Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease:A Structured, Rapid Review

Background: Alzheimer’s Disease is the most common cause of dementia, affecting memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. AD is predicted to increase healthcare spending and costs associated with formal and informal caregiving. The aim of this study was to identify and quantify the contribution of the different cost components associated with AD. Methods: A structured literature review was conducted to identify studies reporting the economic burden of Alzheimer`s Disease beyond the healthcare setting. The search was conducted in Medline, Embase and EconLit and limited to studies published in the last 10 years. For each identified cost component, frequency weighted mean costs were calculated across countries to estimate the percentage contribution of each component by care setting and disease severity. Results obtained by each costing approach were also compared. Results: For community-dwelling adults, the percentage of healthcare, social care and indirect costs to total costs were 13.9%, 17.4% and 68.7%, respectively. The percentage of costs varied by disease severity with 26.0% and 10.4% of costs spent on healthcare for mild and severe disease, respectively. The proportion of total spending on indirect costs changed from 60.7% to 72.5% as disease progressed. For those in residential care, the contribution of each cost component was similar between moderate and severe disease. Social care accounted on average for 85.9% of total costs. Conclusion: The contribution of healthcare costs to the overall burden was not negligible; but was generally exceeded by social and informal care costs

Pion-Muon Asymmetry Revisited

Long ago an unexpected and unexplainable phenomena was observed. The distribution of muons from positive pion decay at rest was anisotropic with an excess in the backward direction relative to the direction of the proton beam from which the pions were created. Although this effect was observed by several different groups with pions produced by different means, the result was not accepted by the physics community, because it is in direct conflict with a large set of other experiments indicating that the pion is a pseudoscalar particle. It is possible to satisfy both sets of experiments if helicity-zero vector particles exist and the pion is such a particle. Helicity-zero vector particles have direction but no net spin. For the neutral pion to be a vector particle requires an additional modification to conventional theory as discussed herein. An experiment is proposed which can prove that the asymmetry in the distribution of muons from pion decay is a genuine physical effect because the asymmetry can be modified in a controllable manner. A positive result will also prove that the pion is NOT a pseudoscalar particle.Comment: 9 pages, 3 figure

Gamma-ray Observations Under Bright Moonlight with VERITAS

Imaging atmospheric Cherenkov telescopes (IACTs) are equipped with sensitive photomultiplier tube (PMT) cameras. Exposure to high levels of background illumination degrades the efficiency of and potentially destroys these photo-detectors over time, so IACTs cannot be operated in the same configuration in the presence of bright moonlight as under dark skies. Since September 2012, observations have been carried out with the VERITAS IACTs under bright moonlight (defined as about three times the night-sky-background (NSB) of a dark extragalactic field, typically occurring when Moon illumination > 35%) in two observing modes, firstly by reducing the voltage applied to the PMTs and, secondly, with the addition of ultra-violet (UV) bandpass filters to the cameras. This has allowed observations at up to about 30 times previous NSB levels (around 80% Moon illumination), resulting in 30% more observing time between the two modes over the course of a year. These additional observations have already allowed for the detection of a flare from the 1ES 1727+502 and for an observing program targeting a measurement of the cosmic-ray positron fraction. We provide details of these new observing modes and their performance relative to the standard VERITAS observations

Access to infertility consultations: what women tell us about it?

The main objective of the present paper is to evaluate the perception of women concerning the barriers and access to infertility consultations. Socio cultural and economic access to infertility consultations is detached and three municipalities of the northwest of Portugal were chosen as an example of a peripheral country. A quantitative/qualitative study was done with 60 women. Three dimensions were evaluated: geographic and structural and functional access; economic access; and sociocultural access. The main barriers were mainly identified in the last two dimensions. The economic access was the less well evaluated by women being the cost of treatment (medication, and concentration of costs in a short period) difficult to bear. This can justify a greater involvement of the Portuguese Government, by developing policies for the reimbursement of part of the costs. Also, some changes in structural and functional access must be done with special regard to the separation of the infertility consultations from the reproductive medicine section. The setting of the teams, with a follow-up by the same team of health professionals is also needed

Biodiversity increases the resistance of ecosystem productivity to climate extremes

