Are Patents Impeding Medical Care and Innovation?

This month's debate examines whether the current patent system is crucial for stimulating health research or whether it is stifling biomedical research and impeding medical care. Background to the debate: Pharmaceutical and medical device manufacturers argue that the current patent system is crucial for stimulating research and development (R&D), leading to new products that improve medical care. The financial return on their investments that is afforded by patent protection, they claim, is an incentive toward innovation and reinvestment into further R&D. But this view has been challenged in recent years. Many commentators argue that patents are stifling biomedical research, for example by preventing researchers from accessing patented materials or methods they need for their studies. Patents have also been blamed for impeding medical care by raising prices of essential medicines, such as antiretroviral drugs, in poor countries. This debate examines whether and how patents are impeding health care and innovation

Evaluation of a clinical method for selective electrode deactivation in cochlear implant programming

BackgroundCochlear implants are a neural prosthesis used to restore the perception of hearing in individuals with severe-to-profound hearing loss by stimulating the auditory nerve with electrical current through a surgically implanted electrode array. The integrity of the interface between the implanted electrode array and the auditory nerve contributes to the variability in outcomes experienced by cochlear implant users. Strategies to identify and eliminate poorly encoding electrodes have been found to be effective in improving outcomes with the device, but application is limited in a clinical setting.ObjectiveThe purpose of this study was to evaluate a clinical method used to identify and selectively deactivate cochlear implants (CI) electrodes related to poor electrode-neural interface.MethodsThirteen adult CI users participated in a pitch ranking task to identify indiscriminate electrode pairs. Electrodes associated with indiscriminate pairs were selectively deactivated, creating an individualized experimental program. Speech perception was evaluated in the baseline condition and with the experimental program before and after an acclimation period. Participant preference responses were recorded at each visit.ResultsStatistically significant improvements using the experimental program were found in at least one measure of speech perception at the individual level in four out of 13 participants when tested before acclimation. Following an acclimation period, ten out of 13 participants demonstrated statistically significant improvements in at least one measure of speech perception. Statistically significant improvements were found with the experimental program at the group level for both monosyllabic words (p = 0.006) and sentences in noise (p = 0.020). Additionally, ten participants preferred the experimental program prior to the acclimation period and eleven preferred the experimental program following the acclimation period.ConclusionResults from this study suggest that electrode deactivation may yield improvement in speech perception following an acclimation period. A majority of CI users in our study reported a preference for the experimental program. This method proved to be a suitable clinical strategy for identifying and deactivating poorly encoding electrodes in adult CI users

A pen device for injection of recombinant human growth hormone: a European usability engineering study.

The Aluetta™ reusable pen device and instructions for use (IFU) for growth hormone (r-hGH; Saizen®, Merck KGaA, Darmstadt, Germany) administration were tested for Human-Factors Usability, to ensure it could be used safely and effectively by the intended users in the intended use environment.Usability testing was conducted under simulated conditions in three groups of participants: pediatric or adult patients with growth hormone deficiency (GHD), participants without GHD, and healthcare professionals (HCPs). The testing comprised a 45-minute training session, a 2-hour testing session, and a participant-feedback session.Twenty-six participants completed the training session and performed all critical tasks related to the pen use across three scenarios. The most difficult tasks were related to the preparation, checking, and maintenance of the device; only 8% of use errors occurred during tasks related to the injection process. Eighty-five percent considered the pen safe and effective to use without further modifications and the training to be clear and effective.The pen device and associated materials benefited from Human Factors Engineering throughout the development process. These evaluations show that patients and HCPs could safely and effectively use the pen device, and the IFU and training were clear and effective

Early Childhood Special Education in a Refugee Resettlement Community: Challenges and Innovative Practices

There has been a significant increase in the number of children who are culturally and linguistically diverse (CLD) who qualify for early childhood special education (ECSE) services (Banerjee & Guiberson, 2012). The current study investigates the challenges and innovative practices in the evaluation and (ECSE) services for preschool aged children who are refugees. Twenty-eight early childhood educators who work in a small refugee resettlement community participated in a qualitative study using semi-structured interviews resulting in themes regarding challenges and innovative practices. Challenges include: lack of validated assessments, wait time for evaluations, different cultural perspectives and family advocacy. Innovative practices include: assessing skills not dependent on language and including caregivers in evaluations. Implications for future research and teacher preparation are discussed

Brief mindfulness training enhances cognitive control in socioemotional contexts: Behavioral and neural evidence.

