231 research outputs found

    The Threat of a Second Constitutional Convention: Patrick Henry\u27s Lasting Legacy

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    The Bill of Rights secured the individual freedoms that constitute the mainstay of American liberty. The Framers of the Constitution did not include these vital rights in the original version of the document. In fact, the first ten amendments were proposed by Congress to secure ratification of the Constitution and, more importantly, to prevent a second constitutional convention

    Diabetes Medication Assistance Service: The pharmacist's role in supporting patient self-management of type 2 diabetes (T2DM) in Australia

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    Objective. To evaluate the capacity and effectiveness of trained community pharmacists in delivering the Diabetes Medication Assistance Service (DMAS) via (1) number and types of self-management support interventions (SMSIs); (2) number of goals set and attained by patients and (3) patient outcomes (glycaemic control, medication adherence and satisfaction). Methods. Pharmacists (n = 109) from 90 community pharmacies in Australia were trained and credentialed to deliver the DMAS. The training focused on developing pharmacists’ knowledge and skills in supporting patients’ diabetes self-management. Results. A total of 387 patients completed the trial. The mean number of SMSIs per patient was 35 (SD ±31) and the majority (87%) had at least one documented goal that was fully or partially attained. There were significant health benefits for patients including improved glycaemic control and a reduced risk of non-adherence to medications. Over 90% of DMAS patients reported improvements in their knowledge about diabetes self-management.Conclusion. The DMAS provides self management support in the community pharmacy for people with T2DM which may result in improved clinical outcomes. Practice implication. Given appropriate training in diabetes care and behavior change strategies, community pharmacists can offer programs which provide self-management support to their patients with T2DM and improve their health outcomes

    Prospectus, October 10, 1984

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    SO YOU AND THE BULLY ON THE BLOCK ARE GOING TO DESTROY THE WORLD?\u27; PC Digest; Use your vote to make needed changes; First semester headaches; Auntie Miranda-Yes? or No?; Dear Reader; PC Happenings; Lifelong Learners to meet; Parkalnd schedules special registration; Workshop focuses on time management; Animal Health Technicians conference set; Health issues series continues; Emotional problems reason for help, not condemnation; Consumer Health Care Hotline; Notes of interest Prospectus read far and wide; Pictures worth more than a thousand words and dollars; Parkland instructor to teach GM class; Staff profile-Jim Scott-Entertainment writer; Advice from the duodenum-by Auntie Miranda; Wallace and Gray assets to both Parkland and \u27Taken in Marriage\u27; Music Poll; Explore the workings of the brain; Who\u27s top in pop?; Chick\u27s newest more than child\u27s play; Don\u27t miss a night of hilarity; Creative Corner...Especially for you!!; \u27The Foreigner\u27; The alarm clock-Monday morning blues; Natural selection; Bittersweet Memory; Pathways; Beautiful Stranger; Too Late; Love in the winter woods; \u27Doom Story\u27 the nightmare begins; Eternity; Green Eyes; Our day; Rejoice the Poet; Life Choices; Our place; Classifieds; Trust and acceptance provide supportive atmosphere; Change brings creation of destiny; Did You Know...; Kirby leads Cobra harriers to 7th; Lady Cobras win three, improve record to 18-5; A Tale of Three Freshmen; IM Volleyball; IM Football; Kirby says \u27Running is good for heart\u27; Schriefer takes pride in Parkland X-Country; Stewart places 3rd to lead Lady Cobras; Mullen twins guests on Cobra Raphttps://spark.parkland.edu/prospectus_1984/1009/thumbnail.jp

    Homozygosity by descent mapping of blood pressure in the Old Order Amish: evidence for sex specific genetic architecture

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    <p>Abstract</p> <p>Background</p> <p>High blood pressure is a well established risk factor for morbidity and mortality acting through heart disease, stroke and cardiovascular disease. Genome wide scans have linked regions of nearly every human chromosome to blood pressure related traits. We have capitalized on beneficial qualities of the Old Order Amish of Lancaster, PA, a closed founder population with a relatively small number of founders, to perform a genome wide homozygosity by descent mapping scan. Each individual in the study has a non zero probability of consanguinity. Systolic and diastolic blood pressures are shown to have appreciable dominance variance components.</p> <p>Results</p> <p>Areas of two chromosomes were identified as suggestive of linkage to SBP and 5 areas to DBP in either the overall or sex specific analyses. The strongest evidence for linkage in the overall sample was to Chromosome 18q12 (LOD = 2.6 DBP). Sex specific analyses identified a linkage on Chromosome 4p12-14 (LOD in men only = 3.4 SBP). At Chromosome 2q32-33, an area where we previously reported significant evidence for linkage to DBP using a conventional identity by descent approach, the LOD was 1.4; however an appreciable sex effect was observed with men accounting for most of the linkage (LOD in men only = 2.6).</p> <p>Conclusion</p> <p>These results add evidence to a sex specific genetic architecture to blood pressure related traits, particularly in regions of linkage on chromosome 2, 4 and 18.</p

