Does morbidity matter? Perceived health status in explaining the share of healthcare expenditures

Cataloged from PDF version of article.We argue that the demand for healthcare services can be better explained by individual need based variables rather than by macro variables such as the Gross Domestic Product (GDP) per capita and the share of public healthcare expenditures. This study introduces a self-rated health variable called morbidity that describes individual needs for health care - healthy individuals need less health care than sick ones - and that is measured through personal interviews conducted by the Organization for Economic Co-operation and Development (OECD). In addition, stationary properties of the series are considered in order to understand the effect of shocks to expenditure behaviour on health care. Stationary test results show that we should not only use differenced values for the model variables but also incorporate time-specific effects into the model. Using the appropriate specification and accounting for the time effect, we find evidence supporting the hypothesis that the share of healthcare expenditure in GDP rises with the increased need for health care. The need for health care is also found to be more important than per capita GDP when explaining the change in the share of healthcare expenditures for the examined countries

Identification of Animal Species and Foreign Tissues in Ready-to-Sell Fresh Processed Meat Products

The demand for ready-to-eat meat products has recently increased, and routine controls are inevitable to provide food safety. Therefore, a total of 250 fresh processed beef meat products collected from local markets and restaurants in the districts of Istanbul mostly with low purchasing power were investigated by histological and biomolecular methods. Chicken tissue was found in 62 (24.8%) of the analysed samples and horse tissue was found in 2 (0.8%) samples, while pork tissue was not detected. Additionally, foreign tissues were detected in 70 (28%) of 250 samples. PCR assays combined with histological examinations can be used as an important method in establishing food safety by determining the deliberate or accidental adulterations of meat products

Effectiveness of 2-D Views for 6-D Robotics Simulation Maneuvers

This study examined operator performance on 6-D robotics simulation maneuvers using a single 2-D view of the robot arm. The BORIS simulator, developed by NASA to support Generic Robotics Training, was used to present four “fly-to” tasks with views representing combinations of good and poor control-display movement compatibility and perceptual quality. Translational (x, y, z) and rotational (pitch, yaw, roll) accuracies were used to assess performance. A significant interaction between movement compatibility and perceptual quality was found for both the overall translational and y accuracy measures (p = 0.0289 and p = 0.0155, respectively). This interaction appeared to indicate that performance was hindered only if both factors were poor. Perceptual quality significantly affected the z accuracy and pitch accuracy measures (p = 0.0461 and p = 0.0429, respectively) with the views identified as poor perceptual quality actually yielding better performance. These results suggest that performance on a 6-D robotics maneuver is not necessarily hindered by using only a 2-D view. If a single view cannot simultaneously provide both good movement compatibility and good perceptual quality, the results suggest that either one is sufficient with respect to overall translational accuracy.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Meeting the Challenges Facing Wheat Production The Strategic Research Agenda of the Global Wheat Initiative

Wheat occupies a special role in global food security since, in addition to providing 20% of our carbohydrates and protein, almost 25% of the global production is traded internationally. The importance of wheat for food security was recognised by the Chief Agricultural Scientists of the G20 group of countries when they endorsed the establishment of the Wheat Initiative in 2011. The Wheat Initiative was tasked with supporting the wheat research community by facilitating col-laboration, information and resource sharing and helping to build the capacity to address chal-lenges facing production in an increasingly variable environment. Many countries invest in wheat research. Innovations in wheat breeding and agronomy have delivered enormous gains over the past few decades, with the average global yield increasing from just over 1 tonne per hectare in the early 1960s to around 3.5 tonnes in the past decade. These gains are threatened by climate change, the rapidly rising financial and environmental costs of fertilizer, and pesticides, combined with declines in water availability for irrigation in many regions. The international wheat research community has worked to identify major opportunities to help ensure that global wheat pro-duction can meet demand. The outcomes of these discussions are presented in this paper

US-triggered Microbubble Destruction for Augmenting Hepatocellular Carcinoma Response to Transarterial Radioembolization: A Randomized Pilot Clinical Trial.

