Optimal regulation of specialized medical care in a mixed system

We study the optimal public intervention in setting minimum standards of formation for specialized medical care. The abilities the physicians obtain by means of their training allow them to improve their performance as providers of cure and earn some monopoly rents.. Our aim is to characterize the most efficient regulation in this field taking into account different regulatory frameworks. We find that the existing situation in some countries, in which the amount of specialization is controlled, and the costs of this process of specialization are publicly financed, can be supported as the best possible intervention.

Resum de la tasca realitzada al Center Biomedical Engineering (CBE) del Massachussets Institute of Technology (MIT). Juliol-Agost 2005

Estudi elaborat a partir d’una estada al Center Biomedical Engineering (CBE) del Massachussets Institute of Technology (MIT), durant els mesos de juliol i agost del 2005. S’investiga una metodologia amb l’objectiu d’obtenir biomaterials que puguin actuar de bastida en la interfície os/cartílag, afavorint la diferenciació i creixement cel·lular de cartílag ossificat que pugui actuar d’unió entre l’articulació i l’os. S’experimenta una metodologia per a establir quins són els péptids afavoridors de la formació de teixit ossi utilitzats en materials d’hidroxiapatita. Es conclou que la tecnologia desenvolupada permet disposar d’una plataforma per assajar l’estudi del signaling sobre cèl·lules embrionàries, que permeti desenvolupar materials amb més capacitat diferenciadora.

Research work in Tokyo Institute of Technology

Research carried out in Tokyo Institute of Technology. The objective is to determine the influence of Interfacial Transition Zone (ITZ) around Lightweight aggregate in concrete on Chloride ion diffusivity. The ITZ of conventional concretes is the weakest point of concrete. The accumulating water on ITZ zone forms the most permeable area inside the concrete. Hence ITZ paves the way for chloride ion diffusion. The quality of ITZ depends on type and quality of aggregates used, water-cement ratio and also the method used for the production of concrete. It has been used two types of lightweight aggregates will be used, Chinese and Japanese, with different absorption capacities. The idea is to produce concrete with same effective water - cement ratio, using the same aggregates in two different conditions, dry and saturated, and compare the chloride ion diffusivity in these concretes (by diffusion test). A comparison of ITZ thickness of these concretes by SEM and EDAX-maps is also proposed. The chloride ion diffusion of concretes produced with the same effective water – cement ratio and same aggregates (dry and ssd) will depend, mainly, on ITZ.

Transferring QTL technology to the pig breeding industry (PigQTech) - a demonstration project

The aim of the project has been to demonstrate how the farm animal breeding industry can utilise gene mapping technology to accelerate genetic improvement. Previous theoretical studies had suggested that the use of marker assisted selection could potentially increase the annual improvement for quantitative traits like backfat with about 10% and for more difficult traits such as meat quality and reproduction by as much as 40-60% compared with existing technology. The work has comprised two major tasks: 1. Commercially relevant populations have been screened for segregation at QTLs identified in experimental populations. The aim has been to establish optimal strategies for QTL detection in commercial pig populations and the extent to which QTLs explaining major phenotypic differences between divergent lines used in experimental studies also explain quantitative variation within commercial lines. The results are important for specifying future strategies for finding economically valuable QTLs. 2. Marker assisted backcrossing has been used to demonstrate how a QTL allele can be introgressed from one breed to another. The work has focused on the major fatness QTL on pig chromosome 4 previously identified in a wild pig/Large White intercross. The end result was not designed to be a commercially viable product in its own right, but the process has validated a number of points of major importance for the exploitation of QTLs in livestock.

Observations on the dipteran fauna in a focus of dermal leishmaniasis in the State of Minas Gerais: II. The distribution of families in relation to their medical, veterinary and economic importance

Miniature light traps used to collect Phlebotominae in a focus of dermal leishmaniasis in the eastern part of the State of Minas Gerais, Brazil. Over a period of seven months, the other Diptera captured in 179 light trap samples were identified to family level. The traps were placed in eight localities which constituted three different biotopes: three woodland aresas, cultivated land, and a peridomestic site. A comparison is made between the totals of Dipeterans collected in each biotope, the total numbers of families collected in each biotope and the estimated indices of diversity. Dendograms representing the degrees of association between families of Diptera in different biotopes are presented. Some families of Diptera are uniformly distributed throughout the study area; a few families seem to have become adapted to areas where human activity has induced the greatest ecological changes. The impact between Dipterans and human well-being is discussed. The availabel evidence indicates that transmission of dermal leishmaniasis does not occur in areas where sand flies can be captured in greatest densities.

