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https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#1
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28611011/application-of-plasma-genotyping-technologies-in-non-small-cell-lung-cancer-a-practical-review
#2
REVIEW
Adrian G Sacher, Kimberly M Komatsubara, Geoffrey R Oxnard
The rational treatment of metastatic NSCLC hinges upon the timely detection of potentially targetable genomic alterations in order to guide therapy. Recent advances in highly sensitive genotyping technologies have allowed for the development of novel plasma genotyping assays which are capable of noninvasively detecting targetable alterations in plasma cell-free DNA without reliance on traditional tissue genotyping. The rapid development of plasma genotyping has led to an explosion in the number of assay platforms available from both commercial and laboratory sources...
June 10, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28598928/occupation-and-obstructive-sleep-apnea-a-meta-analysis
#3
Daniel A Schwartz, Denis Vinnikov, Paul D Blanc
OBJECTIVE: Obstructive sleep apnea (OSA) remains a prevalent condition, but its occupational burden is unclear. We carried out a systematic review to characterize the consistency and magnitude of occupational associations with OSA. METHODS: We studied OSA within three occupational categories: commercial drivers, organic solvent-exposed workers, other selected occupations. We performed a meta-analysis on the prevalence of OSA among drivers and the risk of OSA associated with solvent exposure...
June 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28594073/work-related-injury-factors-and-safety-climate-perception-in-truck-drivers
#4
Naomi J Anderson, Caroline K Smith, Jesse L Byrd
INTRODUCTION: The trucking industry has a high burden of work-related injuries. This study examined factors, such as safety climate perceptions, that may impact injury risk. METHOD: A random sample of 9800 commercial driver's license holders (CDL) were sent surveys, only 4360 were eligible truck drivers. Descriptive statistics and logistic regression models were developed to describe the population and identify variables associated with work-related injury. RESULTS: 2189 drivers completed the pertinent interview questions...
June 8, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28587188/a-review-of-activity-trackers-for-senior-citizens-research-perspectives-commercial-landscape-and-the-role-of-the-insurance-industry
#5
REVIEW
Salvatore Tedesco, John Barton, Brendan O'Flynn
The objective assessment of physical activity levels through wearable inertial-based motion detectors for the automatic, continuous and long-term monitoring of people in free-living environments is a well-known research area in the literature. However, their application to older adults can present particular constraints. This paper reviews the adoption of wearable devices in senior citizens by describing various researches for monitoring physical activity indicators, such as energy expenditure, posture transitions, activity classification, fall detection and prediction, gait and balance analysis, also by adopting consumer-grade fitness trackers with the associated limitations regarding acceptability...
June 3, 2017: Sensors
https://www.readbyqxmd.com/read/28584309/screening-commercial-drivers-for-obstructive-sleep-apnea-validation-of-stop-bang-questionnaire
#6
Martin B Popević, Andjela Milovanović, Ljudmila Nagorni-Obradović, Dejan Nešić, Jovica Milovanović, Aleksandar P S Milovanović
OBJECTIVES: The main aim has been to examine psychometric properties of STOP-Bang (snoring, tiredness, observed apnea, high blood pressure, body mass index (BMI), age, neck circumference, male gender) scoring model (Serbian translation), an obstructive sleep apnea (OSA) screening tool, in a sample of commercial drivers. MATERIAL AND METHODS: After formal translation, validation was performed on a sample of bus and truck drivers evaluating test-retest reliability, construct and criterion validity...
May 29, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/28584177/structural-drivers-of-vulnerability-to-zoonotic-disease-in-africa
#7
Vupenyu Dzingirai, Salome Bukachi, Melissa Leach, Lindiwe Mangwanya, Ian Scoones, Annie Wilkinson
This paper argues that addressing the underlying structural drivers of disease vulnerability is essential for a 'One Health' approach to tackling zoonotic diseases in Africa. Through three case studies-trypanosomiasis in Zimbabwe, Ebola and Lassa fever in Sierra Leone and Rift Valley fever in Kenya-we show how political interests, commercial investments and conflict and securitization all generate patterns of vulnerability, reshaping the political ecology of disease landscapes, influencing traditional coping mechanisms and affecting health service provision and outbreak responses...
