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https://www.readbyqxmd.com/read/27905815/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm-incentive-under-the-physician-fee-schedule-and-criteria-for-physician-focused-payment-models-final-rule-with-comment-period
#1
(no author information available yet)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs)...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27876616/protocol-for-three-parallel-multi-site-stepped-care-effectiveness-studies-for-unhealthy-alcohol-use-in-hiv-positive-patients
#2
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
November 20, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27855702/tumor-immune-microenvironment-characterization-in-clear-cell-renal-cell-carcinoma-identifies-prognostic-and-immunotherapeutically-relevant-messenger-rna-signatures
#3
Yasin Şenbabaoğlu, Ron S Gejman, Andrew G Winer, Ming Liu, Eliezer M Van Allen, Guillermo de Velasco, Diana Miao, Irina Ostrovnaya, Esther Drill, Augustin Luna, Nils Weinhold, William Lee, Brandon J Manley, Danny N Khalil, Samuel D Kaffenberger, Yingbei Chen, Ludmila Danilova, Martin H Voss, Jonathan A Coleman, Paul Russo, Victor E Reuter, Timothy A Chan, Emily H Cheng, David A Scheinberg, Ming O Li, Toni K Choueiri, James J Hsieh, Chris Sander, A Ari Hakimi
BACKGROUND: Tumor-infiltrating immune cells have been linked to prognosis and response to immunotherapy; however, the levels of distinct immune cell subsets and the signals that draw them into a tumor, such as the expression of antigen presenting machinery genes, remain poorly characterized. Here, we employ a gene expression-based computational method to profile the infiltration levels of 24 immune cell populations in 19 cancer types. RESULTS: We compare cancer types using an immune infiltration score and a T cell infiltration score and find that clear cell renal cell carcinoma (ccRCC) is among the highest for both scores...
November 17, 2016: Genome Biology
https://www.readbyqxmd.com/read/27852905/predictors-and-outcomes-of-crossover-to-surgery-from-physical-therapy-for-meniscal-tear-and-osteoarthritis-a-randomized-trial-comparing-physical-therapy-and-surgery
#4
Jeffrey N Katz, John Wright, Kurt P Spindler, Lisa A Mandl, Clare E Safran-Norton, Emily K Reinke, Bruce A Levy, Rick W Wright, Morgan H Jones, Scott D Martin, Robert G Marx, Elena Losina
BACKGROUND: Arthroscopic partial meniscectomy (APM) combined with physical therapy (PT) have yielded pain relief similar to that provided by PT alone in randomized trials of subjects with a degenerative meniscal tear. However, many patients randomized to PT received APM before assessment of the primary outcome. We sought to identify factors associated with crossing over to APM and to compare pain relief between patients who had crossed over to APM and those who had been randomized to APM...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27836506/evaluating-community-health-centers-adoption-of-a-new-global-capitation-payment-echange-study-protocol
#5
H Angier, J P O'Malley, M Marino, K J McConnell, E Cottrell, R L Jacob, S Likumahuwa-Ackman, J Heintzman, N Huguet, S R Bailey, J E DeVoe
Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon's Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment...
November 9, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27798334/serum-25-hydroxyvitamin-d-was-not-associated-with-influenza-virus-infection-in-children-and-adults-in-hong-kong-2009-2010
#6
Cuiling Xu, Vicky J Fang, Ranawaka Apm Perera, Andrea May-Sin Kam, Sophia Ng, Yap-Hang Chan, Kwok-Hung Chan, Dennis Km Ip, Js Malik Peiris, Benjamin J Cowling
BACKGROUND: Some studies have hypothesized that vitamin D may have a role to play in protection against influenza virus infections and illnesses, and that seasonal fluctuation in serum 25-hydroxyvitamin D [25(OH)D] may affect seasonal patterns of influenza virus infections. OBJECTIVE: We aimed to investigate whether serum 25(OH)D concentrations were associated with the incidence of influenza virus infections and illnesses in children and adults in Hong Kong. METHODS: In 2009-2010, 3030 children and adults of all ages from 796 households in Hong Kong were followed up to identify acute respiratory illnesses...
October 26, 2016: Journal of Nutrition
https://www.readbyqxmd.com/read/27788279/accuracy-of-self-reported-estimates-of-daily-voice-use-in-adults-with-normal-and-disordered-voices
#7
Daryush D Mehta, Harold A Cheyne, Asa Wehner, James T Heaton, Robert E Hillman
Purpose: Accurate estimation of daily patterns of vocal behavior is essential to understanding the role of voice use in voice disorders. Given that clinicians currently rely on patient self-report to assess daily vocal behaviors, this study sought to assess the accuracy with which adults with and without voice disorders can estimate their amount of daily voice use in terms of phonation time. Method: Eighteen subjects (6 patients, 6 matched members of a control group without voice disorders, 6 low voice users) wore the accelerometer-based Ambulatory Phonation Monitor (APM; model 3200, KayPENTAX, Montvale, NJ) for at least 5 workdays...
