Economic considerations in the treatment of invasive aspergillosis: a review of voriconazole pharmacoeconomic studies

Invasive aspergillosis is a life-threatening fungal infection predominately affecting immunocompromised individuals. The incidence of inpatient-treated aspergillosis cases in the US is estimated to be between 3.02 and 3.80 per 10,000 hospitalized patients. The estimated difference in hospital costs of patients with an aspergillosis infection is US$36,867 to US$59,356 higher than those of patients without the infection. Voriconazole is a synthetic, broad spectrum triazole antifungal agent, with FDA-approved indications for the treatment of invasive aspergillosis, esophageal candidiasis, candidemia in nonneutropenic patients, invasive candidiasis, and infections due to Scedosporium apiospermum and Fusarium species in patients refractory to or intolerant of other therapy. Eight cost-effectiveness analyses, one cost-minimization analysis, and one cost analysis were identified from a Medline search. The 10 pharmacoeconomic analyses were conducted in six different countries comparing voriconazole to conventional amphotericin B, liposomal amphotericin B, itraconazole, and caspofungin. All the cost-effectiveness and cost-minimization analyses identified voriconazole as the most cost-effective therapy. The cost analysis demonstrated voriconazole cost-savings. While the acquisition costs of voriconazole are higher than those of conventional amphotericin B, the toxicity profile and rate of treatment success associated with voriconazole result in lower total treatment costs per successfully treated patient

Magnetic structure of the field-induced multiferroic GdFe3(BO3)4

We report a magnetic x-ray scattering study of the field-induced multiferroic GdFe3(BO3)4. Resonant x-ray magnetic scattering at the Gd LII,III edges indicates that the Gd moments order at TN ~ 37 K. The magnetic structure is incommensurate below TN, with the incommensurability decreasing monotonically with decreasing temperature until a transition to a commensurate magnetic phase is observed at T ~ 10 K. Both the Gd and Fe moments undergo a spin reorientation transition at TSR ~ 9 K such that the moments are oriented along the crystallographic c axis at low temperatures. With magnetic field applied along the a axis, our measurements suggest that the field-induced polarization phase has a commensurate magnetic structure with Gd moments rotated ~45 degrees toward the basal plane, which is similar to the magnetic structure of the Gd subsystem observed in zero field between 9 and 10 K, and the Fe subsystem has a ferromagnetic component in the basal plane.Comment: 27 pages, 7 figures, to appear in Phys. Rev.

Your Voice Matters: Assessing the Need for a Resource Center

With the transformation of the AGEP project initiative, identifying and preserving the knowledge created and making it available for re-use by other researchers and higher education institutions will require the development of a specific intervention. The current trajectory for the Alliances materials will fail to reach the larger audiences needed to realize their full promise and the materials will be lost over time due to the absence of infrastructure to provide ongoing access

The Emergence of Personalized Health Technology.

Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end

Your voice matters: Assessing the need for a resource center

With the transformation of the AGEP project initiative, identifying and preserving the knowledge created and making it available for re-use by other researchers and higher education institutions will require the development of a specific intervention. The current trajectory for the Alliances materials will fail to reach the larger audiences needed to realize their full promise and the materials will be lost over time due to the absence of infrastructure to provide ongoing access

Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury.

Background:Recent studies have demonstrated the vital influence of commensal microbial communities on human health. The central role of the gut in the response to injury is well described; however, no prior studies have used culture-independent profiling techniques to characterize the gut microbiome after severe trauma. We hypothesized that in critically injured patients, the gut microbiome would undergo significant compositional changes in the first 72 hours after injury. Methods:Trauma stool samples were prospectively collected via digital rectal examination at the time of presentation (0 hour). Patients admitted to the intensive care unit (n=12) had additional stool samples collected at 24 hours and/or 72 hours. Uninjured patients served as controls (n=10). DNA was extracted from stool samples and 16S rRNA-targeted PCR amplification was performed; amplicons were sequenced and binned into operational taxonomic units (OTUs; 97% sequence similarity). Diversity was analyzed using principle coordinates analyses, and negative binomial regression was used to determine significantly enriched OTUs. Results:Critically injured patients had a median Injury Severity Score of 27 and suffered polytrauma. At baseline (0 hour), there were no detectable differences in gut microbial community diversity between injured and uninjured patients. Injured patients developed changes in gut microbiome composition within 72 hours, characterized by significant alterations in phylogenetic composition and taxon relative abundance. Members of the bacterial orders Bacteroidales, Fusobacteriales and Verrucomicrobiales were depleted during 72 hours, whereas Clostridiales and Enterococcus members enriched significantly. Discussion:In this initial study of the gut microbiome after trauma, we demonstrate that significant changes in phylogenetic composition and relative abundance occur in the first 72 hours after injury. This rapid change in intestinal microbiota represents a critical phenomenon that may influence outcomes after severe trauma. A better understanding of the nature of these postinjury changes may lead to the ability to intervene in otherwise pathological clinical trajectories. Level of evidence:III. Study type:Prognostic/epidemiological

The Materials Curation Inventory Toolkit: Interviewer\u27s Manual

The Interviewer’s Manual provides the framework for the interview. It contains text and questions to be read to the participating researcher over the course of the interview. It is meant to be used in conjunction with the Interview Worksheet