In some studies that relate covariates to times of failure it is not feasible to observe all covariates for all subjects. For example, some covariates may be too costly in terms of time, money, or effect on the subject to record for all subjects. This paper considers the relative efficiencies of several designs for sampling a portion of the cohort on which the costly covariates will be observed. Such designs typically measure all covariates for each failure and control for covariates of lesser interest. Control subjects are sampled either from "risk sets" at times of observed failures or from the entire cohort. A new design in which the sampling probability for each individual depends on the amount of information that the individual can contribute to estimated coefficients is shown to be superior to other sampling designs under certain conditions. Primary focus of our designs is on time-invariant covariates, but some methods easily generalize to the time-varying setting. Data from a study conducted by the AIDS Clinical Trials Group are used to illustrate the new sampling procedure and to explore the relative efficiency of several sampling schemes.

Background Documenting standardized dental diagnostic terms represents an emerging change for how dentistry is practiced. We focused on a mid-sized dental group practice as it shifted to a policy of documenting patients’ diagnoses using standardized terms in the electronic health record. Methods Kotter’s change framework was translated into interview questions posed to the senior leadership in a mid-size dental group practice. In addition, quantitative content analyses were conducted on the written policies and forms before and after the implementation of standardized diagnosis documentation to assess the extent to which the forms and policies reflected the shift. Three reviewers analyzed the data individually and reached consensuses where needed. Results Kotter’s guiding change framework explained the steps taken to 97 percent utilization rate of the Electronic Health Record and Dental Diagnostic Code. Of the 96 documents included in the forms and policy analysis, 31 documents were officially updated but only two added a diagnostic element. Conclusion Change strategies established in the business literature hold utility for dental practices seeking diagnosis-centered care. Practical Implications A practice that shifts to a diagnosis-driven care philosophy would be best served by ensuring that the change process follows a leadership framework that is calibrated to the organization’s culture.

Germline mutations in both BRCA2 and CHEK2 are associated with an increased risk for male breast cancer. To search for potential interactions between the products of these breast cancer susceptibility genes, we undertook systematic mapping of BRCA2 for potential phosphorylation sites by CHEK2. In vitro kinase assays and mass spectrometric analysis identified a 50 amino-acid fragment within the N-terminus of BRCA2 potentially targeted by CHEK2, containing two major phosphopeptides. Inducible overexpression of this peptide, but not a derivative with mutated phosphorylation sites, leads to increased chromosome fragmentation and suppression of cellular proliferation. These results suggest a link between CHEK2 and BRCA2 pathways, which may contribute to the spectrum of cancers associated with germline CHEK2 mutations.

Objectives: To assess medical technologies in order to increase efficiency and reduce the cost of thyroid disease treatment. MethOds: We made the retrospective analysis of 52 patients's medical records with diffuse toxic goiter that were hospitalized to the endocrinology department of Ternopil University Hospital (Jan-Dec 2012). The cost of thyrostatic therapy, which was preferred in practice, was analyzed. We also checked the appropriateness of diagnostics and specialist consultations according to the Protocol of medical care for patients with endocrine system disorders. Results: The result of retrospective analysis of 52 patients's medical records with diffuse toxic goiter showed that all patients received thyrostatic therapy by thiamazol. Among them 13 patients were treated with drugs of Ukrainian production while 39 patients were taking medicine of foreign manufacturer. The cost of pharmacotherapy with foreign medicines was 275% more expensive compare to Ukrainian drugs. When comparing diagnostics and specialists consultations with a Protocol of medical care for patients with endocrine system disorders we have established compliance. However, given the prevalence of complications of underlying disease by cardiovascular system disorders (in 100% of patients), we consider it necessary to add cardiologist consultation to Protocol. cOnclusiOns: It is advisable to use domestic drugs in pharmacotherapy of diffuse toxic goiter. Cardiologist consultation should be added to Protocol of medical care for patients with diffuse toxic goiter.Objectives: To examine characteristics of patients diagnosed with type 2 diabetes mellitus (T2DM) initiated on three basal insulin regimens: long-acting basal insulins (LABI), ultra-LABI (ULABI), and LABI combined with any oral antidiabetic medications (LABI+OAD), using real-world clinical data. MethOds: This retrospective study used data (current to March 2016) from a US ambulatory electronic health records (EHR) database to identify patients ≥ 18 years old with International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes for T2DM who initiated ULABI (insulin glargine 300 mg or degludec; n= 3,718), LABI (insulin glargine 100 mg or detemir; n= 11,417), or LABI+OAD (insulin glargine 100 mg or detemir + OAD; n= 4,922) ≤ 1 year prior to March 2016. Demographics and clinical characteristics were extracted from EHR ≤ 2 years prior. A multinomial logistic regression predicted ULABI and LABI+OAD vs. LABI treatment from patient characteristics and clinical characteristics at or prior to treatment initiation. Results: Overall sample (N= 20,057) age was 62.49; 49.7% female; 67.7% white. Significant (two-tailed, p< 0.05) predictors of ULABI vs. LABI use included younger age (odds ratio [OR]= 1.02), male gender (OR= 1.11), white vs. black (OR= 1.60) and unknown/ other race (OR= 1.94), overweight (OR= 1.22) and obese (OR= 1.31) vs. normal/underweight BMI, sleep apnea (OR= 1.25), hypertension (OR= 1.29), and higher prior HbA1c level (OR= 1.04). Significant predi...