Cargo/Logistics Airlift System Study (CLASS), Executive Summary

The current air cargo system is analyzed along with advanced air cargo systems studies. A forecast of advanced air cargo system demand is presented with cost estimates. It is concluded that there is a need for a dedicated advance air cargo system, and with application of advanced technology, reductions of 45% in air freight rates may be achieved

Cargo/Logistics Airlift System Study (CLASS), Volume 2

Air containerization is discussed in terms of lower freight rates, size and pallet limitations, refrigeration, backhaul of empties, and ownership. It is concluded that there is a need for an advance air cargo system as indicated by the industry/transportation case studies, and a stimulation of the air cargo would result in freight rate reductions

Cargo/Logistics Airlift System Study (CLASS), Volume 1

Current and advanced air cargo systems are evaluated using industrial and consumer statistics. Market and commodity characteristics that influence the use of the air mode are discussed along with a comparison of air and surface mode on typical routes. Results of on-site surveys of cargo processing facilities at airports are presented, and institutional controls and influences on air cargo operations are considered

Living kidney donor follow-up in a statewide health information exchange: health services utilization, health outcomes and policy implications

Indiana University-Purdue University Indianapolis (IUPUI)Living donors have contributed about 6,000 kidneys per year in the past 10 years, but more than 100,000 individuals are still waiting for a kidney transplant. Living kidney donors undergo a major surgical procedure without direct medical benefit to themselves, but comprehensive follow-up information on living donors’ health is unfortunately limited. Expert recommendations suggest capturing clinical information beyond traditional sources to improve surveillance of co-morbid conditions from living kidney donors. Currently the United Network for Organ Sharing is responsible for collecting and reporting follow-up data for all living donors from U.S. transplant centers. Under policy implemented in February of 2013, transplant centers must submit follow-up date for two years after donation, but current processes often yield to incomplete and untimely reporting. This dissertation uses a statewide Health Information Exchange as a new clinical data source to 1) retrospectively identify a cohort of living kidney donors, 2) understand their follow-up care patterns, and 3) observe selected clinical outcomes including hypertension, diabetes and post-donation renal function

Effects of the glial modulator palmitoylethanolamide on chronic pain intensity and brain function.

Background: Chronic neuropathic pain (NP) is a complex disease that results from damage or presumed damage to the somatosensory nervous system. Current treatment regimens are often ineffective. The major impediment in developing effective treatments is our limited understanding of the underlying mechanisms. Preclinical evidence suggests that glial changes are crucial for the development of NP and a recent study reported oscillatory activity differences within the ascending pain pathway at frequencies similar to that of cyclic gliotransmission in NP. Furthermore, there is evidence that glial modifying medications may be effective in treating NP. The aim of this Phase I open-label clinical trial is to determine whether glial modifying medication palmitoylethanolamide (PEA) will reduce NP and whether this is associated with reductions in oscillatory activity within the pain pathway. Methods: We investigated whether 6 weeks of PEA treatment would reduce pain and infra-slow oscillatory activity within the ascending trigeminal pathway in 22 individuals (17 females) with chronic orofacial NP. Results: PEA reduced pain in 16 (73%) of the 22 subjects, 11 subjects showed pain reduction of over 20%. Whilst both the responders and non-responders showed reductions in infra-slow oscillatory activity where orofacial nociceptor afferents terminate in the brainstem, only responders displayed reductions in the thalamus. Furthermore, functional connections between the brainstem and thalamus were altered only in responders. Conclusion: PEA is effective at relieving NP. This reduction is coupled to a reduction in resting oscillations along the ascending pain pathway that are likely driven by rhythmic astrocytic gliotransmission

Impact of an Inpatient Geriatric Consultative Service on Outcomes for Cognitively Impaired Patients

Background Impact of geriatric consultative services (GCS) on hospital readmission and mortality outcomes for cognitively impaired (CI) patients is not known. Objective Evaluate impact of GCS on hospital readmission and mortality among CI inpatients. Design Secondary data-analysis of a prospective trial of a computerized decision support system between July 1, 2006, and May 30, 2008. Setting Study conducted at XXXXX hospital, a 340-bed, public hospital with over 2,300 yearly admissions of 65 or older. Patients 415 inpatients aged 65 and older with CI were enrolled from July 2006 to March 2008. Measurements 30 day and one year mortality and hospital readmission following the index admission. Cox’s proportional hazard models were used to determine the association between receiving GCS, re-admission or mortality while adjusting for demographics, discharge destination, delirium, Charlson Comorbidity Index, and prior hospitalizations. The propensity score method was used to adjust for the non-random assignment of GCS. Results Patients receiving GCS were older (79; 8.1 SD vs 76; 7.8 SD; p<.001 with higher incidence of delirium (49% vs. 29%; p<.001)). No significant differences were found between the groups for hospital readmission (Hazard Ratio (HR)=1.19; 95% CI = 0.89, 1.59) and mortality at 12 months of index admission (HR=.91 ; 95% CI = 0.59, 1.40). However, a significant increase in readmissions was observed for the GCS group (HR=1.75; 95% CI = 1.06–2.88) at 30 days post-discharge. Conclusion One year post-discharge outcomes of CI patients that received GCS were not different from patients who did not receive the service. New models of care are needed to improve post-discharge readmission and mortality among hospitalized patients with CI