Coordination in organizations with decision support systems

Bibliography: p. 13.Office of Naval Research. N00014-84-K-0519 (NR 649-003)by Jean-Louis M. Grevet, Alexander H. Levis

Coordination in decision-making organizations

Cover title.Includes bibliographical references.Support provided by the Office of Naval Research. N00014-84-K-0519 (NR 649-003)by Jean-Louis M. Grevet, Alexander H. Levis

Smoking-induced long-lasting modifications of human platelet serotonin catabolism through a MAO epigenetic regulation

Postulating that serotonin, secreted from smoking-activated platelets, could be involved in smoking-induced vascular modifications, we studied 115 men distributed in smokers (S), former smokers (FS) and never smokers (NS). The platelet serotonin content was similar in S and NS but lower in FS. This was unexpected because the monoamine oxidase (MAO) activity, which catabolizes serotonin, was inhibited during smoking. However, the amount of platelet MAO was higher in S and FS than in NS. The persistent elevated MAO amount in FS prompted us to study the methylation of its gene promoter in an additional series of patients: it was markedly lower for S and FS vs. NS due to cigarette smoke-induced increase of nucleic acid demethylase activity. This smoking-induced demethylation of the MAO gene promoter, resulting in high MAO amount persisting long after quitting smoking, has cardiovascular consequences and could impact fields such as behavior, mental health, and cancer

Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.

OBJECTIVES/DESIGN:As antiretroviral therapy (ART) rapidly expands in sub-Saharan Africa using new efficient care models, data on costs of these approaches are lacking. We examined costs of a streamlined HIV care delivery model within a large HIV test-and-treat study in Uganda and Kenya. METHODS:We calculated observed per-person-per-year (ppy) costs of streamlined care in 17 health facilities in SEARCH Study intervention communities (NCT: 01864603) via micro-costing techniques, time-and-motion studies, staff interviews, and administrative records. Cost categories included salaries, ART, viral load testing, recurring goods/services, and fixed capital/facility costs. We then modeled costs under three increasingly efficient scale-up scenarios: lowest-cost ART, centralized viral load testing, and governmental healthcare worker salaries. We assessed the relationship between community-specific ART delivery costs, retention in care, and viral suppression. RESULTS:Estimated streamlined HIV care delivery costs were $291/ppy. ART ($117/ppy for TDF/3TC/EFV [40%]) and viral load testing ($110/ppy for 2 tests/year [39$51/ppy), recurring costs ($5/ppy), and fixed costs ($7/ppy). Optimized ART scale-up with lowest-cost ART ($100/ppy), annual viral load testing ($24/ppy), and governmental healthcare salaries ($27/ppy), lowered streamlined care cost to$163/ppy. We found clinic-to-clinic heterogeneity in retention and viral suppression levels versus streamlined care delivery costs, but no correlation between cost and either retention or viral suppression. CONCLUSIONS:In the SEARCH Study, streamlined HIV care delivery costs were similar to or lower than prior estimates despite including viral load testing; further optimizations could substantially reduce costs further. These data can inform global strategies for financing ART expansion to achieve UNAIDS 90-90-90 targets

Aceclofenac induced morbilliform eruptions: a case report

Maculopapular or morbilliform eruptions may be the most common of all cutaneous drug reactions. Antimicrobials, NSAIDS, barbiturates, anticonvulsants, oral hypoglycemics etc. have been commonly implicated in these adverse reactions (ADR). Here, authors are presenting a case of a 38-year-old female with morbilliform eruptions due to aceclofenac for the treatment of joint pain. The patient was treated with antihistaminics, steroids, antimicrobials and local application of GV paint. She was discharged after eleven days with good recovery

Immunoglobulins may Modulate the Formation of Triple Helix DNA in Pathophysiological States

