The impact of the National Science Foundation's Innovation Corps (I-Corps) on academic innovation and entrepreneurship.

Abstract: In 2011, the U.S. National Science Foundation created the Innovation Corps (I-Corps) program in an effort to explore ways to translate the results of the academic research the agency has funded into new products, processes, devices, or services and move them to the marketplace. The agency established a 3-tier structure to support the implementation of the I-Corps concept. Selected I-Corps teams consisting of the principal investigator, an entrepreneurial lead, and an industry mentor participate in a 7-week accelerated version of the Lean Launchpad methodology that was first developed by Steve Blank at Stanford University. Participating teams engage in talking to potential customers, partners, and competitors and address the challenges and the uncertainty of creating successful ventures. I-Corps sites were set up to promote selected aspects of innovation and entrepreneurship ecosystems at the grantee institutions. I-Corps Regional Nodes were charged with recruiting I-Corps teams in a larger geographical area as well as stimulating a new culture of academic entrepreneurship in the institutions in their area of influence. This Topical Review describes the experiences and the impact of the New York City Regional Innovation Node, which is led by the City University of New York, in partnership with New York University and Columbia University.

Cost-effectiveness of a comprehensive immunization program serving high-risk, uninsured adults.

Despite the numerous social and economic benefits of vaccination, adult immunization rates fall far short of recommended levels costing the United States $9 billion annually in health care expenditures and reduced productivity. While it is well recognized that childhood immunization is highly cost-effective, the economic impact of adult immunization programs varies by disease and is influenced by population demographics. This study aimed to assess the cost-effectiveness of a comprehensive adult immunization program serving high-need populations delivered by a local health department (LHD) in partnership with community organizations. We modeled incremental cost-effectiveness taking the payer perspective of each vaccine separately in simulated cohorts of 100,000 over a 20-year horizon using data provided by the LHD and data from the published literature. We adjusted the results to align with actual program delivery and used them to estimate an incremental cost-effectiveness ratio (ICER) for the entire program. We assessed the effects of varying our base model parameters in univariate sensitivity analyses. We discounted benefits and life years saved (LYS) at 3% and adjusted results to 2016 US$. Four of seven disease models were cost-effective (using a $100,000 CE threshold) with ICERS ranging from $14,260 to $79,022/LYS. Sensitivity analyses did not substantially impact the results. The ICER for program as a whole was $67,940/LYS. A community-delivered comprehensive immunization program serving uninsured, low income, high-risk adults is a cost-effective investment even when most do not receive the full regimen of some vaccines.

Comparison of microscopic and endoscopic view of the internal acoustic meatus: A cadaveric study.

The endoscope is thought to provide an improved exposure of the internal acoustic meatus after retrosigmoid craniotomy for microsurgical resection of intrameatal tumors. The aim of this study is to quantify the differences in internal acoustic meatus (IAM) exposure comparing microscopic and endoscopic visualization. A retrosigmoid approach was performed on 5 cadaver heads. A millimeter gauge was introduced into the internal acoustic meatus, and examinations with a surgical microscope and 0°, 30° and 70° rigid endoscopes were performed. The extent of IAM depth visualized with the microscope and the different angled endoscopes were analyzed. The microscopic view allowed an average IAM depth visualization of 2.8 mm. The endoscope allowed an improved exposure of IAM in all cases. The 0°, 30° and 70° endoscopes permitted an exposure that was respectively 96% (5.5 mm), 139% (6.7 mm) and 200% (8.4 mm) more lateral than the microscopic view. Angled optics, however, provided an image distortion, specifically the 70° endoscope. The endoscope provides a superior visualization of the IAM compared to the microscope when using a retrosigmoid approach. The 30° endoscope represented an ideal compromise of superior visualization with marginal image distortion. Additional implementation of the endoscope into microsurgery of intrameatal tumors likely facilitates complete tumor removal and might spare facial and vestibulocochlear function. Clin. Anat. 31:398-403, 2018. © 2017 Wiley Periodicals, Inc.

The anterolateral ligament (ALL) of the knee-Part of the iliotibial tract or a truly separate structure?

