The Impact of Disability: A Comparative Approach to Medical Resource Allocation in Public Health Emergencies

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people. A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when demand exceeds supply. We previously evaluated the protocols public health and medical organizations have promulgated to guide allocation decisions in a public health emergency. We concluded that many of these protocols violate U.S. law and ethics with respect to people with disabilities, because they exclude some people with disabilities from receiving care altogether or because of a need for prolonged use of resources, poor “quality of life,” or limited long-term prognosis. Because the legal and social status of people with disabilities is tied to underlying societal attitudes toward impairments, cultural differences between populations may lead to significantly different distributive outcomes. In this paper, we examine other countries’ approaches to the allocation problem in public health emergencies, both to identify other approaches to these challenging problems and to provide insight into how to develop more equitable policies to guide allocation decisions during a public health emergency in the U.S

Detachable force sensor for an ultrasound probe to improve rotator cuff injury diagnosis

Rotator cuff disease, common in elderly persons and athletes, is resultant of repetitive use of shoulder muscles or sudden impact to the area. The spectrum of injury ranges from tendonitis to a complete tear of the rotator cuff tendon which results in a myriad of treatments. Even though ultrasound is one of the most frequently used imaging techniques to diagnose this disease, it lacks contextual information and consistency needed for an accurate treatment plan. We are creating an ultrasound probe attachment using pressure sensing pads to measure force applied during imaging. Using our pads, we measured the change in resistance across the pad which can be used with pre-existing ultrasound imaging data to calculate the Young\u27s Modulus of the tissue. We hope this will provide more consistency in characterizing the rotator cuff. For the clinician, having this additional information may help to determine the extent of the injury and be beneficial in determining the appropriate treatment

Genome-Wide Identification and Immune Response Analysis of Serine Protease Inhibitor Genes in the Silkworm, Bombyx mori

In most insect species, a variety of serine protease inhibitors (SPIs) have been found in multiple tissues, including integument, gonad, salivary gland, and hemolymph, and are required for preventing unwanted proteolysis. These SPIs belong to different families and have distinct inhibitory mechanisms. Herein, we predicted and characterized potential SPI genes based on the genome sequences of silkworm, Bombyx mori. As a result, a total of eighty SPI genes were identified in B. mori. These SPI genes contain 10 kinds of SPI domains, including serpin, Kunitz_BPTI, Kazal, TIL, amfpi, Bowman-Birk, Antistasin, WAP, Pacifastin, and alpha-macroglobulin. Sixty-three SPIs contain single SPI domain while the others have at least two inhibitor units. Some SPIs also contain non-inhibitor domains for protein-protein interactions, including EGF, ADAM_spacer, spondin_N, reeler, TSP_1 and other modules. Microarray analysis showed that fourteen SPI genes from lineage-specific TIL family and Group F of serpin family had enriched expression in the silk gland. The roles of SPIs in resisting pathogens were investigated in silkworms when they were infected by four pathogens. Microarray and qRT-PCR experiments revealed obvious up-regulation of 8, 4, 3 and 3 SPI genes after infection with Escherichia coli, Bacillus bombysepticus, Beauveria bassiana or B. mori nuclear polyhedrosis virus (BmNPV), respectively. On the contrary, 4, 11, 7 and 9 SPI genes were down-regulated after infection with E. coli, B. bombysepticus, B. bassiana or BmNPV, respectively. These results suggested that these SPI genes may be involved in resistance to pathogenic microorganisms. These findings may provide valuable information for further clarifying the roles of SPIs in the development, immune defence, and efficient synthesis of silk gland protein

In-line Bragg magnifier based on v-shaped germanium crystals

In this work an X-ray imaging system based on a recently developed in-line two-dimensional Bragg magnifier composed of two monolithic V-shaped crystals made of dislocation-free germanium is presented. The channel-cut crystals were used in one-dimensional and in two-dimensional (crossed) configurations in imaging applications and allowed measurement of phase-contrast radiograms both in the edge-enhanced and in the holographic regimes. The measurement of the phase gradient in two orthogonal directions is demonstrated. The effective pixel size attained was 0.17 mu m in the one-dimensional configuration and 0.5 mu m in the two-dimensional setting, offering a twofold improvement in spatial resolution over devices based on silicon. These results show the potential for applying Bragg magnifiers to imaging soft matter at high resolution with reduced dose owing to the higher efficiency of Ge compared with Si

IT Landscape Management Using Network Analysis

Part 1: Full PapersInternational audienceDependency analyses have become crucial in today’s enterprise architecture practices, which usually face complex IT landscapes with highly interdependent applications. In such environments, a deep understanding of the application’s context is essential to determine its qualities and project its further evolution. However, method support for making this context a tangible IT landscape management part and thus facilitating quantitative decision making still seems expandable. Based on the representation as a network of applications and their relations of data exchange, this paper therefore suggests ways to support the IT landscape’s examination through network analysis. We develop this approach based on a combination of theoretical explanations, past empirical findings, and experiences taken from the architecture practices of four sample organizations. We illustrate and evaluate our approach with a short case study. Our approach, developed and illustrated in close alignment with insights from actual practice, thus offers ideas and advice for researchers and practitioners alike