1,005 research outputs found

    Generic Utilization Rates, Real Pharmaceutical Prices, and Research and Development Expenditures

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    Generic utilization rates have risen substantially since the enactment of The Drug Price Competition and Patent Term Restoration Act (Hatch-Waxman) in 1984. In the year Hatch-Waxman was enacted, generic utilization rates were 19 percent; in contrast, today, the generic utilization rate is approximately 70 percent. Striking a balance between access to existing medicines and access to yet-to-be-discovered (and developed) drugs, through research incentives, was the principal objective of this landmark legislation. However, given the current rate of generic utilization, it seems plausible, if not likely, that any balance achieved by the 1984 Act has since shifted away from research incentives and towards improved access, ceteris paribus. Among other factors, recent mandatory substitution laws in most states have driven up generic utilization rates. In the current paper, we employ semi-annual data from 1992 to 2008 to examine the link between generic utilization rates and real U.S. prescription drug prices. This link is important because previous research has identified a causal relationship between real drug prices in the U.S. and industry-level R&D investment intensity. We identify a statistically significant, positive relationship between generic utilization rates in the U.S. and real U.S. prescription drug prices. Specifically, we estimate an elasticity of real drug prices to generic utilization rates of -0.15. This finding, when coupled with previous empirical work on the determinants of pharmaceutical R&D intensity, suggests an elasticity of R&D to generic utilization rates of about 0.090. While the magnitude of this elasticity is modest, as theory would predict—the effect of greater generic erosion of brand sales at patent expiration is heavily discounted due to the long time horizon to generic erosion when an R&D project is in clinical development. However, because there has been a very substantial increase in generic utilization rates since 1984, the impact on R&D is nevertheless quite large. We explore this and other issues in the current paper.

    Cortex-wide, cellular-resolution two-photon microscopy

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    Functional imaging of the mouse brain in its extreme complexity involves substantial trade-offs. An optical intrinsic spectroscopy system can image the entire cortex but at the expense of spatial and temporal resolution [1]. A two-photon microscope (TPM) can image single neurons with high temporal resolution, but the field of view (FOV) is generally restricted. Advanced techniques like random-access scanning allow for imaging single neurons that are millimeters apart but only by ignoring the neurons and tissue in between [2]. By carefully considering the properties of the optical components as well as the imaging requirements, we present a TPM capable of imaging nearly the entire mouse cortex with 15 Hz frame rates and single neuron resolution. Please click Additional Files below to see the full abstract

    Spitzer observations of the Massive star forming complex S254-S258: structure and evolution

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    We present Spitzer-IRAC, NOAO 2.1meter-Flamingos, Keck-NIRC, and FCRAO-SEQUOIA observations of the massive star forming complex S254-S258, covering an area of 25x20 arc-minutes. Using a combination of the IRAC and NIR data, we identify and classify the young stellar objects (YSO) in the complex. We detect 510 sources with near or mid IR-excess, and we classify 87 Class I, and 165 Class II sources. The YSO are found in clusters surrounded by isolated YSO in a low-density distributed population. The ratio of clustered to total YSO is 0.8. We identify six new clusters in the complex. One of them, G192.63-00, is located around the ionizing star of the HII region S255. We hypothesize that the ionizing star of S255 was formed in this cluster. We also detect a southern component of the cluster in HII region S256. The cluster G192.54-0.15, located inside HII region S254 has a VLSR of 17 km/s with respect to the main cloud, and we conclude that it is located in the background of the complex. The structure of the molecular cloud is examined using 12CO and 13CO, as well as a near-IR extinction map. The main body of the molecular cloud has VLSR between 5 and 9 km/s. The arc-shaped structure of the molecular cloud, following the border of the HII regions, and the high column density in the border of the HII regions support the idea that the material has been swept up by the expansion of the HII regions.Comment: Accepted for publication in The Astrophysical Journa

    Synthesis, Characterization, and Pickering Emulsifier Performance of Anisotropic Cross-Linked Block Copolymer Worms: Effect of Aspect Ratio on Emulsion Stability in the Presence of Surfactant

