Racial Differences in the Use of Most Commonly Performed Medical Procedures in the United States

Objective: This study investigates racial disparities in the use of commonly performed medical procedures in U.S. hospitals. Methods: To examine racial disparities, we calculated age-adjusted rate of procedures used by all Whites, Blacks, Hispanics, Asians or Pacific Islanders and Native Americans and calculated corresponding Relative Risks(RRs) of White vs. all other races based on procedure utilizations and insurance types using 20% random sample of Nationwide Inpatient Sample (NIS) data between 2001 and2003. Results: Whites were significantly more likely to receive 3 of the study procedures than Blacks, 3 of the procedures than Hispanics, 2 of the procedures than Asians or Pacific Islanders and 4 of the procedures than Native Americans (p\u3c0.05). We also found racial disparities to receive medical procedures based on patients’ insurance status.However, only in a few cases were these differences substantial. Conclusion: Race plays a significantly important role in the use of commonly performed medical procedures in U.S. hospitals

Serum cholesterol in neonates and their mothers. a pilot study

Reports from the Aga Khan University indicate that 58% of 400 school children studied had undesirably high serum cholesterol levels. The present study was undertaken to determine whether the high cholesterol levels are present at birth and to determine the relationship between cord blood, maternal blood cholesterol and maternal diet. Cord blood from 58 neonates and fasting venous blood form 45 mothers were analyzed for total serum cholesterol. Mothers were interviewed regarding their usual diet during pregnancy. Mean cord blood cholesterol was 56.90 mg/dl (range 26 to 123 mg/dI). Mean maternal blood cholesterol was 232.4mg/dl (range 141-382 mg/dl). Mean maternal intake of cholesterol was 457 mg (recommended level _ 300 mg/day). There was no significant co-relation between cord blood cholesterol and maternal blood cholesterol or maternal intake of cholesterol. Eighteen percent of the mothers reported a strong family history of hypercholesterolemia and/or heart disease, but this genetic tendency was not observed in the blood cholesterol level at birth indicating that environmental factors namely diet may have a prime role in determining serum cholesterol levels in childhoo

Complement components as potential therapeutic targets for asthma treatment

SummaryAsthma is the most common respiratory disorder, and is characterized by distal airway inflammation and hyperresponsiveness. This disease challenges human health because of its increasing prevalence, severity, morbidity, and the lack of a proper and complete cure. Asthma is characterized by TH2–skewed inflammation with elevated pulmonary levels of IL-4, IL-5, and IL-13 levels. Although there are early forays into targeting TH2 immunity, less-specific corticosteroid therapy remains the immunomodulator of choice. Innate immune injury mediated by complement components also act as potent mediators of the allergic inflammatory responses and offer a new and exciting possibility for asthma immunotherapy. The complement cascade consists of a number of plasma- and membrane-bound proteins, and the cleavage products of these proteins (C3 and C5) regulate the magnitude of adaptive immune responses. Complement protein are responsible for many pathophysiological features of asthma, including inflammatory cell infiltration, mucus secretion, increases in vascular permeability, and smooth muscle cell contraction. This review highlights the complement-mediated injury during asthma inflammation, and how blockade of active complement mediators may have therapeutic application

Optimum spacing between grooved tubes: an experimental study

An experimental study on the optimum spacing between grooved tubes is reported in this paper. Two grooved tubes having a pitch of 10 mm and 15 mm and a plain tube were considered for the heat transfer analysis. The spacing between two tubes with the same pitch was varied from 10 mm to 35 mm with a step size of 5 mm. The velocity of air flowing over the tube surfaces was changed from 0.4 m/s to 1 m/s using a blower fan. Based on Nusselt number (Nu) the optimum spacing between the tubes was decided. The optimum spacing between grooved tubes of pitch 10 mm and 15 mm was compared with that of plain tubes. From the experimental analysis, it was noticed that with an increase in air velocity (increase in Reynolds number) the tube surface temperature reduced irrespective of any tube considered. Nu increased with an increase in air velocity for all the tubes. The important conclusion drawn from the present study was that there exists a limiting spacing (optimum) between the tubes above which no change in Nu was observed. The spacing of 30 mm was found to be the optimum spacing between the tubes irrespective of its surface geometry modifications

TANGENT BUNDLES OF LP-SASAKIAN MANIFOLD ENDOWED WITH GENERALIZED SYMMETRIC METRIC CONNECTION

The aim of the present work is to study and establish conditions for anLP-Sasakian manifold on the tangent bundle $TM$. An LP-Sasakian manifold with the generalized symmetric metric connection on $TM$ is investigated. Next, the curvature tensor and the Ricci tensor of an LP-Sasakian manifold with respect to the generalized symmetric metric connection on $TM$ are calculated. Moreover, the projective curvature tensor with respect to the generalized symmetric metric connection on $TM$ is studied and showed that $TM$ is not $\hat{\xi}^C$-projectively flat. In particular, if $\alpha=0$ and $\beta=1$ then $TM$ is $\hat{\xi}^C$-projectively flat

Genomic imbalances in peripheral blood confirm the diagnosis of myelodysplastic syndrome in a patient presenting with non-immune hemolytic anemia

