Assessment of treatment response in tuberculosis

Antibiotic treatment of tuberculosis has a duration of several months. There is significant variability of the host immune response and the pharmacokinetic-pharmacodynamic properties of Mycobacterium tuberculosis sub-populations at the site of disease. A limitation of sputum-based measures of treatment response may be sub-optimal detection and monitoring of Mycobacterium tuberculosis sub-populations. Potential biomarkers and surrogate endpoints should be benchmarked against hard clinical outcomes (failure/relapse/death) and may need tailoring to specific patient populations. Here, we assess the evidence supporting currently utilized and future potential host and pathogen-based models and biomarkers for monitoring treatment response in active and latent tuberculosis. Biomarkers for monitoring treatment response in extrapulmonary, pediatric and drug resistant tuberculosis are research priorities

Outcomes of Primary Endodontic Therapy in Medicaid Enrollees

The objective of this study was to determine factors affecting survival of teeth after nonsurgical root canal therapy (NSRCT) among enrollees of Wisconsin Medicaid during the years 2001-2009. Only permanent teeth with NSRCTs and that had permanent restorations within 60 days after treatment completion were included in the analysis. Patients with less than 60 days of insurance coverage after treatment completion were excluded. NSRCTs and untoward events (extraction) were identified based on Code on Dental Procedures and Nomenclature (CDT). Kaplan-Meier methods were used to plot the survival distribution for the overall cohort and subgroups by age, gender, race, tooth location, geographic area (urban vs. rural), and restoration type (crown vs. other). Univariate and multivariable Cox proportional hazards regression were used to model time from root canal restoration to extraction. The multiple regression model included all baseline covariates: age, gender, race, tooth location, geography, and restoration type. After applying the inclusion and exclusion criteria, 14,281 teeth among 11,788 patients were included in the final analysis. The overall 5-year survival rate was 88.67%. Survival rates were higher among younger individuals, males, anterior teeth, and when post-operative restoration was a crown as opposed to a filling. This study concludes that the success of primary endodontic therapy in a Medicaid population can be significantly improved by using post-operative crown restorations

Damage identification in structural health monitoring: a brief review from its implementation to the Use of data-driven applications

The damage identification process provides relevant information about the current state of a structure under inspection, and it can be approached from two different points of view. The first approach uses data-driven algorithms, which are usually associated with the collection of data using sensors. Data are subsequently processed and analyzed. The second approach uses models to analyze information about the structure. In the latter case, the overall performance of the approach is associated with the accuracy of the model and the information that is used to define it. Although both approaches are widely used, data-driven algorithms are preferred in most cases because they afford the ability to analyze data acquired from sensors and to provide a real-time solution for decision making; however, these approaches involve high-performance processors due to the high computational cost. As a contribution to the researchers working with data-driven algorithms and applications, this work presents a brief review of data-driven algorithms for damage identification in structural health-monitoring applications. This review covers damage detection, localization, classification, extension, and prognosis, as well as the development of smart structures. The literature is systematically reviewed according to the natural steps of a structural health-monitoring system. This review also includes information on the types of sensors used as well as on the development of data-driven algorithms for damage identification.Peer ReviewedPostprint (published version

A shared-parameter continuous-time hidden Markov and survival model for longitudinal data with informative dropout

A shared-parameter approach for jointly modeling longitudinal and survival data is proposed. With respect to available approaches, it allows for time-varying random effects that affect both the longitudinal and the survival processes. The distribution of these random effects is modeled according to a continuous-time hidden Markov chain so that transitions may occur at any time point. For maximum likelihood estimation, we propose an algorithm based on a discretization of time until censoring in an arbitrary number of time windows. The observed information matrix is used to obtain standard errors. We illustrate the approach by simulation, even with respect to the effect of the number of time windows on the precision of the estimates, and by an application to data about patients suffering from mildly dilated cardiomyopathy

Prediction Models for Cardiac Risk Classification with Nuclear Cardiology Techniques

Regression modeling strategies are increasingly used for the management of subjects with cardiovascular diseases as well as for decision-making of subjects without known disease but who are at risk of disease in the short- or long-term or during life span. Accurate individual risk assessment, taking in account clinical, laboratory, and imaging data is useful for choosing among prevention strategies and/or treatments. The value of nuclear cardiology techniques for risk stratification has been well documented. Many models have been proposed and are available for diagnostic and prognostic purposes and several statistical techniques are available for risk stratification. However, current approaches for prognostic modeling are not perfect and present limitations. This review analyzes some specific aspects related to prediction model development and validation

Aerospace Medicine and Biology. A continuing bibliography with indexes

This bibliography lists 244 reports, articles, and other documents introduced into the NASA scientific and technical information system in February 1981. Aerospace medicine and aerobiology topics are included. Listings for physiological factors, astronaut performance, control theory, artificial intelligence, and cybernetics are included

A proof-of-concept clinical trial using mesenchymal stem cells for the treatment of corneal epithelial stem cell deficiency

Producción CientíficaOcular stem cell transplantation derived from either autologous or allogeneic donor corneoscleral junction is a functional cell therapy to manage extensive and/or severe limbal stem cell deficiencies that lead to corneal epithelial failure. Mesenchymal stem cells have been properly tested in animal models of this ophthalmic pathology, but never in human eyes despite their potential advantages. We conducted a 6- to 12-month proof-of-concept, randomized, and double-masked pilot trial to test whether allogeneic bone marrow-derived mesenchymal stem cell transplantation (MSCT], n = 17) was as safe and as equally efficient as allogeneic cultivated limbal epithelial transplantation (CLET), (n = 11) to improve corneal epithelial damage due to limbal stem cell deficiency. Primary endpoints demanded combination of symptoms, signs, and the objective improvement of the epithelial phenotype in central cornea by in vivo confocal microscopy. This proof-of-concept trial showed that MSCT was as safe and efficacious as CLET. Global success at 6–12 months was 72.7%–77.8% for CLET cases and 76.5%–85.7% for MSCT cases (not significant differences). Central corneal epithelial phenotype improved in 71.4% and 66.7% of MSCT and CLET cases, respectively at 12 months (P = 1.000). There were no adverse events related to cell products. This trial suggests first evidence that MSCT facilitated improvement of a diseased corneal epithelium due to lack of its stem cells as efficiently as CLET. Consequently, not only CLET but also MSCT deserves more preclinical investigational resources before the favorable results of this proof-of-concept trial could be transformed into the larger numbers of the multicenter trials that would provide stronger evidence. (ClinicalTrials.gov number, NCT01562002.)Ministerio de Sanidad, Consumo y Bienestar Social (project SAS/2481/2009)Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla y León (grant SAN 1178/200)Red de Terapia Celular TerCel (project RD12/0019/0036

Implementing Structured Participation for Regional Level Waste Management Planning

The authors present a case study example of a well-structured public participation project that was incorporated into the formal decision-making process in Germany