986 resultados para Bollinger, Lee C., 1946-
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"October 1946."
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"December 1946."
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Mode of access: Internet.
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Mode of access: Internet.
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BACKGROUND: Sustained virological response (SVR) is the primary objective in the treatment of chronic hepatitis C (CHC). Results from a recent clinical trial of patients with previously untreated CHC demonstrate that the combination of peginterferon alpha-2a and ribavirin produces a greater SVR than interferon alpha-2b and ribavirin combination therapy. However, the cost-effectiveness of peginterferon alpha-2a plus ribavirin in the U.S. setting has not been investigated. METHODS: A Markov model was developed to investigate cost-effectiveness in patients with CHC using genotype to guide treatment duration. SVR and disease progression parameters were derived from the clinical trials and epidemiologic studies. The impact of treatment on life expectancy and costs were projected for a lifetime. Patients who had an SVR were assumed to remain virus-free for the rest of their lives. In genotype 1 patients, the SVRs were 46% for peginterferon alpha-2a plus ribavirin and 36% for interferon alpha-2b plus ribavirin. In genotype 2/3 patients, the SVRs were 76% for peginterferon alpha-2a plus ribavirin and 61% for interferon alpha-2b plus ribavirin. Quality of life and costs were based on estimates from the literature. All costs were based on published U.S. medical care costs and were adjusted to 2003 U.S. dollars. Costs and benefits beyond the first year were discounted at 3%. RESULTS: In genotype 1, peginterferon alpha-2a plus ribavirin increases quality-adjusted life expectancy (QALY) by 0.70 yr compared to interferon alpha-2b plus ribavirin, producing a cost-effectiveness ratio of $2,600 per QALY gained. In genotype 2/3 patients, peginterferon alpha-2a plus ribavirin increases QALY by 1.05 yr in comparison to interferon alpha-2b plus ribavirin. Peginterferon alpha-2a combination therapy in patients with HCV genotype 2 or 3 is dominant (more effective and cost saving) compared to interferon alpha-2b plus ribavirin. Results weighted by genotype prevalence (75% genotype 1; 25% genotype 2 or 3) also show that peginterferon alpha-2a plus ribavirin is dominant. Peginterferon alpha-2a and ribavirin remained cost-effective (below $16,500 per QALY gained) under sensitivity analyses on key clinical and cost parameters. CONCLUSION: Peginterferon alpha-2a in combination with ribavirin with duration of therapy based on genotype, is cost-effective compared with conventional interferon alpha-2b in combination with ribavirin when given to treatment-naive adults with CHC.
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C–C bond-forming, cross-coupling reactions of organohalides with nucleophilic compounds, catalysed by palladium, are amongst the most important chemical reactions available to the synthetic chemist. The intimate mechanisms of these reactions, involving Pd0/PdII redox steps, have been of great historical interest and continue to be so. The myriad of possible mechanisms is reviewed in this chapter. The interplay of mononuclear Pd species with higher order Pd species, e.g. nanoclusters/nanoparticles are considered as being equally important in cross-coupling reaction mechanisms. A focus is placed on trichotomic behaviour of cross-coupling catalytic manifolds, from homogeneous to hybrid homogeneous–heterogeneous to truly heterogeneous behaviour. For the latter, surface chemistry and metal atom leaching (and various experimental techniques) are broadly discussed. It is now clear that mechanism for general cross‐coupling reactions, that is as presented to undergraduate students studying Chemistry degrees across the world, is undoubtedly more complex than first thought. New opportunities for catalyst design have therefore emerged in the area of Pd nanoparticles and nanocatalysis, with some wonderful applications especially in chemical biology, providing a snapshot of what the future might hold.
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Este artículo se inserta analiza el complejo proceso de estructuración de las políticas sanitarias en la Argentina. Procura examinar la transformación del sistema de salud pública durante el primer gobierno peronista en Jujuy (1946-1952). En esta tarea se presta atención a la labor del máximo responsable del área sanitaria en el distrito: Emilio Navea. Son objeto de estudio sus antecedentes académicos, sus relaciones políticas, así como las iniciativas y reformas realizadas al sistema de salud local. Esta intensa actividad contribuiría de gran modo a su designación como candidato a vicegobernador, para las elecciones de 1951, en representación del peronismo jujeño.
