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Eric D Shah, Andrew C Chang, Ryan Law
BACKGROUND AND AIMS: Unclear reimbursement for new and innovative endoscopic procedures can limit adoption in clinical practice despite effectiveness in clinical trials. The aim of this study was to determine maximum cost-effective reimbursement for per-oral endoscopic myotomy (POEM) in treating achalasia. METHODS: We constructed a decision analytic model assessing POEM versus laparoscopic Heller myotomy with Dor fundoplication (LHM) in managing achalasia from a payer perspective over a 1-year time horizon...
April 20, 2018: Gastrointestinal Endoscopy
Koan Sik Woo, Hyun-Joo Kim, Ji Hae Lee, Jee Yeon Ko, Byong Won Lee, Byoung Kyu Lee
This study aimed to compare the phenolic compounds and antioxidant activity of barley at different proportion (0, 5, 10, 15, and 20%), and using different cooking methods. The grains used in this experiment are barley ( Hordeum vulgare L. cv. Huinchalssal) and Samkwang rice. The rice-barley mixture was cooked using general and high pressure cooking methods with and without fermented alcohol. The quality characteristics such as water binding capacity, pasting characteristic, water solubility, and swelling power of different proportions of barley were evaluated...
March 2018: Preventive Nutrition and Food Science
Marie Besnier, David Coquerel, Julie Favre, Anais Dumesnil, Dominique Guerrot, Isabelle Remy-Jouet, Paul Mulder, Zoubir Djerada, Fabienne Tamion, Vincent Richard, Antoine Ouvrard-Pascaud
Background- We previously showed that Protein Tyrosine Phosphatase 1B inactivation (PTP1B-/- ) in mice improved left ventricular (LV) angiogenesis, perfusion, remodeling and function, and limits endothelial dysfunction after myocardial infarction. However, whether PTP1B inactivation slows aging-associated cardiovascular dysfunction remains unknown. Methods and Results- WT and PTP1B-/- mice were allowed to age until 18 months. Compared to old WT in which aging increased the LV mRNA expression of PTP1B, old PTP1B-/- mice had: 1) reduced cardiac hypertrophy with decreased LV mRNA levels of hypertrophic markers, atrial and brain natriuretic peptides; 2) lower LV fibrosis (collagen: WT 16{plus minus}3, PTP1B-/- 5{plus minus}3 %, p<0...
March 23, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Omolara R Adegbanke, Toluwase A Dada, Stephen A Akinola, Temitope Akintuyi
Weaning food was produced from the blends of sprouted and unsprouted sorghum-Irish potato, and groundnut flour. In the developed weaning foods, moisture content ranged from 8.44% to 12.70%, crude protein (7.40%-14.53%) crude ash (1.53%-1.77%), crude fiber (6.65%-6.88%), crude fat (3.31%-3.73%) and carbohydrate content (65.10%-69.15%). Sprouting and protein supplementation with groundnut improved the protein content of the formulated meals with values comparable to commercial sample (cereals). Mineral content reduced with sprouting, whereas the addition of Irish potato and groundnut increased the mineral content...
March 2018: Food Science & Nutrition
Sunil W Dutta, Kristine Bauer-Nilsen, Jason C Sanders, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). METHODS AND MATERIALS: Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis...
March 5, 2018: Brachytherapy
Bárbara Biduski, Wyller Max Ferreria da Silva, Rosana Colussi, Shanise Lisie de Mello El Halal, Loong-Tak Lim, Álvaro Renato Guerra Dias, Elessandra da Rosa Zavareze
Gelatinization and retrogradation, influenced by amylose and amylopectin ratio, are important characteristics for starch hydrogels elaboration. The objective of this study was to evaluate the influence of amylose content and the gelatinization method on the physicochemical characteristics of native and cross-linked rice starch hydrogels. The native and cross-linked starches were gelatinized with heating or alkaline solution, added polyvinyl alcohol, frozen and then freeze-dried. The cross-linked starch had a low final viscosity (101...
July 1, 2018: International Journal of Biological Macromolecules
Jeremy A Tanner, Karthik T Rao, Rachel E Salas, Roy E Strowd, Angeline M Nguyen, Alexandra Kornbluh, Evan Mead-Brewer, Charlene E Gamaldo
Background: In this study, we aimed to evaluate ambulatory clinic responsibilities that neurology clerkship students perceive as having the highest educational value and to evaluate the association between a student's presence and level of responsibility and a preceptor's clinical and financial productivity during a clinic session. Methods: Physician preceptors (n = 43) and medical students (n = 67) in the Johns Hopkins Neurology clerkship from 2014 to 2015 were included...
December 2017: Neurology. Clinical Practice
R Douglas Orr, Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Assem A Sultan, Morad Chughtai, Jared M Newman, Jason Savage, Thomas E Mroz, Michael A Mont
BACKGROUND CONTEXT: Relative value units (RVUs) are a compensation model based on the effort required to provide a procedure or service to a patient. Thus, procedures that are more complex and require greater technical skill and aftercare, such as multilevel spine surgery, should provide greater physician compensation. However, there are limited data comparing RVUs with operative time. Therefore, this study aims to compare mean (1) operative times; (2) RVUs; and (3) RVU/min between posterior segmental instrumentation of 3-6, 7-12, and ≥13 vertebral segments, and to perform annual cost difference analysis...
