3,809 research outputs found

    PMH29 ATTENTION DEFICIT HYPERACTIVITY DISORDER MEDICATION CLINICAL PRIOR AUTHORIZATION PROGRAM'S IMPACT ON PRESCRIPTION DRUG UTILIZATION AND COSTS

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    Validity of the Elastic Constant Approximations for the Ultrasonic Evaluation of Multi-Layered Inhomogeneous Composites

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    Several ultrasonic wave mechanics models which are based on the effective elastic properties of the overall fiber reinforced composites are currently being used in the industry and academia. Due to the repetition of the ply orientation and the lay-up sequence traditionally used in the industry, these models which often β€œsmear” the individual ply elastic properties to obtain effective elastic properties of the entire composite. [1,2] This is an acceptable approximation for long wave length waves propagation in homogeneous or quasi-homogeneous ply lay-ups media and has provided useful results in the non-destructive evaluation process.</p

    Discovering monotonic stemness marker genes from time-series stem cell microarray data

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    Β© 2015 Wang et al.; licensee BioMed Central Ltd. Background: Identification of genes with ascending or descending monotonic expression patterns over time or stages of stem cells is an important issue in time-series microarray data analysis. We propose a method named Monotonic Feature Selector (MFSelector) based on a concept of total discriminating error (DEtotal) to identify monotonic genes. MFSelector considers various time stages in stage order (i.e., Stage One vs. other stages, Stages One and Two vs. remaining stages and so on) and computes DEtotal of each gene. MFSelector can successfully identify genes with monotonic characteristics.Results: We have demonstrated the effectiveness of MFSelector on two synthetic data sets and two stem cell differentiation data sets: embryonic stem cell neurogenesis (ESCN) and embryonic stem cell vasculogenesis (ESCV) data sets. We have also performed extensive quantitative comparisons of the three monotonic gene selection approaches. Some of the monotonic marker genes such as OCT4, NANOG, BLBP, discovered from the ESCN dataset exhibit consistent behavior with that reported in other studies. The role of monotonic genes found by MFSelector in either stemness or differentiation is validated using information obtained from Gene Ontology analysis and other literature. We justify and demonstrate that descending genes are involved in the proliferation or self-renewal activity of stem cells, while ascending genes are involved in differentiation of stem cells into variant cell lineages.Conclusions: We have developed a novel system, easy to use even with no pre-existing knowledge, to identify gene sets with monotonic expression patterns in multi-stage as well as in time-series genomics matrices. The case studies on ESCN and ESCV have helped to get a better understanding of stemness and differentiation. The novel monotonic marker genes discovered from a data set are found to exhibit consistent behavior in another independent data set, demonstrating the utility of the proposed method. The MFSelector R function and data sets can be downloaded from: http://microarray.ym.edu.tw/tools/MFSelector/

    Persistent TΒ Cell Repertoire Perturbation and TΒ Cell Activation in HIV After Long Term Treatment

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    Objective: In people living with HIV (PLHIV), we sought to test the hypothesis that long term anti-retroviral therapy restores the normal T cell repertoire, and investigate the functional relationship of residual repertoire abnormalities to persistent immune system dysregulation. Methods: We conducted a case-control study in PLHIV and HIV-negative volunteers, of circulating T cell receptor repertoires and whole blood transcriptomes by RNA sequencing, complemented by metadata from routinely collected health care records. Results: T cell receptor sequencing revealed persistent abnormalities in the clonal T cell repertoire of PLHIV, characterized by reduced repertoire diversity and oligoclonal T cell expansion correlated with elevated CD8 T cell counts. We found no evidence that these expansions were driven by cytomegalovirus or another common antigen. Increased frequency of long CDR3 sequences and reduced frequency of public sequences among the expanded clones implicated abnormal thymic selection as a contributing factor. These abnormalities in the repertoire correlated with systems level evidence of persistent T cell activation in genome-wide blood transcriptomes. Conclusions: The diversity of T cell receptor repertoires in PLHIV on long term anti-retroviral therapy remains significantly depleted, and skewed by idiosyncratic clones, partly attributable to altered thymic output and associated with T cell mediated chronic immune activation. Further investigation of thymic function and the antigenic drivers of T cell clonal selection in PLHIV are critical to efforts to fully re-establish normal immune function

    Deformation of the Fermi surface in the extended Hubbard model

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    The deformation of the Fermi surface induced by Coulomb interactions is investigated in the t-t'-Hubbard model. The interplay of the local U and extended V interactions is analyzed. It is found that exchange interactions V enhance small anisotropies producing deformations of the Fermi surface which break the point group symmetry of the square lattice at the Van Hove filling. This Pomeranchuck instability competes with ferromagnetism and is suppressed at a critical value of U(V). The interaction V renormalizes the t' parameter to smaller values what favours nesting. It also induces changes on the topology of the Fermi surface which can go from hole to electron-like what may explain recent ARPES experiments.Comment: 5 pages, 4 ps figure

    Direct observation of local K variation and its correlation to electronic inhomogeneity in (Ba1-xKx)Fe2As2 Pnictide

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    Local fluctuations in the distribution of dopant atoms are a suspected cause of nanoscale electronic disorder or phase separation observed within the pnictide superconductors. Atom probe tomography results present the first direct observations of dopant nano-clustering in a K-doped 122-phase pnictides. First-principles calculations suggest the coexistence of static magnetism and superconductivity on a lattice parameter length scale over a large range of doping concentrations. Collectively, our results provide evidence for a mixed scenario of phase coexistence and phase separation originating from variation of dopant atom experiments distroibutions.Comment: 4 pages, 4 figures and 1 table, accepted by Physical Review Letter 201

    Cost-Effectiveness of Gene-Specific Prevention Strategies for Ovarian and Breast Cancer.

