How transform fault shear influences where detachment faults form near mid-ocean ridges.

Oceanic detachment faults represent an end-member form of seafloor creation, associated with relatively weak magmatism at slow-spreading mid-ocean ridges. We use 3-D numerical models to investigate the underlying mechanisms for why detachment faults predominantly form on the transform side (inside corner) of a ridge-transform intersection as opposed to the fracture zone side (outside corner). One hypothesis for this behavior is that the slipping, and hence weaker, transform fault allows for the detachment fault to form on the inside corner, and a stronger fracture zone prevents the detachment fault from forming on the outside corner. However, the results of our numerical models, which simulate different frictional strengths in the transform and fracture zone, do not support the first hypothesis. Instead, the model results, combined with evidence from rock physics experiments, suggest that shear-stress on transform fault generates excess lithospheric tension that promotes detachment faulting on the inside corner.

Improving outcomes and managing costs in idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a chronic pulmonary disease that is complicated by diagnostic challenges, multiple comorbidities, and a poor prognosis. Although considered a relatively rare disease, healthcare costs are substantial and disproportionate to the incidence and prevalence of the disease. The comorbidities associated with IPF not only complicate treatment strategies but also increase the burden for patients via higher costs and undesirable health outcomes. Historically, pharmacologic treatment options for IPF have been limited and are often associated with low efficacy. Two drugs approved for IPF, nintedanib and pirfenidone, offer promise for improving health outcomes and survival during the course of the disease. Considerations of cost and adverse events are important when planning treatment options. Optimizing care through patient-centered care management programs can improve outcomes and health-related quality of life for patients. Such programs emphasize communication between healthcare professionals and patients in order to educate patients on their condition, so they can make informed healthcare decisions. Disease registries can be important tools for optimizing data collection and analysis for a disease with limited incidence and prevalence.

Multidrug Resistant HIV Drug Lauded, But Clinical Foundation Not Very Deep.

Trogarzo (ibalizumab-uiyk) is a CD4-directed post-attachment HIV-1 inhibitor, indicated for use with other antiretroviral inhibitors in adults with multidrug resistant HIV-1 infection who aren't responding to their antiretroviral regimen. It is considered an advance. But FDA approval was based on a study of only 40 people-and it had no control group.

New Test for Diagnosing Insulin Resistance Could Turn the Tide Against Diabetes.

Diabetes is the scourge of our times, but we have been chasing the wrong culprits. A simple, $40 test of insulin resistance could put us on the right track.

Hemlibra's Remarkable Efficacy A Beacon For Hemophilia Patients.

Hemlibra demonstrates how far antibody science has progressed. Genentech's drug, approved late last year, connects two clotting factors to prevent the devastating bleeds in hemophilia patients with inhibitors. The high price may be offset by avoided costs in patients with factor VIII inhibitors.

Two New Drugs for Tardive Dyskinesia Hit the Market.

Ingrezza and Austedo were approved last year. ICER calculations raise questions about their price.

FDA Gives First-Ever Approval of Drug To Treat Chagas' Disease.

A partnership that includes two not-for-profit organizations beats out a company formerly led by "pharma bro" Martin Shkreli for the FDA's OK of benznidazole.

Novartis's Kymriah: Harnessing Immune System Comes With Worry About Reining in Costs.

FDA approval of the CAR T-cell therapy for leukemia could usher in an era of genetically engineered, individually tailored immunotherapies. But tap those brakes. Long-term results are in short supply-and there's that $475,000 price tag. Or is it a $750,000 price tag?

Wilson-Cook's Flourish Device Uses Magnets To Fix Pediatric Esophageal Atresia.

EA, although uncommon, is a complex and dangerous newborn birth defect with, until now, only chest surgical approaches. The Flourish Pediatric Esophageal Atresia Device is a remarkable alternative to traditional chest surgical procedures. No procedure or device is free of adverse events, but the results with this are so far impressive.

Ocrevus's Role in MS Battle May Signal Promising Trend.

With a list price that is 25% less than a competing drug, better outcomes, and less frequent dosing, maybe Ocrevus will start a new trend: better outcomes, easier administration-and a lower price. That trifecta is great news for people managing the cost and quality of MS care.

Parsabiv Could Be Pricey Addition In Care for CKD, ESRD Patients.

Because it is given intravenously at the end of dialysis, Parsabiv could be the answer to the adherence problems posed by cinacalcet. Most patients are pretty adherent to dialysis. One study found that people missed only 7.1 episodes of dialysis per patient-year, which isn't perfect but it's certainly better than adherence to self-administered drugs.

$850 Per Bowel Movement?! Hard To Justify That Cost.

Constipation can be a serious and painful problem, and we shouldn't dismiss other people's suffering. On the other hand there's a danger when new medications are compared against placebo rather than against over-the-counter products with a history of effectiveness.

New Therapy for Spinal Muscular Atrophy Offers Modest Bang for Pharamaceutical Buck.

Spinraza is a breakthrough, no doubt. It is a survival SMN-2-directed antisense oligonucleotide indicated for the treatment of SMA in pediatric and adult patients and is administered by injections into the spinal fluid (intrathecally). But it is another ultraexpensive drug, and the evidence so far points to a modest improvement in motor milestones.

Zinplava Tackles Toxins Of Hard-to-Treat C. Difficile.

Merck has recently received FDA approval for bezlotoxumab (Zinplava), as a treatment to reduce recurrence of C. diffcile in patients 18 years of age or older who are receiving antibiotic treatment for the infection and for whom there is a high risk of recurrence.

Mechanical Conflict System: A Novel Operant Method for the Assessment of Nociceptive Behavior.

A new operant test for preclinical pain research, termed the Mechanical Conflict System (MCS), is presented. Rats were given a choice either to remain in a brightly lit compartment or to escape to a dark compartment by crossing an array of height-adjustable nociceptive probes. Latency to escape the light compartment was evaluated with varying probe heights (0, .5, 1, 2, 3, and 4 mm above compartment floor) in rats with neuropathic pain induced by constriction nerve injury (CCI) and in naive control rats. Escape responses in CCI rats were assessed following intraperitoneal administration of pregabalin (10 and 30 mg/kg), morphine (2.5 and 5 mg/kg), and the tachykinin NK1 receptor antagonist, RP 67580 (1 and 10 mg/kg). Results indicate that escape latency increased as a function of probe height in both naive and CCI rats. Pregabalin (10 and 30 mg/kg) and morphine (5 mg/kg), but not RP 67580, decreased latency to escape in CCI rats suggesting an antinociceptive effect. In contrast, morphine (10 mg/kg) but not pregabalin (30 mg/kg) increased escape latency in naive rats suggesting a possible anxiolytic action of morphine in response to light-induced fear. No order effects following multiple test sessions were observed. We conclude that the MCS is a valid method to assess behavioral signs of affective pain in rodents.