Pioglitazone, an Insulin Sensitizing Drug, Attenuates the Development of Kidney and Liver Disease in the PCK Rodent Model of Polycystic Kidney Disease

poster abstractPolycystic kidney disease is a genetic disorder characterized by growth of fluid-filled cysts predominately in kidney and liver. The only treatment currently available is the removal/aspiration of the largest cysts or organ transplantation. Promising pharmaceutical agents in clinical trials interfere with the action of hormones that increase cAMP thereby inhibiting secretion of Cl-, and compensatory fluid flux, into the cysts. Other treatments proposed include chemotherapeutic and immunosuppressive drugs that interfere with cellular proliferation as well as with signaling pathways for Cl- secretion. Long-term use of these agents will have multiple side effects. Based on a recent observation that peroxisome proliferator activated receptor γ agonists such as Actos (pioglitazone) and Avandia (rosiglitazone) decrease mRNA levels of a Cl- transport protein and the Cl- secretory response to vasopressin stimulation in cultured renal cells, it is hypothesized that PPARγ agonists will inhibit cyst growth. The current studies show that a 7 or 14 week feeding regimen of 20 mg/Kg BW pioglitazone inhibits renal and hepatic bile duct cyst growth in a rodent model orthologous to human PKD. In addition, the degree of renal cortical fibrosis was diminished in the pioglitazone-treated animals after 14 weeks. These results suggest that PPARγ agonists may be effective in controlling both renal and hepatic cyst growth and renal fibrotic development in polycystic kidney disease

User-centered virtual environment design for virtual rehabilitation

<p>Abstract</p> <p>Background</p> <p>As physical and cognitive rehabilitation protocols utilizing virtual environments transition from single applications to comprehensive rehabilitation programs there is a need for a new design cycle methodology. Current human-computer interaction designs focus on usability without benchmarking technology within a user-in-the-loop design cycle. The field of virtual rehabilitation is unique in that determining the efficacy of this genre of computer-aided therapies requires prior knowledge of technology issues that may confound patient outcome measures. Benchmarking the technology (e.g., displays or data gloves) using healthy controls may provide a means of characterizing the "normal" performance range of the virtual rehabilitation system. This standard not only allows therapists to select appropriate technology for use with their patient populations, it also allows them to account for technology limitations when assessing treatment efficacy.</p> <p>Methods</p> <p>An overview of the proposed user-centered design cycle is given. Comparisons of two optical see-through head-worn displays provide an example of benchmarking techniques. Benchmarks were obtained using a novel vision test capable of measuring a user's stereoacuity while wearing different types of head-worn displays. Results from healthy participants who performed both virtual and real-world versions of the stereoacuity test are discussed with respect to virtual rehabilitation design.</p> <p>Results</p> <p>The user-centered design cycle argues for benchmarking to precede virtual environment construction, especially for therapeutic applications. Results from real-world testing illustrate the general limitations in stereoacuity attained when viewing content using a head-worn display. Further, the stereoacuity vision benchmark test highlights differences in user performance when utilizing a similar style of head-worn display. These results support the need for including benchmarks as a means of better understanding user outcomes, especially for patient populations.</p> <p>Conclusions</p> <p>The stereoacuity testing confirms that without benchmarking in the design cycle poor user performance could be misconstrued as resulting from the participant's injury state. Thus, a user-centered design cycle that includes benchmarking for the different sensory modalities is recommended for accurate interpretation of the efficacy of the virtual environment based rehabilitation programs.</p

China's Health System Reform, Progress, Challenges

Video of full lecture with presentation slides edited into the video.Karen Eggelston, Director, Stanford Asia Health Policy Program - Starting with a historical overview, this talk focuses on China’s 21st century health system reforms, including progress to date in achieving effective universal coverage, priorities set in the national health meetings, “Healthy China 2030” goals, and local experiments in strengthening patient-centered integrated care. Eggleston summarizes recent health economics research assessing the impact of health insurance and primary care reforms, and discuss numerous challenges, including addressing the social determinants of health and disparities, fostering healthy aging, and assuring quality and accountability while improving efficiency and value.Cornell East Asia Program1_t0fq2e9

The Death Penalty and Sixth Amendment Right to a Jury Trial for Accomplices and Individuals Convicted of Felony Murder

The Death Penalty and Sixth Amendment Right to a Jury Trial for Accomplices and Individuals Convicted of Felony Murde

Estimating the global abundance of ground level presence of particulate matter (PM2.5)

With the increasing awareness of the health impacts of particulate matter, there is a growing need to comprehend the spatial and temporal variations of the global abundance of ground level airborne particulate matter with a diameter of 2.5 microns or less (PM2.5). Here we use a suite of remote sensing and meteorological data products together with groundbased observations of particulate matter from 8,329 measurement sites in 55 countries taken 1997-2014 to train a machinelearning algorithm to estimate the daily distributions of PM2.5 from 1997 to the present. In this first paper of a series, we present the methodology and global average results from this period and demonstrate that the new PM2.5 data product can reliably represent global observations of PM2.5 for epidemiological studies