    Public Health and Cost Benefits of Successful Reperfusion After Thrombectomy for Stroke

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    Background and Purpose- The benefit that endovascular thrombectomy offers to patients with stroke with large vessel occlusions depends strongly on reperfusion grade as defined by the expanded Thrombolysis in Cerebral Infarction (eTICI) scale. Our aim was to determine the lifetime health and cost consequences of the quality of reperfusion for patients, healthcare systems, and society. Methods- A Markov model estimated lifetime quality-adjusted life years (QALY) and lifetime costs of endovascular thrombectomy-treated patients with stroke based on eTICI grades. The analysis was performed over a lifetime horizon in a United States setting, adopting healthcare and societal perspectives. The reference case analysis was conducted for stroke at 65 years of age. National health and cost consequences of improved eTICI 2c/3 reperfusion rates were estimated. Input parameters were based on best available evidence. Results- Lifetime QALYs increased for every grade of improved reperfusion (median QALYs for eTICI 0/1: 2.62; eTICI 2a: 3.46; eTICI 2b: 5.42; eTICI 2c: 5.99; eTICI 3: 6.73). Achieving eTICI 3 over eTICI 2b reperfusion resulted on average in 1.31 incremental QALYs as well as healthcare and societal cost savings of 10327and10 327 and 20 224 per patient. A 10% increase in the eTICI 2c/3 reperfusion rate of all annually endovascular thrombectomy-treated patients with stroke in the United States is estimated to yield additional 3656 QALYs and save 21.0millionand21.0 million and 36.8 million for the healthcare system and society, respectively. Conclusions- Improved reperfusion grants patients with stroke additional QALYs and leads to long-term cost savings. Procedural strategies to achieve complete reperfusion should be assessed for safety and feasibility, even when initial reperfusion seems to be adequate

    A Novel Role for Mc1r in the Parallel Evolution of Depigmentation in Independent Populations of the Cavefish Astyanax mexicanus

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    The evolution of degenerate characteristics remains a poorly understood phenomenon. Only recently has the identification of mutations underlying regressive phenotypes become accessible through the use of genetic analyses. Focusing on the Mexican cave tetra Astyanax mexicanus, we describe, here, an analysis of the brown mutation, which was first described in the literature nearly 40 years ago. This phenotype causes reduced melanin content, decreased melanophore number, and brownish eyes in convergent cave forms of A. mexicanus. Crosses demonstrate non-complementation of the brown phenotype in F2 individuals derived from two independent cave populations: Pachón and the linked Yerbaniz and Japonés caves, indicating the same locus is responsible for reduced pigmentation in these fish. While the brown mutant phenotype arose prior to the fixation of albinism in Pachón cave individuals, it is unclear whether the brown mutation arose before or after the fixation of albinism in the linked Yerbaniz/Japonés caves. Using a QTL approach combined with sequence and functional analyses, we have discovered that two distinct genetic alterations in the coding sequence of the gene Mc1r cause reduced pigmentation associated with the brown mutant phenotype in these caves. Our analysis identifies a novel role for Mc1r in the evolution of degenerative phenotypes in blind Mexican cavefish. Further, the brown phenotype has arisen independently in geographically separate caves, mediated through different mutations of the same gene. This example of parallelism indicates that certain genes are frequent targets of mutation in the repeated evolution of regressive phenotypes in cave-adapted species

    Automatic segmentation of cerebral infarcts in follow-up computed tomography images with convolutional neural networks

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    Background and purpose: Infarct volume is a valuable outcome measure in treatment trials of acute ischemic stroke and is strongly associated with functional outcome. Its manual volumetric assessment is, however, too demanding to be implemented in clinical practice. Objective: To assess the value of convolutional neural networks (CNNs) in the automatic segmentation of infarct volume in follow-up CT images in a large population of patients with acute ischemic stroke. Materials and methods: We included CT images of 1026 patients from a large pooling of patients with acute ischemic stroke. A reference standard for the infarct segmentation was generated by manual delineation. We introduce three CNN models for the segmentati
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