorates. The two ‎researchers used: qualitative research.‎ The interview tool was adopted: it consisted of (3) main themes. The first axis: about ‎budget preparation and included (8) questions. The second axis: about the implementation ‎of the budget, and included (7) questions. The third axis: about the relationship between ‎the budget and the efficiency of financial performance. The interview questions included ‎open questions and closed questions.‎ The study population is made up of members of the Finance Committee and is responsible ‎for the budget preparation process. They number (68) in the second semester of the ‎academic year 2020-2021. The sample size is (19) by 28%. The most important results are: ‎ o The budget plays a major role in raising the efficiency of financial performance, as ‎it is one of the activities planning tools, as the revenue amounts are distributed ‎among the budget items.‎ o The budget has a role in raising the efficiency of financial performance in the ‎education directorates through its oversight role on performance.‎ Recommendations: ‎ o Increasing the powers of education directorates in the budget preparation process ‎by the Ministry of Education in order to achieve a higher level of flexibility in it to ‎meet the needs within the priorities.‎ o Conducting training courses on budget preparation, implementation, and follow-‎up by the Ministry of Education in cooperation with the Ministry of Finance, and ‎not to be limited to department heads only, but extend to all employees in the ‎directorate's departments and those willing and qualified to prepare budgets‎.

scholarly journals Comprehensive Analysis of the Systemic Transcriptomic Alternations and Inflammatory Response during the Occurrence and Progress of COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Shaocong Mo ◽  
Leijie Dai ◽  
Yulin Wang ◽  
Biao Song ◽  
Zongcheng Yang ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Global Economy ◽  
Immune Cell ◽  
Nonnegative Matrix ◽  
Neutrophil Degranulation ◽  
Linear Correlation Analysis ◽  
The Relationship ◽  
Coexpression Network Analysis

The pandemic of the coronavirus disease 2019 (COVID-19) has posed huge threats to healthcare systems and the global economy. However, the host response towards COVID-19 on the molecular and cellular levels still lacks full understanding and effective therapies are in urgent need. Here, we integrate three datasets, GSE152641, GSE161777, and GSE157103. Compared to healthy people, 314 differentially expressed genes were identified, which were mostly involved in neutrophil degranulation and cell division. The protein-protein network was established and two significant subsets were filtered by MCODE: ssGSEA and CIBERSORT, which comprehensively revealed the alternation of immune cell abundance. Weighted gene coexpression network analysis (WGCNA) as well as GO and KEGG analyses unveiled the role of neutrophils and T cells during the progress of the disease. Based on the hospital-free days after 45 days of follow-up and statistical methods such as nonnegative matrix factorization (NMF), submap, and linear correlation analysis, 31 genes were regarded as the signature of the peripheral blood of COVID-19. Various immune cells were identified to be related to the prognosis of the patients. Drugs were predicted for the genes in the signature by DGIdb. Overall, our study comprehensively revealed the relationship between the inflammatory response and the disease course, which provided strategies for the treatment of COVID-19.

scholarly journals D-Dimer to Fibrinogen Ratio as a Novel Prognostic Marker in Patients After Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2020 ◽  
Vol 26 ◽  
pp. 107602962094858
Author(s):  
Yan Bai ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Xu-Ming Yang ◽  
Qian-Qian Guo ◽  
...  
Keyword(s):  
Cox Regression ◽  
Coronary Intervention ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
Percutaneous Coronary ◽  
The Relationship ◽  
D Dimer

The role of activation of the coagulation and fibrinolysis system in the pathogenesis and prognosis of cardiovascular diseases (CVDs) has drawn wide attention. Recently, the D-dimer to fibrinogen ratio (DFR) is considered as a useful biomarker for the diagnosis and prognosis of ischemic stroke and pulmonary embolism. However, few studies have explored the relationship between DFR and cardiovascular disease. In our study, patients were divided into 2 groups according to DFR value: the lower group (DFR < 0.52, n = 2123) and the higher group (DFR ≥ 0.52, n = 1073). The primary outcome was all-cause mortality (ACM) and cardiac mortality (CM). The average follow-up time was 37.59 ± 22.24 months. We found that there were significant differences between the 2 groups in term of ACM (2.4% vs 6.6%, P < 0.001) and CM (1.5% vs 4.0%, P < 0.001). Kaplan–Meier analyses showed that elevated DFR had higher incidences of ACM (log rank P < 0.001) and CM (log rank P < 0.001). Multivariate Cox regression analyses showed that DFR was an independent predictor of ACM (HR = 1.743, 95%CI: 1.187-2.559 P = 0.005) and CM (HR = 1.695, 95%CI: 1.033-2.781 P = 0.037). This study indicates that DFR is an independent and novel predictor of long-term ACM and CM in post-PCI patients with CAD.

Extracapillary Proliferative Glomerulonephritis in Children

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 434-442
Author(s):  
Sudhir K. Anand ◽  
Carl W. Trygstad ◽  
Hari M. Sharma ◽  
James D. Northway
Keyword(s):  
Streptococcal Infection ◽  
Clinical Course ◽  
Renal Involvement ◽  
Therapeutic Agents ◽  
Proliferative Glomerulonephritis ◽  
The Mean ◽  
Histopathologic Changes ◽  
Better Than

The clinical course and renal pathology of 17 children with acute extracapillary proliferative glomerulonephritis is reported. Patients with systemic ses associated with renal involvement were excluded. The onset followed streptococcal infection in ten; of these, four have died, one has been transplanted, and the remaining five have completely healed. The mean follow-up of the latter five patients was 32 months (range, 18 to 57 months). Of the other seven patients without evidence of preceding streptococcal infection, two have died, two have been transplanted, and the remaining three all have hypertension, proteinuria, and reduced creatinine clearance. The mean follow-up of the latter three patients was 29 months (range, 14 to 38 months). The initial renal histopathologic changes and their progress in later renal biopsies is described. The role of various therapeutic agents is discussed. The prognosis in acute extracapillary proliferative glomerulonephritis following streptococcal infection appears to be better than in ones without preceding streptococcal infection.

