Ventilation/perfusion ratio

In respiratory physiology, the ventilation/perfusion ratio (V̇/Q̇ ratio or V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching of two variables:
The V/Q ratio can therefore be defined as the ratio of the amount of air reaching the alveoli per minute to the amount of blood reaching the alveoli per minute—a ratio of volumetric flow rates. These two variables, V & Q, constitute the main determinants of the blood oxygen (O2) and carbon dioxide (CO2) concentration.
The V/Q ratio can be measured with a ventilation/perfusion scan.
A V/Q mismatch can cause a type 1 respiratory failure.
Physiology.
Ideally, the oxygen provided via ventilation would be just enough to saturate the blood fully. In the typical adult, 1 litre of blood can hold about 200 mL of oxygen; 1 litre of dry air has about 210 mL of oxygen. Therefore, under these conditions, the ideal ventilation perfusion ratio would be about 0.95. If one were to consider humidified air (with less oxygen), then the ideal v/q ratio would be in the vicinity of 1.0, thus leading to concept of "ventilation-perfusion equality" or "ventilation-perfusion matching". This matching may be assessed in the lung as a whole, or in individual or in sub-groups of gas-exchanging units in the lung. On the other side "Ventilation-perfusion mismatch" is the term used when the ventilation and the perfusion of a gas exchanging unit are not matched.
The actual values in the lung vary depending on the position within the lung. If taken as a whole, the typical value is approximately 0.8.
Because the lung is centered vertically around the heart, part of the lung is superior to the heart, and part is inferior. This has a major impact on the V/Q ratio:
In a subject standing in orthostatic position (upright) the apex of the lung shows higher V/Q ratio, while at the base of the lung the ratio is lower but nearer to the optimal value for reaching adequate blood oxygen concentrations. While both ventilation and perfusion increase going from the apex to the base, perfusion increases to a greater degree than ventilation, lowering the V/Q ratio at the base of the lungs. The principal factor involved in the creation of this V/Q gradient between the apex and the base of the lung is gravity (this is why V/Q ratios change in positions other than the orthostatic position).
Ventilation.
Gravity and the weight of the lung act on ventilation by increasing pleural pressure at the base (making it less negative) and thus reducing the alveolar volume. The lowest part of the lung in relation to gravity is called the dependent region. In the dependent region smaller alveolar volumes mean the alveoli are more compliant (more distensible) and so capable of more oxygen exchange. The apex, though showing a higher oxygen partial pressure, ventilates less efficiently since its compliance is lower and so smaller volumes are exchanged.
Perfusion.
The impact of gravity on pulmonary perfusion expresses itself as the hydrostatic pressure of the blood passing through the branches of the pulmonary artery in order to reach the apical and basal areas of the lungs, acting synergistically with the pressure developed by the right ventricle. Thus at the apex of the lung the resulting pressure can be insufficient for developing a flow (which can be sustained only by the negative pressure generated by venous flow towards the left atrium) or even for preventing the collapse of the vascular structures surrounding the alveoli, while the base of the lung shows an intense flow due to the higher pressure.
Pathology.
Extreme alterations of V/Q.
Of note, few conditions constitute "pure" shunt or dead space as they would be incompatible with life, and thus the term V/Q mismatch is more appropriate for conditions in between these two extremes.
External links.
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Len Gridley Everett

Len Gridley Everett (April 18, 1925 – November 25, 1984) was an American painter.
Early life.
Everett born in Burlington, Iowa, April 18, 1925 to Maude Gridley Everett and Reid Everett. He grew up near Monmouth, Illinois and graduated from Kirkwood, Illinois High School.
Career.
Len served in the United States Navy during World War II. He attended the State University of Iowa, Iowa City, (BFA-1950, MFA-1952). Everett taught at the University of Iowa briefly. He studied painting and drawing in New York City at the Art Students League with Robert Brackman, Joseph Hirsch, and Robert Hale; at the National Academy of Design with Robert Phillipp; and in Provincetown, Massachusetts at the Provincetown Art School with Henry Hensche. Len maintained professional art studios in Carnegie Hall and at 41 Union Square, New York City, New York. He taught privately from his studio and taught classes at the Kittredge Women's Club in New York City.
The American Heartland was the dominant subjects of his work. Known for his meticulous still life paintings, he combined smooth layer paint, subtleness of color, and his unique perspectives and composition of simple objects such as vegetables, fruits, and flowers. He served leadership positions for the Audubon Artist and the Allied Artists of America.
Death.
Everett died November 25, 1984 at Burlington Medical Center, Burlington, Iowa, after suffering from oral cancer.
Len G. Everett was described as a simple person, with simple tastes, and simple ideas. According to the executor of his estate, R.A. McCannon,"he was uncomfortable with compliments and accolades, but was in awe of other associates in the New York art scene in the 70s and 80s..Every painting was his own idea, every still life component was selected personally, every composition painstakingly studied and developed…Discussion for his plans for a painting were seldom…He was secure and firm about his work…Discussion occurred only after a work was complete."


Tetrachlorodecaoxide

Tetrachlorodecaoxide (TCDO) is a chlorite-containing, immunomodulatory, macrophage-activating drug whose chemical formula is Cl4H2O11. The drug WF10 (Macrokine, Immunokine) is an aqueous solution of tetrachlorodecaoxide designed for intravenous injection. Tetrachlorodecaoxide and WF10 were originally developed by Oxo Chemie.
Tetrachlorodecaoxide / WF10 is used in the management of radiation cystitis, is effective in the treatment of diabetic foot ulcers, and is used in wound healing, where the mechanism of action is activation of the macrophage system, and increasing the partial pressure of oxygen in the wound.


Melissa Freeman

Melissa Freeman (born 1926) is a Bronx-born physician based at the Beth Israel Medical Center.
Education.
Freeman's grandfather was born a slave in the 1850s, who was a teenager when the Emancipation Proclamation was signed. Freeman grew up in Williamsburg, Brooklyn. She attended High School of Music & Art, where she most enjoyed physiology and social work. She graduated Howard University College of Medicine in 1955, where she attended night classes and worked several day jobs. She was one of only 4 women in a class of 150 students.
Career.
Freeman completed an internship at Kings County Hospital Center and a residency at Nassau University Medical Center. She began practicing medicine in 1961. Working with Vincent Dole and Marie Nyswander, she developed the use of methadone to treat heroin addiction. She was one of the first doctors to treat women using methadone maintenance. She set up her own internal medicine practice in Harlem in 1981.
She has worked at Beth Israel Hospital for over 50 years. She runs a methadone maintenance program in New York, and mentors young doctors.
She inspired Valentin Bonilla Jr, Chief Physician Assistant at the Mount Sinai Beth Israel Opioid Treatment Program, to pursue a career in medication-assisted treatment.


