A Budget Impact Model for Two Investigational Agents for the Treatment of Nonalcoholic Steatohepatitis

Statistics show approximately 15 million Americans suffer from NASH, a nonalcoholic fatty liver disease that is projected to become the most common reason for liver transplantation. There are no FDA approved therapies for NASH, so doctors are forced to treat patients with off-label medications while keeping an eye out for breakthroughs in medication development. Two novel therapies, obeticholic acid and elafibranor, are currently in Phase III trials. If they receive FDA approval, interest will be high as they will be the first treatments specifically labeled for NASH. We detail a budget impact model for a sample state Medicaid plan in this poster presentation. This activity is valuable for payers to anticipate the impact of cutting-edge therapies in their population and proactively plan management strategies that ensure member access while maintaining cost-effectiveness. This presentation was given at the American Drug Utilization Review Society (ADURS) conference February 22-24, 2018 in Scottsdale, Arizona

Multiscale electrochemical study of welded al alloys joined by friction stir welding

Friction stir welding (FSW) is an efficient way to join high strength aluminum alloys. However, FSW generates different microstructural areas in contact that may give rise to galvanic couplings, affecting the corrosion resistance of the assembly. In the present work, a multiscale electrochemical study of the 7475-T651 and 2024-T3 aluminum alloys butt-joined by FSW was carried out.Much lower impedances were associated with the FSW affected zones compared to the two aluminum base metals tested individually. Corrosion of the welded system resulted in the establishment of galvanic coupling, shown by local electrochemical impedance spectroscopy (LEIS) measurements, at which the AA7475 behaves anodically with respect to the AA2024. A Zn deposit was observed on the intermetallic particles of the AA2024 after 24 h of immersion in the electrolyte resulting from the galvanic coupling, which seems to reduce the galvanic coupling effects. Such a behavior in combination with LEIS results allowed a description of the galvanic coupling development between two different aluminum alloys (AA2024-T3 and AA7475-T761) butt-welded by FSW as a function of time from the early stage of immersion

Impact of a Pilot Outreach Program upon Provider Awareness and Prescribing of a Concerning Opioid Combination Regimen

This pilot program was developed in response to a drug utilization review within a large Medicaid population that revealed some hazardous practices. Co-prescribing of opioids with benzodiazepines, gabapentin, and other stimulants occurred in more than 500 members, putting them at risk for additive central nervous system depression, misuse, abuse, and death from overdose. The poster presentation outlines the objectives, methods, and results of a telephonic outreach program that addressed these safety concerns. It captures prescriber awareness of the presence and risks of potentially deadly medication combinations among members in their care, with some intriguing results. Our experts provide health plans with framework and support to address the opioid epidemic head on with robust opioid medication management programs, evidence-based clinical guidelines, and prescriber outreach. Our interdisciplinary team’s innovative approach helps health plans decrease inappropriate opioid usage and while ensuring members maintain access to appropriate pain management. This presentation was given at the American Drug Utilization Review Society (ADURS) conference February 22-24, 2018 in Scottsdale, Arizona

New drugs and novel mechanisms of action in multiple myeloma in 2013: a report from the International Myeloma Working Group (IMWG)

Treatment in medical oncology is gradually shifting from the use of nonspecific chemotherapeutic agents toward an era of novel targeted therapy in which drugs and their combinations target specific aspects of the biology of tumor cells. Multiple myeloma (MM) has become one of the best examples in this regard, reflected in the identification of new pathogenic mechanisms, together with the development of novel drugs that are being explored from the preclinical setting to the early phases of clinical development. We review the biological rationale for the use of the most important new agents for treating MM and summarize their clinical activity in an increasingly busy field. First, we discuss data from already approved and active agents (including second- and third-generation proteasome inhibitors (PIs), immunomodulatory agents and alkylators). Next, we focus on agents with novel mechanisms of action, such as monoclonal antibodies (MoAbs), cell cycle-specific drugs, deacetylase inhibitors, agents acting on the unfolded protein response, signaling transduction pathway inhibitors and kinase inhibitors. Among this plethora of new agents or mechanisms, some are specially promising: anti-CD38 MoAb, such as daratumumab, are the first antibodies with clinical activity as single agents in MM. Moreover, the kinesin spindle protein inhibitor Arry-520 is effective in monotherapy as well as in combination with dexamethasone in heavily pretreated patients. Immunotherapy against MM is also being explored, and probably the most attractive example of this approach is the combination of the anti-CS1 MoAb elotuzumab with lenalidomide and dexamethasone, which has produced exciting results in the relapsed/refractory setting.Peer Reviewe

The Patient Journey

AbstractThe wide implementation of patient safety improvement efforts continues to face many barriers including insufficient involvement of all stakeholders in healthcare, lack of individual and organizational learning when medical errors occur and scarce investments in patient safety. The promotion of systems-based approaches offers methods and tools to improve the safety of care. A multidisciplinary perspective must include the involvement of patients and citizens as fundamental contributors to the design, implementation, and delivery of health services.The patient journey is a challenging example of using a systems approach. The inclusion of the patient's viewpoint and experience about their health journey throughout the time of care and across all the care settings represents a key factor in improving patient safety. Patient engagement ensures that the design of healthcare services are aligned with the values, the preferences, and needs of the patient community and integrates the real-life experience and the skills of the people to enhance patient safety in the patient journey.The utmost priority to implement patient engagement is the training of patients. Therefore, training for both patients/families/advocates and health professionals is the foundation on which to build active engagement of patients and consequently an effective and efficient patient journey.The chapter offers examples of successful training courses designed to foster strategic alliances among healthcare professionals and researchers with patients and their organizations. Training of patients constitutes the first step to develop shared knowledge, co-produced projects, and the achievement of active multilevel participation of patients for the implementation of patient safety in the patient journey

BC-SIM-TN-014 SIMBIO-SYS_Compatibility_Rules

This document, in accordance with the Spectrometers and Imagers for MPO BepiColombo Integrated Observatory SYStem (SIMBIO-SYS) Technical Note, Layout and Data flow agreement detailed in [RD.1], reports all the interdependence rules between the parameters (i.e., PSSxxx) in a single SIMBIO-SYS TeleCommand (TC) to make it compatible with respect to the Main Electronics (ME) Application SoftWare ASWv2.7) and so being executable. These rules are fundamental in building correct Flight Operation procedures (FOPs) and all other higher-level commanding sequences as Payload Direct Operation Request (PDOR), Payload Operation Request (POR), Memory Operation Request (MOR) and Instrument TimeLine (ITL) that use FOPs with open (i.e., formal) parameters. This is a sort of “living document” since present version describes two rules which are considered, for the time being, the most important ones: 1. Compatibility between commanded windows size and Compression settings of the Compression Unit (CU) in the ME 2. Definition of the lower limit of the Repetition Time (RT) 3. On-board processing for data refinemen