The Runt domain proteins are comprised mostly of b-strands arranged in an antiparallel fashion to from a b barrel with an s-type immunoglobulin fold. It is interesting to note that the same fold is used in the DNA binding domains of several transcription factors. A common feature is that DNA binding is mediated by loops that extend from one end of the Ig-motif. These proteins bind to different DNA sequences and specific recognition is accounted for by variations in the details of the molecular interactions between the loop regions and the DNA. This review suggests that immunoglobulin fold proteins may play a key role in modulation and formation of triple helix DNA structure with implications for patho-physiological states

The genetics-BIDS extension: Easing the search for genetic data associated with human brain imaging

Metadata are what makes databases searchable. Without them, researchers would have difficulty finding data with features they are interested in. Brain imaging genetics is at the intersection of two disciplines, each with dedicated dictionaries and ontologies facilitating data search and analysis. Here, we present the genetics Brain Imaging Data Structure extension, consisting of metadata files for human brain imaging data to which they are linked, and describe succinctly the genomic and transcriptomic data associated with them, which may be in different databases. This extension will facilitate identifying micro-scale molecular features that are linked to macro-scale imaging repositories, facilitating data aggregation across studies

Kesenjangan dan Konvergensi Ekonomi Atar Kabupaten pada Empat Koridor di Propinsi Jawa Timur

The purpose of this research is to analyze the economic growth in regency area on the forcorridors in Province of East Java; to analyze the imbalance among the regencies on the four corridorsin East Java; to analyze the convergence among the regencies on the four corridors in East Java.There is still an unstable condition on the growth average in the whole regencies/cities in EastJava, sometimes increasing and sometimes decreasing. On the average growth of the four corridorsin East Java, South East corridor has the highest average on economic growth. It is because theregency/city in that corridor becomes an economic central in East Java.From the analysis of discrepancy, it can be showed that there is still discrepancy enhancementamong the regencies on the four corridors in East Java. From the convergence analysis, there is nota lot of enhancement on the economic growth in those four corridors on the regency level. It showsthat there is still necessity on amelioration in any sector to enhance the economic growth

ANTIMICROBIAL-RELATED ADVERSE DRUG REACTION IN A TERTIARY CARE HOSPITAL

  Objective: The objective of the study was to evaluate the adverse drug reaction (ADR) related to commonly used antimicrobials in a tertiary care hospital.Methods: A prospective spontaneous reporting study involving, active methods (pharmacist actively looking for suspected ADRs) and passive methods (stimulating prescribers to report suspected ADRs) was carried out in all departments of a tertiary care hospital, for 1 year. Patients of all age groups were included in the study. The data for the study were taken from case sheets, investigation reports of patients who had experienced an ADR, personal interviews with reporting persons or clinicians, personal interviews with patient or patient's attendant, past history of medication use, which were generally obtained from, prescriptions from the past, reports of medical and surgical interventions, referral letters, ADR reporting forms. Collected data were then analyze for causality assessment by Naranjo's scale and severity assessment by Hartwig and Siegel's scale.Result: During 1 year of study period, 75 ADRs related to antimicrobial were reported among 1354 patients who were given antibiotic for the treatment. The incidence rate of antibiotic was found to be 5.53%. The department that reported ADR was medicine (10.16%), ENT (4.6%), pediatric (8.12%), orthopedics (06.9%), surgery (06.9%), chest and tuberculosis (04.6%), obstetrics and gynecology (06.9%), dentistry (02.3%), and skin (10.16%). The most common ADRs were related to gastrointestinal tract; dermatological reactions were second in the list of antimicrobial drugs causing ADR. In this study, among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. There was no unknown ADR reported that may need to be further investigated through active monitoring. All patients recovered from ADRs without any complications. The causality was assessed by Naranjo's scale and it revealed that out of 75 antibiotics related ADR 48 (64%) were possible, 27 (36%) were probable, 3 (4.00%) were definate, and 0% were unlikely. According to the Hartwig and Siegel's scale, most of ADR were mild 45 (60%) and moderate 30 (40%) in nature.Conclusion: ADRs related to antimicrobials occurs frequently. Among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. The health-care system can promote the spontaneous reporting of antimicrobial ADR to pharmacovigilance center for ensuring safe drug use and patient care