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El presente articulo intenta determinar las razones por las que el santuario de Sant Miquel de Llíria, uno de los más importantes de la actual provincia de Valencia, se consagró al arcàngel guerrero. Se estudia para ello la historia de su culto en Occidente, haciendo hincapié en aspectos como su relación con los lugares elevados y la frecuente proximidad de sus santuarios con aquellos dedicados a la Virgen. Atenderemos también a aspectos fundamentales del contexto histórico, como los movimientos de renovación espiritual medievales, la influencia del médico y teólogo Arnau de Vilanova en la Valencia de principios del siglo XIV y las profecías escatológicas vinculadas a la llegada del Anticristo.
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Graphene, with its unique electronic and structural qualities, has become an important playground for studying adsorption and assembly of various materials including organic molecules. Moreover, organic/graphene vertical structures assembled by van der Waals interaction have potential for multifunctional device applications. Here, we investigate structural and electrical properties of vertical heterostructures composed of C60 thin film on graphene. The assembled film structure of C60 on graphene is investigated using transmission electron microscopy, which reveals a uniform morphology of C60 film on graphene with a grain size as large as 500 nm. The strong epitaxial relations between C60 crystal and graphene lattice directions are found, and van der Waals ab initio calculations support the observed phenomena. Moreover, using C60-graphene heterostructures, we fabricate vertical graphene transistors incorporating n-type organic semiconducting materials with an on/off ratio above 3 × 10(3). Our work demonstrates that graphene can serve as an excellent substrate for assembly of molecules, and attained organic/graphene heterostructures have great potential for electronics applications.
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Objective: To evaluate the association between Acculturation and hypertension among Asian Americans in the Washington, D.C. metropolitan area. Methods: A cross-sectional study was conducted of 600 Chinese, Korean, and Vietnamese adults. Logistic regression was used to investigate the relationship between acculturation variables (years in the U.S., self-rated acculturation, self-rated English fluency) and hypertension, determined from a mean of 3 blood pressure readings taken on site. Results: Compared to those who resided in the U.S. for 0-5 years, individuals who resided for 6-10 years were about 60% less likely to have hypertension (aOR= 0.36; 95% CI: 0.12, 1.05; p-value=0.06). No significant association was observed between self-rated identity and hypertension. Compared to those with poor English fluency, those who speak “so-so” English have increased odds of hypertension (aOR=1.57; 95%CI: 0.93, 2.64; p-value= 0.09). Disaggregated analysis was conducted for Asian American subgroups, which showed differences in trends of acculturation and hypertension. Conclusion: Findings suggest an association between acculturation and hypertension, guiding future studies to investigate further into these observed effects. Some subgroup differences were observed among Asian American subgroups, potentially suggesting a subgroup-focused intervention.
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El concepto de actividad física es concebido de diferentes formas. Mostrando que existen varios factores que afectan de manera directa e indirecta la percepción que los sujetos construyen entorno a él, generando así una aproximación a diferentes definiciones de la actividad física desde varias perspectivas y dimensiones, donde predomina una noción netamente biológica. Este estudio pretende analizar, como desde las clases sociales se concibe la actividad física en sus conceptos y prácticas considerando los modelos de determinantes y determinación social para la salud. Con fin de comprender como los autores de la literatura científica conciben la actividad física y la relación con las clases sociales, desde una perspectiva teórica de los determinantes sociales de la salud y la teoría de la determinación social, se realizó una revisión documental y análisis de contenido de los conceptos y prácticas de la actividad física que se han considerado en los últimos 10 años. Para ello se seleccionaron las bases de datos PubMed y BVS (Biblioteca Virtual de Salud) por sus énfasis en publicaciones de salud mundialmente. Mostrando que la actividad física es concebida dominantemente desde una perspectiva biológica que ejerce una mirada reduccionista. Las relaciones entre actividad física y las clases sociales están claramente establecidas, sin embargo, estas relaciones pueden discrepar teniendo en cuenta el concepto de clase social, el contexto y la orientación de los autores y las poblaciones objetos de estudio. Obteniendo como resultado que los estudios documentados, revisados y analizados muestran una clara tendencia al modelo de determinantes; no obstante, algunos estudios en sus análisis se orientan hacia el modelo de determinación social. En cuanto al concepto de clases sociales los autores consideran una combinación de factores culturales y económicos sin atreverse a adoptar un concepto específico.