In social contexts, the dynamic nature of others' emotions places unique demands on attention and emotion regulation. Mindfulness, characterized by heightened and receptive moment-to-moment attending, may be well-suited to meet these demands. In particular, mindfulness may support more effective cognitive control in social situations via efficient deployment of top-down attention. To test this, a randomized controlled study examined effects of mindfulness training (MT) on behavioral and neural (event-related potentials [ERPs]) responses during an emotional go/no-go task that tested cognitive control in the context of emotional facial expressions that tend to elicit approach or avoidance behavior. Participants (N = 66) were randomly assigned to four brief (20 min) MT sessions or to structurally equivalent book learning control sessions. Relative to the control group, MT led to improved discrimination of facial expressions, as indexed by d-prime, as well as more efficient cognitive control, as indexed by response time and accuracy, and particularly for those evidencing poorer discrimination and cognitive control at baseline. MT also produced better conflict monitoring of behavioral goal-prepotent response tendencies, as indexed by larger No-Go N200 ERP amplitudes, and particularly so for those with smaller No-Go amplitude at baseline. Overall, findings are consistent with MT's potential to enhance deployment of early top-down attention to better meet the unique cognitive and emotional demands of socioemotional contexts, particularly for those with greater opportunity for change. Findings also suggest that early top-down attention deployment could be a cognitive mechanism correspondent to the present-oriented attention commonly used to explain regulatory benefits of mindfulness more broadly

Transcriptomic responses of the heart and brain to anoxia in the Western Painted turtle

Painted turtles are the most anoxia-tolerant tetrapods known, capable of surviving without oxygen for more than four months at 3°C and 30 hours at 20°C. To investigate the transcriptomic basis of this ability, we used RNA-seq to quantify mRNA expression in the painted turtle ventricle and telencephalon after 24 hours of anoxia at 19°C. Reads were obtained from 22,174 different genes, 13,236 of which were compared statistically between treatments for each tissue. Total tissue RNA contents decreased by 16% in telencephalon and 53% in ventricle. The telencephalon and ventricle showed ≥ 2x expression (increased expression) in 19 and 23 genes, respectively, while only four genes in ventricle showed ≤ 0.5x changes (decreased expression). When treatment effects were compared between anoxic and normoxic conditions in the two tissue types, 31 genes were increased (≥ 2x change) and 2 were decreased (≤ 0.5x change). Most of the effected genes were immediate early genes and transcription factors that regulate cellular growth and development; changes that would seem to promote transcriptional, translational, and metabolic arrest. No genes related to ion channels, synaptic transmission, cardiac contractility or excitation-contraction coupling changed. The generalized expression pattern in telencephalon and across tissues, but not in ventricle, correlated with the predicted metabolic cost of transcription, with the shortest genes and those with the fewest exons showing the largest increases in expression

Borehole Radar Attenuation-Difference Tomography During the Tracer/Time-Lapse Test at the Boise Hydrogeophysical Research Site

A tracer test and time-lapse radar imaging experiment was conducted at the Boise Hydrogeophysical Research Site to investigate the utility of crosswell radar in imaging an electrically conductive tracer plume. A multilevel water sampling system down gradient from the tracer injection well and in the radar imaging plane was used to collect detailed, 1-dimensional, fluid electrical conductivity data during the tracer test. We compare the spatial and temporal position and concentration variations of the plume as indicated by the fluid conductivity data to those suggested by radar level run attenuation differences, shot-receiver attenuation difference crossplots, and an attenuation-difference tomogram. We find that attenuation differences generally correlate well with changes in fluid conductivity. Where correlations are not so strong, the discrepancies can be explained by the difference in support volumes for the radar and chemistry measurements, and also by regularization of the radar tomogram. Our results indicate that crosswell radar imaging coupled with hydrologic tracer testing can provide useful information about subsurface fluid flow and mass transport in complex fluvial aquifers

