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Braden Manns, John W M Agar, Mohan Biyani, Peter G Blake, Alan Cass, Bruce Culleton, Werner Kleophas, Paul Komenda, Thierry Lobbedez, Jennifer MacRae, Mark R Marshall, Nairne Scott-Douglas, Vikas Srivastava, Peter Magner
There are advantages to home dialysis for patients, and kidney care programs, but use remains low in most countries. Health-care policy-makers have many levers to increase use of home dialysis, one of them being economic incentives. These include how health-care funding is provided to kidney care programs and dialysis facilities; how physicians are remunerated for care of home dialysis patients; and financial incentives-or removal of disincentives-for home dialysis patients. This report is based on a comprehensive literature review summarizing the impact of economic incentives for home dialysis and a workshop that brought together an international group of policy-makers, health economists and home dialysis experts to discuss how economic incentives (or removal of economic disincentives) might be used to increase the use of home dialysis...
July 13, 2018: Nephrology, Dialysis, Transplantation
Joshua M Liao, Judy A Shea, Arlene Weissman, Amol S Navathe
We surveyed a national sample of internal medicine physicians in March-May 2017 to explore their beliefs about the newly implemented Merit-based Incentive Payment System (MIPS). Respondents believed that their efforts in the four focus areas identified in the survey would ultimately improve the value of care. When informed that those areas represented the four MIPS domains, the majority remained positive about the likely impact on value. However, expectations varied by physicians' characteristics and sense of control over the desired outcomes, and many respondents believed that unintended consequences could occur...
July 2018: Health Affairs
Dongxing Zhu, Xiaosa Li, Vicky E Macrae, Tommaso Simoncini, Xiaodong Fu
The risk of osteoporosis and cardiovascular disease increases significantly in postmenopausal women. Until recently, the underlying mechanisms have been primarily attributed to estrogen decline following menopause. However, follicle-stimulating hormone (FSH) levels rise sharply during menopausal transition and are maintained at elevated levels for many years. FSH receptor has been detected in various extragonadal sites, including osteoclasts and endothelial cells. Recent advances suggest FSH may contribute to postmenopausal osteoporosis and cardiovascular disease...
July 5, 2018: Trends in Endocrinology and Metabolism: TEM
David Sadowsky, Tianyang Li, Usama Hasan, Christopher Harnain, Anthony Gilet, Perry Gerard
The Medicare Access and CHIP Reauthorization Act of 2015 was signed into law on April 16, 2015, fundamentally altering the way clinicians are reimbursed for the treatment of Medicare patients starting in 2017. Under this new pay-for-performance model, reimbursement will be tied to multiple metrics related to quality and cost of care. A scaled scoring system will require providers to compete for positive reimbursement adjustments, while also penalizing poor performers with negative adjustments. A firm understanding of this new system will be essential for all physicians looking to maximize their reimbursement, particularly diagnostic radiologists and members of other highly focused fields where special considerations lead to alterations in the scoring system...
May 23, 2018: Current Problems in Diagnostic Radiology
Jiabo Tan, Thomas H MacRae
Embryos of the crustacean, Artemia franciscana, may undergo oviparous development, forming encysted embryos (cysts) that are released from females and enter diapause, a state of suppressed metabolism and greatly enhanced stress tolerance. Diapause-destined embryos of A. franciscana synthesize three small heat shock proteins (sHsps), p26, ArHsp21 and ArHsp22, as well as artemin, a ferritin homologue, all lacking in embryos that develop directly into nauplii. Of these diapause-specific molecular chaperones, p26 and artemin are important contributors to the extraordinary stress tolerance of A...
2018: PloS One
Jillian Dempsey, Christine Gillis, Stephanie Sibicky, Lina Matta, Calum MacRae, James Kirshenbaum, David Faxon, William Churchill
PURPOSE: The utility of a transitions-of-care (TOC) pharmacist intervention focused on improving the quality and safety of the medication process for high-risk cardiovascular patients was evaluated. METHODS: A quality-improvement initiative was developed for patients with heart failure or acute coronary syndrome followed longitudinally at a hospital's outpatient cardiovascular clinic. The TOC pharmacist intervention occurred either before a patient's outpatient cardiovascular clinic appointment or during a hospitalization...
