Time and Out-of-Pocket Costs Associated with Respiratory Syncytial Virus Hospitalization of Infants

AbstractObjectiveThe objective of this study was to quantify time spent plus out-of-pocket costs associated with confirmed respiratory syncytial virus (RSV) hospitalization of infants not prophylaxed against RSV.MethodsA prospective survey was carried out at multiple tertiary care hospitals in the United States.PatientsThe patients consisted of a consecutive sample of infants <12 months, born between 33 and 35 weeks of gestation. One site also enrolled full-term infants hospitalized with confirmed RSV. Daily patient census identified eligible patients. Consenting caregivers of eligible subjects (n=84, 1 refusal) were interviewed on discharge day and by telephone ∼30 days following discharge regarding time and out-of-pocket costs due to RSV.ResultsTotal average out of pocket expenses were $643.69 (range$21–$16,867; SD$2,403) for premature and $214.42 (range$6–$827; SD$218) (P=.0158) for full-term subjects. Total average economic burden per admission was $4517.07 for premature and$2135.30 for full-term infants, including the value of lost productivity but excluding inpatient hospital and physician bills and lost income. Premature infants (n=48) had longer hospital stays (mean 6.9 days; SD 7.5 vs. 3.4 days; SD 2.6 days) (P=.001) with an associated mean total time spent by up to 5 adults of 281.7 hours (range 25–2819.7 hours; SD 465.8 hours) versus a mean of 139.7 hours (range 31.8–561.3 hours; SD 118.1 hours) for term infants (P=.109). Time and out-of-pocket costs continued after discharge.ConclusionsRSV hospitalization of infants is associated with substantial, previously unmeasured time and monetary losses. These losses continued following discharge. The economic burden on families and society appears heavier for infants born at 33 to 35 weeks of gestation than for full-term infants

Enhanced sensitivity for hyperspectral infrared chemical detection

The sensitivity of imaging, hyperspectral, passive remote sensors in the long-wavelength infrared (LWIR) spectral region is currently limited by the ability to achieve an accurate, time-invariant, pixel-to-pixel calibration of the elements composing the Focal Plane Array (FPA). Pursuing conventional techniques to improve the accuracy of the calibration will always be limited by the trade-off between the time required to collect calibration data of improved precision and the drift in the pixel response that occurs on a timescale comparable to the calibration time. This paper will present the results from a study of a method to circumvent these problems. Improvements in detection capability can be realized by applying a quick, repetitive dither of the field of view (FOV) of the imager (by a small angular amount), so that radiance/spectral differences between individual target areas can be measured by a single FPA pixel. By performing this difference measurement repetitively both residual differences in the pixel-to-pixel calibration and l/f detector drift noise can effectively be eliminated. In addition, variations in the atmosphere and target scene caused by the motion of the sensor platform will cause signal drifts that this technique would be able to remove. This method allows improvements in sensitivity that could potentially scale as the square root of the observation time

Autistic behavior in boys with fragile X syndrome: social approach and HPA-axis dysfunction

The primary goal of this study was to examine environmental and neuroendocrine factors that convey increased risk for elevated autistic behavior in boys with Fragile X syndrome (FXS). This study involves three related analyses: (1) examination of multiple dimensions of social approach behaviors and how they vary over time, (2) investigation of mean levels and modulation of salivary cortisol levels in response to social interaction, and (3) examination of the relationship of social approach and autistic behaviors to salivary cortisol. Poor social approach and elevated baseline and regulation cortisol are discernible traits that distinguish boys with FXS and ASD from boys with FXS only and from typically developing boys. In addition, blunted cortisol change is associated with increased severity of autistic behaviors only within the FXS and ASD group. Boys with FXS and ASD have distinct behavioral and neuroendocrine profiles that differentiate them from those with FXS alone and typically developing boys

Software for the frontiers of quantum chemistry:An overview of developments in the Q-Chem 5 package

This article summarizes technical advances contained in the fifth major release of the Q-Chem quantum chemistry program package, covering developments since 2015. A comprehensive library of exchange–correlation functionals, along with a suite of correlated many-body methods, continues to be a hallmark of the Q-Chem software. The many-body methods include novel variants of both coupled-cluster and configuration-interaction approaches along with methods based on the algebraic diagrammatic construction and variational reduced density-matrix methods. Methods highlighted in Q-Chem 5 include a suite of tools for modeling core-level spectroscopy, methods for describing metastable resonances, methods for computing vibronic spectra, the nuclear–electronic orbital method, and several different energy decomposition analysis techniques. High-performance capabilities including multithreaded parallelism and support for calculations on graphics processing units are described. Q-Chem boasts a community of well over 100 active academic developers, and the continuing evolution of the software is supported by an “open teamware” model and an increasingly modular design

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Advanced laser sensing receiver concepts based on FPA technology.

The ultimate performance of any remote sensor is ideally governed by the hardware signal-to-noise capability and allowed signal-averaging time. In real-world scenarios, this may not be realizable and the limiting factors may suggest the need for more advanced capabilities. Moving from passive to active remote sensors offers the advantage of control over the illumination source, the laser. Added capabilities may include polarization discrimination, instantaneous imaging, range resolution, simultaneous multi-spectral measurement, or coherent detection. However, most advanced detection technology has been engineered heavily towards the straightforward passive sensor requirements, measuring an integrated photon flux. The need for focal plane array technology designed specifically for laser sensing has been recognized for some time, but advances have only recently made the engineering possible. This paper will present a few concepts for laser sensing receiver architectures, the driving specifications behind those concepts, and test/modeling results of such designs

Beyond cyclosporine A: conformation-dependent passive membrane permeabilities of cyclic peptide natural products

Many cyclic peptide natural products are larger and structurally more complex than conventional small molecule drugs. Although some molecules in this class are known to possess favorable pharmacokinetic properties, there have been few reports on the membrane permeabilities of cyclic peptide natural products. Here, we present the passive membrane permeabilities of 39 cyclic peptide natural products, and interpret the results using a computational permeability prediction algorithm based on their known or calculated 3D conformations. We found that the permeabilities of these compounds, measured in a parallel artificial membrane permeability assay, spanned a wide range and demonstrated the important influence of conformation on membrane permeability. These results will aid in the development of these compounds as a viable drug paradigm

Beyond cyclosporine A: conformation-dependent passive membrane permeabilities of cyclic peptide natural products

Many cyclic peptide natural products are larger and structurally more complex than conventional small molecule drugs. Although some molecules in this class are known to possess favorable pharmacokinetic properties, there have been few reports on the membrane permeabilities of cyclic peptide natural products. Here, we present the passive membrane permeabilities of 39 cyclic peptide natural products, and interpret the results using a computational permeability prediction algorithm based on their known or calculated 3D conformations. We found that the permeabilities of these compounds, measured in a parallel artificial membrane permeability assay, spanned a wide range and demonstrated the important influence of conformation on membrane permeability. These results will aid in the development of these compounds as a viable drug paradigm