Hepatic Blood Flow in Hepatic Bilharzial Fibrosis Before and After Surgery

This review confirms that in hepatic bilharziaI fibrosis the hepatic blood flow (HBF) values obtained indirectly by the depuration constant of IlII rose bengal are within the limits of normality. The variations of the HBF before and after splenectomy and splenorenal shunt were also studied.S. Afr. Med. J., 48, 1312 (1974)

Impact of a Multicomponent Digital Therapeutic Mobile App on Medication Adherence in Patients with Chronic Conditions: Retrospective Analysis.

BACKGROUND:Strategies to improve medication adherence are widespread in the literature; however, their impact is limited in real practice. Few patients persistently engage long-term to improve health outcomes, even when they are aware of the consequences of poor adherence. Despite the potential of mobile phone apps as a tool to manage medication adherence, there is still limited evidence of the impact of these innovative interventions. Real-world evidence can assist in minimizing this evidence gap. OBJECTIVE:The objective of this study was to analyze the impact over time of a previously implemented digital therapeutic mobile app on medication adherence rates in adults with any chronic condition. METHODS:A retrospective observational study was performed to assess the adherence rates of patients with any chronic condition using Perx Health, a digital therapeutic that uses multiple components within a mobile health app to improve medication adherence. These components include gamification, dosage reminders, incentives, educational components, and social community components. Adherence was measured through mobile direct observation of therapy (MDOT) over 3-month and 6-month time periods. Implementation adherence, defined as the percentage of doses in which the correct dose of a medication was taken, was assessed across the study periods, in addition to timing adherence or percentage of doses taken at the appropriate time (±1 hour). The Friedman test was used to compare differences in adherence rates over time. RESULTS:We analyzed 243 and 130 patients who used the app for 3 months and 6 months, respectively. The average age of the 243 patients was 43.8 years (SD 15.5), and 156 (64.2%) were female. The most common medications prescribed were varenicline, rosuvastatin, and cholecalciferol. The median implementation adherence was 96.6% (IQR 82.1%-100%) over 3 months and 96.8% (IQR 87.1%-100%) over 6 months. Nonsignificant differences in adherence rates over time were observed in the 6-month analysis (Fr(2)=4.314, P=.505) and 3-month analysis (Fr(2)=0.635, P=.728). Similarly, the timing adherence analysis revealed stable trends with no significant changes over time. CONCLUSIONS:Retrospective analysis of users of a medication adherence management mobile app revealed a positive trend in maintaining optimal medication adherence over time. Mobile technology utilizing gamification, dosage reminders, incentives, education, and social community interventions appears to be a promising strategy to manage medication adherence in real practice

Economic impact of medication non-adherence by disease groups: A systematic review

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Objective To determine the economic impact of medication non-adherence across multiple disease groups. Design Systematic review. Evidence review A comprehensive literature search was conducted in PubMed and Scopus in September 2017. Studies quantifying the cost of medication non-adherence in relation to economic impact were included. Relevant information was extracted and quality assessed using the Drummond checklist. Results Seventy-nine individual studies assessing the cost of medication non-adherence across 14 disease groups were included. Wide-scoping cost variations were reported, with lower levels of adherence generally associated with higher total costs. The annual adjusted disease-specific economic cost of non-adherence per person ranged from 949 to 44 190 (in 2015 US). Costs attributed to 'all causes' non-adherence ranged from 5271 to 52 341. Medication possession ratio was the metric most used to calculate patient adherence, with varying cut-off points defining non-adherence. The main indicators used to measure the cost of non-adherence were total cost or total healthcare cost (83% of studies), pharmacy costs (70%), inpatient costs (46%), outpatient costs (50%), emergency department visit costs (27%), medical costs (29%) and hospitalisation costs (18%). Drummond quality assessment yielded 10 studies of high quality with all studies performing partial economic evaluations to varying extents. Conclusion Medication non-adherence places a significant cost burden on healthcare systems. Current research assessing the economic impact of medication non-adherence is limited and of varying quality, failing to provide adaptable data to influence health policy. The correlation between increased non-adherence and higher disease prevalence should be used to inform policymakers to help circumvent avoidable costs to the healthcare system. Differences in methods make the comparison among studies challenging and an accurate estimation of true magnitude of the cost impossible. Standardisation of the metric measures used to estimate medication non-adherence and development of a streamlined approach to quantify costs is required. PROSPERO registration number CRD42015027338

Statistical Signatures of Photon Localization

The realization that electron localization in disordered systems (Anderson localization) is ultimately a wave phenomenon has led to the suggestion that photons could be similarly localized by disorder. This conjecture attracted wide interest because the differences between photons and electrons - in their interactions, spin statistics, and methods of injection and detection - may open a new realm of optical and microwave phenomena, and allow a detailed study of the Anderson localization transition undisturbed by the Coulomb interaction. To date, claims of three-dimensional photon localization have been based on observations of the exponential decay of the electromagnetic wave as it propagates through the disordered medium. But these reports have come under close scrutiny because of the possibility that the decay observed may be due to residual absorption, and because absorption itself may suppress localization. Here we show that the extent of photon localization can be determined by a different approach - measurement of the relative size of fluctuations of certain transmission quantities. The variance of relative fluctuations accurately reflects the extent of localization, even in the presence of absorption. Using this approach, we demonstrate photon localization in both weakly and strongly scattering quasi-one-dimensional dielectric samples and in periodic metallic wire meshes containing metallic scatterers, while ruling it out in three-dimensional mixtures of aluminum spheres.Comment: 5 pages, including 4 figure

Accurate detection of uniparental disomy and microdeletions by SNP array analysis in myelodysplastic syndromes with normal cytogenetics.

