Improving dialysis adherence for high risk patients using automated messaging: Proof of concept

AbstractComorbidities and socioeconomic barriers often limit patient adherence and self-management with hemodialysis. Missed sessions, often associated with communication barriers, can result in emergency dialysis and avoidable hospitalizations. This proof of concept study explored using a novel digital-messaging platform, EpxDialysis, to improve patient-to-dialysis center communication via widely available text messaging and telephone technology. A randomized controlled trial was conducted through Washington University-affiliated hemodialysis centers involving ESRD patients with poor attendance, defined as missing 2–6 sessions over the preceding 12 weeks. A cross-over study design evaluated appointment adherence between intervention and control groups. Comparing nonadherence rates eight weeks prior to enrollment, median appointment adherence after using the system increased by 75%, and median number of unintended hospitalization days fell by 31%. A conservative cost-benefit analysis of EpxDialysis demonstrates a 1:36 savings ratio from appointment adherence. EpxDialysis is a low-risk, cost-effective, intervention for increasing hemodialysis adherence in high-risk patients, especially at centers caring for vulnerable and low-income patients.</jats:p

Identification of a single nucleotide change in a mutant gene for hypoxanthine-guanine phosphoribosyltransferase (HPRT Ann Arbor)

HPRT Ann Arbor is a variant of hypoxanthine (guanine) phosphoribosyl-transferase (HPRT: EC 2.4.2.8), which was identified in two brothers with hyperuricemia and nephrolithiasis. In previous studies, this mutant enzyme was characterized by an increased K m for both substrates, a normal V max , a decreased intracellular concentration of enzyme protein, a normal subunit molecular weight and an acidic isoelectric point under native isoelectric focusing conditions. We have cloned a full-length cDNA for HPRT Ann Arbor and determined its complete nucleotide sequence. A single nucleotide change (T→G) at nucleotide position 396 has been identified. This transversion predicts an amino acid substitution from isoleucine (ATT) to methionine (ATG) in codon 132, which is located within the putative 5′-phosphoribosyl-1-pyrophosphate (PRPP)-binding site of HPRT.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47622/1/439_2004_Article_BF00291707.pd

The functional range of motion of the finger joints

The purpose of this study was to measure the functional range of motion of the finger joints needed to perform activities of daily living. Using the Sollerman hand grip function test, 20 activities were assessed in ten volunteers. The active and passive range of motion was measured with a computerized electric goniometer. The position of each finger joint was evaluated in the pre-grasp and grasp positions. The functional range of motion was defined as the range required to perform 90% of the activities, utilizing the pre-grasp and grasp measurements. The functional range of motion was 19°-71°, 23°-87°, and 10°-64° at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints, respectively. This represents 48%, 59%, and 60% of the active motion of these joints, respectively. There was a significant difference in the functional range of motion between the joints of the fingers, with the ulnar digits having greater active and functional range. The functional range of motion is important for directing indications for surgery and rehabilitation, and assessing outcome of treatment.G. I. Bain, N. Polites, B. G. Higgs, R. J. Heptinstall, A. M. McGrat

Laboratory Experimentation of Autonomous Spacecraft Approach and Docking to a Collaborative Target

The article of record may be found at http://dx.doi.org/10.2514/1.22092A new laboratory test bed is introduced that enables the hardware-in-the-loop simulation of the autonomous approach and docking of a chaser spacecraft to a target spacecraft of similar mass. The test bed consists of a chaser spacecraft and a target spacecraft simulator floating via air pads on a flat floor. The prototype docking interface mechanism of the Defense Advanced Research Projects Agency’s Orbital Express mission is integrated on the spacecraft simulators. Relative navigation of the chaser spacecraft is obtained by fusing the measurements from a single-camera vision sensor and an inertial measurement unit, through Kalman filters. The target is collaborative in the sense that a pattern of three infrared light emitting diodes is mounted on it as reference for the relative navigation. Eight cold-gas on–off thrusters are used for the translation of the chaser vehicle. They are commanded using a nonlinear control algorithm based on Schmitt triggers. Furthermore, a reaction wheel is used for the vehicle rotation with a proportional derivative linear control. Experimental results are presented of both an autonomous proximity maneuver and an autonomous docking of the chaser simulator to the nonfloating target. The presented results validate the proposed estimation and control methods and demonstrate the capability of the test bed

THE IONIC ENVIRONMENT OF HEMOCYANIN IN LIMULUS POLYPHEMUS

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