The National Coalition on Black Civic Participation

This study evaluates electronic health record (EHR) adoption by primary care providers in Georgia to assess adoption disparities according to practice size and type, payer mix, and community characteristics. Frequency variances of EHR "Go Live" status were estimated. Odds ratios were calculated by univariate and multivariate logistic regression models. Large practices and community health centers (CHCs) were more likely to Go Live (>80% EHR adoption) than rural health clinics and other underserved settings (53%). A significantly lower proportion (68.9%) of Medicaid predominant providers had achieved Go Live status and had a 47% higher risk of not achieving Go Live status than private insurance predominant practices. Disparities in EHR adoption rates may exacerbate existing disparities in health outcomes of patients served by these practices. Targeted support such as that provided to CHCs would level the playing field for practices now at a disadvantage.

Click to increase image sizeClick to decrease image size Notes 1. See www.education.gov.uk/researchandstatistics/research/scri.

Solid organ transplantation is the criterion standard treatment for many with end-organ failure and can offer a new independence from the burden of disease. However solid organ transplant recipients (SOTRs) remain at high risk of cardiovascular (CV) disease, and poor quality of life and physical functioning. Increasing physical activity and exercise can improve the health of the general population; however, the effects on those with a transplant remain unclear. Intensive exercise and sporting activity has the potential to be beneficial, although there remain concerns particularly around the effects on immune function and the CV system. This review summarizes what is known about the effects of exercise on determinants of health in SOTRs and then collates the available literature investigating the consequences of intensive exercise and sport on the health of SOTR. There is a paucity of high-quality research, with most evidence being case studies or anecdotal; this is understandable given the relatively few numbers of SOTRs who are performing sport and exercise at a high level. However, if suitable evidence-based guidelines are to be formed and SOTRs are to be given reassurances that their activity levels are not detrimental to their transplanted organ and overall health, then more high-quality studies are required.

Alternative techniques for cable installation across rock nearshore zones are introduced. (The nearshore zone is variously defined as extending from the beach to water depths between 30 and 200 m.) The alternative techniques are made possible by new equipment developments in directional drilling of oil wells and in rock trenching. First, it is feasible and sometimes economical to directionally drill a borehole from the beach to emerge from the seafloor some 4000 m offshore. This report describes the techniques available to drill, case, and install cable in such a drill hole. Second, it is feasible and economical to cut a trench in soft rock (coral) to medium hard rock (shale, sandstone) using a bottom crawling, modified terrestrial trencher. The equipment modifications necessary are described.

O objetivo deste artigo é trazer algumas informações e discussões acerca do ideário de umaeducação, denominada de Educação 5.0, especialmente como os Objetos Virtuais de Aprendizagem(OVA) podem servir de meios, a serem usados pelos educandos e educadores, na consolidação de umaeducação participativa, reflexiva e que favorece a concretização de uma sociedade ética, onde não háexclusão, a humanidade das pessoas é respeitada e valorizada e os direitos individuais e coletivos sãorespeitados. Quanto aos aspectos metodológicos, este trabalho classifica-se como uma pesquisa bibliográfica e qualitativa. Inicia-se o estudo historiando e definindo a Educação 1.0, 2.0, 3.0, 4.0 e 5.0 e, em seguida, busca-se respostas para as perguntas: as Tecnologias Digitais (TD), em particular os OVA, podem trazer alguma contribuição para a implementação da Educação 5.0? Quais seriam as vantagens e/ou diretrizes do uso dos OVA para se chegar a esta educação? Com base nos estudos consultados conclui-se que o uso dos OVA têm permitido diferentes abordagens na busca, processamento e análise de informações, bem como na exploração, experimentação e resolução de problemas e demandas da vida cotidiana. Estes estudos sugerem ainda, que isso deva ser feito de forma crítica, reflexiva e ética, de forma a contribuir para se alcançar uma sociedade mais humana, socialmente justa e inclusiva. Em síntese, os OVA têm trazido contribuições significativas para se alcançar uma Educação 5.0.

India is the largest democratic country and currently celebrating the festivity of the election. We observed that the editorial by Lancet published about India’s election: Why Data and Transparency Matter (1). After reading the editorial, the most important question came to the mind of Indian readers: Is there any hidden agenda in the editorial team of Lancet Journal? Why did the Lancet choose to deal with the subject of data and transparency at the time of the election in India? Close examination of this editorial’s references, particularly the second one, confirmed the hunch of readers that the comprehension is significantly biased as it is based on a media report and the editor has used his position in a scientific journal to interfere in the affairs of a sovereign nation. It is totally unacceptable and undone of scientific temperament. Through this letter, our team is conveying the feelings of the people of the largest democratic and secular country. We would not pick the Lancet as our first source of information on this issue. Secondly, the journal cannot afford to become politicized by allowing only one point of view to be expressed. How will we know the editor hasn't rejected papers simply because their findings disagree with your politics?

