Systematic review on quality control for drug management programs: Is quality reported in the literature?

<p>Abstract</p> <p>Background</p> <p>Maintaining quality of care while managing limited healthcare resources is an ongoing challenge in healthcare. The objective of this study was to evaluate how the impact of drug management programs is reported in the literature and to identify potentially existing quality standards.</p> <p>Methods</p> <p>This analysis relates to the published research on the impact of drug management on economic, clinical, or humanistic outcomes in managed care, indemnity insurance, VA, or Medicaid in the USA published between 1996 and 2007. Included articles were systematically analyzed for study objective, study endpoints, and drug management type. They were further categorized by drug management tool, primary objective, and study endpoints.</p> <p>Results</p> <p>None of the 76 included publications assessed the overall quality of drug management tools. The impact of 9 different drug management tools used alone or in combination was studied in pharmacy claims, medical claims, electronic medical records or survey data from either patient, plan or provider perspective using an average of 2.1 of 11 possible endpoints. A total of 68% of the studies reported the impact on plan focused endpoints, while the clinical, the patient or the provider perspective were studied to a much lower degree (45%, 42% and 12% of the studies). Health outcomes were only accounted for in 9.2% of the studies.</p> <p>Conclusion</p> <p>Comprehensive assessment of quality considering plan, patient and clinical outcomes is not yet applied. There is no defined quality standard. Benchmarks including health outcomes should be determined and used to improve the overall clinical and economic effectiveness of drug management programs.</p

ABSTRACT Gas Flow Effects on Precision Solder Self-Alignment

Self-aligning soldering technology is being developed for low cost, passive, precision optical alignments. To avoid contamination problems, the solder reflow process must use reacting or inert gas instead of chemical flux materials. Since the accuracy of these optical alignments should reach the range of a few micrometers (μm), the gas flow may affect the aligning process. Therefore, the effects of the gas flow on the self-aligning process must be understood. The experiments described show that gas flow effects do exist. The top plate, 8.4 mm × 8.4 mm, can be moved by the gas flow by as much as 4.5 μm and 7.8 μm at gas flow rates of 2.5 L/min and 5.0 L/min, respectively. The numerical analysis in this study models the gas flow effects for a wide range of chip sizes, solder geometry, and gas flow direction. In the numerical analysis, fluid computation and solder force calculation are conducted to study the gas flow effects on chip displacement that is the distance away from the well aligned position along the gas flow direction. The results show that the gas flow effects are related to many factors including chip size, gas flow rate, solder height, and flow direction. For a one-dimensional laser array, these effects are negligible because the chip size is very small. However, for a chip larger than 5 mm × 5 mm, the effects should be controlled for micron-level precision alignment

Cell-based approaches for tendon regeneration

Cell based therapies have been proposed as potential alternative solutions towards efficient regenerative strategies for damaged tendon tissues. These approaches traditionally envision the delivery of cells, mostly stem cells or tendon cells, often combined with carriers and growth factors to provide the behavioral instructions similar to the ones found in native tissues. The purpose of cell based therapies is to apply living cells to guide and promote enhanced tissue repair and functional regeneration of an injured or diseased tissue. This chapter will focus on the potential of several cell sources, including stem cells from different origins, in tendon regeneration, illustrated by their therapeutic role in animal models of tendinopathies. Furthermore, it will be also addressed experimental cellular therapies currently ongoing in clinical trials that hold the promise for innovative clinical outcomes in tendon regeneration.(undefined)info:eu-repo/semantics/publishedVersio

Suicide prevention discussed at the WHO European Ministerial Conference on Mental Health. (Editorial).

Injectable hyaluronic acid (HA)-based hydrogels compose a promising class of materials for tissue engineering and regenerative medicine applications. However, their limited mechanical properties restrict the potential range of application. In this study, cellulose nanocrystals (CNCs) were employed as nanofillers in a fully biobased strategy for the production of reinforced HA nanocomposite hydrogels. Herein we report the development of a new class of injectable hydrogels composed of adipic acid dihydrazide-modified HA (ADH-HA) and aldehyde-modified HA (a-HA) reinforced with varying contents of aldehyde-modified CNCs (a-CNCs). The obtained hydrogels were characterized in terms of internal morphology, mechanical properties, swelling, and degradation behavior in the presence of hyaluronidase. Our findings suggest that the incorporation of a-CNCs in the hydrogel resulted in a more organized and compact network structure and led to stiffer hydrogels (maximum storage modulus, <i>E</i>′, of 152.4 kPa for 0.25 wt % a-CNCs content) with improvements of <i>E</i>′ up to 135% in comparison to unfilled hydrogels. In general, increased amounts of a-CNCs led to lower equilibrium swelling ratios and higher resistance to degradation. The biological performance of the developed nanocomposites was assessed toward human adipose derived stem cells (hASCs). HA-CNCs nanocomposite hydrogels exhibited preferential cell supportive properties in in vitro culture conditions due to higher structural integrity and potential interaction of microenvironmental cues with CNC’s sulfate groups. hASCs encapsulated in HA-CNCs hydrogels demonstrated the ability to spread within the volume of gels and exhibited pronounced proliferative activity. Together, these results demonstrate that the proposed strategy is a valuable toolbox for fine-tuning the structural, biomechanical, and biochemical properties of injectable HA hydrogels, expanding their potential range of application in the biomedical field