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    IMPORTANCE: Pathogenic variants (PVs) in BRCA1, BRCA2, PALB2, RAD51C, RAD51D, and BRIP1 cancer susceptibility genes (CSGs) confer an increased ovarian cancer (OC) risk, with BRCA1, BRCA2, PALB2, RAD51C, and RAD51D PVs also conferring an elevated breast cancer (BC) risk. Risk-reducing surgery, medical prevention, and BC surveillance offer the opportunity to prevent cancers and deaths, but their cost-effectiveness for individual CSGs remains poorly addressed. OBJECTIVE: To estimate the cost-effectiveness of prevention strategies for OC and BC among individuals carrying PVs in the previously listed CSGs. DESIGN, SETTING, AND PARTICIPANTS: In this economic evaluation, a decision-analytic Markov model evaluated the cost-effectiveness of risk-reducing salpingo-oophorectomy (RRSO) and, where relevant, risk-reducing mastectomy (RRM) compared with nonsurgical interventions (including BC surveillance and medical prevention for increased BC risk) from December 1, 2022, to August 31, 2023. The analysis took a UK payer perspective with a lifetime horizon. The simulated cohort consisted of women aged 30 years who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. Appropriate sensitivity and scenario analyses were performed. EXPOSURES: CSG-specific interventions, including RRSO at age 35 to 50 years with or without BC surveillance and medical prevention (ie, tamoxifen or anastrozole) from age 30 or 40 years, RRM at age 30 to 40 years, both RRSO and RRM, BC surveillance and medical prevention, or no intervention. MAIN OUTCOMES AND MEASURES: The incremental cost-effectiveness ratio (ICER) was calculated as incremental cost per quality-adjusted life-year (QALY) gained. OC and BC cases and deaths were estimated. RESULTS: In the simulated cohort of women aged 30 years with no cancer, undergoing both RRSO and RRM was most cost-effective for individuals carrying BRCA1 (RRM at age 30 years; RRSO at age 35 years), BRCA2 (RRM at age 35 years; RRSO at age 40 years), and PALB2 (RRM at age 40 years; RRSO at age 45 years) PVs. The corresponding ICERs were -Β£1942/QALY (-2680/QALY),βˆ’Β£89/QALY(βˆ’2680/QALY), -Β£89/QALY (-123/QALY), and Β£2381/QALY (3286/QALY),respectively.RRSOatage45yearswascostβˆ’effectiveforRAD51C,RAD51D,andBRIP1PVcarrierscomparedwithnonsurgicalstrategies.ThecorrespondingICERswereΒ£962/QALY(3286/QALY), respectively. RRSO at age 45 years was cost-effective for RAD51C, RAD51D, and BRIP1 PV carriers compared with nonsurgical strategies. The corresponding ICERs were Β£962/QALY (1328/QALY), Β£771/QALY (1064/QALY),andΒ£2355/QALY(1064/QALY), and Β£2355/QALY (3250/QALY), respectively. The most cost-effective preventive strategy per 1000 PV carriers could prevent 923 OC and BC cases and 302 deaths among those carrying BRCA1; 686 OC and BC cases and 170 deaths for BRCA2; 464 OC and BC cases and 130 deaths for PALB2; 102 OC cases and 64 deaths for RAD51C; 118 OC cases and 76 deaths for RAD51D; and 55 OC cases and 37 deaths for BRIP1. Probabilistic sensitivity analysis indicated both RRSO and RRM were most cost-effective in 96.5%, 89.2%, and 84.8% of simulations for BRCA1, BRCA2, and PALB2 PVs, respectively, while RRSO was cost-effective in approximately 100% of simulations for RAD51C, RAD51D, and BRIP1 PVs. CONCLUSIONS AND RELEVANCE: In this cost-effectiveness study, RRSO with or without RRM at varying optimal ages was cost-effective compared with nonsurgical strategies for individuals who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. These findings support personalizing risk-reducing surgery and guideline recommendations for individual CSG-specific OC and BC risk management

    Continuum Modeling of Ultrasonic Behavior in Fluid-Loaded Fibrous Composite Media with Applications to Ceramic and Metal Matrix Composites

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    Elastic wave propagation in fibrous composite materials has been the subject of numerous investigations in recent years. However, the morphology of fiber-reinforced composites can seriously complicate the calculation of their wave propagation properties. Since it is clearly not practical to attempt a solution of the completely general elastic-wave problem, most prior work [1–4] has employed various approximations to render the calculations tractable. Our own approach [5,6] to interacting continua offers an alternative procedure for modeling the response of composites, where in particular, a rational construction of the mixture momentum and constitutive-relation interaction terms is given. This theory leads to simple wave propagation equations which potentially contain the full influence of the microstructure, that is, the distribution of displacements and stresses within individual constituents of the composite
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