Objectives: To simplify processing of RBCs, we compared RBC folate forms in washed and unwashed blood samples.Methods: We obtained fresh EDTA blood (10 blood bank donors; 3 tubes/donor) and generated RBCs (refrigerated centrifugation at 1500xg, 10 min) using no wash (with second centrifugation step), 1x wash, and 3x wash (conventional procedure).Cold saline (1:1) was used for the 1x and 3x wash conditions.We diluted RBCs (unwashed and washed) with saline (1:1), mixed well, prepared lysates (1:11 dilution) with 1% ascorbic acid, and stored samples at -70 C for 1 week.At the time of analysis (2 replicates/sample type over 2 days), we treated RBC lysates with recombinant exo -glutamyl hydrolase for folate polyglutamate deconjugation and conducted sample clean-up by solid phase extraction prior to HPLC-MS/MS analysis.We measured hemoglobin (Hb) in the same RBC lysates to correct for residual moisture in the packed RBCs and normalized the concentration of each folate form to Hb using the mean corpuscular Hb content.Results: Concentrations (meanAESD, nmol/L) of folate forms for no wash or 1x wash vs conventional showed excellent correlation (Pearson r !0.985) and correspondence for 5-methyltetrahydrofolate (5-methylTHF: 774AE270 or 766AE260 vs 761AE264), non-methyl folate (53AE68 or 55AE69 vs 51AE69), and MeFox (164AE39 or 158AE36 vs 159AE38), respectively.The Deming slope (95% CI) was not significantly different from 1 for 5-methylTHF (1.02 [0.95-1.09]or 0.99 [0.95-1.03]),nonmethyl folate (0.98 [0.95-1.01]or 0.99 [0.89-1.09]),and MeFox (1.04 [0.90-1.17]or 0.94 [0.82-1.06])and the Deming intercept was not different from 0. The mean relative difference (% [95% CI]) for no wash or 1x wash vs conventional was mostly small: 5-methylTHF (1.8% [-0.2% to 4%] or 0.82% [-1.54% to 3.2%]), MeFox (3.3% [0.4% to 6.2%] or 0.11% [-2.8% to 3.0%]), and non-methyl folate (13% [1.63% to 24%] or 14% [3.1% to 24%]), respectively.Conclusions: RBC folate form concentrations corresponded well across wash procedures but were slightly higher in no wash samples for minor folate forms.

ABSTRACT Background LB100 is a protein phosphatase 2A (PP2A) inhibitor. Glioma models show inhibition of PP2A by LB100 causes cell death. Whether LB100 crosses the human blood brain barrier (BBB) is unknown. We sought to determine the pharmacokinetic (PK) properties of LB100 in human subject gliomas. Methods A two-stage, phase 0 trial was done. Eligibility required a recurrent adult diffuse type of glioma deemed surgically resectable. In the first stage, 5 patients were pre-surgically dosed with LB100. Resected tumor then underwent PK analysis by LC-MS/MS. If one of five tumors demonstrated a PK response three additional subjects would be enrolled. Pharmacokinetic effect would be declared significant if at least 2 of 8 patients demonstrated a PK response and pharmacodynamic studies would then be performed. Results Five patients were evaluable. Glioblastoma, (n=2), Astrocytoma IDH-mutant grade 3-4 (n=2), and Oligodendroglioma IDH-mutant, grade 2 (n=1). Mean C max was 146 ng/mL (range: 95-179 ng/mL). Mean plasma half-life (T 1/2 ) was 1.2 hours (range: 1.09-1.46 hours). Mean plasma drug exposure (AUC INF ) was 414 hr*ng/mL (range: 325 to 468 ng*hr/mL. Average concentration of LB100 in tumor was 0.19 nM (range: 0 to 0.67 nM). Average plasma concentration of LB100 was 77.26 nM (range: 30.81 to 132.26 nM). The percent of drug penetration into the brain was 0.31% (range: 0% to 1.04%). The IC 50 of PP2A is 0.2-0.4 uM; showing drug penetration was inadequate. Conclusion In this first PK analysis of LB100 in human gliomas there was poor penetration of LB100 into glial tumors. Statement of Translational Relevance This phase 0 study represents the first pharmacokinetic (PK) analysis of LB100 in human brain cancers. It demonstrates there is poor penetration of LB100 crossing the blood brain barrier (BBB) into central nervous system (CNS) tumors. The ratio of the LB100 concentration in tumor to plasma tissue was much less than one percent, which resulted in a median LB100 tumor tissue concentration of 0.19 nM or 1000-fold less than a previously established minimum IC50 of 0.2uM, targeting the enzyme protein phosphatase 2A. This study highlights the importance of phase 0 studies as a component of new drug development for patients with CNS tumors. The poor brain tumor penetration demonstrated in this investigation will inform decision making regarding future LB100 clinical trials. Unless efforts are successful to reengineer LB100 to increase BBB permeability, upcoming trials will focus on non-CNS tumors.

Os progressos na tecnologia de manufatura têm feito fabricantes desenvolverem peças mais complexas em pouco tempo com uma boa qualidade. Essas peças são feitas por tecnologias de usinagem a laser, por plasma, onde elas são algumas dessas tecnologias bem estabelecidas em manufatura. Neste trabalho foi utilizado a pesquisa bibliográfica, sob uma abordagem de pesquisa de campo que foi o processo mecanizado na usinagem por plasma, mostrando o ar comprimido como gás de corte. Foi analisado os parâmetros do processo de entrada como distância, velocidade e pressão, juntamente com os parâmetros de saída que foram, temperatura, alteração nas propriedades. Os dados coletados foram analisados estatisticamente, modelagem computacional e por meio de ensaios não destrutivos. Toda realização de experimentos foi composta por uma mesa bancada em aço, um dispositivo de rotação de tubos, uma máquina de plasma, um compressor de 8 psi, um suporte de regulagem para DBCP (distância bico contato peça) e um termovisor. O aço SAE 1515 teve um aumento de 223,5HV para 357 HV, totalizando um aumento de 59%, analisando os parâmetros utilizados de 0 mm DBCP, 200 mm/min de velocidade e 4 psi de pressão. O aço SAE 1515 a DBCP com a velocidade foi o maior influenciador do aumento da dureza. Na temperatura, a vantagem principal deste sistema reside na diminuição do risco de deformação devido à compactação térmica da zona usinada.