July 5, 2018: American Journal of Health-system Pharmacy: AJHP
Lauren Parks Golding, Gregory N Nicola, Sameer A Ansari, Andrew B Rosenkrantz, Ezequiel Silva Iii, Laxmaiah Manchikanti, Joshua A Hirsch
The Medicare and CHIP Reauthorization Act of 2015 remains the payment policy law of the land. 2017 was the first year in which performance reporting will tangibly impact future physician payments. The Centers for Medicare & Medicaid Services (CMS) considers 2017 and 2018 transitional years before full implementation in 2019. As such, 2018 increases the reporting requirements over 2017 in the form of a gradual phase-in while introducing several key changes and new elements. Indeed, it is the nature of the transition itself that led to the somewhat unique title of this manuscript, i...
July 4, 2018: Journal of Neurointerventional Surgery
Kanchan Phadwal, Dominic Kurian, Muhammad Khalid F Salamat, Vicky E MacRae, Abigail B Diack, Jean C Manson
Autolysosomal dysfunction and unstable microtubules are hallmarks of chronic neurodegenerative diseases associated with misfolded proteins. Investigation of impaired protein quality control and clearance systems could therefore provide an important avenue for intervention. To investigate this we have used a highly controlled model for protein aggregation, an in vitro prion system. Here we report that prion aggregates traffic via autolysosomes in the cytoplasm. Treatment with the natural polyamine spermine clears aggregates by enhancing autolysosomal flux...
July 3, 2018: Scientific Reports
Brittany M Tausen, Lynden K Miles, Louisa Lawrie, C Neil Macrae
Perceiving oneself as agentic is dependent upon the integration of conscious intention, a corresponding outcome, and body-congruent sensorimotor information. Altering these critical cues, such as the vantage point from which an event is viewed, can have a notable impact on one's sense of agency, including an increased sense of ownership over another person's actions or a reduced sense of responsibility (or control) over one's own actions. In three studies, we investigated whether mentally simulated and written perspectives could have similar effects...
June 29, 2018: Consciousness and Cognition
Mark Jenkins, Marie Pirotta, Jennifer G Walker, Jon D Emery, Finlay Macrae, Ashleigh Qama, Alex Boussioutas
BACKGROUND AND OBJECTIVES: There is significant growth in demand for colonoscopies, with over 700,000 performed in Australia in 2012-13. For every one million Australians aged 50 years and older, 80,000 people at average risk of colorectal cancer are being over-screened with colonoscopy, and 29,000 people at increased risk are not having the colonoscopy they need. METHOD: Using monitoring data from the Australian National Bowel Cancer Screening Program and published data on colonoscopic screening, we have developed expected frequency trees (EFTs) to demonstrate projected outcomes of different colorectal cancer screening options for participants at different levels of colorectal cancer risk in Australia...
June 2018: Australian journal of general practice
Samuel M Kim, Jim W Cheung
Over the years, public reporting of patient outcomes has been promoted as a means to improve healthcare quality. More recently, in response to dramatic rises in healthcare costs, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 was implemented in an effort to link quality with reimbursement. As part of a value-based model, public reporting of procedural outcomes has been incorporated into this initiative. Outcomes measures that have been introduced in cardiology include heart failure readmission and post-myocardial infarction medication prescription...
June 30, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sean X Gu, Steven R Lentz
The hemostatic response to vascular injury culminates in a fibrin clot network that forms an initial barrier to blood loss and also contributes to microbial host defense. Fibrinogen is cleaved by thrombin into fibrin monomers that spontaneously polymerize into protofibrils and form the extensive fiber networks characteristic of blood clots. In this issue of the JCI, Macrae and colleagues characterize an alternative fibrin structure in which fibrinogen and fibrin assemble into a continuous 2D film at the exterior face of the fibrin clot network...
June 25, 2018: Journal of Clinical Investigation
Colin M MacRae, Anthony E Hughes, James S Laird, A M Glenn, Nicholas C Wilson, Aaron Torpy, Mark A Gibson, Xiaorong Zhou, Nick Birbilis, George E Thompson
Electron and proton microprobes, along with electron backscatter diffraction (EBSD) analysis were used to study the microstructure of the contemporary Al-Cu-Li alloy AA2099-T8. In electron probe microanalysis, wavelength and energy dispersive X-ray spectrometry were used in parallel with soft X-ray emission spectroscopy (SXES) to characterize the microstructure of AA2099-T8. The electron microprobe was able to identify five unique compositions for constituent intermetallic (IM) particles containing combinations of Al, Cu, Fe, Mn, and Zn...