MedIGS, un sistema segur basat en agents per al descobriment i obtenció de dades mèdiques distribuïdes: estudi i desenvolupament

En aquest projecte es desenvolupa en totes les seves fases(estudi, anàlisi, disseny, implementació i proves) l'aplicació MedIGS. MedIGS és una aplicació destinada a satisfer algunes de les necesitats actuals del sistema sanitari, la compartició d’informació i la màxima coordinació possible, utilitzant una tecnologia novedosa: els agents, i més concretament, els agents mòbils. Gràcies a aquesta tecnologia aconseguirem una integració segura de dades mèdiques distribuïdes. Està previst fer una prova pilot a Portugal, a partir dels resultats d’aquest projecte.

Nanosensors for cancer detection.

Cancer is a major burden in today's society and one of the leading causes of death in industrialised countries. Various avenues for the detection of cancer exist, most of which rely on standard methods, such as histology, ELISA, and PCR. Here we put the focus on nanomechanical biosensors derived from atomic force microscopy cantilevers. The versatility of this novel technology has been demonstrated in different applications and in some ways surpasses current technologies, such as microarray, quartz crystal microbalance and surface plasmon resonance. The technology enables label free biomarker detection without the necessity of target amplification in a total cellular background, such as BRAF mutation analysis in malignant melanoma. A unique application of the cantilever array format is the analysis of conformational dynamics of membrane proteins associated to surface stress changes. Another development is characterisation of exhaled breath which allows assessment of a patient's condition in a non-invasive manner.

PFO closure vs. medical therapy in cryptogenic stroke or transient ischemic attack: A systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: This study aims to assess whether patent foramen ovale (PFO) closure is superior to medical therapy in preventing recurrence of cryptogenic ischemic stroke or transient ischemic attack (TIA). METHODS: We searched PubMed for randomized trials which compared PFO closure with medical therapy in cryptogenic stroke/TIA using the items: "stroke or cerebrovascular accident or TIA" and "patent foramen ovale or paradoxical embolism" and "trial or study". RESULTS: Among 650 potentially eligible articles, 3 were included including 2303 patients. There was no statistically significant difference between PFO-closure and medical therapy in ischemic stroke recurrence (1.91% vs. 2.94% respectively, OR: 0.64, 95%CI: 0.37-1.10), TIA (2.08% vs. 2.42% respectively, OR: 0.87, 95%CI: 0.50-1.51) and death (0.60% vs. 0.86% respectively, OR: 0.71, 95%CI: 0.28-1.82). In subgroup analysis, there was significant reduction of ischemic strokes in the AMPLATZER PFO Occluder arm vs. medical therapy (1.4% vs. 3.04% respectively, OR: 0.46, 95%CI: 0.21-0.98, relative-risk-reduction: 53.2%, absolute-risk-reduction: 1.6%, number-needed-to-treat: 61.8) but not in the STARFlex device (2.7% vs. 2.8% with medical therapy, OR: 0.93, 95%CI: 0.45-2.11). Compared to medical therapy, the number of patients with new-onset atrial fibrillation (AF) was similar in the AMPLATZER PFO Occluder arm (0.72% vs. 1.28% respectively, OR: 1.81, 95%CI: 0.60-5.42) but higher in the STARFlex device (0.64% vs. 5.14% respectively, OR: 8.30, 95%CI: 2.47-27.84). CONCLUSIONS: This meta-analysis does not support PFO closure for secondary prevention with unselected devices in cryptogenic stroke/TIA. In subgroup analysis, selected closure devices may be superior to medical therapy without increasing the risk of new-onset AF, however. This observation should be confirmed in further trials using inclusion criteria for patients with high likelihood of PFO-related stroke recurrence.

Changes in the demand for private medical insurance following a shift in tax incentives

The 1998 Spanish reform of the Personal Income Tax eliminated the 15% deduction for private medical expenditures including payments on private health insurance (PHI) policies. To avoid an undesirable increase in the demand for publicly funded health care, tax incentives to buy PHI were not completely removed but basically shifted from individual to group employer-paid policies. In a unique fiscal experiment, at the same time that the tax relief for individually purchased policies was abolished, the government provided for tax allowances on policies taken out through employment. Using a bivariate probit model on data from National Health Surveys, we estimate the impact of said reform on the demand for PHI and the changes occurred within it. Our findings suggest that the total probability of buying PHI was not significantly affected. Indeed, the fall in the demand for individual policies (by 10% between 1997 and 2001) was offset by an increase in the demand for group employer-paid ones, so that the overall size of the market remained virtually unchanged. We also briefly discuss the welfare effects on the state budget, the industry and society at large.