Factors Affecting Laboratory Test Use and Prices

The use of clinical laboratory tests has more than doubled during the past decade. Some observers of the health system feel that this growth is excessive and is a result of current payment systems. This article examines the effects of current reimbursement policies with regard to the use of laboratory tests and prices charged for tests. The results suggest the following: The method of financing medical care, including cost sharing and prepaid group practice arrangements, affects the volume of laboratory testing through the number of patient contacts with the medical care system rather than through the number of tests used per patient contact. Fee ceilings on physician time appear to be partially offset by higher test prices. Cost-based reimbursement for hospital services is associated with higher charges in hospital laboratories

IS Early Career Job Advertisements: A Content Analysis

In this paper we examine through the content analysis of job advertisements the required knowledge, skills and competencies demanded of early career information systems graduates. Jobs appropriate for graduates with three or fewer years in the workforce were investigated. The job advertisement data was gathered in 2006. The analysis showed a wide variety of job titles. There was a high demand for technical knowledge and competencies as well as communication skills. A core cluster of IS knowledge and skills emerged which appear to be in demand across a wide variety of jobs. Issues raised include the role of entry level positions in the preparation of their incumbents for future more senior positions

Gene expression changes following extinction testing in a heroin behavioral incubation model

<p>Abstract</p> <p>Background</p> <p>A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes that persist following relapse. In this study, genome-wide analysis of gene expression was conducted following an extinction session (90 min) in rats that expressed behavioral incubation of heroin-seeking and goal-directed behavior. As an important modulator of goal-directed behavior, the medial prefrontal cortex (mPFC) was the target of genomic analysis. Rats were trained to self-administer heroin during 3 h daily sessions for 14 d. Following the self-administration period, rats were reintroduced to the self-administration chambers for a 90-minute extinction session in which they could seek heroin, but received none. Extinction sessions were conducted on groups after either 1 d or 14 d of drug-free enforced abstinence to demonstrate behavioral incubation.</p> <p>Results</p> <p>Behavioral data demonstrated incubation (increased expression) of heroin-seeking and goal-directed behavior after the 14 d abstinent period. That is, following 14 d of enforced abstinence, animals displayed heightened drug-seeking behavior when returned to the environment where they had previously received heroin. This increased drug-seeking took place despite the fact that they received no drug during this extinction session. Whole genome gene expression analysis was performed and results were confirmed by quantitative real-time PCR (RT-qPCR). Microarrays identified 66 genes whose expression was identified as changed by at least 1.4 fold (p < 0.02) following 14 d of abstinence and the 90-minute extinction session compared to the saline treated controls. Orthogonal confirmation by RT-qPCR demonstrated significant alterations in <it>bdnf</it>, <it>calb1</it>, <it>dusp5</it>, <it>dusp6</it>, <it>egr1</it>, <it>npy</it>, <it>rgs2</it>.</p> <p>Conclusion</p> <p>Ontological analysis indicates that several of the genes confirmed to be changed are important for neuroplasticity, and through that role may impact learning and behavior. The importance of drug-seeking behavior and memory of previous drug-taking sessions suggest that such genes may be important for relapse. The global gene expression analysis adds to the knowledge of heroin-induced changes and further highlights similarities between heroin and other drugs of abuse.</p

The Ursinus Weekly, November 6, 1950

Kunkel tells IRC forum conditions in Europe good • MSGA proposes dorm government; Will ask approval • Students hear Yost read Frost\u27s poetry at Tuesday program • Popowich elected to MSGA • Englishman to discuss labor economy tonight • Record room opens • Newman Club to dine • Graf, Roberts get Curtain Club roles in Angel Street • Y Commission plans toy, clothing drive • Weekly adds seventeen to staff, nine freshmen • Como to give concert • Local sororities announce acceptance of 48 women • Wagner to speak Sunday at Trinity worship service • Rev. Harris to address Y association meeting • Juniors to choose heads of \u2752 Ruby during November • Approximately 150 castaways attend Juniors\u27 Shipwreck Ball • To conduct hymn sing • Editorial: Outlet for enthusiasm • Speaker and square dance to highlight annual World Student Service Drive • Miss Maroney is capable librarian • Do changing world conditions require new college courses? • Ruby show next weekend to reveal true nature of conditions in Hades • Saporoschenko reveals facts about red regime • Gunther writes Roosevelt in retrospect, revealing and unorthodox biography • Bruins to oppose Adelphi Panthers on Patterson Field • Basketball squad works out daily • Girls\u27 third team beats Temple 2-1 and ties Penn 2-2 • Belles win three in tournament; Vadner honored • Soccer team loses to Haverford, 8-1 • Fords down Bears in X-country • F & M routs Bears 39-0 as Lowder paces attack • To present German play • Rosicrucians to give teahttps://digitalcommons.ursinus.edu/weekly/1551/thumbnail.jp