Pectus carinatum

Pectus carinatum, also called pigeon chest, is a malformation of the chest characterized by a protrusion of the sternum and ribs. It is distinct from the related malformation pectus excavatum.
Signs and symptoms.
People with pectus carinatum usually develop normal hearts and lungs, but the malformation may prevent these from functioning optimally. In moderate to severe cases of pectus carinatum, the chest wall is rigidly held in an outward position. Thus, respirations are inefficient and the individual needs to use the accessory muscles for respiration, rather than normal chest muscles, during strenuous exercise. This negatively affects gas exchange and causes a decrease in stamina. Children with pectus malformations often tire sooner than their peers due to shortness of breath and fatigue. Commonly concurrent is mild to moderate asthma.
Some children with pectus carinatum also have scoliosis (i.e., curvature of the spine). Some have mitral valve prolapse, a condition in which the heart mitral valve functions abnormally. Connective tissue disorders involving structural abnormalities of the major blood vessels and heart valves are also seen. Although rarely seen, some children have other connective tissue disorders, including arthritis, visual impairment and healing impairment.
Apart from the possible physiologic consequences, pectus malformations can have a significant psychologic impact. Some people, especially those with milder cases, live happily with pectus carinatum. For others, though, the shape of the chest can damage their self-image and confidence, possibly disrupting social connections and causing them to feel uncomfortable throughout adolescence and adulthood. As the child grows older, bodybuilding techniques may be useful for balancing visual impact.
A less common variant of pectus carinatum is "pectus arcuatum" (also called type 2 pectus excavatum, chondromanubrial malformation or Currarino–Silverman syndrome or pouter pigeon malformation), which produces a manubrial and upper sternal protrusion, particularly also at the sternal angle. Pectus arcuatum is often confused with a combination of pectus carinatum and pectus excavatum, but in pectus arcuatum the visual appearance is characterized by a protrusion of the costal cartilages and there is no depression of the sternum.
Causes.
Pectus carinatum is an overgrowth of costal cartilage causing the sternum to protrude forward. It primarily occurs among four different patient groups, and males are more frequently affected than females. Most commonly, pectus carinatum develops in 11-to-14-year-old pubertal males undergoing a growth spurt. Some parents report that their child's pectus carinatum seemingly popped up overnight. Second most common is the presence of pectus carinatum at or shortly after birth. The condition may be evident in newborns as a rounded anterior chest wall. As the child reaches age 2 or 3 years of age, the outward sternal protrusion becomes more pronounced. Pectus carinatum can also be caused by vitamin D deficiency in children (Rickets) due to deposition of unmineralized osteoid. Least common is a pectus carinatum malformation following open-heart surgery or in children with poorly controlled bronchial asthma.
Pectus carinatum is generally a solitary, non-syndromic abnormality. However, the condition may be present in association with other syndromes: Turner syndrome, Noonan syndrome, Loeys–Dietz syndrome, Marfan syndrome, Ehlers–Danlos syndrome, Morquio syndrome, trisomy 18, trisomy 21, homocystinuria, osteogenesis imperfecta, multiple lentigines syndrome (LEOPARD syndrome), Sly syndrome (mucopolysaccharidosis type VII), and scoliosis.
In about 25% of cases of pectus carinatum, the patient has a family member with the condition.
Diagnosis.
The pectus carinatum can be easily diagnosed by certain tests like a CT scan (2D and 3D). It may then be found out that the rib cage is in normal structure. If there is more than average growth of sternum than pectus carinatum protrudes. Also it is of two types, as pectus carinatum is symmetrical or unsymmetrical. On the basis of that further treatment is given to the patient.
Treatment.
External bracing technique.
The use of orthotic bracing, pioneered by Sydney Haje as of 1977, is finding increasing acceptance as an alternative to surgery in select cases of pectus carinatum. In children, teenagers, and young adults who have pectus carinatum and are motivated to avoid surgery, the use of a customized chest-wall brace that applies direct pressure on the protruding area of the chest produces excellent outcomes. Willingness to wear the brace as required is essential for the success of this treatment approach. The brace works in much the same way as orthodontics (braces that correct the alignment of teeth). The brace consists of front and back compression plates that are anchored to aluminum bars. These bars are bound together by a tightening mechanism which varies from brace to brace. This device is easily hidden under clothing and must be worn from 14 to 24 hours a day. The wearing time varies with each brace manufacturer and the managing physicians protocol, which could be based on the severity of the carinatum malformation (mild moderate severe) and if it is symmetric or asymmetric.
Depending on the manufacturer and/or the patient's preference, the brace may be worn on the skin or it may be worn over a body 'sock' or sleeve called a Bracemate, specifically designed to be worn under braces. A physician or orthotist or brace manufacturer's representative can show how to check to see if the brace is in correct position on the chest.
Bracing is becoming more popular over surgery for pectus carinatum, mostly because it eliminates the risks that accompany surgery. The prescribing of bracing as a treatment for pectus carinatum has 'trickled down' from both paediatric and thoracic surgeons to the family physician and pediatricians again due to its lower risks and well-documented very high success results. The pectus carinatum guideline of 2012 of the American Pediatric Surgical Association has stated: "As reconstructive therapy for the compliant pectus [carinatum] malformation, nonoperative compressive orthotic bracing is usually an appropriate first line of therapy as it does not preclude the operative option. For appropriate candidates, orthotic bracing of chest wall malformations can reasonably be expected to prevent worsening of the malformation and often results in a lasting correction of the malformation. Orthotic bracing is often successful in prepubertal children whose chest wall is compliant. Expert opinion suggests that the noncompliant chest wall malformation or significant asymmetry of the pectus carinatum malformation caused by a concomitant excavatum-type malformation may not respond to orthotic bracing."
Regular supervision during the bracing period is required for optimal results. Adjustments may be needed to the brace as the child grows and the pectus improves.
Surgical.
For patients with severe pectus carinatum, surgery may be necessary. However bracing could and may still be the first line of treatment. Some severe cases treated with bracing may result in just enough improvement that patient is happy with the outcome and may not want surgery afterwards.
If bracing should fail for whatever reason then surgery would be the next step. The two most common procedures are the Ravitch technique and the Reverse Nuss procedure.
A modified Ravitch technique uses bioabsorbable material and postoperative bracing, and in some cases a diced rib cartilage graft technique.
The Nuss was developed by Donald Nuss at the Children's Hospital of the King's Daughters in Norfolk, Va. The Nuss is primarily used for Pectus Excavatum, but has recently been revised for use in some cases of PC, primarily when the malformation is symmetrical.
Other options.
After adolescence, some men and women use bodybuilding as a means to hide their malformation. Some women find that their breasts, if large enough, serve the same purpose. Some plastic surgeons perform breast augmentation to disguise mild to moderate cases in women. Bodybuilding is suggested for people with symmetrical pectus carinatum.
Prognosis.
Pectus malformations usually become more severe during adolescent growth years and may worsen throughout adult life. The secondary effects, such as scoliosis and cardiovascular and pulmonary conditions, may worsen with advancing age.
Body building exercises (often attempted to cover the defect with pectoral muscles) will not alter the ribs and cartilage of the chest wall, and are generally considered not harmful.
Most insurance companies no longer consider chest wall malformations like pectus carinatum to be purely cosmetic conditions. While the psychologic impact of any malformation is real and must be addressed, the physiological concerns must take precedence. The possibility of lifelong cardiopulmonary difficulties is serious enough to warrant a visit to a thoracic surgeon.
Epidemiology.
Pectus malformations are common; about 1 in 400 people have a pectus disorder.
Pectus carinatum is rarer than pectus excavatum, another pectus disorder, occurring in only about 20% of people with pectus malformations. About four out of five patients are males.


Theodora Clemens Hall

Theodora Clemens Hall (12 June 1902–19 December 1980) was a New Zealand doctor. She was born in Wellington, Wellington, New Zealand on 12 June 1902.


William Cecil Bosanquet

William Cecil Bosanquet (12 October 1866, Whiligh estate near Wadhurst, Sussex – 24 January 1941, London) was an English physician and classical scholar.
After education at Eton, Bosanquet matriculated at New College, Oxford, where he achieved a first in honour moderations in classics in 1887 and a first in "literae humaniores" in 1889. He studied medicine at the University of Oxford and at Charing Cross Hospital, graduating with B.M. and D.M. degrees in 1897. At Charing Cross Hospital he was appointed pathologist in 1900, assistant physician in 1903, and full physician in 1913. He also held appointments at Royal Brompton Hospital and originated the "Brompton Hospital Reports" in 1931. He was an assistant editor for "The Practitioner" for some years until the end of 1904. He was elected FRCP in 1904. He delivered the 1905 Goulstonian Lectures on "Some Considerations on the Nature of Diabetes Mellitus". Bosanquet edited the 10th edition in 1905 of Green's "Pathology and Morbid Anatomy"; he was also the editor of the 11th edition in 1911, the co-editor with W. W. C. Topley of the 12th edition in 1918, and the co-editor with G. S. Wilson of the 13th edition in 1923.
During WWI Bosanquet served as captain and then major in the RAMC. He became a staff member of the 4th London General Hospital (which was one of four hospitals in Greater London opened in August 1914) and was afterwards attached to the 44th General Hospital in Deolali, India, serving in 1919 as a consulting physician to the North-West Frontier Force.
George Stanley Bosanquet.
Admiral George S. Bosanquet, A.D.C. (1835–1914) was W. Cecil Bosanquet's father. On 27 October 1884 George S. Bosanquet was appointed one of the naval "aides-de-camp" to the Queen.


Michael Glick

Michael Glick is an American dentist, professor and researcher. He served as editor of the "Journal of the American Dental Association" ("JADA") from 2005 until 2020 and as dean of the State University of New York at Buffalo School of Dental Medicine until August 14, 2015.
Biography.
Glick, whose father was a dentist, was born in Sweden and was trained in dentistry at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel and Temple University Dental School in Philadelphia, Pennsylvania. He completed graduate work in oral medicine at the University of Pennsylvania School of Dental Medicine. After finishing his training he founded one of the first dental clinics in the US dedicated to treating patients infected with HIV.
Before being appointed dean of SUNY Buffalo Dental School, Glick was professor of oral medicine and associate dean for oral and medical sciences at the A.T. Still University School of Osteopathic Medicine in Mesa, Arizona from January 1, 2007. Prior to that, he was professor and chair of oral diagnostic sciences at New Jersey Dental School and on the faculty at UPenn Dental in the department of oral medicine. Glick was a practicing dentist in Delaware and Pennsylvania for 15 years.
In December 2004, Glick was chosen as the editor of "JADA", having been the associate editor for dentistry and medicine since 1998. He also served as president of the American Board of Oral Medicine. Glick has given more than eight hundred presentations in more than thirty different countries.
Glick is the editor of ten textbooks on dental management and oral medicine, and has published over three hundred articles on health-related topics.
His son is actor Gideon Glick.


Jill Sampson

Susan Jill Sampson, MSC of Qualicum Beach, British Columbia, is a Canadian semi-retired veterinarian.
Dr Sampson founded Poco a Poco (Spanish for "little by little") in 1995 to provide medical, surgical and dental relief in Guatemala. Since then, she has organized many expeditions by teams of volunteer doctors, surgeons and dentists to serve the needs of the poorest citizens of that country. She has also arranged many shipments of medical supplies and equipment to Guatemala.
In 2004, she was presented with the Meritorious Service Cross by Governor General Adrienne Clarkson. She was recognized for her "dedication and her exceptional qualities in the area of public relations." She was commended for bringing "honour to her profession and to Canada."
In 2005 Dr Sampson travelled to Sri Lanka to provide medical and housing relief from tsunami damage that followed the 2004 Indian Ocean earthquake.


Caudal artery

The Caudal artery is the portion of the dorsal aorta of a vertebrate that passes into the tail.
It is analogous to the median sacral artery in humans.


Acalvaria

Acalvaria is a rare malformation consisting of absence of the calvarial bones, dura mater and associated muscles in the presence of a normal skull base and normal facial bones. The central nervous system is usually unaffected. The presumed pathogenesis of acalvaria is faulty migration of the membranous neurocranium with normal placement of the embryonic ectoderm, resulting in absence of the calvaria but an intact layer of skin over the brain parenchyma. In other words, instead of having a skull cap protecting the brain, there is only skin covering it. The size of the area that is missing the skull cap can vary from case to case. In extreme cases, the entire top part of the cranium that is dome-shaped may be absent.
Sign and symptoms.
There are four main signs of acalvaria: absence of the flat bones of the cranial vault, absence of the dura mater and muscles associated with it, skull abnormalities, and the absence of a skull cap. This condition can be diagnosed prior to birth using ultrasonography. Physicians often use magnetic resonance imaging to confirm the diagnosis because in utero, acalvaria is sometimes confused with anencephaly or encephalocele. A distinguishable difference is that with anencephaly, the cerebral hemispheres are missing, but with acalvaria, all parts of the cerebrum are usually present and developed, whereas parts of the calvarium are missing.
Pathogenesis.
Currently there is no identified cause of acalvaria. The primary presumed pathogenesis is problematic migration of the membranous neurocranium with respect to the normal positioning of the immature ectoderm. When an embryo develops normally, the anterior neural pore closes about the fourth week. After this occurs, mesenchymal tissue migrates under the ectoderm. This ectoderm underlies where the cerebral hemisphere will eventually be. When a fetus has acalvaria, the embryonic ectoderm is in its correct place, but the mesenchymal migration does not occur correctly. Therefore, acalvaria is considered to be a postneurulation defect. Because it is a postneurulation defect, it must develop after embryonic stage 11, between 24 and 26 days after conception.
Treatment.
Because this malformation is rare and there are extremely few individuals living with this condition, treatment is limited. Treatment consists of carefully managing the condition in a controlled manner. Proceeding with a bone graft when the child reaches school age is also recommended.
Prognosis.
Usually babies with this malformation do not survive past birth. However, there have been cases of survival. As of 2004, there were only two reported living cases. Of these two, one was severely cognitively impaired and physically disabled. The status of the other was unreported. If the fetus progresses to full term, there is the risk that it will have head trauma from the pressure applied to the head while being delivered. A few other cases of acalvaria have been reported, which did not progress to birth. In addition to the lack skull cap, there were brain malformations present in each case, and all of the pregnancies were terminated either electively or the fetuses were spontaneously aborted.
Epidemiology.
Acalvaria usually occurs in less than 1 of every 100,000 births. By way of epidemiological data, it is thought that females are more prone to have this defect. Currently, acalvaria is not thought to have much of a risk of recurrence.


