scholarly journals Developing Threshold Parameters to Administer Live Vaccines in Cellular Immunodeficiency: A Survey of Practicing Clinical Immunologists

2021 ◽  
Author(s):  
Justine M. Ade ◽  
Avni Joshi
Keyword(s):  
The United States ◽  
Cd4 Count ◽  
Treatment Threshold ◽  
Live Vaccines ◽  
Future Studies ◽  
Mild Disease ◽  
Immune Deficiencies ◽  
Survey Results ◽  
Cellular Immunodeficiency ◽  
Question Survey

Abstract Live vaccines are contraindicated in patients with severe cellular immunodeficiencies while guidelines regarding the administration of live vaccines in patients with more mild disease are ill-defined. We sought to decipher different parameters used by practicing immunologists for the administration of live vaccines in cellular immunodeficiency patients. A 27-question survey assessing clinical and laboratory threshold parameters used in the administration of live vaccines to immunodeficient patients was distributed to practicing clinicians specializing in immune deficiencies. There were 83 survey respondents, 65% identified as female, and 71% were based in the United States. Allergy / Immunology and Immunodeficiency were the most common identified specialties, accounting for 84% of respondents. Most clinicians did administer live vaccines to patients with humoral (54/67; 80.6%), cellular (41/67; 61.2%), and combined diseases (37/67; 55.2%) . Most clinicians who reported giving live vaccines to patients with immune deficiencies considered a threshold CD4 count of ≥ 400 cells/mm3 (MMR 48/60 [80%], Varicella 42/53 [79%], Rotavirus 40/45 [88.89%]), a CD8 count of ≥ 250 cells/mm3 (MMR 30/39 [76.92%], Varicella 29/37 [78.34%], Rotavirus 27/34 [79.41%]), and normal mitogen function (MMR 44/53 [83.02%], Varicella 40/48 [83.33%], Rotavirus 37/40 [92.5%]). Using these survey results, we propose a treatment threshold of using CD4 count of ≥ 400 cells/mm3, a CD8 count of ≥ 250 cells/mm3, and normal lymphocyte proliferative responses to mitogen. Future studies are needed to determine clinical efficacy and safety using these thresholds.

scholarly journals ArcGIS Urban: an application for plan assessment

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ellen Soward ◽  
Jianling Li
Keyword(s):  
United States ◽  
The United States ◽  
Spatial Context ◽  
Future Studies ◽  
Planning Profession ◽  
Gis Tools ◽  
Comprehensive Plans ◽  
Near Future ◽  
The City

AbstractMost cities in the United States rely on zoning to address important planning-related issues within their jurisdictions. Planners often use GIS tools to analyze these issues in a spatial context. ESRI’s ArcGIS Urban software seeks to provide the planning profession with a GIS-based solution for various challenges, including zoning’s impacts on the built environment and housing capacity.This research explores the use of ArcGIS Urban for assessing the existing zoning and comprehensive plans in meeting the projected residential growth in the near future using the City of Arlington, Texas as a case study. The exploration provides examples and lessons for how ArcGIS Urban might be used by planners to accomplish their tasks and highlights the capabilities and limitations of ArcGIS Urban in its current stand. The paper is concluded with some suggestions for future studies.

scholarly journals 652. Comparison of fosfomycin (FOF) activity and prevalence of subpopulations between Escherichia coli (EC) and Klebsiella pneumoniae (KP) during susceptibility testing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S384-S384
Author(s):  
Jadyn C Anderson ◽  
Amanda R Krueger ◽  
Elizabeth C Smith ◽  
Morgan L Bixby ◽  
Hunter V Brigman ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Inhibitory Concentration ◽  
Panel Member ◽  
Colony Growth ◽  
The United States ◽  
Research Support ◽  
Review Panel ◽  
Agreement Rate ◽  
Future Studies ◽  
Agar Dilution

