Summary of Martinez v. State

Gina Martinez appealed a district court order denying her motion for return of money deposited as bail

An engineering approach to improving hospital supply chains

Thesis (M. Eng. in Logistics)--Massachusetts Institute of Technology, Engineering Systems Division, 2008.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references (leaves 130-132).This thesis explores supply chain management practices that have been implemented, and have improved supply chains in industries outside of healthcare. The presented supply chain practices have been selected because they have the potential to improve efficiency, reduce costs and improve patient safety within hospitals. Due to the diverse nature of hospitals and a unique product profile, there is no "one size fits all" supply chain solution that can be implemented. Therefore, product specific characteristics are discussed that can be used by hospitals in order to develop segmentation policies. Supply chain best practices from outside of the healthcare industry are presented for each category of segmented products. The culmination of this thesis is the presentation of a supply chain that will enable the hospital to significantly reduce inventory storage space, on hand inventory value, and time spent by nurses managing inventory. The proposed supply chain model is patient specific and involves the delivery of items from an offsite warehouse directly to the patient's bedside. In order to successfully implement a new supply chain solution in a hospital setting, change management is a critical part of the process. Methods are presented that have resulted in successful implementations of complex systems within hospitals. Three areas must be considered when managing change in this type of setting, the healthcare environment, the hospital's internal management and operational aspects of the hospital supply chain. Using simulation models, we show that implementation of the proposed supply chain for appropriately segmented products will result in significant supply chain cost savings and boost the revenue.by Scott Hsiang-Jen Cheng and Graham J. Whittemore.M.Eng.in Logistic

Transplantation of Ciliary Neurotrophic Factor-Expressing Adult Oligodendrocyte Precursor Cells Promotes Remyelination and Functional Recovery after SpinalCord Injury

Demyelination contributes to the dysfunction after traumatic spinal cord injury (SCI). We explored whether the combination of neurotrophic factors and transplantation of adult rat spinal cord oligodendrocyte precursor cells (OPCs) could enhance remyelination and functional recovery after SCI. Ciliary neurotrophic factor (CNTF) was the most effective neurotrophic factor to promote oligodendrocyte (OL) differentiation and survival of OPCs in vitro. OPCs were infected with retroviruses expressing enhanced green fluorescent protein (EGFP) or CNTF and transplanted into the contused adult thoracic spinal cord 9 d after injury. Seven weeks after transplantation, the grafted OPCs survived and integrated into the injured spinal cord. The survival of grafted CNTF-OPCs increased fourfold compared with EGFP-OPCs. The grafted OPCs differentiated into adenomatus polyposis coli (APC+) OLs, and CNTF significantly increased the percentage of APC+ OLs from grafted OPCs. Immunofluorescent and immunoelectron microscopic analyses showed that the grafted OPCs formed central myelin sheaths around the axons in the injured spinal cord. The number of OL-remyelinated axons in ventrolateral funiculus (VLF) or lateral funiculus (LF) at the injured epicenter was significantly increased in animals that received CNTF-OPC grafts compared with all other groups. Importantly, 75% of rats receiving CNTF-OPC grafts recovered transcranial magnetic motor-evoked potential and magnetic interenlargement reflex responses, indicating that conduction through the demyelinated axons in VLF or LF, respectively, was partially restored. More importantly, recovery of hindlimb locomotor function was significantly enhanced in animals receiving grafts of CNTF-OPCs. Thus, combined treatment with OPC grafts expressing CNTF can enhance remyelination and facilitate functional recovery after traumatic SCI

Astrocytes from the contused spinal cord inhibit oligodendrocyte differentiation of adult oligodendrocyte precursor cells by increasing the expression of bone morphogenetic proteins.

Promotion of remyelination is an important therapeutic strategy to facilitate functional recovery after traumatic spinal cord injury (SCI). Transplantation of neural stem cells (NSCs) or oligodendrocyte precursor cells (OPCs) has been used to enhance remyelination after SCI. However, the microenvironment in the injured spinal cord is inhibitory for oligodendrocyte (OL) differentiation of NSCs or OPCs. Identifying the signaling pathways that inhibit OL differentiation in the injured spinal cord could lead to new therapeutic strategies to enhance remyelination and functional recovery after SCI. In the present study, we show that reactive astrocytes from the injured rat spinal cord or their conditioned media inhibit OL differentiation of adult OPCs with concurrent promotion of astrocyte differentiation. The expression of bone morphogenetic proteins (BMP) is dramatically increased in the reactive astrocytes and their conditioned media. Importantly, blocking BMP activity by BMP receptor antagonist, noggin, reverse the effects of active astrocytes on OPC differentiation by increasing the differentiation of OL from OPCs while decreasing the generation of astrocytes. These data indicate that the upregulated bone morphogenetic proteins in the reactive astrocytes are major factors to inhibit OL differentiation of OPCs and to promote its astrocyte differentiation. These data suggest that manipulation of BMP signaling in the endogenous or grafted NSCs or OPCs may be a useful therapeutic strategy to increase their OL differentiation and remyelination and enhance functional recovery after SCI

