497 research outputs found
Congenital Chagas Disease in the United States: Cost Savings Through Maternal Screening
Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors through transfusions, transplants, insect feces in food, and from mother to child during gestation. Congenital infection could perpetuate Chagas disease indefinitely, even in countries without vector transmission. An estimated 30% of infected persons will develop lifelong, potentially fatal, cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment of Chagas disease in the United States. We constructed a decision-analytic model to find the lower cost option, comparing costs of testing and treatment, as needed, for mothers and infants with the lifetime societal costs without testing and the consequent morbidity and mortality due to lack of treatment or late treatment. We found that maternal screening, infant testing, and treatment of Chagas disease in the United States are cost saving for all rates of congenital transmission greater than 0.001% and all levels of maternal prevalence above 0.06% compared with no screening program. Newly approved diagnostics make universal screening cost saving with maternal prevalence as low as 0.008%. The present value of lifetime societal savings due to screening and treatment is about $634 million saved for every birth year cohort. The benefits of universal screening for T. cruzi as part of routine prenatal testing far outweigh the program costs for all U.S. births
Interactive computer modules for undergraduate chemical engineering instruction
Interactive computer modules have been developed for four of the core courses in the Chemical Engineering curriculum: Introduction to Chemical Engineering, Fluids/Transport, Separations, and Kinetics. These modules generally consist of a review of the material, followed by an interactive problemāsolving session, which may include a computer simulation of the processes involved. The problem is often presented as part of a scenario, to capture the student's interest, and hints are available to guide the student. This study examines the components of these modules, as well as considerations that educators should take into account when developing interactive computer modules.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106870/1/6180010103_ftp.pd
Congenital Chagas Disease in the United States: The Effect of Commercially Priced Benznidazole on Costs and Benefits of Maternal Screening
Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors, and through transfusions, transplants, insect feces in food, and mother to child during gestation. An estimated 30% of infected persons will develop lifelong, potentially fatal cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment for Chagas disease in the United States, including the cost of commercially available benznidazole. We compare costs of testing and treatment for mothers and infants with the lifetime societal costs without testing and consequent morbidity and mortality due to lack of treatment or late treatment. We constructed a decision-analytic model, using one tree that shows the combined costs for every possible motherāchild pairing. Savings per birth in a targeted screening program are 105 per birth. At current screening costs, universal screening results in $420 million in lifetime savings per birth-year cohort. We found that a congenital Chagas screening program in the United States is cost saving for all rates of congenital transmission greater than 0.001% and all levels of maternal prevalence greater than 0.06% compared with no screening program
Acute Chagas Disease in a Returning Traveler
Acute Chagas disease is rarely recognized, and the risk for acquiring the disease is undefined in travelers to Central America. We describe a case of acute Chagas disease in a traveler to Costa Rica and highlight the need for increased awareness of this infection in travelers to Chagas-endemic areas
Impact of two rounds of praziquantel mass drug administration on Schistosoma mansoni infection prevalence and intensity: a comparison between community wide treatment and school based treatment in western Kenya
AbstractThis study compared the effectiveness of the community-wide treatment and school-based treatment approaches in the control of Schistosoma mansoni infections in villages with ā©¾25% prevalence in western Kenya. Stool samples from first year students, 9ā12year olds and adults (20ā55years) were analyzed by the KatoāKatz technique for S. mansoni eggs. After two rounds of treatment, S. mansoni prevalence and intensity levels significantly declined in both treatment approaches. Prevalence comparisons between the two approaches did not show any significant differences following treatment. However, infection intensity levels in the 9ā12year old school-attending pupils were significantly higher in the community-wide treatment arm than in the school-based treatment arm. Nevertheless, significant reductions in S. mansoni infection prevalence and intensity levels were achieved among school-age children regardless of the treatment approach used
On the trace of the antipode and higher indicators
We introduce two kinds of gauge invariants for any finite-dimensional Hopf
algebra H. When H is semisimple over C, these invariants are respectively, the
trace of the map induced by the antipode on the endomorphism ring of a
self-dual simple module, and the higher Frobenius-Schur indicators of the
regular representation. We further study the values of these higher indicators
in the context of complex semisimple quasi-Hopf algebras H. We prove that these
indicators are non-negative provided the module category over H is modular, and
that for a prime p, the p-th indicator is equal to 1 if, and only if, p is a
factor of dim H. As an application, we show the existence of a non-trivial
self-dual simple H-module with bounded dimension which is determined by the
value of the second indicator.Comment: additional references, fixed some typos, minor additions including a
questions and some remark
Family Involvement in Traumatic Brain Injury Inpatient Rehabilitation: A Propensity Score Analysis of Effects on Outcomes During the First Year After Discharge
Objective
To evaluate the effect of family attendance at inpatient rehabilitation therapy sessions on traumatic brain injury (TBI) patient outcomes at discharge and up to 9 months postdischarge.
Design
Propensity score methods are applied to the TBI Practice-Based Evidence database, a database consisting of multisite, prospective, longitudinal, and observational data.
Setting
Nine inpatient rehabilitation centers in the United States.
Participants
Patients (N=1835) admitted for first inpatient rehabilitation after an index TBI.
Intervention
Family attendance during therapy sessions.
Main Outcome Measures
Participation Assessment for Recombined Tools-Objective-17 (Total scores and subdomain scores of Productivity, Out and About, and Social Relations), Functional Independence Measure, Satisfaction with Life Scale, and Patient Health Questionnaire-9.
Results
Participants whose families were in attendance for at least 10% of the treatment time were more out and about in their communities at 3 and 9 months postdischarge than participants whose families attended treatment less than 10% of the time. Although findings varied by propensity score method, improved functional independence in the cognitive area at 9 months was also associated with increased family attendance.
Conclusions
Family involvement during inpatient rehabilitation may improve community participation and cognitive functioning up to 9 months after discharge. Rehabilitation teams should engage patientsā families in the rehabilitation process to maximize outcomes
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