Access Health CT

Access Health CT is the health insurance marketplace for the U.S. state of Connecticut. Access Health CT will enable people and small businesses to purchase health insurance at federally subsidized rates.
Background.
Health insurance exchanges were established as a part of the 2010 Patient Protection and Affordable Care Act to enable individuals to purchase health insurance in state-run marketplaces. In this legislation, states could choose to establish their own health insurance exchanges; if they choose not to do so, the federal government would run one for the state.


Smith-Kettlewell Eye Research Institute

The Smith-Kettlewell Eye Research Institute is a nonprofit research institute in San Francisco, California, with a focus on vision science and rehabilitation engineering. It was founded in 1959 by Arthur Jampolsky and Alan B. Scott, when some members of Stanford University's Ophthalmology Department elected to stay in San Francisco rather than move to Palo Alto.
Scientific contributions.
The Institute did early experiments in sensory substitution, especially the subsitution of tactile information for visual information to help blind people navigate and other methods to obtain accessible technology. This research is often performed by scientists who are blind, such as Josh Miele
The institute's use of Botulinum Toxin in humans as a therapy to treat strabismus. This initial therapeutic use led to later cosmetic use in Botox. Other impactful work involved Anthony Norcia's study of vision in infants and Erich Sutter's invention of the multifocal electroretinogram and of the multifocal evoked potential.
The Institute has originated various visual illusions, including Christopher Tyler's development of autostereograms, and Anthony Norcia's coffer illusion. Also popular are Tyler's analysis of the position of eyes in paintings, of Mona Lisa's smile and of Leonardo da Vinci's possible eye condition
Scientists.
Over the decades, the Institute has hosted generations of vision scientists, including


Robert B. Ammons

Robert Bruce Ammons (February 27, 1920 – May 21, 1999) was the founder, along with his wife Carol H. Ammons, of "Psychological Reports" and "Perceptual and Motor Skills". He received his Ph.D. in clinical and experimental psychology from the University of Iowa in 1946. He was a psychology professor at the University of Montana in Missoula.
Ammons was a Fellow of the American Association for the Advancement of Science, and of several divisions of the American Psychological Association.
The Ammons are also known for developing the Ammons Quick Test of intelligence, a short (five minutes) intelligence test for adults, consisting of an orally administered picture vocabulary test. It is mostly used for pre-screening the elderly, particularly because it minimizes fatigue. Its results correlate highly with those of the Wechsler Adult Intelligence Scale, particularly with the verbal IQ scale. It also benefits from simple and objective scoring.


Christian Gerhard Leopold

Christian Gerhard Leopold (24 February 1846 – 12 September 1911) was a German gynecologist born in Meerane, Saxony.
In 1870 he earned his medical doctorate from the University of Leipzig, where he studied under Carl Siegmund Franz Credé (1819-1892), who would later become his father-in-law. From 1877 until 1883 he taught midwifery at the "Frauenklinik" in Leipzig, and afterwards succeeded Franz von Winckel (1837-1911) as director of the Dresden Royal Gynecological Infirmary.
Leopold is remembered for the eponymous "Leopold maneuvers" ("Leopold-Handgriffe"), which are four classic maneuvers used to determine the position of the fetus within the uterus. Beginning in 1894 he was co-editor of the "Archiv für Gynäkologie" with Adolf Gusserow (1836-1906). Also, with Dr. Credé and Paul Zweifel (1848-1927), he published textbooks on midwifery.
N.B. - Leopold Landau, who was also a German gynecologist born around this time, may be confused with Christian Gerhard Leopold.


Mbarara University School of Medicine

Mbarara University School of Medicine (MUSM), also known as Mbarara University Medical School (MUMS) is the school of medicine of Mbarara University of Science and Technology, one of Uganda's public universities. The medical school was founded in 1989, the same year that the university was established.
Location.
The school's campus is located on the premises of Mbarara Regional Referral Hospital, in the city of Mbarara, in Mbarara District, Western Uganda. Mbarara is the largest urban center in this region of the county, approximately , by road, southwest of Kampala, the capital of Uganda, and the largest city in the country. The coordinates of the medical school are:0°37'00.0"S, 30°39'27.0"E (Latitude:-0.616667; Longitude:30.657500).
Overview.
Mbarara University School of Medicine constitutes the Faculty of Medicine at Mbarara University. The faculty is headed by a Dean, who is deputized by a Deputy Dean. The teaching discipline of the medical school are integrated with the regional referral hospital. The hospital's consultants and registrars, and interns also serve as teaching staff for the university's medical students.


Fibromuscular Dysplasia Society of America

Fibromuscular Dysplasia Society of America is an American health charity that deals with fibromuscular dysplasia, a vascular disease.
The society sponsors a registry of patients with fibromuscular dysplasia.


Louis B. Wilson

Louis Blanchard Wilson (December 22, 1866 – October 5, 1943) was an American pathologist and the chief of pathology at Mayo Clinic from 1905 to 1937. Wilson is most famous for initiating the routine use of the frozen section procedure for rapid intraoperative diagnosis.
Wilson received his medical degree from the University of Minnesota in 1896. After this, Wilson was the assistant director of the bacteriology laboratory at the Minnesota State Board of Health and an assistant professor of pathology and bacteriology at the University of Minnesota and lived in Minneapolis. Dr. Henry Plummer urged the Mayo brothers to hire a well-trained pathologist to develop the laboratories at Mayo Clinic and Dr. Wilson reluctantly agreed to move to Rochester, Minnesota for this position. On January 1, 1905, Wilson began working at Mayo Clinic as the chief of pathology and he initiated a new scientific way of doing things at St. Marys Hospital. He systematized the processing of surgical and autopsy specimens and increased the number of autopsies performed at the hospital. Wilson began using a frozen section technique he created in 1905 and published a paper on his method in "JAMA" at the end of that year. His technique proved lasting and has had a major impact in modern medicine. He also initiated animal experimentation during those early years. In 1918, Wilson went overseas as the assistant director of the AEF division of laboratories and infectious diseases. Wilson and his chief, Col. Joseph F. Siler, greatly increased the number of laboratories in use. This exposed thousands of doctors to the use of laboratories in medicine and they returned home to demand laboratories in their hospitals. In the 1920s, Wilson married Maud Mellish [editor of Mayo Clinic's publications] and together they wrote the "Sketch of the History of the Mayo Clinic and the Mayo Foundation" anonymously in 1926. Wilson retired from the Mayo Clinic in 1937. Dr. Wilson's home where he lived with his second wife Maud Mellish, Walnut Hill (architect Harold Crawford), is extant on the grounds of the Assisi Heights convent in Rochester Minnesota and owned by the Mayo Clinic.


Helen Keller National Center for Deaf-Blind Youths and Adults

The Helen Keller National Center for Deaf-Blind Youths and Adults (also known as the Helen Keller National Center or HKNC) is a foundation in the United States that provides services for individuals who, like Helen Keller, are both blind and deaf.
Authorized by an Act of Congress in 1967, the Center provides nationwide services for people who are deaf-blind according to the definition of deaf-blindness in the Helen Keller Act. It operates a residential rehabilitation and training facility at its headquarters in Sands Point, New York, which opened in 1976, and a system of ten regional field offices, also supporting families and professional carers. In 2010 the Center served 72 adult training clients and specialized short term training for 26 clients; in addition the regional programs served 1,478 consumers, 441 families, and 881 organizations. The organization provides independent living skills training, referral, employment training, counseling, and transition assistance for individuals well as technical assistance and training for service providers. There is an international internship program for professionals.
The Center is funded in part by the Rehabilitation Services Administration of the U.S. Department of Education. In 2001, federal government provided $8.5 million a year of the $11 million annual operating costs. Congressional findings were that the Center "is a vital national resource for meeting the needs of individuals who are deaf-blind and no State currently has the facilities or personnel to meet such needs".
There are about 70,000 deaf-blind people in the United States. Most have Usher syndrome, a congenital disorder in which the individual is born deaf and there is loss of sight by adolescence. Federal law mandates that individual States take responsibility for education until the age of 16—after that the Center takes over.


