Disparities in physical access and healthcare utilization among adults with and without disabilities in South Africa

Background

In South Africa barriers to accessing health services by persons with a disability would appear to be exacerbated by the overburdened state of public healthcare.

Evaluating alcohol and marijuana use among emerging adult males via analysis of text messages

Background: Advances in social technologies offer new tools for large scale data collection and analysis of peer influence and social networks on substance use attitudes and behaviors. Objective: The objective of this study was to determine if text message content can predict alcohol and marijuana use attitudes and behaviors. Methods: Text messages from 91 males ages 18–25 were monitored over a period of 6 months and examined for content related to alcohol and marijuana. Self-report data indicating alcohol and marijuana use attitudes and behaviors were used to determine relationships between text message content, social network structure, and substance use attitudes and behaviors. Results: In total, 23,173 text messages were analyzed with 166 text messages including alcohol related terms and 195 text messages including drug related terms. Individuals who sent text messages related to alcohol use were more likely to have problem alcohol use and positive attitudes toward alcohol use, and individuals who sent text messages related to marijuana use reported higher frequency of marijuana use and more positive attitudes toward marijuana use. Individuals with multiple daily marijuana use were in positions that had less control over network structure. Conclusions: The results of this study indicate that monitoring text message content and social network structure among emerging adult males can potentially predict alcohol and marijuana use attitudes and behaviors. Text message content analysis is a novel technique increasing our understanding of the role of peer influence and social network on substance use attitudes and behaviors.     

Renal Effects of Crizotinib in Patients With ALK-Positive Advanced NSCLC

IntroductionWe retrospectively analyzed the effects of crizotinib on serum creatinine and creatinine-based estimated glomerular filtration rate (eGFR) in patients with anaplastic lymphoma kinase–positive advanced NSCLC across four trials (NCT00585195, NCT00932451, NCT00932893, and NCT01154140).MethodsChanges from baseline data in serum creatinine and eGFR, calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-based equation, were assessed over time. eGFR was graded using standard chronic kidney disease criteria.ResultsMedian serum creatinine increased from 0.79 mg/dL at baseline to 0.93 mg/dL after 2 weeks of treatment (median percentage increase from baseline, 21.2%), was stable from week 12 (0.96 mg/dL) to week 104 (1.00 mg/dL), and decreased to 0.90 mg/dL at 28 days after last dose (median percentage increase from baseline, 13.1%). Median eGFR decreased over time (96.42, 80.23, 78.06 and 75.45 mL/min/1.73 m² at baseline, week 2, week 12, and week 104, respectively) and increased to 83.02 mL/min/1.73 m² at 28 days after the last dose. Median percentage decrease from baseline was 14.9%, 17.0%, and 10.4% at week 2, week 12, and 28 days after last dose of crizotinib, respectively. Overall, 12.6% of patients had a shift from eGFR grade less than or equal to 3a (≥45 mL/min/1.73 m²) at baseline to greater than or equal to 3b (<45 mL/min/1.73 m²) post-baseline.ConclusionsCrizotinib resulted in a decline in creatinine-based estimates of renal function mostly over the first 2 weeks of treatment. However, there was minimal evidence of cumulative effects with prolonged treatment and these changes were largely reversible following treatment discontinuation, consistent with previous reports suggesting this may be predominantly an effect on creatinine secretion as opposed to true nephrotoxicity.     

Lateral Position-Dependent Velocity Estimation Error in Plane-Wave Doppler Ultrasound Systems

Doppler ultrasound has become a standard method used to diagnose and grade vascular diseases and monitor their progression. Conventional focused-beam color Doppler imaging is routinely used in clinical practice, but suffers from inherent trade-offs between spatial, temporal and velocity resolution. Newer, plane-wave Doppler imaging offers rapid simultaneous acquisition of B-mode, color and spectral Doppler information across large fields of view, making it a potentially useful method for quantitative estimation of blood flow velocities in the clinic. However, plane-wave imaging can lead to a substantial error in velocity estimation, which is dependent on the lateral location within the image. This is seen in both clinical and experimental plane-wave systems. In the work described in this article, we quantified this velocity error under different geometric and beamforming conditions using numerical simulation and experimental phantoms. We found that the lateral-dependent velocity errors are caused by asymmetrical geometric spectral broadening, and outline a correction algorithm that can mitigate these errors.