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    Reversible addition–fragmentation chain transfer (RAFT) aqueous dispersion polymerization is used to prepare epoxy-functional PGMA–P(HPMA-stat-GlyMA) diblock copolymer worms, where GMA, HPMA, and GlyMA denote glycerol monomethacrylate, 2-hydroxypropyl methacrylate, and glycidyl methacrylate, respectively. The epoxy groups on the GlyMA residues were ring-opened using 3-aminopropyltriethoxysilane (APTES) in order to cross-link the worm cores via a series of hydrolysis–condensation reactions. Importantly, the worm aspect ratio can be adjusted depending on the precise conditions selected for covalent stabilization. Relatively long cross-linked worms are obtained by reaction with APTES at 20 °C, whereas much shorter worms with essentially the same copolymer composition are formed by cooling the linear worms from 20 to 4 °C prior to APTES addition. Small-angle X-ray scattering (SAXS) studies confirmed that the mean aspect ratio for the long worms is approximately eight times greater than that for the short worms. Aqueous electrophoresis studies indicated that both types of cross-linked worms acquired weak cationic surface charge at low pH as a result of protonation of APTES-derived secondary amine groups within the nanoparticle cores. These cross-linked worms were evaluated as emulsifiers for the stabilization of n-dodecane-in-water emulsions via high-shear homogenization at 20 °C and pH 8. Increasing the copolymer concentration led to a reduction in mean droplet diameter, indicating that APTES cross-linking was sufficient to allow the nanoparticles to adsorb intact at the oil/water interface and hence produce genuine Pickering emulsions, rather than undergo in situ dissociation to form surface-active diblock copolymer chains. In surfactant challenge studies, the relatively long worms required a thirty-fold higher concentration of a nonionic surfactant (Tween 80) to be displaced from the n-dodecane–water interface compared to the short worms. This suggests that the former nanoparticles are much more strongly adsorbed than the latter, indicating that significantly greater Pickering emulsion stability can be achieved by using highly anisotropic worms. In contrast, colloidosomes prepared by reacting the hydroxyl-functional adsorbed worms with an oil-soluble polymeric diisocyanate remained intact when exposed to high concentrations of Tween 80

    Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach

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    Objective To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. Methods A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. Findings The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. Conclusion The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease

    Femtosecond x-ray diffraction from an aerosolized beam of protein nanocrystals

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    We demonstrate near-atomic-resolution Bragg diffraction from aerosolized single granulovirus crystals using an x-ray free-electron laser. The form of the aerosol injector is nearly identical to conventional liquid-microjet nozzles, but the x-ray-scattering background is reduced by several orders of magnitude by the use of helium carrier gas rather than liquid. This approach provides a route to study the weak diffuse or lattice-transform signal arising from small crystals. The high speed of the particles is particularly well suited to upcoming MHz-repetition-rate x-ray free-electron lasers

    Stage progression and neurological symptoms in Trypanosoma brucei rhodesiense sleeping sickness: role of the CNS inflammatory response

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    Background: Human African trypanosomiasis progresses from an early (hemolymphatic) stage, through CNS invasion to the late (meningoencephalitic) stage. In experimental infections disease progression is associated with neuroinflammatory responses and neurological symptoms, but this concept requires evaluation in African trypanosomiasis patients, where correct diagnosis of the disease stage is of critical therapeutic importance. Methodology/Principal Findings: This was a retrospective study on a cohort of 115 T.b.rhodesiense HAT patients recruited in Eastern Uganda. Paired plasma and CSF samples allowed the measurement of peripheral and CNS immunoglobulin and of CSF cytokine synthesis. Cytokine and immunoglobulin expression were evaluated in relation to disease duration, stage progression and neurological symptoms. Neurological symptoms were not related to stage progression (with the exception of moderate coma). Increases in CNS immunoglobulin, IL-10 and TNF-α synthesis were associated with stage progression and were mirrored by a reduction in TGF-β levels in the CSF. There were no significant associations between CNS immunoglobulin and cytokine production and neurological signs of disease with the exception of moderate coma cases. Within the study group we identified diagnostically early stage cases with no CSF pleocytosis but intrathecal immunoglobulin synthesis and diagnostically late stage cases with marginal CSF pleocytosis and no detectable trypanosomes in the CSF. Conclusions: Our results demonstrate that there is not a direct linkage between stage progression, neurological signs of infection and neuroinflammatory responses in rhodesiense HAT. Neurological signs are observed in both early and late stages, and while intrathecal immunoglobulin synthesis is associated with neurological signs, these are also observed in cases lacking a CNS inflammatory response. While there is an increase in inflammatory cytokine production with stage progression, this is paralleled by increases in CSF IL-10. As stage diagnostics, the CSF immunoglobulins and cytokines studied do not have sufficient sensitivity to be of clinical value

    Estimating Black Hole Masses in Triaxial Galaxies

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    Most of the super massive black hole mass estimates based on stellar kinematics use the assumption that galaxies are axisymmetric oblate spheroids or spherical. Here we use fully general triaxial orbit-based models to explore the effect of relaxing the axisymmetric assumption on the previously studied galaxies M32 and NGC 3379. We find that M32 can only be modeled accurately using an axisymmetric shape viewed nearly edge-on and our black hole mass estimate is identical to previous studies. When the observed 5 degrees kinematical twist is included in our model of NGC 3379, the best shape is mildly triaxial and we find that our best-fitting black hole mass estimate doubles with respect to the axisymmetric model. This particular black hole mass estimate is still within the errors of that of the axisymmetric model and consistent with the M-sigma relationship. However, this effect may have a pronounced impact on black hole demography, since roughly a third of the most massive galaxies are strongly triaxial.Comment: Accepted for publication in MNRAS. 11 pages, 9 figures. PDFlate
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