Eric Topol

Eric Jeffrey Topol (born 26 June 1954) is an American cardiologist, scientist, and author. He is the founder and director of the Scripps Research Translational Institute, a professor of Molecular Medicine at The Scripps Research Institute, and a senior consultant at the Division of Cardiovascular Diseases at Scripps Clinic in La Jolla, California. He is editor-in-chief of Medscape and "theheart.org". He has published three bestseller books on the future of medicine. "The Creative Destruction of Medicine" (2010), "The Patient Will See You Now" (2015), and "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again" (2019). He was also commissioned by the UK 2018–2019 to lead planning for the National Health Service's future workforce, integrating genomics, digital medicine, and artificial intelligence.
In 2016, Topol was awarded a US$207 million grant from the National Institutes of Health to lead a significant part of the Precision Medicine Initiative (All of Us Research Program), a one million American prospective research program. This is in addition to his role as principal investigator for a US$35 million grant from the National Institutes of Health to promote innovation in medicine and the education and career training of future medical researchers.
Research.
As a researcher, Topol has published over 1,200 peer-reviewed articles, with more than 310,000 citations, h-index 235, elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine. His principal scientific focus has been on the genomic and digital tools, with the use of artificial intelligence analytics, to individualize medicine. He also pioneered the development of many medications that are routinely used in medical practice including t-PA, Plavix, Angiomax, and ReoPro. He has led clinical trials in over 40 countries involving over 200,000 patients (first in series – GUSTO trials). He has edited over 30 books, including the Textbook of Interventional Cardiology (8th ed - Elsevier, 2020), and the Textbook of Cardiovascular Medicine (3rd ed - Lippincott Williams & Wilkins).
Education and career.
Topol completed medical school at the University of Rochester (MD with Honor), his residency in internal medicine at the University of California, San Francisco, and his fellowship in cardiovascular medicine at Johns Hopkins University.
Topol was a tenured professor at the University of Michigan for 6 years. At age 36, Topol was named chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, where he is widely credited for leading its already long outstanding cardiovascular program to being ranked #1 by U.S. News & World Report for more than a decade during his 13 years at the helm. In 2002 he founded the Cleveland Clinic Lerner College of Medicine, the first new medical school in the US in 20 years, with its first class in 2004, and served as its provost and chief academic officer of the Cleveland Clinic. In 2003 he became a professor of genetics at Case Western Reserve University, while maintaining his primary appointment at Cleveland Clinic.
Topol departed from the Cleveland Clinic Lerner College of Medicine in 2006 following the removal of the chief academic officer position, and continued at Case Western Reserve University. He was then recruited by Scripps Health and The Scripps Research Institute in late 2006 to create a new institute, now called Scripps Research Translational, dedicated to individualized medicine. In 2009, Topol worked with Gary and Mary West to create the West Wireless Health Institute, now called West Health Institute, to foster the use of digital tools in medical research and practice.
Genetics and genomics.
At the University of Virginia, Topol authored his baccalaureate thesis in 1975 entitled “Prospects for Genetic Therapy in Man” and received a Bachelor of Arts degree With Highest Distinction. During his fellowship at Johns Hopkins, he was involved with the first patient who was administered tissue plasminogen activator (t-PA) in 1984, a genetically engineered protein. In 1996, he started the first dedicated cardiovascular gene bank while at Cleveland Clinic. This effort led to many discoveries in the genetics of cardiovascular disease, including the identification of key genes associated with heart attacks. Both thrombospondin variants and the MEF2A deletion reports were recognized as top 10 advances by the American Heart Association in 2000 and 2004. He was the principal investigator of the National Institutes of Health's Specialized Centers of Clinically Oriented Research grant on the genomics of heart attack with a $17 million award in 2005. His work in genetics has been recognized by the American College of Cardiology with the Simon Dack Award and Lecture in 2005 and by the European Society of Cardiology by the Andreas Gruentzig Award and Lecture in 2004.
Wireless medicine.
Topol has been involved with wireless medicine since its inception. He was the first physician to serve on CardioNet's Medical Advisory Board in 1999, the first dedicated wireless medicine company that performs real-time remote, continuous electrocardiogram rhythm monitoring. In 2007 he joined the Board of Sotera Wireless that has developed the first continuous non-invasive blood pressure monitoring device, which also captures all vital signs. In 2008 he forged a new educational program with Qualcomm and Scripps Health to train physicians in wireless medicine, a 2-year clinician scholar program: STSI Wireless Health Scholar. At the 2009 International Wireless CTIA meeting, he gave the keynote address on wireless health, the first time that topic was the subject of a CTIA plenary session. Also in 2009, he served as co-Founder with Gary and Mary West to form the West Wireless Health Institute. He is the vice-chairman of the institute and its chief innovation officer. In 2009 he also presented at TEDMED the rapid progress being made in this field. In addition, in early 2010 Topol gave a wireless medicine presentation at the Consumer Electronic Show. He led the first trial with the GE Vscan device GE Reports, a pocket high resolution, mobile ultrasound imaging device, introduced in the US in 2010 "The Doctor Will “e” You Now" and is currently leading clinical trials of heart rhythm and heart failure monitoring wireless devices.
NHS.
He was commissioned by Jeremy Hunt in 2018 to carry out a review of how the NHS workforce, will need to change “to deliver a digital future”. His report suggested that within ten years most patients would be managing their own long-term conditions with wearable devices and sensors, and that that would be much more effective than occasional appointments with a doctor. Patients would not be monitored in hospitals but at home. This rise in regular monitoring would necessitate new workflows and frameworks in digital healthcare. More nursing and physician associates would be required, enabling doctors to focus on the most difficult cases. The report also recommended specific digital training for NHS staff and physicians. His work on "High-performance medicine" that builds on this report was also published in "Nature."
Vioxx.
Topol served as chairman of cardiovascular medicine at Cleveland Clinic from 1991 to 2005. He was one of the first researchers to question the cardiovascular safety of rofecoxib (Vioxx), culminating in that drug's withdrawal from the market. Topol's advocacy on the subject led to what "The New York Times" described as an "unusually public dispute" with the Cleveland Clinic's leadership over ties between the academic institution and the pharmaceutical industry, ultimately leading to Topol's departure after his administrative position as head of their academic program was abolished.
Topol gained prominence as the first physician researcher to raise questions about the safety of rofecoxib (Vioxx). and was highly critical of Merck's handling of its safety issues. In a 2004 editorial in "The New York Times", he wrote that "Merck finally had to acknowledge the truth [about the drug's cardiovascular risks], but only by accident." Topol also authored an editorial in the "New England Journal of Medicine", arguing that "neither Merck nor the FDA fulfilled its responsibilities to the public" and encouraging a "full congressional review" of the situation.
In 2004, Bethany McLean, writing in "Fortune", questioned Topol's own potential financial conflicts of interest. She reported that Topol served as a scientific advisor to a hedge fund which profited substantially by short selling Merck stock, which plummeted due to the concerns about Vioxx which Topol had publicized. Topol denied giving the hedge fund advance information, and subsequently severed his ties to industry, donating all such income directly to charity. In a 2005 "Journal of the American Medical Association" commentary, Topol pointed to these allegations as an example of the complications that physicians can experience when associating with the investment industry, at the same time reiterating that "no true conflict of interest existed in this case."
In November 2005, Topol was subpoenaed in a class action lawsuit against Merck. He testified that Vioxx posed an "extraordinary risk", and that Raymond Gilmartin, former chief executive officer of Merck, had contacted the head of the Cleveland Clinic board to complain about Topol's work on Vioxx. Two days afterward, Topol was informed that the position as chief academic officer at the Cleveland Clinic had been abolished, and he was removed as provost of the Cleveland Clinic Lerner College of Medicine, which he had founded. The clinic described the timing as coincidental. "The New York Times" described Topol's demotion as part of an "unusually public dispute" between Topol and the Cleveland Clinic's chief executive, Delos Cosgrove, and stated that Topol's criticism of Merck had focused scrutiny and criticism on the clinic's deep and longstanding ties to the pharmaceutical and medical-device industries.
COVID-19.
In August, 2020, Topol published an open letter in Medscape to FDA Commissioner Stephen Hahn, criticizing his Emergency Use Authorizations of hydroxychloroquine, convalescent plasma, and remdesivir for COVID-19. "These repeated breaches demonstrate your willingness to ignore the lack of scientific evidence, and to be complicit with the Trump Administration's politicization of America's healthcare institutions," wrote Topol.
Hahn had stated that he was prepared to authorize a vaccine before Phase 3 trials were completed. Topol said that this would not allow the FDA to establish safety and efficacy, would jeopardize the vaccine program, and would betray the public trust. He called on Hahn to either tell the truth in a public statement, or resign.
After conversations with Topol, Hahn retracted some of those claims. In September, Hahn tightened up the rules for approving a vaccine, leading to criticism from Trump. Trump attacked Hahn in a tweet, and said that the rules should be loosened up, in order to have a vaccine by election day. With the support of Topol and others in the scientific community, Hahn held firm, and was not fired.
Topol has been vocal on Twitter arguing against the policy of "first doses first" in vaccine distribution, a policy which has been adopted in both the UK and Canada to save more lives.
Honors.
Topol was selected as one of the 12 “Rock Stars of Science” by "GQ" and the Geoffrey Beene Foundation in 2009. He was elected to the American Society for Clinical Investigation, the Association of American Physicians, and the Johns Hopkins Society of Scholars. In 2004, he was elected to the Institute of Medicine of the National Academy of Sciences. He was named Doctor of the Decade by the Institute for Scientific Information for being one of the top 10 most cited medical researchers. In 2011, Topol received the Hutchinson Medal from the University of Rochester in addition to giving the commencement speech for the School of Medicine and Dentistry. In 2012, "Modern Healthcare" ranked Topol as the most influential physician executive in the United States.
Personal life.
He is married to Susan Merriman Topol with whom he has two children.


Joseph Abadie

Joseph Louis Irenée Jean Abadie (15 December 1873, Tarbes – 1934) was a French neurologist who is remembered for naming Abadie's symptom.
Brief biography.
Joseph Louis Irenée Jean Abadie was born in 1873 in Tarbes, département Hautes-Pyrénées, France. He studied medicine at the University of Bordeaux, qualifying in 1900. In 1918 he became professor of neurology and psychiatry at Bordeaux. His work included the study of tabes dorsalis and alcoholism. He died in 1934.


Charles Decimus Barraud

Charles Decimus Barraud (9 May 1822 – 26 December 1897) was a New Zealand pharmacist and artist. The tenth recorded child of William Francis Barraud and his wife, Sophia Hull, Charles was born in Camberwell, Surrey, England on 9 May 1822.
He emigrated with his family to New Zealand, arriving in Wellington in August 1849. His wife was a cousin of Judge Henry Samuel Chapman, and it was Chapman who encouraged the emigration, lending the Barrauds a cottage when they arrived, and in which they lived until their own house had been built.
Barraud quickly set up shop in Lambton Quay as a pharmacist. At the same time he soon gained recognition as an artist, at this point regarded as an "enthusiastic amateur", and working mostly in watercolours. He painted the children of Henry William Petre in 1850, but the visiting Charlotte Godley, who wanted a portrait of her son Arthur, was scathing of his talent:
There is a chemist here who has lately turned artist, and who has perpetrated a few likenesses, very like, but very bad... If it were likely to be tolerable I should so like to have Arthur done, but I am afraid it would be only a disappointment.
Personal.
Barraud married Sarah Maria Style on 17 March 1849 at St Lawrence's Church, Southampton. The marriage produced six recorded sons and three daughters.