November 1, 2016: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/27776293/converging-effects-of-diverse-treatment-modalities-on-frontal-cortex-in-schizophrenia-a-review-of-longitudinal-functional-magnetic-resonance-imaging-studies
#8
REVIEW
Ayse Sakalli Kani, Ann K Shinn, Kathryn E Lewandowski, Dost Öngür
OBJECTIVES: A variety of treatment options exist for schizophrenia, but the effects of these treatments on brain function are not clearly understood. To facilitate the development of more effective treatment strategies, it is important to identify how brain function in schizophrenia patients is affected by the diverse therapeutic approaches that are currently available. The aim of the present article is to systematically review the evidence for functional brain changes associated with different treatment modalities for schizophrenia...
January 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/27755264/understanding-value-based-reimbursement-models-and-trends-in-orthopaedic-health-policy-an-introduction-to-the-medicare-access-and-chip-reauthorization-act-macra-of-2015
#9
Khaled J Saleh, William O Shaffer
In 2015, the US Congress passed legislation entitled the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA), which led to the formation of two reimbursement paradigms: the merit-based incentive payment system (MIPS) and alternative payment models (APMs). The MACRA effectively repealed the Centers for Medicare and Medicaid Services (CMS) sustainable growth rate (SGR) formula while combining several CMS quality-reporting programs. As such, MACRA represents an unparalleled acceleration toward reimbursement models that recognize value rather than volume...
November 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27740481/optimizing-acoustic-activation-of-phase-change-contrast-agents-with-the-activation-pressure-matching-method-a-review
#10
Juan D Rojas, Paul A Dayton
Sub-micron phase-change contrast agents consist of a liquid perfluorocarbon core that can be vaporized by ultrasound (acoustic droplet vaporization) to generate contrast with excellent spatial and temporal control. When these agents, commonly referred to as nanodroplets, are formulated with cores of low boiling-point perfluorocarbons such as decafluorobutane and octafluoropropane, they can be activated with lowmechanical index imaging pulses for diagnostic applications. Since the utilization of minimum mechanical index is often desirable to avoid unnecessary biological effects, enabling consistent activation of these agents in an acoustic field is a challenge because the energy that must be delivered to achieve the vaporization threshold increases with depth due to attenuation...
October 12, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/27736238/influence-of-factors-on-release-of-antimicrobials-from-antimicrobial-packaging-materials
#11
Yu-Mei Wu, Zhi-Wei Wang, Chang-Ying Hu, Cristina Nerín
Antimicrobial packaging materials (films or coatings) (APMs) have aroused great interest among the scientists or the experts specialized in material science, food science, packaging engineering, biology and chemistry. APMs have been used to package the food such as dairy products, poultry, meat (e.g. beef), salmon muscle, pastry dough, fresh pasta, bakery products, fruits, vegetables and beverages. Some materials have been already commercialized. The ability of APMs to extend the shelf-life of the food depends on the release rate of the antimicrobials (AMs) from the materials to the food...
October 13, 2016: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/27695273/antihyperglycemic-and-insulin-secretagogue-activities-of-abrus-precatorius-leaf-extract
#12
Balekari Umamahesh, Ciddi Veeresham
AIM: Abrus precatorius leaves methanolic extract (APME) was evaluated for in vivo antihyperglycemic activity and in vitro insulinotropic effect. MATERIALS AND METHODS: In vivo antihyperglycemic and insulin secretagogue activities were assessed in streptozotocin-induced diabetic rats by oral administration of APME (200 mg/kg body weight [bw]) for 28 days. In vitro insulin secretion mechanisms were studied using mouse insulinoma beta cells (MIN6-β). In vivo body weight and blood glucose and in vivo and in vitro insulin levels were estimated...
October 2016: Pharmacognosy Research
https://www.readbyqxmd.com/read/27679168/treatment-of-bladder-pain-syndrome-and-interstitial-cystitis-a-systematic-review
#13
J C Rosa-E-Silva, C Pazin, Apm Silva, A M Mitidieri, M B Gurian
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27676686/merit-based-incentive-payment-system-mips-harsh-choices-for-interventional-pain-management-physicians
#14
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
UNLABELLED: The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27672736/a-critical-review-of-approaches-and-limitations-of-inhalation-bioavailability-and-bioaccessibility-of-metal-loid-s-from-ambient-particulate-matter-or-dust
#15
Farzana Kastury, Euan Smith, Albert L Juhasz
Inhalation of metal(loid)s in ambient particulate matter (APM) represents a significant exposure pathway to humans. Although exposure assessment associated with this pathway is currently based on total metal(loid) content, a bioavailability (i.e. absorption in the systemic circulation) and/or bioaccessibility (i.e. solubility in simulated lung fluid) based approach may more accurately quantify exposure. Metal(loid) bioavailability-bioaccessibility assessment from APM is inherently complex and lacks consensus...