Myelodysplastic syndrome (MDS) is a clonal stem-cell disorder characterized by dyshematopoiesis. We report a patient who presented with cytopenias and microangiopathic hemolytic anemia. Chromosome microarray analysis (CMA), using single nucleotide polymorphism arrays, on peripheral blood revealed genomic imbalances indicative of MDS, which was confirmed by bone marrow examination. This report highlights the importance of suspecting MDS in patients with cytopenias and microangiopathic hemolytic anemia. CMA of peripheral blood may assist in the preliminary diagnosis of MDS, representing a comparatively less invasive diagnostic procedure and may aid bone marrow evaluation when an aspirate sample is insufficient for conventional cytogenetic analysis

Bayesian method for estimating Weibull parameters for wind resource assessment in the tropical region: a comparison between two-parameter and three - parameter Weibull distributions

The two-parameter Weibull distribution has garnered much attention in the assessment of wind energy potential. The estimation of the shape and scale parameters of the distribution has brought forth a successful tool for the wind energy industry. However, it may be inappropriate to use the two-parameter Weibull distribution to assess energy at every location, especially at sites where low wind speeds are frequent, such as the tropical region. In this work, a robust technique for wind resource assessment using a Bayesian approach for estimating Weibull parameters is first proposed. Secondly, the wind resource assessment techniques using a two-parameter Weibull distribution and a three-parameter Weibull distribution, which is a generalized form of two-parameter Weibull distribution, are compared. Simulation studies confirm that the Bayesian approach seems a more robust technique for accurate estimation of Weibull parameters. The research is conducted using data from seven sites in tropical region from 1o N of Equator to 21o South of Equator. Results reveal that a three-parameter Weibull distribution with non-zero shift parameter is a better fit for the wind data having a higher percentage of low wind speeds (0-1 ms-1) and low skewness. However, wind data with a smaller percentage of low wind speeds and high skewness showed better results with a two-parameter distribution that is a special case of three-parameter Weibull distribution with zero shift parameter. The proposed distribution can be incorporated in commercial software like WAsP to improve the accuracy of wind resource assessments. The results also demonstrate that the proposed Bayesian approach and application of a three-parameter Weibull distribution are extremely useful for accurate estimation of wind power density

Record of the rare serranid fish Boulenger’s anthias Sacura boulengeri (Heemstra, 1973) from Mumbai waters

The family Serranidae comprising of 62 genera with 449 species is divided into three subfamilies namely, Anthiinae, Epinephelinae (tribes Epinephelini, Niphonini, Liopropomatini, Diploprioni, Grammistini) and Serraninae. Among the genera, Epinephelus has the largest number of species and are the most commercially important. The Anthiinae, comprising fairy basslets and sea goldies, though relatively smaller and very colourful, do not make good aquarium candidates as they are exclusively planktivorus

Enhanced Tunnelling in a Hybrid of Single-Walled Carbon Nanotubes and Graphene

Transparent and conductive films (TCFs) are of great technological importance. The high transmittance, electrical conductivity and mechanical strength make single-walled carbon nanotubes (SWCNTs) a good candidate for their raw material. Despite the ballistic transport in individual SWCNTs, however, the electrical conductivity of their networks is limited by low efficiency of charge tunneling between the tube elements. Here, we demonstrate that the nanotube network sheet resistance at high optical transmittance is decreased by more than 50% when fabricated on graphene and thus provides a comparable improvement as widely adopted gold chloride ($\mathrm{AuCl_3}$) doping. However, while Raman spectroscopy reveals substantial changes in spectral features of doped nanotubes, no similar effect is observed in presence of graphene. Instead, temperature dependent transport measurements indicate that graphene substrate reduces the tunneling barrier heights while its parallel conductivity contribution is almost negligible. Finally, we show that combining the graphene substrate and $\mathrm{AuCl_3}$ doping, the SWCNT thin films can exhibit sheet resistance as low as 36 $\Omega$/sq. at 90% transmittance.Comment: 21 pages, 6 figure

BRAF inhibitors and radiotherapy for melanoma brain metastases: potential advantages and disadvantages of combination therapy

Melanoma is an aggressive malignancy that frequently spreads to the brain, resulting in rapid deterioration in both quality and quantity of life. Historically, treatment options for melanoma brain metastases (MBM) have predominantly consisted of surgery and radiotherapy. While these options can help provide local control, the majority of patients still develop intracranial progression. Indeed, novel therapeutic options, including molecularly targeted agents and immunotherapy, have improved outcomes and are now changing the role of radiotherapy. Up to 50% of melanomas contain an activating BRAF mutation, resulting in hyperactive cellular proliferation and survival. Drugs that target BRAF have been introduced for the treatment of metastatic melanoma and offer hope in improving disease outcomes; however, many of these trials either excluded or had a limited amount of patients with MBM. Recent studies have revealed that melanoma cell lines become more radiosensitive following BRAF inhibition, thus providing a potential synergistic mechanism when combining BRAF inhibitor (BRAFi) and radiotherapy. However, neurotoxicity concerns also exist with this combination. This article reviews the efficacy and limitations of BRAFi therapy for MBM, describes current evidence for combining BRAFis with radiation, discusses the rationale and evidence for combination modalities, and highlights emerging clinical trials specifically investigating this combination in MBM