Robert J. Waldinger

Robert J. Waldinger (born 1951) is an American psychiatrist and Professor at Harvard Medical School. He is known for a TED talk about his findings from the Grant Study, a longitudinal study on adult happiness that's based at Harvard and has been running continuously since 1938.
Since 2005, Waldinger has been Director of the Study of Adult Development at Harvard University, a longitudinal study that has tracked the health and mental well-being of a group of 724 American men for more than 80 years. Waldinger is also a faculty member in the adult training program at the Boston Psychoanalytic Society and Institute.
He is the Director of the Center for Psychodynamic Therapy and Research at Massachusetts General Hospital. He is a Zen priest as well. After the viral success of his TED talk, he took a 3-week silent retreat; Waldinger explains "the Zen tradition holds that contemplation helps us stay grounded in what’s most important in life."
He also is Founder and Executive Director of the Lifespan Research Foundation, which conducts and translates research, and disseminates information and programs that promote adaptive adult development.
Waldinger graduated summa cum laude from Harvard College in 1973. He completed his M.D. at Harvard Medical School in 1978.


Walter Keller (researcher)

Walter Keller is a mathematician, physicist, researcher, designer, and inventor. He designed and holds the patent on the first implantable atrial synchronous heart pacemaker; he designed a demand circuit critical to the controls of the artificial heart; and he pioneered the first remotely programmable computer implantable prosthesis.


Metopism

Metopism is the condition of having a persistent metopic suture, or persistence of the frontal metopic suture in the adult human skull. The premature fusion of cranial sutures named craniosynostosis, it is “simple” when only one cranial suture is involved and “compound” when two or more cranial sutures are involved. Metopism is the opposite of craniosynostosis. The main factor of the metopic suture is to increase the volume of the anterior cranial fossa. The frontal bone includes the forehead, and the roofs of the orbits (bony sockets) of the eyes.
The frontal bone has vertical portion (squama) and horizontal portion (orbital part). Some adults have a metopic or frontal suture in the vertical portion. In uterine period in right and left half of frontal region of the fetus there is a membrane tissue. On each half a primary ossification center appears about the end of the second month of the fetus. Primary ossification center extends to form the corresponding half of the vertical part (squama) and horizontal part (orbital part) of the frontal bone.
At birth the frontal bone contains two portions, separated by the metopic (frontal) suture. Metopism is the condition of having a persistent metopic suture. Metopic suture is regularly obliterated, except at its lower part, by the eighth year, but infrequently persists throughout life. There is no single proven cause of metopism. The occurrence is from mild to serious situations. Visional, learning, and behavioral problems may happen in serious metopism. Some don't need any medical treatment. Surgery is a successful approach for those who need it. Treatment teams include: neurosurgeons, plastic surgeons, neurologists, oral and maxillofacial surgeons, audiologists, neuroscience nursing professionals, speech therapists, physical therapists, dentist, otolaryngologists, ophthalmologists, psychiatrists, psychologists and social workers.


Jules Comby

Jules Comby (; 28 April 1853, Arnac-Pompadour – 18 March 1947) was a French pediatrician.
The eponymous "Comby's sign" is named after him, which is an early indication of measles characterized by thin whitish patches on the gums and buccal mucous membrane.
Written works.
With Antoine Marfan (1858–1942) and Jacques-Joseph Grancher (1843–1907), he published the influential "Traité des maladies de l’enfance" (Treatise of the Diseases of Childhood). Other publications and translated works of his include:


International Board of Medicine and Surgery

The International Board of Medicine and Surgery (IBMS) is an international professional association, established in 2001 and headquartered in Palm Harbor, Florida, that serves as the authority for certifying the credentials and the professionalism of physicians, surgeons, and dentists across all territories and jurisdictions of the world.
Mission.
The purpose of IBMS is to promote patient safety and professional integrity and to facilitate medical tourism with information that traveling patients need to make informed choices for their healthcare needs.
Overview.
Professional credentials are generally issued by the authority of governmental entities and by the authority of specific professional disciplines. The requirements of these authorities vary somewhat from country to country and from group to group. With the advent of medical tourism, prospective patients have encountered some difficulty in identifying homologous credentials across the world's jurisdictions. To address this confusion, the International Board of Medicine and Surgery (IBMS) applies the requirements and procedures used by public health departments in the United States to effect a standardized certification of medical, surgical, and dental professionals worldwide.
IBMS respects the procedures controlling professional credentials in each jurisdiction and it confirms that each professional member of IBMS has received the appropriate credentials. Homologation of those credentials is effected by ensuring that all professional members of IBMS, regardless of jurisdiction, subscribe to the same international standards of medical treatment and code of ethics.
IBMS's international standards of medical treatment stipulate that:
IBMS's code of ethics stipulates that each professional member shall:
Certification with IBMS is voluntary and is graduated into five levels. All levels require that the member acknowledge IBMS's international standards of medical treatment and IBMS's code of ethics. With each higher level, the professional member produces increasingly more credible evidence demonstrating that he or she can be counted on to adhere to those standards.
Advocacy.
By means of its graduated certification and its conferences, IBMS encourages its members to pursue continuing education and continual improvement. For the patients of its members, IBMS will act as an impartial intermediary to correct any dissatisfaction with the professional services.


Nick Curran

Nick Curran (September 30, 1977 – October 6, 2012) was an American blues/rock and roll singer and guitarist. He has been likened to T-Bone Walker, Little Richard, The Sonics, Doug Sahm, Misfits, and The Ramones.
Early life.
Nick Curran was born in Biddeford, Maine. He began playing drums at the age of 3, showing an amazing ability to keep time even at such a young age. It was a daily ritual for him. He would turn on his radio and play along with the music. His dad, Michael, taught Nick everything he wanted and needed to know with the guitar. Any "lick" that Nick learned early on, he simply asked Michael (Mike) to show him how to do it... and a few hours later, Nick would emerge from his room having learned and practiced it. When asked at a young age why he wanted to play so badly, he replied, "I got the feelin'." He had received no formal lessons for guitar. At age 15, he played guitar and harp in his father's band, Mike Curran and the Tremors, and at the age of 17 played drums, again alongside his father, guitarist Michael Curran, in a band called The Upsetters-based out of Portland, Maine. That same year, he also formed the Rockabilly band Nick Danger and the Sideburners, frequently playing at a number of clubs in the Portland, Maine area. At 18, he auditioned for James Montgomery.
Career.
Curran began his professional career at age nineteen, leaving Maine to tour with Ronnie Dawson, "The Blonde Bomber". Although Dawson was primarily a rockabilly musician, many blues and punk fans appreciated his performances. He taught Curran not to get pigeonholed. Curran toured next with Texas rockabilly doyenne Kim Lenz, moving to Dallas to join her backup band the Jaguars, and performing on Lenz's recording, "The One And Only". Curran would stay with the Jaguars for two years. He is also featured on Lenz's next CD, "It's All True", and toured with her in the summer of 2009.
In 1999, the Texas Jamboree label issued Curran's debut solo recording, "Fixin' Your Head". As he would do on all future CDs, Curran used vintage recording equipment to achieve the feel and sound of old 45s and 78s, and the LPs of the 1950s. To support the recording he formed the band, Nick Curran & the Nitelifes. From 2004 to 2007 Curran played with The Fabulous Thunderbirds appearing on their 2005 recording, "Painted On". During that time, bassist Ronnie James started the punk band Deguello. In 2008, James and Curran formed The Attitudes with Nick, singing and playing drums standing up, and with guitarist CoffeeBoy Johnson. "This band is like when you and your buddy wanted to have a band in high school and there was no bass player. We just play what ever we wanted to," according to CoffeeBoy Johnson. Their set consisted of covers of The Misfits, The Ramones, Howlin' Wolf, Jimmy Reed, Muddy Waters and Little Richard. "We wanted to give the black keys a run for their money."
Curran performed four songs in a scene in the 2008 HBO Series, "True Blood," based on The Southern Vampire Mysteries by Charlaine Harris, which explores the co-existence of humans and vampires.
After performing a solo show in November 2008, Curran formed the rock ‘n’ roll roots band, The Lowlifes, who were critically acclaimed and became a mainstay on Little Steven's Underground Garage, earning three "Coolest Song in the World" titles with tracks from the album, "Reform School Girl".
Death.
In 2009, Curran was diagnosed with oral cancer. In June 2010, he had been deemed cancer free, but by April 2011 the cancer had returned and he underwent treatment. Curran eventually succumbed to the disease on October 6, 2012, at the age of 35.
Discography.
Allmusic gave four stars for every album.


Triple-S Management Corporation

The Triple-S Management Corporation (TSM) —commonly known as Triple-S, or SSS— is an insurance holding company based in San Juan, Puerto Rico, which offers a wide range of insurance products and services in Puerto Rico through its wholly owned subsidiaries. Listed in the NYSE as GTS, Its headquarters are located at 1441 Franklin D. Roosevelt Ave., in the San Patricio section of San Juan.
Triple-S is the leading managed care company in Puerto Rico. With over one million customers, in addition to its core managed care business, TSM operates two complementary businesses in life, and property and casualty insurance. Founded in 1959, it has become the largest medical insurance provider in Puerto Rico thanks to its licensed affiliation with the Blue Cross and Blue Shield Association. Since 1965, Triple-S, Inc. has been an independent licensee of the Blue Cross and Blue Shield Association, holding the exclusive rights to the Blue Cross and Blue Shield name and trademark in Puerto Rico and the US Virgin Islands. Triple-S also has operations in Costa Rica as Blue Cross Blue Shield of Costa Rica. This provides its members with access to the Blue Card network in the U.S. It is the only managed-care company that serves all market sectors, including Medicare, Medicaid, Group and Individual, in Puerto Rico and is one of the most recognized brands locally.


Abdul Rahman Saleh (physician)

Abdulrahman Saleh (1 July 1909, in Batavia – 29 July 1947, in Maguwoharjo, Yogyakarta) was a National Hero of Indonesia.
Personal life.
With the help of a local noble family, he was buried at Kuncen Cemetery in Yogyakarta, which is reserved for Javanese nobles.
Career.
He was an Indonesian aviator. His Dakota (registration VT-CLA) was shot down by a Dutch Kittyhawk when landing in Maguwo Airfield (now Adisucipto International Airport), Sleman Regency, Yogyakarta. The same plane carried Adisucipto and Adi Sumarmo (also national heroes of Indonesia).
Recognition.
The medical faculty of the University of Indonesia honored him as Indonesia's father of Physiology. The annual Medical and General Biology Competition is called the Abdulrahman Saleh trophy.
In 2000, based on Indonesian Air Force initiative and family approval, his grave was relocated to Ngoto, near the crash site. Many friends and supporters came to lay him to rest and thanked him for his service. The new grave is part of the Indonesian Air Force's Monument Perjuangan Ngoto, together with the graves of Mrs. Ismudiati Abdulrahman Saleh, Agustinus Adisucipto, and Mrs. Adisucipto.
In honour of his service, the Indonesian Air Force has named the Abdulrahman Saleh Air Force Base in Malang, East Java after him. This Air Force Base is also serving civil aviation for the city.