scholarly journals CDC73 mutational status and loss of parafibromin in the outcome of parathyroid cancer

2013 ◽  
Vol 2 (4) ◽  
pp. 186-195 ◽  
Author(s):  
Filomena Cetani ◽  
Chiara Banti ◽  
Elena Pardi ◽  
Simona Borsari ◽  
Paolo Viacava ◽  
...  
Keyword(s):  
Mutational Analysis ◽  
Survival Rates ◽  
Suppressor Gene ◽  
Added Value ◽  
Carrier Status ◽  
Mutational Status ◽  
Immunohistochemical Studies ◽  
Better Than

Inactivating mutations of the CDC73 tumor suppressor gene have been reported in parathyroid carcinomas (PC), in association with the loss of nuclear expression of the encoded protein, parafibromin. The aim of this study was to further investigate the role of the CDC73 gene in PC and evaluate whether gene carrier status and/or the loss of parafibromin staining might have an effect on the outcome of the disease. We performed genetic and immunohistochemical studies in parathyroid tumor samples from 35 patients with sporadic PC. Nonsense or frameshift CDC73 mutations were detected in 13 samples suitable for DNA sequencing. Six of these mutations were germline. Loss of parafibromin expression was found in 17 samples. The presence of the CDC73 mutation as well as the loss of parafibromin predicted a high likelihood of subsequent recurrence and/or metastasis (92.3%, P=0.049 and 94.1%, P=0.0017 respectively), but only the latter was associated with a decreased overall 5- and 10-year survival rates (59%, P=0.107, and 23%, P=0.0026 respectively). The presence of both the CDC73 mutation and loss of parafibromin staining compared with their absence predicted a lower overall survival at 10- (18 vs 84%, P=0.016) but not at 5-year follow-up. In conclusion, loss of parafibromin staining, better than CDC73 mutation, predicts the clinical outcome and mortality rate. The added value of CDC73 mutational analysis is the possibility of identifying germline mutations, which will prompt the screening of other family members.

scholarly journals Attempting to disentangle the relationship between impulsivity and longitudinal self-harm: Epidemiological analysis of UK household survey data

2019 ◽  
Vol 65 (2) ◽  
pp. 114-122 ◽  
Author(s):  
Angharad N de Cates ◽  
Gennaro Catone ◽  
Paul Bebbington ◽  
Matthew R Broome
Keyword(s):  
Household Survey ◽  
Detailed Examination ◽  
Epidemiological Analysis ◽  
Mood Instability ◽  
Adult Psychiatry ◽  
Self Harm ◽  
Household Survey Data ◽  
The Relationship

Background: Impulsivity may be an important risk factor in terms of future self-harm. However, the extent of this, whether it may relate to self-harm that is new in onset and/or repetition of self-harm, and the detail of any interaction with mood instability (MI) and childhood sexual abuse (CSA) requires detailed examination. Aims: We used the 2000 Adult Psychiatry Morbidity Survey and an 18-month follow-up data to test hypotheses relating to the role of impulsivity, CSA and MI in the inception and persistence of self-harm. Methods: We assessed associations of impulsivity with (1) suicidal self-harm (SSH) and (2) non-SSH (NSSH) at baseline and follow-up, controlling for confounders including MI. Finally, we tested whether impulsivity mediated the relationship between CSA and self-harm. Results: A total of 8,580 respondents were assessed at baseline and 2,406 at follow-up as planned. Impulsivity significantly predicted emergence of new NSSH at 18-month follow-up even after adjustment for MI and other confounders. Impulsivity did not significantly predict repetition of NSSH, or repetition or new inception of SSH, even before inclusion of MI in the model. However, the absolute numbers involved were small. Cross-sectionally, impulsivity was a stronger mediator of the link between CSA and SSH (13.1%) than that between CSA and NSSH (4.8%). Conclusion: Impulsivity may increase the risk of future development of NSSH independently of MI, which is clinically important for risk assessment. The involvement of impulsivity in the repetition of self-harm generally appears less certain. However, impulsivity may have a role in SSH in the context of previous CSA.

scholarly journals Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up

2014 ◽  
Vol 205 (1) ◽  
pp. 60-67 ◽  
Author(s):  
A. I. Gumley ◽  
M. Schwannauer ◽  
A. Macbeth ◽  
R. Fisher ◽  
S. Clark ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Attachment Security ◽  
First Episode Psychosis ◽  
Adult Attachment Interview ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
The Relationship

BackgroundIncreasing evidence shows attachment security influences symptom expression and adaptation in people diagnosed with schizophrenia and other psychoses.AimsTo describe the distribution of secure and insecure attachment in a cohort of individuals with first-episode psychosis, and to explore the relationship between attachment security and recovery from positive and negative symptoms in the first 12 months.MethodThe study was a prospective 12-month cohort study. The role of attachment, duration of untreated psychosis (DUP), baseline symptoms and insight in predicting and mediating recovery from symptoms was investigated using multiple regression analysis and path analysis.ResultsOf the 79 participants, 54 completed the Adult Attachment Interview (AAI): 37 (68.5%) were classified as insecure, of which 26 (48.1%) were insecure/dismissing and 11 (20.4%) insecure preoccupied. Both DUP and insight predicted recovery from positive symptoms at 12 months. Attachment security, DUP and insight predicted recovery from negative symptoms at 12 months.ConclusionsAttachment is an important construct contributing to understanding and development of interventions promoting recovery following first-episode psychosis.

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