In this Short Communication, the issue is discussed whether the recently reported anterolateral ligament of the knee is a unique structure or just part of the iliotibial tract. The presented findings from investigations in body donors support the view of a unique structure.

Consumer Health Informatics in the Context of Engaged Citizens and eHealth Services - A New CHI Meta Model.

Consumer Health Informatics (CHI) is a relatively new and interdisciplinary field in Medical Informatics. It focuses on consumer- rather than professional-centered services. However, the definitions and understanding of a) what is a "consumer"? or b) what is health technology in the context of CHI? and c) what factors and actors influence the usage of eHealth services? vary widely. The CHI special interest group (SIG) - associated with the German Association for Medical Informatics, Biometry and Epidemiology - conducted two workshops in 2015 to improve the common understanding on these topics. The workshop outcomes, the derived CHI-specific meta model and examples how to apply this model are presented in this paper. The model supports the definition of multi-actor contexts, as it not solely reflects the conventional patient-physician relationship but also allows for the description of second health market providers.

Distribution of miRNA expression across human tissues.

We present a human miRNA tissue atlas by determining the abundance of 1997 miRNAs in 61 tissue biopsies of different organs from two individuals collected post-mortem. One thousand three hundred sixty-four miRNAs were discovered in at least one tissue, 143 were present in each tissue. To define the distribution of miRNAs, we utilized a tissue specificity index (TSI). The majority of miRNAs (82.9%) fell in a middle TSI range i.e. were neither specific for single tissues (TSI > 0.85) nor housekeeping miRNAs (TSI < 0.5). Nonetheless, we observed many different miRNAs and miRNA families that were predominantly expressed in certain tissues. Clustering of miRNA abundances revealed that tissues like several areas of the brain clustered together. Considering -3p and -5p mature forms we observed miR-150 with different tissue specificity. Analysis of additional lung and prostate biopsies indicated that inter-organism variability was significantly lower than inter-organ variability. Tissue-specific differences between the miRNA patterns appeared not to be significantly altered by storage as shown for heart and lung tissue. MiRNAs TSI values of human tissues were significantly (P = 10(-8)) correlated with those of rats; miRNAs that were highly abundant in certain human tissues were likewise abundant in according rat tissues. We implemented a web-based repository enabling scientists to access and browse the data (https://ccb-web.cs.uni-saarland.de/tissueatlas).

Cold plasma therapy of a tooth root canal infected with enterococcus faecalis biofilms in vitro.

INTRODUCTION: Complete sterilization of an infected root canal is an important challenge in endodontic treatment. Traditional methods often cannot achieve high-efficiency sterilization because of the complexity of the root canal system. The objective of the study was to investigate in vitro the feasibility of using a cold plasma treatment of a root canal infected with Enterococcus faecalis biofilms. METHODS: Seventy single-root teeth infected with E. faecalis biofilms were divided into 7 groups. Group 1 served as the negative control group (no treatment), and group 7 was the positive control group with teeth treated with calcium hydroxide intracanal medication for 7 days. Groups 2 to 6 included teeth treated by cold plasma for 2, 4, 6, 8, and 10 minutes, respectively. The disinfection of the E. faecalis biofilm was evaluated by colony-forming unit (CFU) counting. Scanning electron microscopy was used to evaluate the structural changes of the E. faecalis biofilm before and after plasma treatment. Confocal scanning laser microscopy was used to investigate the vitality of the microorganisms in the biofilm before and after plasma treatment. RESULTS: A significant decrease in the number of CFUs was observed after prolonged cold plasma treatment (based on the statistical analysis of the teeth in groups 2-6). Compared with the positive control group, cold plasma treatment of 8 or 10 minutes (groups 5 and 6) had a significantly higher antimicrobial efficacy (P < .05). The scanning electron microscopic analysis showed that the bacteria membrane was ruptured, and the structure of the biofilm was fully destroyed by the plasma. Confocal scanning laser microscopic studies indicated that the plasma treatment induced E. faecalis death and destruction of the biofilm. CONCLUSIONS: The cold plasma had a high efficiency in disinfecting the E. faecalis biofilms in in vitro dental root canal treatment.

