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Holgate S.T.,Level Inc
Trends in Immunology | Year: 2012

Drugs used to treat asthma have a long history, beginning with the bronchodilators and evolving into compounds that suppress airway inflammation. Guidelines for treatment of asthma are largely based on disease severity and control, rather than underlying mechanisms. However, identification of biomarkers in the causal pathways of asthma is enabling responders to be differentiated from nonresponders. Initial efforts have focused on biomarkers of the T helper (Th)2 pathway because this is a target of novel therapeutics. A concerted effort is now needed to substratify asthma beyond Th2 pathways, and using appropriate biomarkers, to target only those patients likely to respond to a specific biologic. To achieve this goal, a different type of relationship is needed between academia and industry, and also within industry, to promote collaboration in the precompetitive space. © 2012 Elsevier Ltd.

Menon M.,Level Inc
Nature Reviews Clinical Oncology | Year: 2016

In the clinical setting, the term 'unwarranted variation' refers to variations in patient outcomes that cannot be explained by the patient's underlying illness or medical needs, or the dictates of evidence-based medicine. These types of variations persist even after adjusting for patient-specific factors. Unwarranted variation depends on a complex mix of disparities, including inequalities in access to appropriate care in a wide variety of geographical and cultural settings, in the uptake and application of clinical knowledge, in the prioritization and allocation of resources, and differences in organizational and professional culture. Nevertheless, unwarranted variation has been inexorably linked with clinical practice. Thus, awareness of the antecedents of unwarranted variations in clinical practice is strategically important. In this Perspective, we discuss these antecedents in colorectal cancer clinical care pathways with an emphasis upon the multidisciplinary team (MDT), and suggest pragmatic steps that could be taken to address latent unwarranted variation. © 2016 Nature Publishing Group, a division of Macmillan Publishers Limited. All Rights Reserved.

Clark J.E.,Level Inc
Archives of Disease in Childhood | Year: 2015

Over recent years non-culture techniques such as specific viral and bacterial nucleic acid amplification, serology and antigen detection have considerably developed and been applied within research studies to clinical samples, significantly increasing pathogen detection in pneumonia. There are promising signs of improved diagnostic yields for pneumococcal pneumonia when using molecular techniques to detect pneumococcal gene sequences in blood or by combining serum biomarkers with rapid pneumococcal urinary antigen testing. Pathogens have traditionally been difficult to detect in pneumonia and treatment is usually successful with empiric antibiotics. However, directed antibiotic treatment has significant benefits in terms of antibiotic stewardship and these new technologies make this goal a possibility, though not yet a reality. © 2015, BMJ Publishing Group. All rights reserved.

To evaluate the properties of a combination bone graft consisting of biphasic calcium phosphate ceramic, polyetheretherketone (PEEK) cage in one- and two-level surgery. Over a 12-month time period, a prospective single surgeon series of 75 patients were included in the study and 58 patients selected based on adequate data points. From these 58 patients, 32 were supplemented with anterior plate fixation and 26 patients without plating. Duration of clinical follow-up was a mean of 12.4 months (range, 6-26 months) in the Plated Group and 10.5 months (range, 6-21 months) in the Non-Plated Group. A 100% fusion rate with nil graft related complications was achieved in the Plated group compared with 96.2% fusion and 11.5% subsidence rates reported in the Non-Plated group. Patients in both groups experienced statistically significant improvement in pain and functional outcomes compared to their pre-operative status; however, there was no significant difference in outcome between the Plated and Non-Plated Groups. Biphasic calcium phosphate ceramic contained within a PEEK cage is an effective implant for use in anterior cervical surgery with high fusion rates and good clinical outcome. © 2012 Tianjin Hospital and Wiley Publishing Asia Pty Ltd.

Level Inc | Date: 2014-03-27

An adjustable combination square includes a longitudinally extending blade slidably received within a slot in a head. A movable clamping member is engaged with the blade, and a biasing member acts on the clamping member to normally bias the clamping member toward an engaged position in which the blade is engaged against a surface of the slot. A manually operable pivotable actuator arrangement is carried by the head. Actuation of the pivotable actuator arrangement applies a force to the clamping member that works against the biasing member so as to selectively move the clamping member away from the engaged position to enable the blade to be moved axially relative to the head. Releasing the pivotable actuator arrangement releases the force so that the biasing member returns the clamping member to the engaged position to maintain the blade in position relative to the head.

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