The Risks of Key Recovery, Key Escrow, and Trusted Third-Party Encryption

A variety of "key recovery," "key escrow," and "trusted third-party" encryption requirements have been suggested in recent years by government agencies seeking to conduct covert surveillance within the changing environments brought about by new technologies. This report examines the fundamental properties of these requirements and attempts to outline the technical risks, costs, and implications of deploying systems that provide government access to encryption keys

The Risks of Key Recovery, Key Escrow, and Trusted Third-Party Encryption

A variety of "key recovery," "key escrow," and "trusted third-party" encryption requirements have been suggested in recent years by government agencies seeking to conduct covert surveillance within the changing environments brought about by new technologies. This report examines the fundamental properties of these requirements and attempts to outline the technical risks, costs, and implications of deploying systems that provide government access to encryption keys

FORENSIC PAIN MEDICINE SECTION Original Research Article Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United Statesp me_1075 657..667

Abstract Objectives. The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. Methods. Costs were grouped into three categories: health care, workplace, and criminal justice. Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse. Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries. Other data/ information were derived from publicly available survey and other secondary sources. Conclusions. The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future

Timed sequential chemotherapy with concomitant Granulocyte Colony-Stimulating Factor for high-risk acute myelogenous leukemia: a single arm clinical trial

BACKGROUND: The timed-sequential chemotherapy regimen consisting of etoposide, mitoxantrone and cytarabine (EMA) is an effective therapy for relapsed or refractory acute myelogenous leukemia (AML). We postulated that granulocyte colony-stimulating factor (G-CSF) might enhance the cytotoxicity of EMA by increasing the proportion of leukemic blasts in S-phase. We added G-CSF to EMA (EMA-G) for therapy of advanced high-risk AML patients. METHODS: High-risk AML was defined as refractory, relapsed or secondary to either an antecedent hematologic disorder or exposure to cytotoxic agents. The patients were treated with one course of EMA-G consisting of mitoxantrone and cytarabine on days 1–3, and etoposide and cytarabine on days 8–10. G-CSF was started on day 4 and continued until absolute neutrophil count recovered. RESULTS: Thirty patients were enrolled. The median age was 51 years (range, 25–75). Seventeen (61%) patients had unfavorable cytogenetic karyotypes. Twenty (69%) patients had secondary AML. Ten (34%) had relapsed disease. Four (14%) had refractory AML. Three (10%) patients died from febrile neutropenia and sepsis. Major non-hematologic toxicity included hyperbilirubimenia, renal insufficiency, mucositis, diarrhea, nausea and vomiting, skin rash. A complete remission was achieved in 13 (46%) patients. Median overall survival was 9 months (range, 0.5–66). Median relapse-free survival (RFS) for those who had a CR was 3 months (range, 0.5–63) with RFS censored at the time of allogeneic bone marrow transplantation or peripheral stem cell transplantation for 6 of the patients. CONCLUSIONS: EMA-G is a safe and efficacious option for induction chemotherapy in advanced, high-risk AML patients. The activity of EMA may be increased if applied in patients with less advanced disease

BUS 201: Legal Environment for Business OER Curation

This OER curation is an annotated bibliography of prospective OER for the GVSU course BUS 201: Legal Environment for Business

Direct and Indirect Costs of Non-Vertebral Fracture Patients with Osteoporosis in the US

Background: Osteoporosis is a condition marked by low bone mineral density and the deterioration of bone tissue. One of the main clinical and economic consequences of osteoporosis is skeletal fractures. Objective: To assess the healthcare and work loss costs of US patients with non-vertebral (NV) osteoporotic fractures. Methods: Privately insured (aged 18-64 years) and Medicare (aged ≥65 years) patients with osteoporosis (ICD-9-CM code: 733.0x) were identified during 1999-2006 using two claims databases. Patients with an NV fracture (femur, pelvis, lower leg, upper arm, forearm, rib or hip) were matched randomly on age, sex, employment status and geographic region to controls with osteoporosis and no fractures. Patient characteristics and annual healthcare costs were assessed over the year following the index fracture for privately insured (n - 4764) and Medicare (n - 48 742) beneficiaries (Medicare drug costs were estimated using multivariable models). Indirect (i.e. work loss) costs were calculated for a subset of privately insured, employed patients with available disability data (n - 1148). All costs were reported in &dollar;US, year 2006 values. Results: In Medicare, mean incremental healthcare costs per NV fracture patient were &dollar;US13 387 (&dollar;US22 466 vs &dollar;US9079; p < 0.05). The most expensive patients had index fractures of the hip, multiple sites and femur (incremental costs of &dollar;US25 519, &dollar;US20 137 and &dollar;US19 403, respectively). Patients with NV non-hip (NVNH) fractures had incremental healthcare costs of &dollar;US7868 per patient (&dollar;US16 704 vs &dollar;US8836; p < 0.05). Aggregate annual incremental healthcare costs of NVNH patients in the Medicare research sample (n - 35 933) were &dollar;US282.7 million compared with &dollar;US204.1 million for hip fracture patients (n - 7997). Among the privately insured, mean incremental healthcare costs per NV fracture patient were &dollar;US5961 (&dollar;US11 636 vs &dollar;US5675; p < 0.05). The most expensive patients had index fractures of the hip, multiple sites and pelvis (incremental costs of &dollar;US13 801, &dollar;US9642 and &dollar;US8164, respectively). Annual incremental healthcare costs per NVNH patient were &dollar;US5381 (&dollar;US11 090 vs &dollar;US5709; p < 0.05). Aggregate annual incremental healthcare costs of NVNH patients in the privately insured sample (n - 4478) were &dollar;US24.1 million compared with &dollar;US3.5 million for hip fracture patients (n - 255). Mean incremental work loss costs per NV fracture employee were &dollar;US1956 (&dollar;US4349 vs &dollar;US2393; p < 0.05). Among patients with available disability data, work loss accounted for 29.5% of total costs per NV fracture employee. Conclusion: The cost burden of NV fracture patients to payers is substantial. Although hip fracture patients were more costly per patient in both Medicare and privately insured samples, NVNH fracture patients still had substantial incremental costs. Because NVNH patients accounted for a larger proportion of the fracture population, they were associated with greater aggregate incremental healthcare costs than hip fracture patients.Cost-of-illness, Fracture, treatment, Hip-fracture, treatment, Osteoporosis, treatment

Ultrasound image of the iliopsoas muscle (IPM) in transverse section.

<p>The external iliac artery (EIA) is located medial to the IPM and the femoral nerve (FN) is identified as a round hypoechoic structure within the muscle.</p

Plasma bupivacaine concentrations (μg mL^-1) following femoral nerve blocks.

<p>Plasma bupivacaine concentrations (μg mL^-1) following femoral nerve blocks.</p

Ultrasound image of the lateral aspect of the pelvic limb.

<p>The sciatic nerve (ScN) is located medial to the biceps femoris muscle and is identified as two ovoid hypoechoic structures with the cranial component (peroneal nerve) being smaller than the caudal component (tibial nerve) in transverse section.</p