September 24, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/27650182/viral-il-10-down-regulates-the-mhc-i-antigen-processing-operon-through-the-nf-%C3%AE%C2%BAb-signaling-pathway-in-nasopharyngeal-carcinoma-cells
#16
Yan-Xin Ren, Jie Yang, Rui-Mei Sun, Li-Juan Zhang, Liu-Fang Zhao, Bao-Zhong Li, Lei Li, Hai-Ting Long, Qiang-Ming Sun, Yun-Chao Huang, Xiao-Jiang Li
The HLA-I antigen processing machinery (APM) plays a crucial role in the anticancer immune response. The loss of surface expression of HLA-I molecules is particularly important as this enables tumor cells to evade recognition and lysis by cytotoxic T-lymphocytes. Transcriptional control of the APM genes is regulated by the nuclear factor kappa B (NF-κB). BCRFl is an Epstein-Barr virus homologue of human IL-10 (hIL-10) and is known as viral IL-10 (vIL-10). vIL-10 shares many immunosuppressive effects with hIL-10 but lacks the immunostimulatory effect of hIL-10...
December 2016: Cytotechnology
https://www.readbyqxmd.com/read/27619158/discovery-of-a-metastatic-immune-escape-mechanism-initiated-by-the-loss-of-expression-of-the-tumour-biomarker-interleukin-33
#17
Iryna Saranchova, Jeffrey Han, Hui Huang, Franz Fenninger, Kyung Bok Choi, Lonna Munro, Cheryl Pfeifer, Ian Welch, Alexander W Wyatt, Ladan Fazli, Martin E Gleave, Wilfred A Jefferies
A new paradigm for understanding immune-surveillance and immune escape in cancer is described here. Metastatic carcinomas express reduced levels of IL-33 and diminished levels of antigen processing machinery (APM), compared to syngeneic primary tumours. Complementation of IL-33 expression in metastatic tumours upregulates APM expression and functionality of major histocompatibility complex (MHC)-molecules, resulting in reduced tumour growth rates and a lower frequency of circulating tumour cells. Parallel studies in humans demonstrate that low tumour expression of IL-33 is an immune biomarker associated with recurrent prostate and kidney renal clear cell carcinomas...
September 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27600166/beneficial-effect-of-amorphophallus-paeoniifolius-tuber-on-experimental-ulcerative-colitis-in-rats
#18
Yadu Nandan Dey, Garima Sharma, Manish M Wanjari, Dharmendra Kumar, Vinay Lomash, Ankush D Jadhav
CONTEXT: The tuber of Amorphophallus paeoniifolius (Dennst.) Nicolson (Araceae), commonly called Suran or Jimmikand, has high medicinal value and is used ethnomedicinally for the treatment of different gastrointestinal and inflammatory disorders. OBJECTIVE: The present study evaluated the effects of extracts of Amorphophallus paeoniifolius tubers on acetic acid-induced ulcerative colitis (UC) in rats. MATERIALS AND METHODS: Wistar rats were orally administered methanol extract (APME) or aqueous extract (APAE) (250 and 500 mg/kg) or standard drug, prednisolone (PRDS) (4 mg/kg) for 7 days...
September 7, 2016: Pharmaceutical Biology
https://www.readbyqxmd.com/read/27595077/arthroscopic-meniscectomy-for-medial-meniscus-horizontal-cleavage-tears-in-patients-under-age-45
#19
Jae Gyoon Kim, Seung-Yup Lee, Suhwoo Chay, Hong Chul Lim, Ji-Hoon Bae
PURPOSE: The purpose of this study was to evaluate the demographics, clinical features, and outcomes of arthroscopic partial meniscectomy (APM) for isolated medial meniscus horizontal cleavage tears (MMHCTs) in patients under 45 years of age. MATERIALS AND METHODS: We retrospectively reviewed 98 patients (100 knees) under 45 years who underwent APM for MMHCTs. Clinical outcomes were assessed using International Knee Document Committee (IKDC) subjective core, Tegner activity scale, visual analog scale (VAS) pain score, and a question on the symptom relief...
September 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27548938/-investigation-of-aerosol-mixed-state-and-ccn-activity-in-nanjing
#20
Lin Zhu, Yan Ma, Jun Zheng, Shi-zheng Li, Li-peng Wang
During 11-18 September 2014, the size-resolved aerosol Cloud Condensation Nuclei (CCN) activity and mixing state were measured using Cloud Condensation Nuclei Counter (CCNC), Aerosol Particle Mass (APM) and Scanning Mobility Particle Sizer (SMPS). The results showed that aerosols mainly existed as an internal mixture. For 76, 111, 138 and 181 nm particles, black carbon (BC) accounted for 5.4%, 10%, l0.7% and 6.7% of the particle mass, but as high as 51%, 57%, 70% and 59% of the particle number concentrations, respectively, suggesting that BC was a type of important condensation nuclei in the atmosphere and made significant contributions to particle numbers...
April 15, 2016: Huan Jing Ke Xue= Huanjing Kexue
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