June 18, 2018: Microscopy and Microanalysis
Andrew Bang, Wayne S Kendal, Scott A Laurie, Graham Cook, Robert M MacRae
PURPOSE: The role of prophylactic cranial irradiation (PCI) remains controversial in extensive stage small cell lung cancer (ES-SCLC) with the publication of 2 randomized control trials demonstrating differing outcomes in overall survival. The aim of this study is to determine the impact of PCI on survival and the development of brain metastasis while addressing the disparate use of postchemotherapy brain imaging in the aforementioned trials. METHODS AND MATERIALS: The medical records of 397 consecutive patients with ES-SCLC between Jan...
May 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Amanda C Kentner, Urma Khan, M MacRae, Scot E Dowd, Siyang Yan
Epidemiological evidence suggests that exposure to infection during early development increases the risk for neurodevelopmental disorders associated with symptoms such as a decreased desire to engage in social interactions. In animals, disruptions in social behavior can be modelled by administering bacterial mimetics such as liposaccharide (LPS). However, when evaluating social interactions in the laboratory, attention is rarely directed on the reciprocal relationship as a whole, which is important as peers may drive social withdrawal...
June 13, 2018: Physiology & Behavior
Mayumi Fujiwara, Marie J Haskell, Alastair I Macrae, Kenneth M D Rutherford
Dry period management of the dairy cow focuses on maximising milk production during the subsequent lactation but may include procedures that negatively affect dry cow health and welfare. A survey of dairy farmers in the UK was conducted to investigate dry cow management procedures. The questionnaire was completed by 148 farmers. Most farms (84 per cent) kept dry cows in dynamic social groups. The median length of the dry period was 56 days, and 83 per cent of farms stopped milking abruptly, regardless of milk production level at dry-off...
June 15, 2018: Veterinary Record
Xiaodun Li, Sam Kleeman, Sally B Coburn, Carlo Fumagalli, Juliane Perner, Sriganesh Jammula, Ruth M Pfeiffer, Linda Orzolek, Haiping Hao, Philip R Taylor, Ahmad Miremadi, Núria Galeano-Dalmau, Pierre Lao-Sirieix, Maria Tennyson, Shona MacRae, Michael B Cook, Rebecca C Fitzgerald
BACKGROUND & AIMS: MicroRNA (miRNA) is highly stable in biospecimens and provides tissue-specific profiles, making it a useful biomarker of carcinogenesis. We aimed to discover a set of miRNAs that could accurately discriminate Barrett's esophagus (BE) from normal esophageal tissue and to test its diagnostic accuracy when applied to samples collected by a non-invasive esophageal cell sampling device. METHODS: We analyzed miRNA expression profiles of 2 independent sets of esophageal biopsy tissues collected during endoscopy from 38 patients with BE and 26 patients with normal esophagus (controls) using Agilent microarray and Nanostring counter assays...
June 12, 2018: Gastroenterology
Meaghan Lunney, Bronwyn Tonelli, Rachel Lewis, Natasha Wiebe, Chandra Thomas, Jennifer MacRae, Marcello Tonelli
BACKGROUND: Thermometers that measure core (internal) body temperature are the gold standard for monitoring temperature. Despite that most modern hemodialysis machines are equipped with an internal blood monitor that measures core body temperature, current practice is to use peripheral thermometers. A better understanding of how peripheral thermometers compare with the dialysis machine thermometer may help guide practice. METHODS: The study followed a prospective cross-sectional design...
June 14, 2018: BMC Nephrology
Daron Smith, Bruce Macrae
No abstract text is available yet for this article.
July 2018: BJU International
Isabella M Ondiba, Florence A Oyieke, George O Ong'amo, Macrae M Olumula, Isaac K Nyamongo, Benson B A Estambale
Malaria, a major cause of morbidity and mortality, is the most prevalent vector borne disease in Baringo County; a region which has varied house designs in arid and semi-arid areas. This study investigated the association between house structures and indoor-malaria vector abundance in Baringo County. The density of malaria vectors in houses with open eaves was higher than that for houses with closed eaves. Grass thatched roof houses had higher density of malaria vectors than corrugated iron sheet roofs. Similarly, mud walled houses had higher vector density than other wall types...
2018: PloS One
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