Estudiar medicina en Alemania / Studying medicine in Germany

Este artículo da una visión general de la organización, la estructura y el currículo de estudios de medicina en Alemania. La normativa que regula estos estudios, denominada Approbationsordnung, fue revisada y modificada en 2002, adaptándola a las nuevas reglas creadas por la Unión Europea. El plan de estudios dedica seis años y tres meses al estudio y formación de los estudiantes (dos años de ciencias básicas, tres de ciencias clínicas y un último año dedicado al trabajo clínico en el hospital). Cualquier candidato que solicite una plaza para estudiar en una universidad alemana debe cumplir ciertos requisitos, independientemente de si proviene o no de un país miembro de la Unión Europea. La evaluación del estudio se lleva a cabo a diferentes niveles durante el curso. Esencial aquí es el examen de estado en medicina, que se divide en dos partes: la primera parte trata de las ciencias básicas y la segunda se refiere al período clínico. La nueva Approbationsordnung (AppOÄ) trajo consigo una serie de cambios que todavía están en fase de ejecución. La especialización se lleva a cabo en el período de posgrado de los estudios de medicina. Al final de este período, el médico obtiene un título especialista (Facharzt) otorgado por el Colegio de Médicos. Tradicionalmente, la organización de estos estudios está en manos de los propios alumnos, pero ello está en vías de sufrir una modificación sustancial. Como especialista, el médico está obligado a participar en los programas de educación continuada, con una evaluación periódica de sus rendimientos. Un tema controvertido en la actualidad es el título de Doctor en Medicina y su importancia médica. Muchos programas de investigación están surgiendo dentro de un contexto clínico, lo que puede contribuir a corregir algunas desviaciones del pasado a este respecto. Se han incluido enlaces web y fuentes para obtener información sobre los estudios en las diferentes facultades en Alemania (AU)

This article gives a general overview on the organization, structure and curriculum of medical studies in Germany. The regulations governing these studies, called Approbationsordung, were reviewed and amended in 2002, in adaptation to the new rules created by the European Union. The curriculum dedicates six years and three months to the study and training of students (two years of basic sciences, three years of clinical sciences, and a final year dedicated to clinical work in hospital). Any candidate applying for a course at a German University must meet certain requirements, regardless of whether or not he or she is member of the EU. Assessment of progress is carried out at different levels during the course. Essential here is the state exam in Medicine, which is divided into two parts, the first part dealing with the basic and the second with the clinical period. The new Approbationsordung (AppOÄ) brought a series of changes that are still under implementation. Specialization takes place in the postgraduate period of medical studies. At the end of this period the doctor obtains a specialist (Facharzt) title granted by the College of Physicians. Traditionally the organization of these studies lies in the hands of the trainees themselves; however, this is lined up for substantial modification. As a specialist the doctor is obliged to participate in ongoing education programs, with periodic performance evaluation. A controversial topic at present is the Doctor title in Medicine and its medical relevance. Many research programs are emerging thematically in a clinical context and apparently some past deviations can be corrected. Links and sources to obtain information about studying in different faculties in Germany have been included (AU)

Proton transfer reaction mass spectrometry and the unambiguous real-time detection of 2,4,6 trinitrotoluene.

Fears of terrorist attacks have led to the development of various technologies for the real-time detection of explosives, but all suffer from potential ambiguities in the assignment of threat agents. Using proton transfer reaction mass spectrometry (PTR-MS), an unusual bias dependence in the detection sensitivity of 2,4,6 trinitrotoluene (TNT) on the reduced electric field (E/N) has been observed. For protonated TNT, rather than decreasing signal intensity with increasing E/N, which is the more usual sensitivity pattern observed in PTR-MS studies, an anomalous behavior is first observed, whereby the signal intensity initially rises with increasing E/N. We relate this to unexpected ion-molecule chemistry based upon comparisons of measurements taken with related nitroaromatic compounds (1,3,5 trinitrobenzene, 1,3 dinitrobenzene, and 2,4 dinitrotoluene) and electronic structure calculations. This dependence provides an easily measurable signature that can be used to provide a rapid highly selective analytical procedure to minimize false positives for the detection of TNT. This has major implications for Homeland Security and, in addition, has the potential of making instrumentation cost-effective for use in security areas. This study shows that an understanding of fundamental ion-molecule chemistry occurring in low-pressure drift tubes is needed to exploit selectivity and sensitivity for analytical purposes.