Chromosomal in situ suppression hybridization of immunologically classified mitotic cells in hematologic malignancies

Chromosomal in situ suppression (CISS) hybridization was performed with library DNA from sorted human chromosomes 8, 9, 15, 17, 21, and 22 on immunologically stained bone marrow cells of four patients with a hematologic neoplasm, including two patients with myelodysplastic syndrome and trisomy 8, one patient with promyelocytic leukemia bearing the translocation t(15;17)(q22;q11-12), and one patient with chronic myeloid leukemia and the translocation t(9;22)(q34;q11). In all patients, the results of conventional karyotype analysis could be confirmed by one- or two-color CISS hybridization using the appropriate chromosome-specific libraries. Our results show that CISS hybridization can detect both numerical and structural chromosome changes in immunologically classified cells with high specificity and reliability. The fact that chromosome spreads of very poor quality can now be included in such analyses is a decisive advantage of this approach. In addition, the suitability of this approach for interphase cytogenetics is discussed

Pennsylvania Folklife Vol. 43, No. 2

• The America\u27s Industrial Heritage Project: A Model for Cultural Tourism • The Harmonists are Waiting for You • The Quest for Authenticity in Tourism and Folklife Studies • Tourism and the Old Order Amish • The Log Cabin: Notes on its Structure and Dissemination • On the Making of Die Union Choral Harmonie (1833): Evidence from Henry C. Eyer\u27s Working Papers • In Memoriam: Paul R. Wieand, a True Artisthttps://digitalcommons.ursinus.edu/pafolklifemag/1139/thumbnail.jp

The Ursinus Weekly, November 20, 1950

14th Messiah will be given December 7th • Fifteen seniors honored with listing in annual publication of Who\u27s Who • WSSF drive kindles much campus activity • Thespians to give psychological mystery, Angel Street, December first and second • May Day petition deadline is Tuesday • Bloodmobile coming to Collegeville December 7 • Ruby group pictures to be taken after Thanksgiving • MSGA to seek vote on dorm amendment • Jones reads poems of Eliot to Tuesday night audience • Gillespie\u27s orchestra to furnish music for December 8 Sunnybrook senior ball • Editorial: Spirit of Thanksgiving; Dorm government: Its meaning; Counsel for the councils • Frosberg has three-fold job • Herbsleb discusses international law before local IRC • Freshmen women elect Jen Price chairman of decoration committee • Library work in progress • Undergrads invited to join competition in contract bridge • Dart tourney • Como concert postponed • Chess Club wins • Herbsleb addresses pre-legal society • Belles edged 2-1 by Owlette squad • Chestnut Hill falls to Snell\u27s Belles 5-0 • Jayvee coeds triumph over Chestnut Hill 2-0 • Diplomats win 2-0 over Bear booters • Dragons 5-1 victors over soccer squad • Plan student bowling • Grizzlies tie Susquehanna in grid season finale, 6-6https://digitalcommons.ursinus.edu/weekly/1553/thumbnail.jp

The Ursinus Weekly, November 13, 1950

Fraternities fete, bid men during week of rushing • First movies of year, Little Men, Great Guns, to be shown on Friday • Debaters to oppose Swarthmore varsity • Lantern asks students for Fall issue material • Herbsleb to address IRC Tuesday on international law topic • Chi Alpha to meet Tuesday • 51\u27ers assume commercial name • Smith tells Forum of status of Britain in trade, economy • Ruby launches campaigns for photography and selling • Student authored, produced Dusty Halo receives plaudits • YM-YW conducts WSSF and toy-clothing drives • Harris stresses need of developing maturity in religious matters • Dorm at 724 Main wins spirit trophy • Sophs to send gift to injured classmate • Big Sisters hold party • Editorials: Case against apathy; Challenge to our intellect • Class idiosyncrasies bared • Scribe pens WSGA notes • Drum majorettes use many maneuvers, combine long experience and ingenuity • Committee heads announced for Curtain Club Fall production • MSGA to cut mealtime announcements, substitute rebuilt outdoor bulletin board • Newman Club holds banquet • Beaver falls 3-2 to hockey squad; Boyd paces team • Jay-Vees triumph 6-1 over Beaver JV squad • Bruins to oppose Crusaders eleven at Selinsgrove • Grizzlies bow 3-0 to Lehigh booters • Undefeated Derr cops intramural grid title • Panthers build early lead to conquer Bruins 13-6 • St. Joseph\u27s takes cross-country meet • Cheer and comfort for the weary, tale of mid-semester\u27s evil birth • Weekly sports poll reveals majority wants powerhouse intercollegiate teamhttps://digitalcommons.ursinus.edu/weekly/1552/thumbnail.jp

Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status

Background: Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. Methods: We recruited Malawian adults with CD4<100 cells/ul two weeks after starting ART in the REALITY trial (NCT01825031), as well as volunteers without HIV infection. Clinical assessment, socioeconomic evaluation, blood draw for immune activation markers and carotid femoral pulse wave velocity (cfPWV) were carried out at 2- and 42-weeks post-ART initiation. Socioeconomic risk factors for immune activation and arterial stiffness were assessed using linear regression models. Results: Of 279 PLWH, the median (IQR) age was 36 (31–43) years and 122 (44%) were female. Activated CD8 T-cells increased from 70% amongst those with no education to 88% amongst those with a tertiary education (p = 0.002); and from 71% amongst those earning less than 10 USD/month to 87% amongst those earning between 100–150 USD/month (p = 0.0001). Arterial stiffness was also associated with higher SES (car ownership p = 0.003, television ownership p = 0.012 and electricity access p = 0.029). Conversely, intermediate monocytes were higher amongst those with no education compared to a tertiary education (12.6% versus 7.3%; p = 0.01) and trended towards being higher amongst those earning less than 10 USD/month compared to 100–150 USD/month (10.5% versus 8.0%; p = 0.08). Water kiosk use showed a protective association against T cell activation (p = 0.007), as well as endothelial damage (MIP1β, sICAM1 and sVCAM1 p = 0.047, 0.026 and 0.031 respectively). Conclusions: Socioeconomic risk factors for persistent inflammation amongst PLWH in SSA differ depending on the type of inflammatory pathway. Understanding these pathways and their socioeconomic drivers will help identify those at risk and target interventions for NCDs. Future studies assessing drivers of inflammation in HIV should include an SES assessment

Inflammatory phenotypes predict changes in arterial stiffness following antiretroviral therapy initiation

Abstract Background Inflammation drives vascular dysfunction in HIV, but in low-income settings causes of inflammation are multiple, and include infectious and environmental factors. We hypothesized that patients with advanced immunosuppression could be stratified into inflammatory phenotypes that predicted changes in vascular dysfunction on ART. Methods We recruited Malawian adults with CD4 &amp;lt;100 cells/μL 2 weeks after starting ART in the REALITY trial (NCT01825031). Carotid femoral pulse-wave velocity (cfPWV) measured arterial stiffness 2, 12, 24, and 42 weeks post–ART initiation. Plasma inflammation markers were measured by electrochemiluminescence at weeks 2 and 42. Hierarchical clustering on principal components identified inflammatory clusters. Results 211 participants with HIV grouped into 3 inflammatory clusters representing 51 (24%; cluster-1), 153 (73%; cluster-2), and 7 (3%; cluster-3) individuals. Cluster-1 showed markedly higher CD4 and CD8 T-cell expression of HLADR and PD-1 versus cluster-2 and cluster-3 (all P &amp;lt; .0001). Although small, cluster-3 had significantly higher levels of cytokines reflecting inflammation (IL-6, IFN-γ, IP-10, IL-1RA, IL-10), chemotaxis (IL-8), systemic and vascular inflammation (CRP, ICAM-1, VCAM-1), and SAA (all P &amp;lt; .001). In mixed-effects models, cfPWV changes over time were similar for cluster-2 versus cluster-1 (relative fold-change, 0.99; 95% CI, .86–1.14; P = .91), but greater in cluster-3 versus cluster-1 (relative fold-change, 1.45; 95% CI, 1.01–2.09; P = .045). Conclusions Two inflammatory clusters were identified: one defined by high T-cell PD-1 expression and another by a hyperinflamed profile and increases in cfPWV on ART. Further clinical characterization of inflammatory phenotypes could help target vascular dysfunction interventions to those at highest risk