Combined US-triggered microbubble destruction and hepatocellular carcinoma radioembolization showed improved treatment response compared with radioembolization alone and no changes in vital signs or liver function. Background US contrast agents are gas-filled microbubbles (MBs) that can be locally destroyed by using external US. Among other bioeffects, US-triggered MB destruction, also known as UTMD, has been shown to sensitize solid tumors to radiation in preclinical models through localized insult to the vascular endothelial cells. Purpose: To evaluate the safety and preliminary efficacy of combining US-triggered MB destruction and transarterial radioembolization (TARE) in participants with hepatocellular carcinoma (HCC). Materials and Methods: In this pilot clinical trial, participants with HCC scheduled for sublobar TARE were randomized to undergo either TARE or TARE with US-triggered MB destruction 1–4 hours and approximately 1 and 2 weeks after TARE. Enrollment took place between July 2017 and February 2020. Safety of US-triggered MB destruction was evaluated by physiologic monitoring, changes in liver function tests, adverse events, and radiopharmaceutical distribution. Treatment efficacy was evaluated by using modified Response Evaluation Criteria in Solid Tumors (mRECIST) on cross-sectional images, time to required next treatment, transplant rates, and overall survival. Differences across mRECIST reads were compared by using a Mann-Whitney U test, and the difference in prevalence of tumor response was evaluated by Fisher exact test, whereas differences in time to required next treatment and overall survival curves were compared by using a log-rank (Mantel-Cox) test. Results: Safety results from 28 participants (mean age, 70 years ± 10 [standard deviation]; 17 men) demonstrated no significant changes in temperature (P = .31), heart rate (P = .92), diastolic pressure (P = .31), or systolic pressure (P = .06) before and after US-triggered MB destruction. No changes in liver function tests between treatment arms were observed 1 month after TARE (P \u3e .15). Preliminary efficacy results showed a greater prevalence of tumor response (14 of 15 [93%; 95% CI: 68, 100] vs five of 10 [50%; 95% CI: 19, 81]; P = .02) in participants who underwent both US-triggered MB destruction and TARE (P = .02). Conclusion: The combination of US-triggered microbubble destruction and transarterial radioembolization is feasible with an excellent safety profile in this patient population and appears to result in improved hepatocellular carcinoma treatment response

Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care

<p>Abstract</p> <p>Background</p> <p>Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable.</p> <p>Discussion</p> <p>While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders.</p> <p>Summary</p> <p>Integrated PHRs promote active, ongoing patient collaboration in care delivery and decision making. With some exceptions, however, the integrated PHR model is still a theoretical framework for consumer-centric health care. The authors pose questions that need to be answered so that the field can move forward to realize the potential of integrated PHRs. How can integrated PHRs be moved from concept to practical application? Would a coordinating body expedite this progress? How can existing initiatives and policy levers serve as catalysts to advance integrated PHRs?</p

Congenital Diarrhea and Cholestatic Liver Disease: Phenotypic Spectrum Associated with MYO5B Mutations.

Myosin Vb (MYO5B) is a motor protein that facilitates protein trafficking and recycling in polarized cells by RAB11- and RAB8-dependent mechanisms. Biallelic MYO5B mutations are identified in the majority of patients with microvillus inclusion disease (MVID). MVID is an intractable diarrhea of infantile onset with characteristic histopathologic findings that requires life-long parenteral nutrition or intestinal transplantation. A large number of such patients eventually develop cholestatic liver disease. Bi-allelic MYO5B mutations are also identified in a subset of patients with predominant early-onset cholestatic liver disease. We present here the compilation of 114 patients with disease-causing MYO5B genotypes, including 44 novel patients as well as 35 novel MYO5B mutations, and an analysis of MYO5B mutations with regard to functional consequences. Our data support the concept that (1) a complete lack of MYO5B protein or early MYO5B truncation causes predominant intestinal disease (MYO5B-MVID), (2) the expression of full-length mutant MYO5B proteins with residual function causes predominant cholestatic liver disease (MYO5B-PFIC), and (3) the expression of mutant MYO5B proteins without residual function causes both intestinal and hepatic disease (MYO5B-MIXED). Genotype-phenotype data are deposited in the existing open MYO5B database in order to improve disease diagnosis, prognosis, and genetic counseling