Abstract Background In the United States, interpretive criteria for FOF are established only for EC, yet those criteria are often extrapolated to KP. Recent studies have highlighted both inferior clinical outcomes after FOF treatment and difficulties in interpretation of inner colony subpopulations, the presence of which may affect clinical efficacy. We sought to compare FOF activity against EC and KP and to determine the prevalence of inner colony subpopulations following disk diffusion (DD) testing of the two species. Methods A convenience collection of 73 KP and 42 EC isolates from 3 U.S. institutions were included. Minimal inhibitory concentration (MIC) testing was performed in duplicate on separate days using agar dilution (AD) and DD as recommended by the Clinical and Laboratory Standards Institute guidelines, with application of EC susceptibility (≤ 64mg/L) breakpoints. The frequency and counts of inner colonies observed during DD testing was calculated, and colonies were subcultured for use in future studies. Results MIC50/90 values were 1/16 mg/L and 32/256 mg/L for EC and KP respectively. All EC isolates were considered susceptible and therefore categorical agreement was 100%. The majority of KP isolates were considered susceptible (83.6% with AD and 86.3% with DD) and categorical agreement between the methods was 84.9%. Inner colonies were observed during DD testing in 88.1% of EC isolates and 80.8% of KP isolates during at least one replicate, with 47.6% of EC isolates and 39.7% of KP isolates showing inner colony growth during both DD test replicates. More than 10 inner colonies were observed in 50% of EC isolates compared to 12.3% of KP isolates. Conclusion KP isolates demonstrated considerably higher FOF MIC values compared to EC, as evidenced by MIC50/90 values 4-5 dilutions higher than those for EC. The categorical agreement rate was higher among EC than KP, highlighting concerns regarding the practice of extrapolating FOF susceptibility breakpoints for EC to KP. The high frequency of inner colonies observed in DD for both species necessitates further studies to determine best practices for interpreting their relevance, fitness, and resistance in order to identify potential impacts to clinical efficacy of FOF. Disclosures Elizabeth B. Hirsch, PharmD, Merck (Grant/Research Support)Nabriva Therapeutics (Advisor or Review Panel member)

Greener than Others? Exploring Generational Differences in Green Purchase Intent

2021 ◽  
pp. 147078532110341
Author(s):  
Chang-Dae Ham ◽  
Un Chae Chung ◽  
Woo Jin Kim ◽  
Seo Yoon Lee ◽  
Sang-Hwa Oh
Keyword(s):  
Generational Differences ◽  
Social Intelligence ◽  
The United States ◽  
Purchase Intentions ◽  
Generation Gap ◽  
Purchase Intent ◽  
Consumer Socialization ◽  
Survey Results ◽  
Nationally Representative ◽  
Practical Implications

This study explored the generation gap in American consumers’ green perceptions and purchase intentions across four generations (Gen Z, Y, X, and Baby Boomers) from the perspectives of consumer socialization and social intelligence. Analyzing a nationally representative sample of adults in the United States ( N = 19,450), the survey results revealed that the American consumer’s green norms and beliefs varied by generation. A series of multiple regression analyses showed that each generation had similar but idiosyncratic beliefs in purchasing products from green companies. Theoretical and practical implications are discussed.

Is Vascularized Composite Allograft Transplantation Experimental or an Accepted Surgical Procedure: Results from a National Survey

2020 ◽  
Vol 36 (04) ◽  
pp. 276-280
Author(s):  
Salih Colakoglu ◽  
Seth Tebockhorst ◽  
David Woodbridge Mathes
Keyword(s):  
Clinical Investigation ◽  
The United States ◽  
Representative Sampling ◽  
Electronic Survey ◽  
Internal Review ◽  
Vascularized Composite Allograft ◽  
American Society ◽  
Question Survey ◽  
Internal Review Board