National coverage determination

A national coverage determination (NCD) is a United States nationwide determination of whether Medicare will pay for an item or service. It is a form of utilization management and forms a medical guideline on treatment.
Medicare coverage is limited to items and services that are considered "reasonable and necessary" for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category).
In the absence of a NCD, an item or service is covered at the discretion of the Medicare contractors based on a local coverage determination (LCD). As of 2015, local coverage determinations only become public on an appeal, and do not set a precedent.
What triggers an NCD?
NCDs can be requested by external parties who identify an item or service as a potential benefit (or to prevent potential harm) to Medicare beneficiaries. External parties who may request an NCD are Medicare beneficiaries, manufacturers, providers, suppliers, medical professional associations, or health plans.
NCDs can also be internally generated by the Centers for Medicare and Medicaid Services (CMS) under multiple circumstances.
For existing items or services
For new items or services
The NCD decision process.
The NCD development process generally takes 6–9 months, depending on the need for external technology assessments or coverage advisory committee reviews. For NCD requests that do not require these assessments/reviews, the entire NCD decision will be made no more than 6 months after the date the request is received.
Phases during the first 6 months:
Phases during last 3 months
Relationship of NCDs and LCDs.
NCD decisions are binding on all Medicare contractors, and LCD policy can be no more restrictive than the NCD, although it can be less restrictive. If an NCD or other coverage provision states that an item is "covered for diagnoses/conditions A, B and C", contractors should not use that as a basis to develop an LCD to cover only "diagnoses/conditions A, B and C". When an NCD does not exclude coverage for other diagnoses/conditions, contractors should allow individual consideration, unless the LCD supports automatic denial of some or all of those other diagnoses/conditions. When national policy bases coverage on need assessment by the beneficiary's provider, LCDs should not include prerequisites.
Evaluating LCDs for NCD consideration.
CMS is required (under the MMA) to evaluate LCDs to decide which decisions should be adopted nationally. When new LCDs are developed, a 731 Advisory Group reviews LCD topic submissions to determine which topics are forwarded to the CMS Coverage and Analysis Group (CAG).
To promote consistency across LCDs, CMS requires Medicare contractors to:


Dr. Gloria Nathan


Lisa Dixon

Lisa Dixon is a Professor of Psychiatry at the University of Maryland, Baltimore, where her primary research interests have focused on persons with severe mental illnesses who have co-morbid medical and substance use disorders, homelessness, and other vulnerabilities as well as on services to family members. She is the director of the Division of Services Research within the Department of Psychiatry at Maryland, and joined the Veterans Affairs Capital Health Care Network as Associate Director for Research at the Mental Illness Research, Education, and Clinical Center. She was previously the Director of Education and Residency Training at Maryland.
Dixon received her Bachelor's Degree in Economics from Harvard in 1980 and her medical degree from Weill Medical College of Cornell University in 1985. After completing her residency at the Payne Whitney Psychiatric Clinic in 1989, she completed a research fellowship at the Maryland Psychiatric Research Center. She later earned a Masters in Public Health from Johns Hopkins University.
Dixon has collaborated with the National Alliance on Mental Illness (NAMI) to establish the effectiveness of NAMI's Family to Family education program.
She also directs the Center for Practice Innovations (CPI) at the New York State Psychiatric Institute.
Areas of Expertise.
Bipolar Disorder, Psychopharmacology, Mood Disorders, Obessive Compulsive Disorder (OCD)
Awards.
She is a recipient of NAMI’s Scientific Research Award, NAMI NYC Metro’s Volunteer of the Year Award and NAMI-NYS’s Dr. Lewis Opler Memorial Award acknowledging her dedicated support for the organization.


Cephalic disorder

Cephalic disorders (from the Greek word "κεφαλή", meaning "head") are congenital conditions that stem from damage to, or abnormal development of, the budding nervous system. Cephalic means "head" or "head end of the body".
Cephalic disorders are not necessarily caused by a single factor, but may be influenced by hereditary or genetic conditions, nutritional deficiencies, or by environmental exposures during pregnancy, such as medication taken by the mother, maternal infection, or exposure to radiation. Some cephalic disorders occur when the cranial sutures (the fibrous joints that connect the bones of the skull) join prematurely. Most cephalic disorders are caused by a disturbance that occurs very early in the development of the fetal nervous system.
The human nervous system develops from a small, specialized plate of cells on the surface of the embryo. Early in development, this plate of cells forms the neural tube, a narrow sheath that closes between the third and fourth weeks of pregnancy to form the brain and spinal cord of the embryo. Four main processes are responsible for the development of the nervous system: cell proliferation, the process in which nerve cells divide to form new generations of cells; cell migration, the process in which nerve cells move from their place of origin to the place where they will remain for life; cell differentiation, the process during which cells acquire individual characteristics; and cell death, a natural process in which cells die.
Damage to the developing nervous system is a major cause of chronic, disabling disorders and, sometimes, death in infants, children, and even adults. The degree to which damage to the developing nervous system harms the mind and body varies enormously. Many disabilities are mild enough to allow those affected to eventually function independently in society, others are not. Some infants, children, and adults die, others remain totally disabled, and an even larger population is partially disabled, functioning well below normal capacity throughout life.
The National Institute of Neurological Disorders and Stroke (NINDS) is currently "conducting and supporting research on normal and abnormal brain and nervous system development."
Types.
More common cephalic disorders.
The ICD-10 codes are listed below per disorder.
Notes.
"Portions of this article were based on the page: https://web.archive.org/web/20080920160408/http://www.ninds.nih.gov/disorders/cephalic_disorders/detail_cephalic_disorders.htm at the National Institute of Neurological Disorders and Stroke's public domain resource."


National Healthcareer Association

The National Healthcareer Association (NHA) is a national professional certification agency for healthcare workers in the United States. Granting credentials in more than 8 allied health specialties, it is an organizational member of the National Organization for Competency Assurance (NOCA). The National Healthcareer Association partners with educational institutions nationwide with over 350,000 certified individuals. It is one of the largest certification and continuing education providers. The National Healthcareer Association works with health training institutions, hospitals, unions, and the US Defense Department through DANTES; it has approved over 2400 training/testing locations throughout the US and in several countries. These institutions offer allied health programs and use the national certification as their "End Of Program Credential."
Healthcare professional certification is different from a license such as a Registered Nurse, or a licensed practical nurse. Although certification is not state mandated and/or regulated in all 50 states, most employers and industry organizations prefer their employees to be certified.
Certified occupations.
Certified technicians work alongside licensed nurses and/or doctors. These positions would include individuals working as a phlebotomist, EKG technician, clinical medical assistant, patient care technicians, medical laboratory assistants, medical transcriptionists, medical administrative assistants, billing and coding specialists, mental health technicians, and surgical/operating room technicians. Many hospitals, private practices, and organizations throughout the country require national certification as a competence standard. The National Healthcareer Association is a part of the National Organization for Competency Assurance. The National Healthcareer Association helps set performance ethics standards among health care professionals, establish education requirements, and set guidelines for national certifications.
Continuing education requirements.
Because of changes and updates in the healthcare industry, certified technicians are required to maintain their certification by completing continuing education credits throughout the year, or the duration of their certificate's expiration date. These continuing education credits or units (CEUs) can be earned through the certification agency or through their employer and then verified by the National Healthcareer Association. Continuing education ensures competency standards throughout the duration of employment of the certified individual, and keeps them aware of changes and new regulations in the allied healthcare industry.
Certification exams.
The National Healthcareer Association writes, develops and publishes the certification exams for allied health professions: medical assistant, phlebotomy, EKG, pharmacy technician, medical billing and coding, administrative medical assistants, patient care technician and electronic health records.
Partnerships.
The State of New Jersey's program was the Certified Patient Care Technician (CPCT) Program. It was an accelerated, three-week program for UH Nursing staff and shows the coordination that exists between the National Healthcareer Association and state and regional associations. The training and certification were sponsored by UMDNJ's Career Training and Advancement Center (CTAC), coordinated by the Department of Human Resources and grant-funded by the Bank of America.
CTAC and nursing leadership at the University Hospital worked closely with the National Healthcareer Association to develop a comprehensive program specific to the needs of the university. The CPCT model advanced the skills and competencies of incumbent Nursing Assistants in entry-level positions within the nursing career ladder while instituting a new, team-based, patient care model. The new skills developed were phlebotomy, EKG/ECG, basic patient care and medical assisting skills.
The United States Department of Defense's agency, Defense Activity for Non-Traditional Education Support (DANTES), offers the National Healthcareer Association's (NHA) certification exams at all 520 DANTES test sites worldwide. The National Healthcareer Association's partnership with DANTES offered new opportunities to the thousands of military trainees as well as experienced medical personnel stationed around the world.
Global expansion.
The National Healthcareer Association (NHA), the largest Allied Health Certification Agency in the US and the National Lutheran Health and Medical Board (NLHMB), Chennai, India, which is a leading NGO and sponsor of Two Universities have come together to offer the US employment National Healthcareer Association Certificate Examination in India.