Surface characterization of Ti and Y-TZP following non-thermal plasma exposure.

Novel non-thermal plasma (NTP) technology has the potential to address the bonding issues of Y-TZP and Ti surfaces. This study aims to chemically characterize and evaluate the surface energy (SE) of Y-TZP and Ti surfaces after NTP application. Y-TZP and Ti discs were treated with a hand-held NTP device followed by SE evaluation. Spectra of Y-TZP 3d and Ti 2p regions, survey scans, and quantification of the elements were performed via X-ray photoelectron Spectroscopy (XPS) prior and after NTP. Separate Y-TZP and Ti discs were NTP treated for contact angle readings using (10-methacryloyloxydecyl dihydrogenphosphate) MDP primer. Significant augmentation of SE values was observed in all NTP treated groups. XPS detected a large increase in the O element fraction on both Y-TZP and Ti surfaces. Reduction of contact angle reading was obtained when the MDP primer was placed on NTP treated Y-TZP. Ti surface showed high SE before and after NTP application on Ti surfaces. NTP decreased C and increased O on both surfaces independently of application protocol. Wettability of MDP primer on Y-TZP was significantly increased after NTP. The high polarity obtained on Y-TZP and Ti surfaces after NTP applications appear promising to enhance bonds.

The impact of microsurgery, stereotactic radiosurgery and radiotherapy in the treatment of meningiomas depending on different localizations.

SCIENTIFIC BACKGROUND: Meningiomas are the most common benign intracranial neoplasms with a slow growth presented as the intracranial lesion. These tumors are without any symptoms for a long time. At the time of diagnosis it is frequently an asymptomatic tumor. In that case the therapist may well suggest a wait-and-see strategy. The therapy of meningiomas focuses firstly on the microsurgical treatment. Volume reduction can be achieved immediately after treatment. Stereotactic radiosurgery is an important non-invasive treatment option for recurrent tumors or meningiomas with partial resection. The technical equipment for the stereotactic radiosurgery is a cost intensive investment. In this context the high precision of the intervention, presented as a low invasiveness of the treatment, is an important factor. The aim of this assessment is to identify the chances and limitations of the diverse treatment options and to estimate their outcome for different localisations of meningiomas. METHODS: In December 2007 a systematic literature search was conducted using the most relevant medical databases. The whole strategy and the used search terms were documented. The literature search was supplemented with an internet and literature based hand search on law, ethics and economics. Primary studies and systematic reviews which report relevant outcomes are included in this analysis. The current assessment is based on the available evidence that was found at the time of the literature search. RESULTS: A total of 31 publications for the medical focus of assessment and three reports from the economical hand search were included. In general, it is not possible to identify neither randomised clinical trials or prospective, contrasting cohort studies nor studies summarising results from such studies. The results presented in the literature published by surgeons strongly vary regarding localisation of meningiomas. Publications not differentiating between the localisation of meningiomas indicate a progression free survival rate of five years in 77 to 97% of the cases after complete surgical resection of the tumor, in 18 to 70% of the cases after subtotal resection and for patients who had undergone surgical resection and a combined radiotherapeutical treatment of their meningiomas a five year progression free survival rate between 82 and 97%. Other treatment options like hormone therapy or treatments to stop tumor growth had been used unsuccessfully so far. Based on the results presented regarding economic evaluation, costs resulting from radiosurgical treatment are lower in contrast to costs resulting from surgical resection. However, it has to be taken into account that costs resulting from radiosurgical treatment strongly depend on the number of patients treated in total with the radiosurgical equipment. CONCLUSION: Due to the strong dependencies between the results from surgical therapy and the localisation of the tumor, it is only possible to derive recommendations on whether or not to perform the surgical therapy with respect to the localisation of the tumor. Only for patients with tumors with a spinal localisation or WHO Grade I meningiomas with a cortical localisation, primary treatment with by means of microsurgery can be suggested. For all other localisations of the tumor, alternative treatment by radiosurgery should be discussed. From the literature identified, a clear recommendation of one or the other therapy however can not be deduced. Thus, there is a strong need for randomised clinical trials or prospective or contrasting cohort studies, which compare rigorously microsurgery with radiosurgery concerning different localisations of tumors.

