Will the Affordable Care Act Move Patient-Centeredness to Center Stage?

Outlines the evolution of ethical, economic, and clinical concepts of the patient's role in health care; efforts to develop a measurement infrastructure; and provisions in the healthcare reform law aimed at integrating and aligning measures

Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives

Outlines initiatives in Alabama, Oklahoma, Oregon, Pennsylvania, and Washington to implement patient-centered medical home models designed to coordinate and improve quality of care; strategies; key lessons; and new opportunities under healthcare reform

COBRA Subsidies for Laid-Off Workers: An Initial Report Card

Reviews the implementation of the government subsidy of COBRA health insurance premiums for laid-off workers in the 2009 stimulus package and its effects on COBRA enrollment and medical spending. Considers policy implications for access and affordability

Federal Subsidy for Laid-Off Workers' Health Insurance: A First Year's Report Card for the New COBRA Premium Assistance

Analyzes how the subsidy for laid-off workers' costs to continue their health coverage, included in the 2009 stimulus bill, affected enrollment. Considers determining factors, implications of health reform for extending the subsidy, and lessons learned

Kaurenoic Acid Possesses Leishmanicidal Activity by Triggering a NLRP12/IL-1β/cNOS/NO Pathway

Leishmania amazonensis (L. amazonensis) infection can cause severe local and diffuse injuries in humans, a condition clinically known as American cutaneous leishmaniasis (ACL). Currently, the therapeutic approach for ACL is based on Glucantime, which shows high toxicity and poor effectiveness. Therefore, ACL remains a neglected disease with limited options for treatment. Herein, the in vitro antiprotozoal effect and mechanisms of the diterpene kaurenoic acid [ent-kaur-16-en-19-oic acid] (KA) against L. amazonensis were investigated. KA exhibited a direct antileishmanial effect on L. amazonensis promastigotes. Importantly, KA also reduced the intracellular number of amastigote forms and percentage of infected peritoneal macrophages of BALB/c mice. Mechanistically, KA treatment reestablished the production of nitric oxide (NO) in a constitutive NO synthase- (cNOS-) dependent manner, subverting the NO-depleting escape mechanism of L. amazonensis. Furthermore, KA induced increased production of IL-1β and expression of the inflammasome-activating component NLRP12. These findings demonstrate the leishmanicidal capability of KA against L. amazonensis in macrophage culture by triggering a NLRP12/IL-1β/cNOS/NO mechanism

Kaurenoic Acid Possesses Leishmanicidal Activity by Triggering a NLRP12/IL-1 /cNOS/NO Pathway

Leishmania amazonensis (L. amazonensis) infection can cause severe local and diffuse injuries in humans, a condition clinically known as American cutaneous leishmaniasis (ACL). Currently, the therapeutic approach for ACL is based on Glucantime, which shows high toxicity and poor effectiveness. Therefore, ACL remains a neglected disease with limited options for treatment. Herein, the in vitro antiprotozoal effect and mechanisms of the diterpene kaurenoic acid [ent-kaur-16-en-19-oic acid] (KA) against L. amazonensis were investigated. KA exhibited a direct antileishmanial effect on L. amazonensis promastigotes. Importantly, KA also reduced the intracellular number of amastigote forms and percentage of infected peritoneal macrophages of BALB/c mice. Mechanistically, KA treatment reestablished the production of nitric oxide (NO) in a constitutive NO synthase-(cNOS-) dependent manner, subverting the NO-depleting escape mechanism of L. amazonensis. Furthermore, KA induced increased production of IL-1 and expression of the inflammasome-activating component NLRP12. These findings demonstrate the leishmanicidal capability of KA against L. amazonensis in macrophage culture by triggering a NLRP12/IL-1 /cNOS/NO mechanism

Hormonal, Neurochemical, and Behavioral Response to a Forced Swim Test in Adolescent Rats throughout Cocaine Withdrawal

The use of cocaine in adults has been linked to depression and/or anxiety. Several studies have shown an association between cocaine-primed craving and depressive symptoms. In animal models, the forced swim test (FST) is frequently used for screening depressive-like behavior. This study aimed to verify the presence of depression-like symptoms in adolescent rats after chronic cocaine exposure by analyzing behavior in a FST. The subsequent alterations in neurotransmitters and hypothalamus-pituitary-adrenal axis activity induced by this test were also analyzed. Both male and female adolescent Wistar rats were submitted to a chronic “binge” pattern of administration of cocaine hydrochloride, and subjects were tested in a forced swim test 2 days after cocaine's last administration. At the end of the behavioral test, trunk blood was collected for quantification of corticosterone plasma levels, and hypothalamus, prefrontal cortex, amygdala, and hippocampus were dissected for neurochemical determinations. No significant differences were found in the behavior on the FST of both males and females after withdrawal from chronic cocaine administration. Nevertheless, plasma levels of corticosterone were increased in cocaine-treated males, although not significantly (P= 0.065). In females cocaine failed to affect corticosterone levels. Of interest, neurochemical analyses showed that dopamine turnover was decreased in amygdala in cocaine-treated males (not significantly, P= 0.055). No significant differences were found on neurotransmitter levels in the other brain regions analyzed. Withdrawal from chronic cocaine administration during adolescence did not have a significant effect on stress-induced behavioral alterations, although the neurochemical response to the stressful situation provided by FTS seemed to be affected.info:eu-repo/semantics/publishedVersio

Measurement of pseudorapidity distributions of charged particles in proton-proton collisions at sqrt(s) = 8 TeV by the CMS and TOTEM experiments

Pseudorapidity ( $\eta$ ) distributions of charged particles produced in proton–proton collisions at a centre-of-mass energy of 8 $~\text {TeV}$ are measured in the ranges $|\eta | < 2.2$ and $5.3 < |\eta | < 6.4$ covered by the CMS and TOTEM detectors, respectively. The data correspond to an integrated luminosity of $\mathcal {L} = 45 \mu {\mathrm {b}}^{-1}$ . Measurements are presented for three event categories. The most inclusive category is sensitive to 91–96 % of the total inelastic proton–proton cross section. The other two categories are disjoint subsets of the inclusive sample that are either enhanced or depleted in single diffractive dissociation events. The data are compared to models used to describe high-energy hadronic interactions. None of the models considered provide a consistent description of the measured distributions