Henry Bond (physician)

Henry John Hayles Bond, FRCP (22 December 1801 – 1 September 1883) was a British physician and academic. From 1851 to 1872, he was Regius Professor of Physic at the University of Cambridge.
Early life.
Bond was born on 22 December 1801 in Wheatacre, Norfolk, England, to the Rev William Bond, an academic and clergyman, and his wife Martha Bond (née Hayles). He was educated at Norwich Grammar School, then an all-boys independent school in Norwich. The high master at the time of his attendance was the Rev Edward Valpy. He then studied medicine in a variety of European cities including Cambridge, London, Edinburgh and Paris. He graduated from Corpus Christi College, Cambridge with a Bachelor of Medicine (MB) degree in 1825. In November 1828, he was awarded the Licentiate in Physic by the University of Cambridge. He remained to undertake postgraduate research and completed his Doctor of Medicine (MD) degree in 1831.
Medical career.
By the time of completing his doctorate in 1831, Bond had established a large medical practice in Cambridge. He was elected a Fellow of the Royal College of Physicians (FRCP) in 1835. He additionally worked as a physician in Addenbrooke's Hospital, Cambridge, after it was founded in 1842.
In 1851, he was appointed Regius Professor of Physic at the University of Cambridge. The General Medical Council was founded in 1958 and he was a member from 1858 to 1863. He lectured regularly at the university and his only publication, "Analysis of an Elementary Course of Lectures on Pathology" (1866), was a collection of some of his lectures. He stopped practising medicine towards the end of time at the University of Cambridge and he finally resigned the Regius Professorship in 1872.
Later life.
Bond retired from academia but remained living in Cambridge. In June 1882, he fractured his hip, which left him confined to a bed. On 3 September 1883, he died at his home on Regent Street, Cambridge; he was 81 years old. He was buried in one of the city's cemeteries.
Personal life.
On 11 December 1834, Bond married Mary Carpenter, daughter of William Carpenter. One of Mary's uncles was Sir Edward Berry, an admiral who had served with Horatio Nelson. Together, they had many children.


Peribronchial cuffing

Peribronchial cuffing, also referred to as peribronchial thickening or bronchial wall thickening, is a radiologic sign which occurs when excess fluid or mucus buildup in the small airway passages of the lung causes localized patches of atelectasis (lung collapse). This causes the area around the bronchus to appear more prominent on an X-ray. It has also been described as donut sign, considering the edge is thicker, and the center contains air.
Examples.
Peribronchial cuffing is seen in a number of conditions including:
Treatment.
As peribronchial cuffing is a sign rather than a symptom or condition, there is no specific treatment except to treat the underlying cause.


Ara Parseghian Medical Research Foundation


NHS care trust

A care trust is a type of NHS trust in the English National Health Service and NHS Wales that provides both health and social care. They may carry out a range of services, including social care, mental health services or primary care services. Care Trusts are set up when the NHS and local authorities agree to work closely together, usually where it is felt that a closer relationship between health and social care is needed or would benefit local care services.
Care trusts were established under the NHS Plan 2000, in England to bring together in one legal entity the commissioning and provision of health and social care services, especially for older people. Torbay and Southern Devon Health and Care NHS Trust was regarded as the most successful. Others are Worcestershire Health and Care NHS Trust, Bradford District Care Trust, Kent and Medway NHS and Social Care Partnership Trust and Sheffield Health & Social Care NHS Foundation Trust
Care trusts do not exist in Scotland, nor are there plans to introduce them.
In Northern Ireland, health and social care is organised through five sub-regional health and social care trusts.


Rameck Hunt


Robert Defries

Robert Davies Defries, (July 23, 1889 – October 25, 1975) was a Canadian physician and Director of Connaught Medical Research Laboratories.
Born in Toronto, Ontario, he received his M.D. from the University of Toronto in 1913.


Eduard Kaufmann

Eduard Kaufmann (24 March 1860, Bonn – 15 December 1931, Göttingen) was a German physician.
The disease Abderhalden–Kaufmann–Lignac syndrome is named for him.
Career.
Kaufmann studied in Bonn and Berlin, and earned his doctorate from the University of Bonn in 1884. He was appointed privatdozent for anatomical pathology in Breslau three years later, and assisted at Emil Ponfick’s institute.
In 1896 Kaufmann became prosector at Allerheiligenhospital in Breslau and professor in 1897. In 1898 he became professor of pathology and anatomical pathology and head of the Pathological Anatomical Institute of the University of Basel. Kaufmann moved in 1907 to Göttingen and finally withdrew from active work in 1927.
Kaufmann undertook the first study of cartilage changes in achondroplasia. His textbook on pathological anatomy, "Lehrbuch der speciellen pathologischen Anatomie", has been tractitioners</ref> He was the author of significant works involving chondrodystrophy and on malignant tumors of the prostate.


Jan Breslow

Jan Leslie Breslow (born 1943) is an American physician and medical researcher who studies atherosclerosis. As of 2017, he is Frederick Henry Leonhardt Professor at Rockefeller University and directs the university's Laboratory of Biochemical Genetics and Metabolism.
Biography.
Breslow attended Columbia College, Columbia University, gaining AB (1963) and MA (1964) degrees in chemistry. He then studied at Harvard Medical School, receiving his MD in 1968. He worked in pediatric medicine at the Boston Children's Hospital (1968–70) and then held a post-doctoral position at the National Heart, Lung, and Blood Institute (1970–73).
In 1973, he took up a post as head of the metabolism division of Boston Children's Hospital, as well as successively instructor, assistant and associate professor in pediatric medicine at Harvard Medical School. In 1984, he moved to Rockefeller University as a professor, and in 1986, was appointed Frederick Henry Leonhardt Professor at the Laboratory of Biochemical Genetics and Metabolism. In 2014, he was appointed director of the university's Sackler Center for Biomedicine and Nutrition. He also works at Rockefeller University Hospital as a senior physician and was physician-in-chief in the 1990s.
Research.
Breslow's research has focused on the genetic factors that govern an individual's predisposition to develop atherosclerosis. He started to work on the genetics of cholesterol handling in the late 1970s, and in the early 1980s, with Vassilis Zannis, he was one of the earliest to dissect the different variants of human apolipoprotein E (ApoE), a component of very low-density lipoprotein. People with different ApoE variants are now known to have different risks not only of heart disease but also of Alzheimer's disease. In 1992, his group found that deleting the mouse gene for ApoE caused the animals to develop elevated blood cholesterol levels and atherosclerosis within around 6 months, on a normal diet. Nobuyo Maeda's group at the University of North Carolina at Chapel Hill also independently created ApoE knockouts ("apoe−/−") that developed atherosclerosis at the same time. The ApoE knockout was the earliest mouse model of the disease, and has been widely used in atherosclerosis research.
His group has subsequently researched other genes associated with atherosclerosis, and for example, in 2003, were among the first to identify and characterize "PCSK9", which encodes an enzyme acting in a novel cholesterol regulatory pathway. Antibodies targeting PCSK9 were approved by the US FDA as a novel class of cholesterol-lowering drugs in 2015.
Awards and honours.
Breslow is an elected fellow of the American Society for Clinical Investigation (1984), US National Academy of Sciences (1995), Deutsche Akademie der Naturforscher Leopoldina (1996) and the Institute of Medicine (1997). He served as president of the American Heart Association – using the position to lobby vigorously for more government funding for research into heart disease – and has received several awards from the association, including their Lifetime Research Achievement Award in 2010. He has also served as vice president of the American Society for Clinical Investigation. He has won the E. Mead Johnson Award of the American Academy of Pediatrics (1984), the Heinrich Wieland Prize (1991) and the Bristol-Myers Squibb Award for Cardiovascular Research (2000). In March 2013, Rockefeller University organized a symposium entitled "Genetics of Lipid Disorders and Atherosclerosis" to mark his seventieth birthday.
Personal life.
Breslow is married to Marilyn G. Breslow, an investment manager and sculptor; the couple have two sons. Breslow is one of the signatories of a letter entitled "No Need to Panic About Global Warming", which was published in "The Wall Street Journal" in 2012.


James Kocsis

James Kocsis is professor of psychiatry at Weill Cornell Medical College and Payne Whitney Psychiatric Clinic. His clinical research trials focused on the treatment of chronic depression, initially with antidepressant medications and, more recently, with psychotherapy. These studies were pivotal in the reconceptualization of depressive neurosis, a personality disorder, into dysthymia, a variant of major depression.
Kocsis graduated from Amherst and Cornell Medical College.