Abstract Background More than 85 patients have received over 100 hand/arm transplants and more than 35 patients have received full or partial face transplants at institutions around the world. Given over two decades of experience in the field and in the light of successful outcomes with up to 17 years follow up time, should we still consider vascularized composite allograft (VCA) as a research/clinical investigation? We present the results of a nationwide electronic survey whose intent was to gather institutional bias with regard to this question. Methods An 11 question survey that was developed by VCA advisory committee of American Society of Transplantation was sent to all identified Internal Review Board chairs or directors in the United States. Results We received a total of 54 responses (25.3%) to the survey. The majority (78%) of responses came from either the chairperson, director, or someone who is administratively responsible for an IRB. Conclusion Though certainly not an exhaustive investigation into each institution's preference, we present a representative sampling. The results of which favor VCA as an accepted clinical procedure given the appropriate setting. Further research is needed to fully ascertain practices at each individual institution.

Health Care Cost Containment in Large American Cities

1989 ◽  
Vol 18 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Perry Moore
Keyword(s):  
Health Care ◽  
Cost Containment ◽  
Local Governments ◽  
Health Care Cost ◽  
The United States ◽  
Public Agencies ◽  
The Public ◽  
Survey Results ◽  
The Cost ◽  
American Cities

This research provides information about the health care cost containment efforts of local governments and agencies across the United States, particularly in large American cities. Survey results indicate that while the public sector lags behind the private sector, public agencies are beginning to match the cost containment efforts of private employers. While initiation of these efforts represents considerable recent progress, their tangible benefits are not yet apparent.

Letters to the Editor

PEDIATRICS ◽  
1957 ◽  
Vol 20 (5) ◽  
pp. 918-919
Author(s):  
AIMS C. MCGUINNESS
Keyword(s):  
United States ◽  
Bacterial Infections ◽  
The United States ◽  
The State ◽  
Letters To The Editor ◽  
Mild Disease ◽  
The Individual

I certainly agree with Dr. Dietrich that Asian influenza thus far has been a mild disease and not too serious a problem for the individual. Dr. Burney has pointed this out on a number of occasions, as, for example, in his remarks before the State and Territorial Health Officers on August 27. I agree, too, that the availability of antibiotics to deal with secondary bacterial infections should, to a great extent, minimize the severity of any epidemic in the United States.

Identifying New Directions for African Studies: Methodology Report and Survey Results

2002 ◽  
Vol 30 (2) ◽  
pp. 76-88
Author(s):  
Larry W. Bowman ◽  
Diana T. Cohen
Keyword(s):  
United States ◽  
Graduate Students ◽  
The United States ◽  
African Studies ◽  
The Internet ◽  
Coverage Error ◽  
New Directions ◽  
Survey Results

The sample frame was constructed over several months through the combined efforts of three graduate students and Prof. Larry W. Bowman. Using the Internet whenever possible, and backed by the assistance of colleagues from many institutions, we constructed a sample frame of 1,793 U.S.-based Africanists. Our sample frame includes 46 percent more Africanists than the 1,229 individual U.S. members of the African Studies Association (ASA) in 2001 (1,112 individual members and 117 lifetime members). In all cases we allowed institutions to self-define who they considered their African studies faculty to be. By assembling this broad sample frame of African studies faculty, we probe more deeply into the national world of African studies than can be done even through a membership survey of our largest and most established national African studies organization. The sample frame for this study approximates a full enumeration of the Africanist population in the United States. Therefore, data collected from samples drawn from this frame can with some confidence be generalized to all Africanists in the United States, with minimal coverage error.