It remains unclear whether biodiversity buffers ecosystems against climate extremes, which are becoming increasingly frequent worldwide1. Early results suggested that the ecosystem productivity of diverse grassland plant communities was more resistant, changing less during drought, and more resilient, recovering more quickly after drought, than that of depauperate communities2. However, subsequent experimental tests produced mixed results3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13. Here we use data from 46 experiments that manipulated grassland plant diversity to test whether biodiversity provides resistance during and resilience after climate events. We show that biodiversity increased ecosystem resistance for a broad range of climate events, including wet or dry, moderate or extreme, and brief or prolonged events. Across all studies and climate events, the productivity of low-diversity communities with one or two species changed by approximately 50% during climate events, whereas that of high-diversity communities with 16–32 species was more resistant, changing by only approximately 25%. By a year after each climate event, ecosystem productivity had often fully recovered, or overshot, normal levels of productivity in both high- and low-diversity communities, leading to no detectable dependence of ecosystem resilience on biodiversity. Our results suggest that biodiversity mainly stabilizes ecosystem productivity, and productivity-dependent ecosystem services, by increasing resistance to climate events. Anthropogenic environmental changes that drive biodiversity loss thus seem likely to decrease ecosystem stability14, and restoration of biodiversity to increase it, mainly by changing the resistance of ecosystem productivity to climate events

Upper limits from five years of blazar observations with the VERITAS Cherenkov telescopes

Between the beginning of its full-scale scientific operations in 2007 and 2012, the VERITAS Cherenkov telescope array observed more than 130 blazars; of these, 26 were detected as very-high-energy (VHE; E > 100 GeV) γ-ray sources. In this work, we present the analysis results of a sample of 114 undetected objects. The observations constitute a total live-time of ~570 hr. The sample includes several unidentified Fermi-Large Area Telescope (LAT) sources (located at high Galactic latitude) as well as all the sources from the second Fermi-LAT catalog that are contained within the field of view of the VERITAS observations. We have also performed optical spectroscopy measurements in order to estimate the redshift of some of these blazars that do not have spectroscopic distance estimates. We present new optical spectra from the Kast instrument on the Shane telescope at the Lick observatory for 18 blazars included in this work, which allowed for the successful measurement or constraint on the redshift of four of them. For each of the blazars included in our sample, we provide the flux upper limit in the VERITAS energy band. We also study the properties of the significance distributions and we present the result of a stacked analysis of the data set, which shows a 4σ excess

Measurement of the W+W- Production Cross Section in ppbar Collisions at sqrt(s)=1.96 TeV using Dilepton Events

We present a measurement of the W+W- production cross section using 184/pb of ppbar collisions at a center-of-mass energy of 1.96 TeV collected with the Collider Detector at Fermilab. Using the dilepton decay channel W+W- -> l+l-vvbar, where the charged leptons can be either electrons or muons, we find 17 candidate events compared to an expected background of 5.0+2.2-0.8 events. The resulting W+W- production cross section measurement of sigma(ppbar -> W+W-) = 14.6 +5.8 -5.1 (stat) +1.8 -3.0 (syst) +-0.9 (lum) pb agrees well with the Standard Model expectation.Comment: 8 pages, 2 figures, 2 tables. To be submitted to Physical Review Letter

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field

Pengaruh Pemberian Ketotifen terhadap Jumlah Sel Fibroblas dan Kepadatan Sel Kolagen pada Luka Insisi Tikus Wistar