Short-term genome stability of serial Clostridium difficile ribotype 027 isolates in an experimental gut model and recurrent human disease

Copyright: © 2013 Eyre et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedClostridium difficile whole genome sequencing has the potential to identify related isolates, even among otherwise indistinguishable strains, but interpretation depends on understanding genomic variation within isolates and individuals.Serial isolates from two scenarios were whole genome sequenced. Firstly, 62 isolates from 29 timepoints from three in vitro gut models, inoculated with a NAP1/027 strain. Secondly, 122 isolates from 44 patients (2–8 samples/patient) with mostly recurrent/on-going symptomatic NAP-1/027 C. difficile infection. Reference-based mapping was used to identify single nucleotide variants (SNVs).Across three gut model inductions, two with antibiotic treatment, total 137 days, only two new SNVs became established. Pre-existing minority SNVs became dominant in two models. Several SNVs were detected, only present in the minority of colonies at one/two timepoints. The median (inter-quartile range) [range] time between patients’ first and last samples was 60 (29.5–118.5) [0–561] days. Within-patient C. difficile evolution was 0.45 SNVs/called genome/year (95%CI 0.00–1.28) and within-host diversity was 0.28 SNVs/called genome (0.05–0.53). 26/28 gut model and patient SNVs were non-synonymous, affecting a range of gene targets.The consistency of whole genome sequencing data from gut model C. difficile isolates, and the high stability of genomic sequences in isolates from patients, supports the use of whole genome sequencing in detailed transmission investigations.Peer reviewe

Seasonality of Holocene hydroclimate in the Eastern Mediterranean reconstructed using the oxygen isotope composition of carbonates and diatoms from Lake Nar, central Turkey

A positive shift in the oxygen isotope composition (δ18O) of lake carbonates in the Eastern Mediterranean from the early to late Holocene is usually interpreted as a change to drier (reduced P/E) conditions. However, it has also been suggested that changes in the seasonality of precipitation could explain these trends. Here, Holocene records of δ18O from both carbonates and diatom silica, from Lake Nar in central Turkey, provide insights into palaeoseasonality. We show how Δδ18Olakewater (the difference between spring and summer reconstructed δ18Olakewater) was minimal in the early Holocene and for most of the last millennium, but was greater at other times. For example, between ~4,100-1,600 years BP we suggest that increased Δδ18Olakewater could have been the result of relatively more spring/summer evaporation, amplified by a decline in lake level. In terms of change in annual mean δ18O, isotope mass balance modelling shows that this can be influenced by changes in seasonal P/E as well as inter-annual P/E, but lake level falls inferred from other proxies confirm there was a mid Holocene transition to drier climatic conditions in central Turkey

Polarization and relaxation of radon

Investigations of the polarization and relaxation of $^{209}$Rn by spin exchange with laser optically pumped rubidium are reported. On the order of one million atoms per shot were collected in coated and uncoated glass cells. Gamma-ray anisotropies were measured as a signal of the alignment (second order moment of the polarization) resulting from the combination of polarization and quadrupole relaxation at the cell walls. The temperature dependence over the range 130$^\circ$C to 220$^\circ$C shows the anisotropies increasing with increasing temperature as the ratio of the spin exchange polarization rate to the wall relaxation rate increases faster than the rubidium polarization decreases. Polarization relaxation rates for coated and uncoated cells are presented. In addition, improved limits on the multipole mixing ratios of some of the main gamma-ray transitions have been extracted. These results are promising for electric dipole moment measurements of octupole-deformed $^{223}$Rn and other isotopes, provided sufficient quantities of the rare isotopes can be produced.Comment: 4 pages, 4 figure