Abstract 5921: Medicare Beneficiaries with Mild to Severe Heart Failure See 15–23 Different Providers Annually

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Robert L Page ◽  
Christopher Hogan ◽  
Kara Strongin ◽  
Roger Mills ◽  
JoAnn Lindenfeld
Keyword(s):  
Heart Failure ◽  
Severe Heart Failure ◽  
The United States ◽  
Outpatient Setting ◽  
Fiscal Year ◽  
Hospital Inpatient ◽  
Medicare Beneficiaries ◽  
Improvement Program ◽  
Data Set ◽  
Mild Disease

In fiscal year 2003, Medicare beneficiaries with heart failure (HF) accounted for 37% of all Medicare spending and nearly 50% of all hospital inpatient costs. On average, each beneficiary had 10.3 outpatient and 2 inpatient visits specifically for HF. Despite significant improvements in medical care for HF, mortality and hospital admissions remain high. No data exist regarding the number of providers ordering and providing care for this population. An analysis of fiscal year 2005 Medicare claims was conducted, using a 5% sample standard analytic and denominator file, limited data set version to extrapolate the 34,150,200 Medicare beneficiaries. Three cohorts were defined according to mild, moderate, severe HF employing the Centers for Medicare and Medicaid Services Hierarchical Condition Categories Model and Chronic Care Improvement Program definitions. HMO enrollees, persons without Part A and Part B coverage, and those outside the United States were excluded. We identified physicians by using the unique physician identification number of performing physicians. Based on inclusion criteria, 173,863 beneficiaries were identified. The average number of providers providing care in all sites were 15.9, 18.6, 23.1 for beneficiaries with mild, moderate, and severe HF, respectively; and 10.1, 11.5, and 12.1 in the outpatient setting, respectively. The average number of providers ordering care in all sites consisted of 8.3, 9.6, and 11.2 for beneficiaries with mild, moderate, and severe HF, respectively; and 6.5,7.3, and 7.8 in the outpatient setting, respectively. For beneficiaries with mild disease, only 10% of all office visits were specifically for HF, while those with moderate or severe disease, only 20% were specifically for HF. Medicare beneficiaries with HF, even those with mild disease, have a large number of providers ordering and providing care. These data highlight the importance for developing systems and processes of coordinated care for this population.

scholarly journals #GERIATRICS: AN ANALYSIS OF THE IMPACT OF THE GERIATRICS TWITTER NETWORK

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S337-S337
Author(s):  
Varun Ayyaswami ◽  
Arpan Prabhu ◽  
Steven Gambert
Keyword(s):  
Network Analysis ◽  
Geriatric Medicine ◽  
The United States ◽  
Annual Growth ◽  
Social Media Analytics ◽  
User Characteristics ◽  
Future Studies ◽  
Digital Community ◽  
Support Organizations ◽  
The Impact

Abstract Twitter connects an international community of healthcare stakeholders, potentially augmenting access to information related to geriatric medicine. The purpose of this study is to analyze the geriatric medicine Twitter network, and we hypothesize this community has substantially grown in the last six years. We analyzed all publicly available tweets including the hashtag #geriatrics from January 1, 2013-January 1, 2019 using Symplur Signals, a health care social media analytics platform. We evaluated #geriatrics metrics over time related to activity, content analysis, user characteristics, engagement, and network analysis. A total of 159,008 tweets (containing 42.8% re-tweets) with the hashtag #geriatrics were written by 29,443 users, resulting in 393.6 million impressions. The number of tweets increased from 9,705 in 2013 to 39,151 in 2018 (32.2% compound annual growth); users increased from 3,366 in 2013 to 29,443 in 2018 (55.3% compound annual growth). Users were primarily found in the United States, United Kingdom, and Canada. The most commonly trending topic from 2013-2015 and from 2016-2018 was ‘older adults’. The top hashtags included in tweets with #geriatrics were #job, #aging, and #hpm (hospice and palliative medicine). Network analysis showed central hubs to be medical journals, provider organizations, individual physicians, and individual advocates. The top 150 influencers consisted primarily of physicians (49.1%), advocate/support organizations (13.8%), and media organizations (6.3%). The use of Twitter to promote geriatric medicine using #geriatrics has matured into an international digital community of interest. Future studies should examine hashtags related to age prevalent illnesses and hashtags likely to be used by patients.

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