Ingga Hadian, S-501202027. PENGARUH PEMBERIAN KETOTIFEN TERHADAP JUMLAH SEL FIBROBLAS DAN KEPADATAN SEL KOLAGEN PADA LUKA INSISI TIKUS WISTAR. Pembimbing I : DR. Untung Alfianto, dr, Sp.Bs, Pembimbing II : dr. Ardana Tri Arianto. Msi. Med. Sp.An-KNA. Program studi Magister Kedokteran Keluarga, Minat Utama Ilmu Biomedik, Fakultas Kedokteran Universitas Sebelas Maret, Surakarta, 2016. Latar Belakang : Sel mast merupakan salah satu yang berperan dalam proses inflamasi pada penyembuhan luka. Sel mast dikaitkan dengan kejadian luka kronis, sehingga sel mast diduga ikut memelihara proses inflamasi secara berlebihan. Hambatan pada degranulasi sel mast diharapkan akan mempercepat penyembuhan luka yang ditandai dengan meningkatnya jumlah sel fibroblas dan kepadatan sel kolagen. Ketotifen mampu mengurangi dreganulasi sel Mast dan mengurangi pelepasan Histamin, protease sel Mast, myeloperoxidase, leukotriens, PAF dan bermacam-macam Prostaglandin. Ketotifen juga menghambat agregasi polimorfonuklear serta mengurangi respon inflamasi dan mempercepat migrasi fibroblas di fase proliferasi. Tujuan :Mengetahui perbedaan jumlah sel fibroblas dan kepadatan sel kolagen pada tikus wistar yang diberikan Ketotifen oral dosis 0.3 mg/kg dibandingkan plasebo pada penyembuhan luka insisi tikus wistar. Metode : Penelitian ini termasuk true eksperimental laboratorik dengan desain Randomized Controlled Trial yang menggunakan tikus wistar sebagai obyek penelitian. 14 tikus Wistar dibagi dalam 2 kelompok, masing masing kelompok terdiri atas 7 tikus Wistar. Kelompok 1 merupakan kelompok kontrol yang dilakukan insisi sepanjang 2cm pada kulit punggung tikus dan diberikan plasebo per oral selama 6 hari. Kelompok 2 merupakan kelompok perlakuan yang dilakukan insisi sepanjang 2cm pada kulit punggung tikus dan diberikan Ketotifen 0,3 mg/kgBB per oral setiap 12 jam selama 6 hari. Analisis data untuk membandingkan rerata antar kedua kelompok yaitu kelompok perlakuan dan kelompok kontrol menggunakan uji independent samples t-test, dengan tingkat kemaknaan p < 0,05 (dikatakan bermakna secara statistik). Hasil : Pada kelompok kontrol didapatkan rerata persentase kepadatan sel kolagen sebesar 26,05 %, sedangkan pada kelompok Ketotifen didapatkan rerata persentase kepadatan sel kolagen sebesar 36,13 %. Untuk jumlah sel fibroblas pada kelompok kontrol didapatkan rerata sebesar 423 per lapang pandang, sedangkan pada kelompok Ketotifen didapatkan rerata sebesar 555,43 per lapang pandang. Kesimpulan : Ketotifen mempercepat penyembuhan luka ditandai dengan peningkatan sel fibroblas dan sel kolagen. Kata Kunci : Sel Mast, Ketotifen, Sel fibroblas, Serabut Kolagen. ABSTRACT Ingga Hadian, S-501202027. EFFECTS OF KETOTIFEN ON FIBROBLAST CELL COUNT AND COLLAGEN DENSITY ON INCISED WISTAR RATS. DR. Untung Alfianto, dr., Sp.BS, dr. Ardana Tri Arianto, Msi, Med, Sp.An-KNA. Background: Mast cells have a pivotal role in every healing process that involves inflammation of the cells, usually in wounds of chronic nature. If the degranulation process of the mast cells are inhibited, the healing process of the wound will accelerate, indicated by a raise in fibroblast cells and collagen density. Ketotifen are shown to inhibit the degranulation process and decreasing the release of histamin, mast cells proteases, myeloperoxidases, leukotriens, PAF, and various prostaglandins. Ketotifen can also inhibit the aggregation of polymorphonuclear cells, increasing the rate of fibroblast migration in the proliferation phase. This study was aimed to identify the effects of ketotifen on fibroblast cell count and collagen density tested on a wistar rats model. Methods: This study was a true laboratoric experimental study with randomized controlled trial using wistar rats model as objects. 14 rats were divided into two groups, each group contained seven rats. The first group was the control group, where the rats were incised 2 cm above the back skin, and were given per oral placebo for 6 days. The second group were given the same treatment, only the rats were given ketotifen 0.3 mg/kg per oral, every 12 hours lasting 6 days. The data were then collected and tested with independent sample t-test, with p value less than 0,05 is statistically significant. Results: In the control group, the mean percentage of the thickest collagen density were marked at 26.05%, whereas in the treatment group collagen density were marked at 36.13%. The mean fibroblast cell count were marked at 423 and 555.43 each viewing field, on the control group and the treatment group respectively. Conclusion: Ketotifen can accelerate the healing process, marked by the significant increase in collagen density and fibroblast cell count. Keywords: mast cells, ketotifen, fibroblast cells, collagen fibers