The relationship between healthcare services and financial burden among families of children with autism spectrum disorders: A US perspective

OBJECTIVE: The research was designed to determine the financial burden among families of children with ASD and to identify the predictors of financial burden METHODS: Children with a confirmed diagnosis of ASD were identified in the Interaction Autism Network Registry. Multiple regression analyses was used to determine the association between financial burden and coordination of care, quality of healthcare interactions, adequacy of insurance, and adequacy of medical insurance coverage RESULTS: Families of children diagnosed as having ASD reported higher financial burden as compared to other developmental disorders. The financial burden was significantly associated with various facets of healthcare provision CONCLUSIONS: The findings highlight the role of coordinated care, access to care, and quality of healthcare interactions in improving caregiver burde

Strategy for scaling semi-continuous downstream and integration of process analytical tools for monoclonal antibody toxicology

Currently, continuous processing for biologics is being pursued from a technology perspective in order to increase productivity and decrease cost of manufacture. Disruptive technologies, such as PCC (Periodic Counter-current Chromatography), have been researched extensively in order to reduce the bottleneck for the downstream capture chromatography step. However, there is extremely limited knowledge in how to scale these disruptive technologies for clinical and commercial manufacturing. In this presentation, we demonstrate a strategy for scaling and integration of a PCC capture step into a semi-continuous downstream process (Protein A chromatography-Viral inactivation-Filtration-Anion exchange chromatography). Harvest cell culture fluid (HCCF) feed streams ranging from 0.5 – 1 kg of various subclasses of IgG antibodies was purified using this integration process to generate material for toxicology studies. The process parameters on PCC for each mAb is matched to the process parameters in batch mode except for loading. The productivity (g/L-1 hr-1), product quality and yield are compared to the small scale semi-continuous operations and traditional batch mode operation. The use of PAT (Process Analytical Tools) for monitoring real time product quality and processing is also described

Highly Sensitive Detection of Staphylococcus aureus Directly from Patient Blood

Background: Rapid detection of bloodstream infections (BSIs) can be lifesaving. We investigated the sample processing and assay parameters necessary for highly-sensitive detection of bloodstream bacteria, using Staphylococcus aureus as a model pathogen and an automated fluidic sample processing – polymerase chain reaction (PCR) platform as a model diagnostic system. Methodology/Principal Findings: We compared a short 128 bp amplicon hemi-nested PCR and a relatively shorter 79 bp amplicon nested PCR targeting the S. aureus nuc and sodA genes, respectively. The sodA nested assay showed an enhanced limit of detection (LOD) of 5 genomic copies per reaction or 10 colony forming units (CFU) per ml blood over 50 copies per reaction or 50 CFU/ml for the nuc assay. To establish optimal extraction protocols, we investigated the relative abundance of the bacteria in different components of the blood (white blood cells (WBCs), plasma or whole blood), using the above assays. The blood samples were obtained from the patients who were culture positive for S. aureus. Whole blood resulted in maximum PCR positives with sodA assay (90 % positive) as opposed to cell-associated bacteria (in WBCs) (71 % samples positive) or free bacterial DNA in plasma (62.5 % samples positive). Both the assays were further tested for direct detection of S. aureus in patient whole blood samples that were contemporaneous culture positive. S. aureus was detected in 40/45 of culture-positive patients (sensitivity 89%, 95 % CI 0.75–0.96) and 0/59 negative controls with the sodA assay (specificit

Uptake and yield of HIV testing and counselling among children and adolescents in sub-Saharan Africa: a systematic review.

INTRODUCTION: In recent years children and adolescents have emerged as a priority for HIV prevention and care services. We conducted a systematic review to investigate the acceptability, yield and prevalence of HIV testing and counselling (HTC) strategies in children and adolescents (5 to 19 years) in sub-Saharan Africa. METHODS: An electronic search was conducted in MEDLINE, EMBASE, Global Health and conference abstract databases. Studies reporting on HTC acceptability, yield and prevalence and published between January 2004 and September 2014 were included. Pooled proportions for these three outcomes were estimated using a random effects model. A quality assessment was conducted on included studies. RESULTS AND DISCUSSION: A total of 16,380 potential citations were identified, of which 21 studies (23 entries) were included. Most studies were conducted in Kenya (n=5) and Uganda (n=5) and judged to provide moderate (n=15) to low quality (n=7) evidence, with data not disaggregated by age. Seven studies reported on provider-initiated testing and counselling (PITC), with the remainder reporting on family-centred (n=5), home-based (n=5), outreach (n=5) and school-linked HTC among primary schoolchildren (n=1). PITC among inpatients had the highest acceptability (86.3%; 95% confidence interval [CI]: 65.5 to 100%), yield (12.2%; 95% CI: 6.1 to 18.3%) and prevalence (15.4%; 95% CI: 5.0 to 25.7%). Family-centred HTC had lower acceptance compared to home-based HTC (51.7%; 95% CI: 10.4 to 92.9% vs. 84.9%; 95% CI: 74.4 to 95.4%) yet higher prevalence (8.4%; 95% CI: 3.4 to 13.5% vs. 3.0%; 95% CI: 1.0 to 4.9%). School-linked HTC showed poor acceptance and low prevalence. CONCLUSIONS: While PITC may have high test acceptability priority should be given to evaluating strategies beyond healthcare settings (e.g. home-based HTC among families) to identify individuals earlier in their disease progression. Data on linkage to care and cost-effectiveness of HTC strategies are needed to strengthen policies

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Going Green at Rutgers UniversitySpring 201

Analytical sensitivity of the <i>nuc</i> and <i>sodA</i> assays for the detection of <i>Staphylococcus aureus</i> genomic DNA (A) and <i>S. aureus</i> cells spiked in blood (B).

<p>Analytical sensitivity of the <i>nuc</i> and <i>sodA</i> assays for the detection of <i>Staphylococcus aureus</i> genomic DNA (A) and <i>S. aureus</i> cells spiked in blood (B).</p

Blood components study processing schematic.

<p>CBC blood from patients with blood culture positive for <i>S. aureus</i> was divided into 1 ml each for detection of <i>S. aureus</i> load in plasma, white blood cells (WBCs) and whole blood. Plasma was processed using a column based resin (CBR) cartridge. WBCs and whole blood was processed in a filter based (FB) cartridge.</p