Invasive home mechanical ventilation, mainly focused on neuromuscular disorders.

INTRODUCTION AND BACKGROUND: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula) to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. RESEARCH QUESTIONS: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient's symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. METHODS: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment), clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. RESULTS AND DISCUSSION: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia) are rare. Mobile home ventilators are available for the implementation of the ventilation. Their technical performance however, differs regrettably. Studies comparing the economic aspects of ventilation in a hospital to outpatient ventilation, describe home ventilation as a more cost-effective alternative to in-patient care in an intensive care unit, however, more expensive in comparison to a noninvasive (via mask) ventilation. Higher expenses arise due to the necessary equipment and the high expenditure of time for the partial 24-hour care of the affected patients through highly qualified personnel. However, none of the studies applies to the German provisionary conditions. The calculated costs strongly depend on national medical fees and wages of caregivers, which barely allows a transmission of the results. The results of quality-of-life studies are mostly qualitative. The patient's quality of life using mechanical ventilation is predominantly considered well. Caregivers of ventilated patients report positive as well as negative ratings. Regarding the ethical questions, it was researched which aspects of ventilation implementation will have to be considered. From a legal point of view the financing of home ventilation, especially invasive mechanical ventilation, requiring specialised technical nursing is regulated in the code of social law (Sozialgesetzbuch V). The absorption of costs is distributed to different insurance carriers, who often, due to cost pressures within the health care system, insurance carriers, who consider others and not themselves as responsible. Therefore in practice, the necessity to enforce a claim of cost absorption often arises in order to exercise the basic right of free choice of location. CONCLUSION: Positive effects of the invasive mechanical ventilation (overall survival and symptomatic) are highly probable based on the analysed literature, although with a low level of evidence. An establishment of a home ventilation registry and health care research to ascertain valid data to improve outpatient structures is necessary. Gathering specific German data is needed to adequately depict the national concepts of provision and reimbursement. A differentiation of the cost structure according to the type of chosen outpatient care is currently not possible. There is no existing literature concerning the difference of life quality depending on the chosen outpatient care (homecare, assisted living, or in a nursing home specialised in invasive home ventilation). Further research is required. For a so called participative decision - made by the patient after intense counselling - an early and honest patient education pro respectively contra invasive mechanical ventilation is needed. Besides the long term survival, the quality of life and individual, social and religious aspects have also to be considered.

Effects of traction, distension, and joint position on distraction of the hip joint: an experimental study in cadavers.

PURPOSE: To quantify the effects of traction alone and in combination with distension of air in different joint positions in order to find out the conditions for adequate distraction of the hip joint with minimal traction force. TYPE OF STUDY: Experimental cadaver study. METHODS: Eight cadaver hip joints were studied. The cadavers were placed supine on a fracture table and traction was applied in different joint positions for flexion and abduction with and without distension using air. For the measurement, the joint space between the acetabulum and femoral head was separated by 4 different lines characterizing the lateral margin of the acetabulum, the superior portions of the lunate cartilage, and the acetabular fossa. RESULTS: At all measurement lines, distraction of the hip was significantly better when traction and distension were combined. At traction forces from 250 to 300 N, traction plus distension resulted in a 1.59- to 2.25-fold increase of joint distraction compared to traction alone. The maximum effect of distension was achieved between 200 and 250 N. Up to traction forces of 250 N, the joint vacuum force counted for more than half of the total resistance. The effects of flexion and abduction on distraction of the hip were smaller. A trend for better distraction was found for 20 degrees of flexion and a significantly better distraction by avoiding abduction. CONCLUSIONS: High traction forces by breakage of the joint seal can be avoided by distension using air. The passive resistance of the soft tissues increases at higher traction forces. Slight flexion without abduction showed further increase of joint distraction. Reducing the amount of traction may possibly reduce the risk of soft tissue perineal and neurologic injuries.