Arthur Askey

Arthur Bowden Askey, (6 June 190016 November 1982) was an English comedian and actor. Askey's humour owed much to the playfulness of the characters he portrayed, his improvisation, and his use of catchphrases, which included "Hello playmates!", "I thank you" (pronounced "Ay-Thang-Yaw"), and "Before your very eyes". He was short (5' 2", 1.58 m), with a breezy, smiling personality, and wore distinctive horn-rimmed glasses.
Early life and education.
Askey was born at 29 Moses Street, Dingle, Liverpool, the eldest child and only son of Betsy (née Bowden, d. 1949), originally from Knutsford, Cheshire, and Samuel Askey (d. 1958), company secretary of Sugar Products of Liverpool. Six months after his birth, the family moved to 90 Rosslyn Street, Liverpool. It was here that a sister, Irene Dorothy, was born.
Askey was educated at St. Michael's Council School (1905–11) and the Liverpool Institute for Boys (1911–16).
Career.
Askey served in the armed forces in World War I and performed in army entertainments.
After working as a clerk for Liverpool Corporation's Education Department, he was in a touring concert party, the music halls and was in the stage company of Powis Pinder on the Isle of Wight in the early 1930s before he rose to stardom in 1938 through his role in the first regular radio comedy series, "Band Waggon" on the BBC.
"Band Waggon" began as a variety show, but had been unsuccessful until Askey and his partner, Richard Murdoch, took on a larger role in the writing.
Film roles.
During the Second World War Askey starred in several Gainsborough Pictures comedy films, including "Band Waggon" (1940), based on the radio show; "Charley's (Big-Hearted) Aunt" (1940); "The Ghost Train" (1941); "I Thank You" (1941); "Back Room Boy" (1942); "King Arthur Was a Gentleman" (1942); "Miss London Ltd." (1943); "Bees in Paradise" (1944); "The Love Match" (1955) and "Make Mine a Million" (1959). His last film was "Rosie Dixon - Night Nurse" (1978), starring Debbie Ash.
Television.
In the early 1930s, Askey appeared on an early form of BBC television—the spinning disc invented by John Logie Baird that scanned vertically and had only thirty lines. Askey had to be heavily made up for his face to be recognisable at such low resolution. When television became electronic, with 405 horizontal lines, Askey was a regular performer in variety shows.
When television returned after World War II, his first TV series was "Before Your Very Eyes!" (1952), named after his catchphrase. On 3 May 1956, Askey presented "Meet The People", a launch night programme for Granada Television. In 1957 writers Sid Colin and Talbot Rothwell revived the "Band Waggon" format for "Living It Up", a series that reunited Askey and Murdoch after 18 years. He continued to appear frequently on television in the 1970s, such as being a panellist on the ITV talent show "New Faces", where his usually sympathetic comments would offset the harsher judgments of fellow judges Tony Hatch and Mickie Most. He also appeared on the comedy panel game "Jokers Wild". He made many TV appearances in variety, including BBC TV's long running show, "The Good Old Days".
Radio.
In the late 1940's, Arthur Askey participated in a BBC radio show called "How Do You Do" in which listeners could write into the BBC asking for him to come and broadcast a show from their homes, twelve shows were broadcast with Arthur, his daughter Anthea and special guests, as well as a surprise guest each week which was revealed some time throughout the programme. The theme of each show was worked around the occupation of the family from where it was broadcast. This was broadcast on the Light Programme. Only one of the shows was recorded onto acetate discs, which are now held at The British Library.
During the 1950s and 1960s, he appeared in many sitcoms, including "Love and Kisses", "Arthur's Treasured Volumes" and "The Arthur Askey Show". He was the subject of "This Is Your Life" on two occasions, in December 1959 when he was surprised by Eamonn Andrews, and in December 1974, when Andrews, dressed as Humpty Dumpty, surprised him on a television show while discussing the art of pantomime.
Theatre.
Askey appeared in the West End musical "Follow the Girls". He also made many stage appearances as a pantomime dame.
Recordings.
Askey's recording career included "The Bee Song", which was an integral part of his stage and television act for many years, "The Thing-Ummy Bob" and his theme tune, "Big-Hearted Arthur" (which was also his nickname). In 1941 a song he intended to record, "It's Really Nice to See You Mr Hess" (after Hitler's deputy Rudolf Hess fled to Scotland), was banned by the War Office. A collection of Askey's wartime recordings appear on the CD album "Band Waggon/Big Hearted Arthur Goes To War".
"Private Eye".
"Private Eye" magazine in the 1970s regularly made the comment that he and the Queen Mother had "never been seen in the same room together", referring to the fact that they were about the same age and height and suggesting that the Queen Mother was Askey in drag.
Honours.
Askey was appointed OBE in 1969 and advanced to CBE in 1981.
Personal life.
Askey was married to Elizabeth May Swash in 1925 until her death in 1974; he was the father of actress Anthea Askey (1933–1999).
Death.
Askey carried on working on his comedy career until just before he was hospitalised in July 1982 due to poor circulation which resulted in gangrene and the amputation of both legs. He died in London's St Thomas's Hospital on 16 November 1982 and was cremated at Putney Vale Cemetery.
Legacy.
Paul Whitehouse in "The Fast Show" played 'Arthur Atkinson' a spoof of Arthur Askey and Max Miller.


Philippe Gaucher

Philippe Charles Ernest Gaucher () (July 26, 1854 – January 25, 1918) was a French dermatologist born in the department of Nièvre.
He received his medical doctorate in 1882, and soon after headed a medical clinic at Necker Hospital. During the subsequent years he was an instructor at several hospital clinics in Paris. He taught classes on pathological anatomy, bacteriology and histology, as well as dermatology.
In 1902 he succeeded Jean Alfred Fournier (1832–1914) as the university chair of dermatology and syphilography. Gaucher was also founder of a journal on venereal disease called "Annales des Maladies Vénériennes".
He is remembered for providing a description of a disorder that was to become known as Gaucher's disease. In 1882 while still a student, he discovered the disease in a 32-year-old woman who had an enlarged spleen. At the time, Gaucher thought it to be a form of splenetic cancer, and published his findings in his doctorate thesis, titled "De l'epithelioma primitif de la rate, hypertrophie idiopathique de la rate sans leucemie". However, it was not until 1965 that the true biochemical nature of Gaucher's disease was understood.


Moda Health

Moda Health (formerly ODS Health) is a health insurance company based in Portland, Oregon. The company provides medical and dental insurance in Oregon and Alaska (and in Washington state before 2016). The Moda Center, a sports arena that is home to the Portland Trail Blazers; and Moda Tower, the tenth-tallest building in Portland; are both named after the company. Moda Health is a member of Delta Dental.
History.
Originally started as part of the Oregon Dental Society (now the Oregon Dental Association), the company began as a dental insurance plan. In 1995, the Oregon Department of Justice investigated claims of anti-trust issues related to a most favored nation clause in its contracts with dentists, which led to the removal of the clause. The company announced in 1996 it would move to what became the ODS Tower. In July 1999, ODS moved into the new office building, and the next month sold its former headquarters for $9.6 million to the retirement trusts for Les Schwab Tires and law firm Stoel Rives. ODS changed its name to Moda Health in May 2013, though it kept the ODS moniker for its dental plans in Oregon. Later that year it announced a sponsorship deal with the NBA's Portland Trail Blazers, in which the former Rose Garden Arena would be renamed as the Moda Center. The company is also the shirt sponsor of National Women's Soccer League side Seattle Reign. As of 2013, the company had nearly 1,400 employees and $1.7 billion in annual revenues.
ACA's Risk corridor program.
The risk corridors program under the PPACA section 1342, was a temporary risk management device, modeled on similar successful risk corridors in
Medicare Part D, to encourage reluctant insurers into the "new and untested" ACA insurance market during the first three years that ACA was implemented (2014-2016). While the program did succeed in attracting insurers, it did not pay for itself and suffered billions of dollars of losses and funds were to be paid from "general government revenues". Congressional Republicans "railed against" the program as a 'bailout' for insurers. and in 2014, then-Rep. Jack Kingston (R-Ga.), on the Appropriations Committee that funded the HHS "[slipped] in a sentence" — Section 227 — in the "massive" spending bill that said that no funds in the discretionary spending bill "could be used for risk-corridor payments." This effectively "blocked the administration from obtaining the necessary funds from other programs." Moda, and a number of other insurers, suffered financially.
As a result, in January 2016, regulators in Oregon and Alaska temporarily suspended the ability of Moda Health to sell insurance after large financial losses left it with a lack of capital. The restrictions were lifted in February 2016 after the parent company agreed to raise additional funds.
Moda Health Plan, Inc. v. The United States.
Moda Health took the case to court and won a "$214-million judgment against the federal government". On February 10, 2017 Judge Thomas C. Wheeler stated, "the Government "made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, 'to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."
On June 14, 2018 the U.S. Court of Appeals for the Federal Circuit Court overturned the lower court ruling, reversing the $214 million judgment.


John Templeton Bowen

John Templeton Bowen (8 July 1857 – 3 December 1940) was an American dermatologist. He was a professor of dermatology at Massachusetts General Hospital.
Bowen obtained his doctoral degree in medical sciences from the Harvard University in 1884. From 1884 to 1887, he pursued postgraduate studies in Berlin, Munich, and Vienna. He joined Massachusetts General Hospital in 1889 as an assistant in the skin diseases department.
In 1907 he became a professor of dermatology at Harvard Medical School. During his time at Harvard, he was elected president of the American Society of Dermatology.
Bowen's disease and bowenoid papulosis are named after him.


John Abramson

John Abramson is an American physician and the author of the book "Overdosed America: The Broken Promise of American Medicine". He has worked as a family doctor in Appalachia and in Hamilton, Massachusetts, and has served as chairman of the department of family practice at Lahey Clinic. He was a Robert Wood Johnson Fellow and is on the clinical faculty of Harvard Medical School, where he teaches primary care.
He graduated from Harvard College. In 1974, he received a BMS from Dartmouth Medical School followed by his MD from Brown Medical School.


Clinical Excellence Awards

Clinical Excellence Awards are awarded within the English National Health Service to consultants and academic GPs who perform 'over and above' the standard expected of their role. The present scheme was established in 2003. There is a similar scheme in the NHS in Northern Ireland. In the Welsh NHS there are commitment awards for consultants. In Scotland there is a similar scheme run by the Scottish Advisory Committee on Distinction Awards. The schemes are intended to reward consultants who show commitment to the NHS - i.e. do not practice privately.
The administration of the scheme nationally is in the hands of the Advisory Committee on Clinical Excellence Awards. There are 12 levels of award. Levels 1-8 are awarded locally by employing NHS Trusts, and levels 10-12 (silver, gold and platinum hereafter) are awarded nationally. Level 9 awards can be awarded locally or nationally, and are referred to as bronze. In 2016-17 awards were worth £2,986 for level one, £35,832 for bronze, £47,110 for silver, £58,888 for gold and £76,554 for platinum annually. Payments are pensionable. Consultants have to reapply after 5 years and a small minority lose their award. 25,300 consultants in England and Wales (54%) received a local or national excellence award in 2016-17. Rates have not increased since 2010 and the number of awards has been reduced. Rules have changed so that renewal is no longer automatic. Radical changes or abolition were repeatedly suggested as part of the consultant contract negotiations from 2010 and in 2018 radical changes to the local scheme were agreed between NHS Employers and the British Medical Association. New points will be time limited for between one and three years, the award will not be pensionable and will paid annually by lump sum. These changes will not apply to the national scheme.
Applicants are assessed in five areas:
The nature of the scheme tends to reward academic clinicians who can produce impressive and well documented research.
The coalition government conducted a review of the scheme whose report was published in 2012.
History.
The earlier scheme of distinction awards was established at the foundation of the NHS in 1948 as part of Aneurin Bevan's efforts to win support from doctors by "stuffing their mouths with gold".
The Royal Commission on the National Health Service described the system of distinction awards in 1979. Awards were made on the advice of the Advisory Committee on Distinction, a predominantly professional body traditionally headed by a distinguished doctor. The total value of awards was about £20m per annum, 10% of total consultant remuneration. About half of all consultants received an award during their careers. At any one time, just over a third were award holders. There were four levels of award, with annual values ranging from £2,664 for level C with 3421 beneficiaries to £11,880 for A+ awards of which there were 140. Awards were then secret, and there was criticism that most went to consultants in teaching hospitals and the more glamorous specialities.
In 2015-16 £157 million was paid to 2,948 consultants in England and Wales. In 2016-17 £147 million was paid to 2,779 consultants. 300 awards were made in 2017.
In 2019 the Care Quality Commission suggested that awards should be withheld from doctors at trusts in special measures.