Our Patient System and Health Care Information Technology: Valuable Incentive or Impediment to Innovation?

Patentable inventions have often been transformative, but the pace of such innovation has changed exponentially in the last thirty years. The patent law still seeks to reward ingenuity and nowhere should this maxim be truer than in the area of health information technology. But the pace and scope of changes in that arena have made rewarding that ingenuity with a patent increasingly difficult. The courts have struggled to apply patent laws to technology that is new and novel to a fault. This Article seeks to address how it is possible to continue to reward ingenuity in a field where progress will save not just money but lives

Perch, Perca fluviatilis show a directional preference for, but do not increase attacks toward, prey in response to water-borne cortisol

In freshwater environments, chemosensory cues play an important role in predatorprey interactions. Prey use a variety of chemosensory cues to detect and avoid predators. However, whether predators use the chemical cues released by disturbed or stressed prey has received less attention. Here we tested the hypothesis that the disturbance cue cortisol, in conjunction with visual cues of prey, elevates predatory behavior. We presented predators (perch, Perca fluviatilis) with three chemosensory choice tests and recorded their location, orientation, and aggressive behavior. We compared the responses of predators when provided with (i) visual cues of prey only (two adjacent tanks containing sticklebacks); (ii) visual and natural chemical cues of prey vs. visual cues only; and (iii) visual cues of prey with cortisol vs. visual cues only. Perch spent a significantly higher proportion of time in proximity to prey, and orientated toward prey more, when presented with a cortisol stimulus plus visual cues, relative to presentations of visual and natural chemical cues of prey, or visual cues of prey only. There was a trend that perch directed a higher proportion of predatory behaviors (number of lunges) toward sticklebacks when presented with a cortisol stimulus plus visual cues, relative to the other chemosensory conditions. But they did not show a significant increase in total predatory behavior in response to cortisol. Therefore, it is not clear whether water-borne cortisol, in conjunction with visual cues of prey, affects predatory behavior. Our results provide evidence that cortisol could be a source of public information about prey state and/or disturbance, but further work is required to confirm this

Changes in Health and Physical Fitness Parameters After 6 Months of High-intensity Group Exercise in Firefighters: Preliminary Data

The physical demands of firefighting require the men and women employed in this profession to be in optimal physical condition to perform their jobs proficiently, as well as to mitigate the risk of injury. Every year, the city of Addison, TX, budgets many thousands of dollars to the compensation plan for first responders. Most of the funding is used for rehabilitation services due to work related injuries. PURPOSE: While many of these injuries are unavoidable due to the inherent risks of the profession, ensuring proper physical fitness is one of the most effective methods to reduce many of these impairments. The purpose of this preliminary study was to characterize health and fitness parameters in 18 professional firefighters from the city of Addison, TX, prior to a 6-month training program. METHODS: Upon arrival, all participants underwent testing in the following order: body composition, range of motion, anaerobic power, muscular endurance, and cardiorespiratory fitness. All participants also completed a detailed health history questionnaire and answered questions specifically addressing chronic low back pain. RESULTS: The following values were attained from testing: total body fat: 30.1±9.7%; flexibility: 24.9±6.3 cm; peak power: 1068.7±272.9 W; mean power: 636.9±143.4 W; time to peak power 0.57±0.35 sec; pushup: 28.8±14.9; curl up: 22.1±15.8; VO2max: 34.1±5.1 ml/kg/min. CONCLUSION: Based off the comparison of reported means and ACSM’s fitness norms, it can be concluded that improvements are necessary in body composition, muscular endurance, range of motion and cardiorespiratory fitness. With improvements in these physiological variables, tactical performance may be optimally performed in a safer manner

A Report on the Status of Standards for Tenure and Promotion in Debate

In what follows, we first provide an overview of debate in order to explain the importance of the activity and then review the status of tenure and evaluation standards among directors/coaches in various types of programs across the country. A mass email was used to ask directors/coaches to submit information about the nature of their current appointment (tenure track, term appointment, and so forth) and the standards through which their performance is evaluated. In addition to seeking information about appointment and evaluation standards for current coaches, we reviewed material from previous developmental conferences and the Quail Roost document, as well as information about how faculty in theater and academic professionals in positions similar to that of a debate director/ coach are evaluated. Following the review of current appointment and evaluation practices, we develop a case for the proposed two tracks for evaluating the performance of debate coaches. We conclude with draft standards

Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control.

