Cardiac Catheter Reuse in An Era of Reform: Cost-Efficiency and Regulatory Policy in the Face of Scientific Uncertainty

Cardiac catheters have become an essential element of current cardiovascular practice with several hundred thousand used each year in both diagnostic and angioplasty procedures. Uke many other disposable devices they are also increasingly being reused as hospitals attempt to cut costs.' The general progression of device reuse seems to follow rather directly the rise in the expense of medical equipment and procedures. For example, in 1976, only 14% of United States' hospitals reported reusing single-use devices, while in 1982, 90% of hospitals admitted practicing reuse.2 As for the government's regulation of such reuse, 1981 saw the FDA issuing guidelines practically proscribing the reuse of catheters when their average cost was only $10-$25.~ Even as late as 1987, however, only 2.4 full-time FDA employees and $19,000 were dedicated to monitoring the reuse of nondurable devices.4 The General Accounting Office concluded that the FDA knew of less than 1% of medical device problems occurring in hospitals.5 On the heels of the longstanding debate about the reuse of hemodialyzers and the Safe Medical Devices Act of 1990 and 1992 Medical Device Amendments, it appears as if the FDA is more receptive to tightening regulatory control over medical device reuse

Insight into partial agonism by observing multiple equilibria for ligand-bound and Gs-mimetic nanobody-bound β1-adrenergic receptor.

A complex conformational energy landscape determines G-protein-coupled receptor (GPCR) signalling via intracellular binding partners (IBPs), e.g., Gs and β-arrestin. Using 13C methyl methionine NMR for the β1-adrenergic receptor, we identify ligand efficacy-dependent equilibria between an inactive and pre-active state and, in complex with Gs-mimetic nanobody, between more and less active ternary complexes. Formation of a basal activity complex through ligand-free nanobody-receptor interaction reveals structural differences on the cytoplasmic receptor side compared to the full agonist-bound nanobody-coupled form, suggesting that ligand-induced variations in G-protein interaction underpin partial agonism. Significant differences in receptor dynamics are observed ranging from rigid nanobody-coupled states to extensive μs-to-ms timescale dynamics when bound to a full agonist. We suggest that the mobility of the full agonist-bound form primes the GPCR to couple to IBPs. On formation of the ternary complex, ligand efficacy determines the quality of the interaction between the rigidified receptor and an IBP and consequently the signalling level

The GNAT library for local and remote gene mention normalization

Summary: Identifying mentions of named entities, such as genes or diseases, and normalizing them to database identifiers have become an important step in many text and data mining pipelines. Despite this need, very few entity normalization systems are publicly available as source code or web services for biomedical text mining. Here we present the Gnat Java library for text retrieval, named entity recognition, and normalization of gene and protein mentions in biomedical text. The library can be used as a component to be integrated with other text-mining systems, as a framework to add user-specific extensions, and as an efficient stand-alone application for the identification of gene and protein names for data analysis. On the BioCreative III test data, the current version of Gnat achieves a Tap-20 score of 0.1987

Muon spin rotation and relaxation in magnetic materials

A review of the muon spin rotation and relaxation ($\mu$SR) studies on magnetic materials published from July 1993 is presented. It covers the investigation of magnetic phase diagrams, of spin dynamics and the analysis of the magnetic properties of superconductors. We have chosen to focus on selected experimental works in these different topics. In addition, a list of published works is provided.Comment: Review article, 59 pages, LaTeX with IoP macro

Income inequality and participation: A comparison of 24 European countries

Previous research suggests that where inequality is high, participation is low. Two arguments are generally put forward to explain this finding: First, inequality depresses participation because people have diverging statuses and therefore fewer opportunities to share common goals. Second, people may participate more in social and civic life when they have more resources to do so. However, up till now, these explanations have been lumped together in empirical analyses. Using EU-SILC data for 24 European countries, we analyse how inequality in different parts of the income distribution is related to civic, cultural and social participation. Results indicate that a substantial part of the impact of inequality manifests itself through resources at the individual and societal level. However, independent of resources, it is still the case that higher inequality magnifies the relationship between income and participation. This is in line with a view that inter-individual processes explain why inequality diminishes participation

Prevalence of <i>Mycobacterium avium</i> in Slaughter Pigs Based on Serological Monitoring Results and Bacteriological Validation

Mycobacterium avium (MA) is a potential food safety hazard in pigs. Blood samples of slaughtered pigs in the Netherlands and Germany were tested for the presence of MA antibodies to estimate the serological prevalence in the tested population. In the Dutch and German population 1.0% and 1.7% samples were positive, and 0.5% and 17.4% of the herds were at risk for having a MA infection respectively. The validity of the applied MA-ELISA was evaluated under field conditions. The specificity of the MA-ELISA was high (>98.4%). The average herd sensitivity was 18%. In the affected herds on average 50% of the animals were tested bacteriological positive for MA. It can be concluded that serological screening for the presence of MA antibodies is capable of identifying pig populations that are at risk for a MA infection