Solution‐processed tandem solar cells created from nanocrystal quantum dots with size‐tuned energy levels are demonstrated. Prototype devices featuring interconnected quantum dot layers of cascaded ...energy gaps exhibit IR sensitivity and an open circuit voltage, Voc, approaching 1 V. The tandem solar cell performance depends critically on the optical and electrical properties of the interlayer.
Background and Aims
There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed.
...Methods
We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs. Panelists rated QIs prior to a planned meeting using a standard 9-point RAND appropriateness scale. These ratings guided discussion during a day-long phone conference meeting, and final ratings were then provided by panel members. Final QI scores were computed and QIs with a final median score of greater than or equal to 7, and no disagreement was included in the final set.
Results
Among 28 candidate QIs, the panel rated 19 as valid measures of quality care. These 19 quality indicators cover care related to information and care planning (13) and supportive care (6).
Conclusions
These QIs are evidence-based process measures of care that may be useful to improve the quality of palliative care. Research is needed to better understand the quality of palliative care provided to patients with cirrhosis.
Oral contraceptive use increases risk for venous thromboembolism, but data on the effect of postmenopausal hormone therapy are limited.
To determine the effect of therapy with estrogen plus progestin ...on risk for venous thromboembolic events in postmenopausal women.
Randomized, double-blind, placebo-controlled trial.
20 clinical centers in the United States.
2763 postmenopausal women younger than 80 years of age (mean age, 67 years) who had coronary heart disease but no previous venous thromboembolism and had not had a hysterectomy.
Conjugated equine estrogens, 0.625 mg, plus medroxyprogesterone acetate, 2.5 mg, in one tablet (n = 1380) or placebo that was identical in appearance (n = 1383).
Documented deep venous thrombosis or pulmonary embolism.
During an average of 4.1 years of follow-up, 34 women in the hormone therapy group and 13 in the placebo group experienced venous thromboembolic events (relative hazard, 2.7 95% CI, 1.4 to 5.0 P = 0.003; excess risk, 3.9 per 1000 woman-years CI, 1.4 to 6.4 per 1000 woman-years; number needed to treat for harm, 256 CI, 157 to 692). In multivariate analysis, the risk for venous thromboembolism was increased among women who had lower-extremity fractures (relative hazard, 18.1 CI, 5.4 to 60.4) or cancer (relative hazard, 3.9 CI, 1.6 to 9.4) and for 90 days after inpatient surgery (relative hazard, 4.9 CI, 2.4 to 9.8) or nonsurgical hospitalization (relative hazard, 5.7 CI, 3.0 to 10.8). Risk was decreased with aspirin (relative hazard, 0.5 CI, 0.2 to 0.8) or statin use (relative hazard, 0.5 CI, 0.2 to 0.9).
Postmenopausal therapy with estrogen plus progestin increases risk for venous thromboembolism in women with coronary heart disease. This risk should be considered when the risks and benefits of therapy are being weighed.
Background
Most patients with Cystic fibrosis (CF) have chronic sinus disease which may require multiple sinus surgeries and antibiotic courses. Ivacaftor can improve lung function, lower sweat ...chloride levels and improve weight by targeting the primary defect, a faulty gene and its protein product, cystic fibrosis transmembrane conductance regulator (CFTR) in patients with the G551D mutation. Its role in improving sinus disease has not been evaluated.
Objective
The objective of this study was to evaluate efficacy of ivacaftor in improving CF related sinus disease.
Design
Observational study.
Participants
Twelve patients with cystic fibrosis and a G551D‐CFTR mutation.
Methods
Twelve patients with a G551D‐CFTR mutation were monitored for at least one year before and after starting ivacaftor.
Outcome Measures
Sinus disease progression was monitored by comparing computed tomography (CT) of sinuses before and at one year on therapy. Hospital admissions, pulmonary exacerbations, weight, BMI and lung function were also compared.
Results
Median age was 17 years (range 10–44). Weight, BMI, FEV1 significantly increased and sweat chloride significantly decreased by six months on ivacaftor therapy. CT of the sinuses in all patients improved. Seven patients had severe sinus disease, improved to moderate in three and mild in remaining four. Four patients had moderate disease which improved to mild in all. One patient had normal sinus CT before and after the therapy.
Conclusions
Patients with CF and G551D mutation, within 6 months of starting ivacaftor had significant improvements in weight, BMI and mean % FEV1. Significant lessening of underlying sinus disease measured by CT scan was noted, suggesting a disease modifying effect.
Poor adherence to HIV protease inhibitors may compromise the effectiveness of treatment. Few studies have compared methods for measuring adherence or have related adherence measures to a clinical ...outcome.
To examine the relationship among a composite score of adherence, the three primary measures of adherence, and HIV virologic response.
Longitudinal cohort study.
Public HIV clinic.
108 HIV-infected adults receiving protease inhibitors or non-nucleoside reverse transcriptase inhibitors who were monitored for 666 monthly intervals.
Medication Event Monitoring System (MEMS), pill count, and interview combined into a composite adherence score (CAS), and HIV viral load.
Mean antiretroviral adherence differed by adherence measure (MEMS, 0.63; pill count, 0.83; interview, 0.93; and CAS, 0.76). Composite adherence score decreased significantly over time. Composite adherence score, MEMS values, pill values, and interview values were statistically significantly associated with achievement of an undetectable viral load within 6 months of initiating therapy. Composite adherence score showed the strongest predictive relationship (odds ratios for a 10% increase in adherence for CAS, MEMS, pill count, and interview, respectively, were 1.26 95% CI, 1.16 to 1.37, 1.13 CI, 1.06 to 1.21, 1.10 CI, 1.02 to 1.19, and 1.35 CI, 0.94 to 1.94).
Different measures applied to the same patient suggest different levels of adherence. Adherence may be underestimated by MEMS and overestimated by pill count and interview. A summary measure combining several measures is more strongly related to a clinical response, but more practical measurement methods are needed for clinical use.
Coronary heart disease (CHD) remains the leading cause of mortality for US women, responsible for almost 250,000 deaths annually. Preventive heart‐health behavioral changes by women and aggressive ...coronary risk reduction can decrease the number of women disabled and killed by CHD. Angina is the predominant initial and subsequent presentation of CHD in women; categorization of chest pain and risk stratification of women assume pivotal roles. A robust evidence‐based algorithm can guide cardiovascular imaging techniques to evaluate women with suspected myocardial ischemia to detect those with worsened survival. Restricted functional capacity (<5 METs) is a consistent marker of worsened prognosis. Younger women have substantially higher mortality rates than men following myocardial infarction and coronary bypass surgery. Although these women have more comorbidity and risk factors, other issues including biological differences, treatment differences, and psychosocial factors require management strategies tailored to the unique needs of women.
Clinical Pharmacology & Therapeutics (2008) 83, 37–51; doi:10.1038/sj.clpt.6100447; published online 28 November 2007
Coronary heart disease has traditionally been considered a problem that affects men, but the Framingham study shows that women are more likely to die after myocardial infarction than men. Coronary ...heart disease in women is examined.
PDF