BACKGROUND: Mass drug administration (MDA) with azithromycin, carried out for the control of blinding trachoma, has been linked to reduced mortality in children. While the mechanism behind this reduction is unclear, it may be due, in part, to improved nutritional status via a potential reduction in the community burden of infectious disease. To determine whether MDA with azithromycin improves anthropometric indices at the community level, we measured the heights and weights of children aged 1 to 4 years in communities where one (single MDA arm) or three annual rounds (annual MDA arm) of azithromycin had been distributed. METHODS: Data collection took place three years after treatment in the single MDA arm and one year after the final round of treatment in the annual MDA arm. Mean height-for-age, weight-for-age and weight-for-height z scores were compared between treatment arms. RESULTS: No significant differences in mean height-for-age, weight-for-age or weight-for-height z scores were found between the annual MDA and single MDA arms, nor was there a significant reduction in prevalence of stunting, wasting or underweight between arms. CONCLUSIONS: Our data do not provide evidence that community MDA with azithromycin improved anthropometric outcomes of children in The Gambia. This may suggest reductions in mortality associated with azithromycin MDA are due to a mechanism other than improved nutritional status

Quenched QCD with O(a) improvement: I. The spectrum of light hadrons

We present a comprehensive study of the masses of pseudoscalar and vector mesons, as well as octet and decuplet baryons computed in O(a) improved quenched lattice QCD. Results have been obtained using the non-perturbative definition of the improvement coefficient c_sw, and also its estimate in tadpole improved perturbation theory. We investigate effects of improvement on the incidence of exceptional configurations, mass splittings and the parameter J. By combining the results obtained using non-perturbative and tadpole improvement in a simultaneous continuum extrapolation we can compare our spectral data to experiment. We confirm earlier findings by the CP-PACS Collaboration that the quenched light hadron spectrum agrees with experiment at the 10% level.Comment: 36 pages, 7 postscript figures, REVTEX; typo in Table XVIII corrected; extended discussion of finite-size effects in sections III and VII; version to appear in Phys. Rev.

Bicistronic Lentiviruses Containing a Viral 2A Cleavage Sequence Reliably Co-Express Two Proteins and Restore Vision to an Animal Model of LCA1

The disease processes underlying inherited retinal disease are complex and are not completely understood. Many of the corrective gene therapies designed to treat diseases linked to mutations in genes specifically expressed in photoreceptor cells restore function to these cells but fail to stop progression of the disease. There is growing consensus that effective treatments for these diseases will require delivery of multiple therapeutic proteins that will be selected to treat specific aspects of the disease process. The purpose of this study was to design a lentiviral transgene that reliably expresses all of the proteins it encodes and does so in a consistent manner among infected cells. We show, using both in vitro and in vivo analyses, that bicistronic lentiviral transgenes encoding two fluorescent proteins fused to a viral 2A-like cleavage peptide meet these expression criteria. To determine if this transgene design is suitable for therapeutic applications, we replaced one of the fluorescent protein genes with the gene encoding guanylate cyclase -1 (GC1) and delivered lentivirus carrying this transgene to the retinas of the GUCY1*B avian model of Leber congenital amaurosis – 1 (LCA1). GUCY1*B chickens carry a null mutation in the GC1 gene that disrupts photoreceptor function and causes blindness at hatching, a phenotype that closely matches that observed in humans with LCA1. We found that treatment of these animals with the 2A lentivector encoding GC1 restored vision to these animals as evidenced by the presence of optokinetic reflexes. We conclude that 2A-like peptides, with proper optimization, can be successfully incorporated into therapeutic vectors designed to deliver multiple proteins to neural retinal. These results highlight the potential of this vector design to serve as a platform for the development of combination therapies designed to enhance or prolong the benefits of corrective gene therapies

TREM2 inhibition triggers antitumor cell activity of myeloid cells in glioblastoma

Triggering receptor expressed on myeloid cells 2 (TREM2) plays important roles in brain microglial function in neurodegenerative diseases, but the role of TREM2 in the GBM TME has not been examined. Here, we found that TREM2 is highly expressed in myeloid subsets, including macrophages and microglia in human and mouse GBM tumors and that high TREM2 expression correlates with poor prognosis in patients with GBM. TREM2 loss of function in human macrophages and mouse myeloid cells increased interferon-γ-induced immunoactivation, proinflammatory polarization, and tumoricidal capacity. In orthotopic mouse GBM models, mice with chronic and acute Trem2 loss of function exhibited decreased tumor growth and increased survival. Trem2 inhibition reprogrammed myeloid phenotypes and increased programmed cell death protein 1 (PD-1