Progress in the management of patients with myelodysplastic syndromes (MDS) has been hampered by the inability to detect cytogenetic abnormalities in 40-60% of cases. We prospectively analyzed matched pairs of bone marrow and buccal cell (normal) DNA samples from 51 MDS patients by single nucleotide polymorphism (SNP) arrays, and identified somatically acquired clonal genomic abnormalities in 21 patients (41%). Among the 33 patients with normal bone marrow cell karyotypes, 5 (15%) had clonal, somatically acquired aberrations by SNP array analysis, including 4 with segmental uniparental disomies (UPD) and 1 with three separate microdeletions. Each abnormality was detected more readily in CD34+ cells than in unselected bone marrow cells. Paired analysis of bone marrow and buccal cell DNA from each patient was necessary to distinguish true clonal genomic abnormalities from inherited copy number variations and regions with apparent loss of heterozygosity. UPDs affecting chromosome 7q were identified in two patients who had a rapidly deteriorating clinical course despite a low-risk International Prognostic Scoring System score. Further studies of larger numbers of patients will be needed to determine whether 7q UPD detected by SNP array analysis will identify higher risk MDS patients at diagnosis, analogous to those with 7q cytogenetic abnormalities

White Paper for Research Beyond 5G

The documents considers both research in the scope of evolutions of the 5G systems (for the period around 2025) and some alternative/longer term views (with later outcomes, or leading to substantial different design choices). This document reflects on four main system areas: fundamental theory and technology, radio and spectrum management; system design; and alternative concepts. The result of this exercise can be broken in two different strands: one focused in the evolution of technologies that are already ongoing development for 5G systems, but that will remain research areas in the future (with “more challenging” requirements and specifications); the other, highlighting technologies that are not really considered for deployment today, or that will be essential for addressing problems that are currently non-existing, but will become apparent when 5G systems begin their widespread deployment

Direct determination of the solar neutrino fluxes from solar neutrino data

We determine the solar neutrino fluxes from a global analysis of the solar and terrestrial neutrino data in the framework of three-neutrino mixing. Using a Bayesian approach we reconstruct the posterior probability distribution function for the eight normalization parameters of the solar neutrino fluxes plus the relevant masses and mixing, with and without imposing the luminosity constraint. This is done by means of a Markov Chain Monte Carlo employing the Metropolis-Hastings algorithm. We also describe how these results can be applied to test the predictions of the Standard Solar Models. Our results show that, at present, both models with low and high metallicity can describe the data with good statistical agreement.Comment: 24 pages, 1 table, 7 figures. Acknowledgments correcte

The Age of the Galactic Disk

I review different methods devised to derive the age of the Galactic Disk, namely the Radio-active Decay (RD), the Cool White Dwarf Luminosity Function (CWDLF), old opne clusters (OOC) and the Color Magnitude Diagram (CMD) of the stars in the solar vicinity. I argue that the disk is likely to be 8-10 Gyr old. Since the bulk of globulars has an age around 13 Gyr, the possibility emerges that the Galaxy experienced a minimum of Star Formation at the end of the halo/bulge formation. This minimum might reflect the time at which the Galaxy started to acquire material to form the disk inside-out.Comment: 10 pages, 4 figure, invited review, in "The chemical evolution of the Milky Way : Stars vs Clusters, Vulcano (Italy), 20-24 September 199

Impact of metabolic comorbidity on the association between body mass index and heatlh-related quality of life: a Scotland-wide cross-sectional study of 5,608 participants

<p/>Background: The prevalence of obesity is rising in Scotland and globally. Overall, obesity is associated with increased morbidity, mortality and reduced health-related quality of life. Studies suggest that "healthy obesity" (obesity without metabolic comorbidity) may not be associated with morbidity or mortality. Its impact on health-related quality of life is unknown. <p/>Methods: We extracted data from the Scottish Health Survey on self-reported health-related quality of life, body mass index (BMI), demographic information and comorbidity. SF-12 responses were converted into an overall health utility score. Linear regression analyses were used to explore the association between BMI and health utility, stratified by the presence or absence of metabolic comorbidity (diabetes, hypertension, hypercholesterolemia or cardiovascular disease), and adjusted for potential confounders (age, sex and deprivation quintile). <p/>Results: Of the 5,608 individuals, 3,744 (66.8%) were either overweight or obese and 921 (16.4%) had metabolic comorbidity. There was an inverted U-shaped relationship whereby health utility was highest among overweight individuals and fell with increasing BMI. There was a significant interaction with metabolic comorbidity (p = 0.007). Individuals with metabolic comorbidty had lower utility scores and a steeper decline in utility with increasing BMI (morbidly obese, adjusted coefficient: -0.064, 95% CI -0.115, -0.012, p = 0.015 for metabolic comorbidity versus -0.042, 95% CI -0.067, -0.018, p = 0.001 for no metabolic comorbidity). <p/>Conclusions: The adverse impact of obesity on health-related quality of life is greater among individuals with metabolic comorbidity. However, increased BMI is associated with reduced health-related quality of life even in the absence of metabolic comorbidity, casting doubt on the notion of "healthy obesity"