Medicines and vaccines for the world's poorest: Is there any prospect for public-private cooperation?

This paper reviews the current status of the global pharmaceutical industry and its research and development focus in the context of the health care needs of the developing world. It will consider the attempts to improve access to critical drugs and vaccines, and increase the research effort directed at key public health priorities in the developing world. In particular, it will consider prospects for public-private collaboration. The challenges and opportunities in such public-private partnerships will be discussed briefly along with a look at factors that may be key to success. Much of the focus is on HIV/AIDS where the debate on the optimal balance between intellectual property rights (IPR) and human rights to life and health has been very public and emotive

Application of discrete distributions in quality control

M.S.Douglas C. Montgomer

Republican States Bolstered Their Health Insurance Rate Review Programs Using Incentives From the Affordable Care Act.

The Affordable Care Act (ACA) included financial and regulatory incentives and goals for states to bolster their health insurance rate review programs, increase their anticipated loss ratio requirements, expand Medicaid, and establish state-based exchanges. We grouped states by political party control and compared their reactions across these policy goals. To identify changes in states rate review programs and anticipated loss ratio requirements in the individual and small group markets since the ACAs enactment, we conducted legal research and contacted each states insurance regulator. We linked rate review program changes to the Centers for Medicare and Medicaid Services (CMS) criteria for an effective rate review program. We found, of states that did not meet CMSs criteria when the ACA was enacted, most made changes to meet those criteria, including Republican-controlled states, which generally oppose the ACA. This finding is likely the result of the relatively low administrative burden associated with reviewing health insurance rates and the fact that doing so prevents federal intervention in rate review. However, Republican-controlled states were less likely than non-Republican-controlled states to increase their anticipated loss ratio requirements to align with the federal retrospective medical loss ratio requirement, expand Medicaid, and establish state-based exchanges, because of their general opposition to the ACA. We conclude that federal incentives for states to strengthen their health insurance rate review programs were more effective than the incentives for states to adopt other insurance-related policy goals of the ACA

Accountable Care Organizations in California: Promise and Performance

California has more accountable care organizations (ACOs) than any other state in the country, with particularly rapid growth over the past two years. This report introduces new evidence that ACOs improve the quality of care, increase patient satisfaction, and may reduce costs

Demand for Mental Health Services: An Episode of Treatment Approach

This paper analyzes the demand for mental health services using data aggregated to the level of episode of treatment or the bundle of mental health services received during a period of continuous contact with the health care system. We estimate a multinomial logit model and provide estimates of the price elasticity of demand for episodes of mental health care by treatment category (inpatient, outpatient, outpatient with prescription drugs) and the price elasticity of demand for outpatient visits within an episode of care.Demand for health care services; price elasticity of demand; episodes of treatment

Demand for Mental Health Services: An Episode of Treatment Approach

This paper analyzes the demand for mental health services using data aggregated to the level of episode of treatment or the bundle of mental health services received during a period of continuous contact with the health care system. We estimate a multinomial logit model and provide estimates of the price elasticity of demand for episodes of mental health care by treatment category (inpatient, outpatient, outpatient with prescription drugs) and the price elasticity of demand for outpatient visits within an episode of care

Graphene and graphene oxide on Ir(111) are transparent to wetting but not to icing

Anti-icing coatings reduce the freezing onset temperature for water by changing the chemical and physical environment at the water-substrate interface to prevent ice nucleation and growth. Graphene oxide has several attributes that make it attractive as an anti-icing coating and it has been theoretically predicted that graphene oxide has a lower freezing onset temperature than pristine graphene. Here, we test this hypothesis using carefully prepared, well-characterized graphene oxide substrates. We compare the water contact angle for graphene and graphene oxide coatings, both prepared on iridium(111) surfaces. The results show both materials to be transparent to wetting, but indicate a lower freezing onset temperature for graphene oxide than for pristine graphene. The measured water contact angles are dominated by the properties of the underlying Ir(111) substrate while the freezing onset temperature is dictated by the functional groups present on the graphene basal plane. We suggest that the lowering of the freezing onset temperature is caused by the formation of a viscous water layer on the surface. Scanning tunneling microscopy and x-ray photoelectron spectroscopy data are used to evaluate the robustness of the coating material and suggest ways to improve the long-term performance, namely by advancing strategies to avoid water intercalation.publishedVersio

Association mapping and marker-assisted selection of the lettuce dieback resistance gene Tvr1

Background: Lettuce (Lactuca saliva L.) is susceptible to dieback, a soilborne disease caused by two viruses from the family Tombusviridae. Susceptibility to dieback is widespread in romaine and leaf-type lettuce, while modern iceberg cultivars are resistant to this disease. Resistance in iceberg cultivars is conferred by Tvr1 - a single, dominant gene that provides durable resistance. This study describes fine mapping of the resistance gene, analysis of nucleotide polymorphism and linkage disequilibrium in the Tvr1 region, and development of molecular markers for marker-assisted selection. Results: A combination of classical linkage mapping and association mapping allowed us to pinpoint the location of the Tvr1 resistance gene on chromosomal linkage group 2. Nine molecular markers, based on expressed sequence tags (EST), were closely linked to Tvr1 in the mapping population, developed from crosses between resistant (Salinas and Salinas 88) and susceptible (Valmaine) cultivars. Sequencing of these markers from a set of 68 cultivars revealed a relatively high level of nucleotide polymorphism (θ = 6.7 × 10-3) and extensive linkage disequilibrium (r2 = 0.124 at 8 cM) in this region. However, the extent of linkage disequilibrium was affected by population structure and the values were substantially larger when the analysis was performed only for romaine (r2 = 0.247) and crisphead (r2 = 0.345) accessions. The association mapping approach revealed that one of the nine markers (Cntg10192) in the Tvr1 region matched exactly with resistant and susceptible phenotypes when tested on a set of 200 L. sativa accessions from all horticultural types of lettuce. The marker-trait association was also confirmed on two accessions of Lactuca serriola - a wild relative of cultivated lettuce. The combination of three single-nucleotide polymorphisms (SNPs) at the Cntg10192 marker identified four haplotypes. Three of the haplotypes were associated with resistance and one of them was always associated with susceptibility to the disease. Conclusion: We have successfully applied high-resolution DNA melting (HRM) analysis to distinguish all four haplotypes of the Cntg10192 marker in a single analysis. Marker-assisted selection for dieback resistance with HRM is now an integral part of our breeding program that is focused on the development of improved lettuce cultivars