Response-dependent two-phase sampling designs

This is the peer reviewed version of the following article: McIsaac, M. A. and Cook, R. J. (2014), Response-dependent two-phase sampling designs for biomarker studies. Can J Statistics, 42: 268–284. doi: 10.1002/cjs.11207, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1002/cjs.11207/references. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.Two-phase sampling designs are developed and investigated for use in the context of a rheumatology study where interest lies in the association between a biomarker with an expensive assay and disease progression. We derive optimal phase-II stratum-specific sampling probabilities for analyses from parametric maximum likelihood (ML), mean score (MS), inverse probability weighted (IPW), and augmented IPW (AIPW) estimating equations. The easy-to-implement optimally efficient design for the MS estimator is found to be asymptotically optimal for the IPW and AIPW estimators we consider, and is shown to result in efficiency gains over balanced and simple random sampling even when analyses are likelihood-based. We further demonstrate the robustness of this optimal design and show that it results in very efficient estimation even when the model or parameters used in its derivation are misspecified.Natural Sciences and Engineering Research Council of Canada (RGPIN 155849); Canadian Institutes for Health Research (FRN 13887

Engaging fathers in child welfare services: a narrative review of recent research evidence

It is widely recognized as problematic that there are generally low levels of engagement with child welfare services from biological and social fathers. The result can be limited resources for children's care and potentially poor risk assessment and management. This paper reviews the published research from 2000 to 2010 about the barriers to and facilitators of better father engagement, as well as the very limited evidence on the effectiveness of work with maltreating fathers. There is relatively little known about what works in engaging men, but there are some promising indicators from family support and child protection practice contexts. These include early identification and early involvement of fathers; a proactive approach, including an insistence on men's involvement with services; and the use of practical activities. In the light of what is known about the characteristics of maltreating fathers, there is a logical fit with cognitive‐behavioural approaches. Although there is no direct evidence of the effectiveness of motivational interviewing in this context, its effectiveness in allied fields of practice would suggest that it may hold some promise for the initial engagement of fathers who pose a risk to children.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90556/1/j.1365-2206.2012.00827.x.pd

Transcriptional activation of endothelial cells by TGFβ coincides with acute microvascular plasticity following focal spinal cord ischaemia/reperfusion injury

Microvascular dysfunction, loss of vascular support, ischaemia and sub-acute vascular instability in surviving blood vessels contribute to secondary injury following SCI (spinal cord injury). Neither the precise temporal profile of the cellular dynamics of spinal microvasculature nor the potential molecular effectors regulating this plasticity are well understood. TGFβ (transforming growth factor β) isoforms have been shown to be rapidly increased in response to SCI and CNS (central nervous system) ischaemia, but no data exist regarding their contribution to microvascular dysfunction following SCI. To examine these issues, in the present study we used a model of focal spinal cord ischaemia/reperfusion SCI to examine the cellular response(s) of affected microvessels from 30 min to 14 days post-ischaemia. Spinal endothelial cells were isolated from affected tissue and subjected to focused microarray analysis of TGFβ-responsive/related mRNAs 6 and 24 h post-SCI. Immunohistochemical analyses of histopathology show neuronal disruption/loss and astroglial regression from spinal microvessels by 3 h post-ischaemia, with complete dissolution of functional endfeet (loss of aquaporin-4) by 12 h post-ischaemia. Coincident with this microvascular plasticity, results from microarray analyses show 9 out of 22 TGFβ-responsive mRNAs significantly up-regulated by 6 h post-ischaemia. Of these, serpine 1/PAI-1 (plasminogen-activator inhibitor 1) demonstrated the greatest increase (>40-fold). Furthermore, uPA (urokinase-type plasminogen activator), another member of the PAS (plasminogen activator system), was also significantly increased (>7.5-fold). These results, along with other select up-regulated mRNAs, were confirmed biochemically or immunohistochemically. Taken together, these results implicate TGFβ as a potential molecular effector of the anatomical and functional plasticity of microvessels following SCI

A field investigation of phreatophyte-induced fluctuations in the water table

This is the published version. Copyright American Geophysical Union[1] Hydrographs from shallow wells in vegetated riparian zones frequently display a distinctive pattern of diurnal water table fluctuations produced by variations in plant water use. A multisite investigation assessed the major controls on these fluctuations and the ecohydrologic insights that can be gleaned from them. Spatial and temporal variations in the amplitude of the fluctuations are primarily a function of variations in (1) the meteorological drivers of plant water use, (2) vegetation density, type, and vitality, and (3) the specific yield of sediments in the vicinity of the water table. Past hydrologic conditions experienced by the riparian zone vegetation, either in previous years or earlier within the same growing season, are also an important control. Diurnal water table fluctuations can be considered a diagnostic indicator of groundwater consumption by phreatophytes at most sites, so the information embedded within these fluctuations should be more widely exploited in ecohydrologic studies

Oral contraceptive use and ovarian cancer risk among carriers of BRCA1 or BRCA2 mutations

Women with mutations of the genes BRCA1 or BRCA2 are at increased risk of ovarian cancer. Oral contraceptives protect against ovarian cancer in general, but it is not known whether they protect against the disease in carriers of these mutations. We obtained self-reported lifetime histories of oral contraceptive use from 451 women who carried mutations of BRCA1 or BRCA2. We used conditional logistic regression to estimate the odds ratios associated with oral contraceptive use, comparing the histories of 147 women with ovarian cancer (cases) to those of 304 women without ovarian cancer (controls) who were matched to cases on year of birth, country of residence and gene (BRCA1 vs BRCA2). Reference ages for controls had to exceed the ages at diagnosis of their matched cases. After adjusting for parity, the odds-ratio for ovarian cancer associated with use of oral contraceptives for at least 1 year was 0.85 (95 percent confidence interval, 0.53-1.36). The risk decreased by 5% (1-9%) with each year of use (P for trend=0.01). Use for 6 or more years was associated with an odds-ratio of 0.62 (0.35-1.09). These data support the hypothesis that long-term oral contraceptive use reduces the risk of ovarian cancer among women who carry mutations of BRCA1 or BRCA2