July 19, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28581874/cost-drivers-for-breast-lung-and-colorectal-cancer-care-in-a-commercially-insured-population-over-a-six-month-episode-an-economic-analysis-from-the-payer-perspective
#8
Bhuvana Sagar, Yu Shen Lin, Liana D Castel
AIMS: In the absence of clinical data, accurate identification of cost drivers is needed for economic comparison in an alternate payment model. From a payer perspective using claims data in a commercial population, our objective was to identify and quantify the effects of cost drivers in economic models of breast, lung, and colorectal cancer costs over a six-month episode following initial chemotherapy. RESEARCH DESIGN AND METHODS: We analyzed claims data from 9,748 Cigna beneficiaries with diagnosis of breast, lung, and colorectal cancer following initial chemotherapy from January 1, 2014 to December 31, 2015...
June 5, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28549274/mechanisms-and-risk-of-cumulative-impacts-to-coastal-ecosystem-services-an-expert-elicitation-approach
#9
Gerald G Singh, Jim Sinner, Joanne Ellis, Milind Kandlikar, Benjamin S Halpern, Terre Satterfield, Kai M A Chan
Coastal environments are some of the most populated on Earth, with greater pressures projected in the future. Managing coastal systems requires the consideration of multiple uses, which both benefit from and threaten multiple ecosystem services. Thus understanding the cumulative impacts of human activities on coastal ecosystem services would seem fundamental to management, yet there is no widely accepted approach for assessing these. This study trials an approach for understanding the cumulative impacts of anthropogenic change, focusing on Tasman and Golden Bays, New Zealand...
September 1, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28529920/global-progress-in-prevention-of-cardiovascular-disease
#10
Shanthi Mendis
Although there is measurable global progress in prevention of cardiovascular disease (CVD), it has been highly uneven and inadequate, particularly in low- and middle-income countries. Voluntary global targets have helped to galvanize attention, resources and accountability on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity which are the major behavioural drivers of CVD. Many obstacles and challenges continue to impede the progress of cardiovascular prevention. The inclusion of noncommunicable diseases (NCDs) in the sustainable development agenda as a specific target, offers an unprecedented opportunity to further advance the global progress of cardiovascular prevention...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28527798/short-communication-effect-of-a-citrus-extract-in-lactating-dairy-cows
#11
Y Ying, M Niu, A R Clarke, K J Harvatine
Dry matter intake is a main driver of energy balance in lactating dairy cows, and some plant extracts have been commercially fed to dairy cows to stimulate feed intake. Citrus extracts contain several bioactive components and have been shown to modify metabolism in other animal models. Our hypothesis was that a citrus extract would increase dry matter intake. Two experiments were conducted to determine the effect of a citrus extract on intake and milk production in lactating dairy cows. In experiment one, 11 early-lactation dairy cows (experiment 1; 77 ± 15 d in milk, mean ± standard deviation) were used in a switchback design, and in experiment two, 15 mid-lactation Holstein cows (experiment 2; 157 ± 44 d in milk, mean ± standard deviation) were used in a crossover design...
July 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28509578/the-burden-of-hepatorenal-syndrome-among-commercially-insured-and-medicare-patients-in-the-united-states
#12
J Bradford Rice, Alan G White, Philip Galebach, Kevin M Korenblat, Aneesha Wagh, Belinda Lovelace, George J Wan, Khurram Jamil
BACKGROUND: This study evaluated the characteristics, healthcare resource utilization (HCRU), and costs, from the payer perspective, of hepatorenal syndrome (HRS) patients covered by commercial and Medicare insurance. Mortality was assessed as a secondary outcome. METHODS: Patients were identified from claims databases of commercially insured patients (OptumHealth Care Solutions Inc.) in 1998-2014 and Medicare beneficiaries in 2009-2013 (5% Standard Analytic Files)...
June 2, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28501264/challenges-around-automotive-shredder-residue-production-and-disposal
#13
Ala Khodier, Karl Williams, Neil Dallison
The challenge for the automotive industry is how to ensure they adopt the circular economy when it comes to the disposal of end-of-life vehicles (ELV). According to the European Commission the UK achieved a total reuse and recovery rate of 88%. This is short of the revised ELV directive target of 95% materials recovery, which requires a minimum of 85% of materials to be recycled or reused. A significant component of the recycling process is the production of automotive shredder residue (ASR). This is currently landfilled across Europe...
May 10, 2017: Waste Management
https://www.readbyqxmd.com/read/28478991/comparison-of-3d-displacements-of-screw-retained-zirconia-implant-crowns-into-implants-with-different-internal-connections-with-respect-to-screw-tightening
#14
Hanadi A Rebeeah, Burak Yilmaz, Jeremy D Seidt, Edwin McGlumphy, Nancy Clelland, William Brantley
STATEMENT OF PROBLEM: Internal conical implant-abutment connections without horizontal platforms may lead to crown displacement during screw tightening and torque application. This displacement may affect the proximal contacts and occlusion of the definitive prosthesis. PURPOSE: The purpose of this in vitro study was to evaluate the displacement of custom screw-retained zirconia single crowns into a recently introduced internal conical seal implant-abutment connection in 3D during hand and torque driver screw tightening...
May 5, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28472260/whole-genome-sequencing-accurately-identifies-resistance-to-extended-spectrum-%C3%AE-lactams-for-major-gram-negative-bacterial-pathogens
#15
Samuel A Shelburne, Jiwoong Kim, Jose M Munita, Pranoti Sahasrabhojane, Ryan K Shields, Ellen G Press, Xiqi Li, Cesar A Arias, Brandi Cantarel, Ying Jiang, Min S Kim, Samuel L Aitken, David E Greenberg
Background: There is marked interest in using DNA based methods to detect antimicrobial resistance (AMR) with targeted polymerase chain reaction (PCR) approaches increasingly being incorporated into clinical care. Whole genome sequencing (WGS) could offer significant advantages over targeted PCR for AMR detection, particularly for species where mutations are major drivers of AMR. Methods: Illumina MiSeq WGS and broth microdilution (BMD) assays were performed on 90 bloodstream isolates of the four most common gram-negative bacteria causing bloodstream infections in neutropenic patients...
May 3, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28462017/an-interview-based-approach-to-assess-sea-turtle-bycatch-in-italian-waters
#16
Alessandro Lucchetti, Claudio Vasapollo, Massimo Virgili
The loggerhead sea turtle (Caretta caretta, Linnaeus, 1758) is the most abundant sea turtle species in the Mediterranean Sea, where commercial fishing appears to be the main driver of mortality. So far, information on sea turtle bycatch in Italy is limited both in space and time due to logistical problems in data collected through onboard observations and on a limited number of vessels involved. In the present study, sea turtle bycatch in Italian waters was examined by collecting fishermen's information on turtle bycatch through an interview-based approach...
2017: PeerJ
https://www.readbyqxmd.com/read/28458064/towards-precision-prevention-technologies-for-identifying-healthy-individuals-with-high-risk-of-disease
#17
Zachary D Nagel, Bevin P Engelward, David J Brenner, Thomas J Begley, Robert W Sobol, Jason H Bielas, Peter J Stambrook, Qingyi Wei, Jennifer J Hu, Mary Beth Terry, Caroline Dilworth, Kimberly A McAllister, Les Reinlib, Leroy Worth, Daniel T Shaughnessy
The rise of advanced technologies for characterizing human populations at the molecular level, from sequence to function, is shifting disease prevention paradigms toward personalized strategies. Because minimization of adverse outcomes is a key driver for treatment decisions for diseased populations, developing personalized therapy strategies represent an important dimension of both precision medicine and personalized prevention. In this commentary, we highlight recently developed enabling technologies in the field of DNA damage, DNA repair, and mutagenesis...
April 6, 2017: Mutation Research
https://www.readbyqxmd.com/read/28441679/the-drivers-of-discretionary-utilization-clinical-history-versus-physician-supply
#18
Gregory W Ruhnke, Willard G Manning, David T Rubin, David O Meltzer
PURPOSE: Because the effect of physician supply on utilization remains controversial, literature based on non-Medicare populations is sparse, and a physician supply expansion is under way, the potential for physician-induced demand across diverse populations is important to understand. A substantial proportion of gastrointestinal endoscopies may be inappropriate. The authors analyzed the impact of physician supply, practice patterns, and clinical history on esophagogastroduodenoscopy (EGD, defined as discretionary) among patients hospitalized with lower gastrointestinal bleeding (LGIB)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#19
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28414584/screening-commercial-vehicle-drivers-for-obstructive-sleep-apnea-tools-barriers-and-recommendations
#20
Kelly A Evans, Tracey Yap, Barbara Turner
Obstructive sleep apnea (OSA) is a disorder characterized by a cessation of breathing during sleep, leading to poor sleep patterns and daytime somnolence. Daytime somnolence is of particular concern for commercial vehicle drivers, whose crash risk increases 50% with untreated OSA. The process of diagnosing and treating OSA in commercial drivers begins with effective and consistent screening. Therefore, the researchers screened drivers with both the STOP-Bang Questionnaire and the Obstructive Sleep Apnea Evaluation Worksheet (OSAEW) and compared the two tools...
April 1, 2017: Workplace Health & Safety
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