February 2, 2018: Spine Journal: Official Journal of the North American Spine Society
Ramin M Lalezari, Alexis Pozen, Christopher J Dy
BACKGROUND: Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. METHODS: The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Z Fazil, J C Ten Berge, A W Langerak, A Rothova, W A Dik
PURPOSE: To analyze intraocular cytokine levels and cell profiles in patients with rubella virus-associated uveitis (RVU). METHODS: We collected intraocular fluid samples from patients with RVU (n = 10), uveitis of other causes (n = 27), and cataract (n = 22). Levels of 15 cytokines (IL-1β, IL-1ra, IL-2, IL-6, IL-6rα, IL-7, IL-8, IL-10, IL-17A, IL-23, TARC, MCP-1, TNF-α, PlGF, and VEGF) were measured using multiplex assay, and intraocular cell populations were determined by multiparameter flowcytometry...
January 25, 2018: Ocular Immunology and Inflammation
Nipun Sodhi, Benjamin Yao, Jared M Newman, Michael Jawad, Anton Khlopas, Assem A Sultan, Suela Lamaj, George A Beyer, Alyeesha B Wilhelm, Michael A Mont
INTRODUCTION: To determine the effort required to provide a service, the United States Medicare uses Relative Value Units (RVUs). Consequently, higher RVUs are assigned to the procedures or services that require more effort, which ultimately means the physician will be properly compensated for the additional effort required. In total ankle arthroplasty (TAA), revision cases usually are more technically challenging and require more effort than primary TAA. Therefore, the purpose of this study was to compare the: 1) RVUs; 2) length-of-surgery; 3) RVU per unit of time between primary and revision total ankle arthroplasty; and 4) the individualized idealized surgeon annual cost difference analysis...
December 22, 2017: Surgical Technology International
Hooman Molavi, Seyed Mohammad Ali Razavi, Reza Farhoosh
Native acorn starch had high purity and the granules were mainly elliptical and spherical with the mean diameter of 7.32 μm. Hydrothermal modifications slightly changed the morphology. The solubility, swelling properties and amylose leaching of acorn starch were mostly influenced by Heat-moisture treatment (HMT). XRD pattern of native starch (C-type) did not change on hydrothermal modifications, but native and annealing (ANN) modified starches showed the most crystallinity. DSC results showed that the gelatinization temperatures and enthalpy of native starch were 59...
April 15, 2018: Food Chemistry
Mark D Kovacs, Douglas H Sheafor, Paul G Thacker, Andrew D Hardie, Philip Costello
PURPOSE: In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. METHODS: Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets...
March 2018: Journal of the American College of Radiology: JACR
Jennifer Peterson, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Jared M Newman, Assem A Sultan, Kim L Stearns, Michael A Mont
BACKGROUND: In total knee arthroplasty (TKA), revision cases are often technically more challenging, and require more operative time and aftercare than primary cases. These time and effort differences should therefore be appropriately compensated for when using the relative value unit (RVU) system. Therefore, the purpose of this study is to compare the mean (1) RVUs; (2) operative times; and (3) RVU/min; and (4) perform an individualized idealized surgeon annual cost difference analysis for primary vs revision TKA...
December 6, 2017: Journal of Arthroplasty
Carlo J Milani, Sean D Rundell, Jeffrey G Jarvik, Janna Friedly, Patrick J Heagerty, Andy Avins, David Nerenz, Laura S Gold, Judith A Turner, Thiru Annaswamy, Srdjan S Nedeljkovic, Pradeep Suri
STUDY DESIGN: Secondary analysis of the Back Pain Outcomes using Longitudinal Data (BOLD) cohort study. OBJECTIVE: To characterize associations of self-reported race/ethnicity with back pain (BP) patient-reported outcomes (PROs) and health care utilization among older adults with a new episode of care for BP. SUMMARY OF BACKGROUND DATA: No prior longitudinal studies have characterized associations between multiple race/ethnicity groups, and BP-related PROs and health care utilization in the US...
November 20, 2017: Spine
Umar L Ssonko, Florence I Muranga
The SEM of starch from five EAHB cultivars showed a mixture of irregular granule shapes with smooth surfaces. The starches' average diameter size ranged between 16.31 and 21.98 μm. The moisture, protein, and ash content of the starches were: 11.12%-11.84%, 0.1% and 0.23%-0.47% respectively. The amylose content of these starches was between 11% and 13%. The starches peak viscosity ranged between 488.42 and 558.66 RVU. The EAHB starches exhibited relatively low pasting temperatures (<75°C), a high peak viscosity (488...
November 2017: Food Science & Nutrition
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads. DESIGN: Observational cohort study. SETTING: 116 hospitals in Iowa with inpatient or outpatient surgery from July 1, 2013 through June 30, 2015...
February 2018: Journal of Clinical Anesthesia
Michael Breyer, Heather Farley, Greg Neyman, Wendy Nichols, John Kendall
BACKGROUND: Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). OBJECTIVES: We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. METHODS: This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet...
November 2017: Journal of Emergency Medicine
Kristine Bauer-Nilsen, Colin Hill, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. METHODS AND MATERIALS: Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained...
January 1, 2018: International Journal of Radiation Oncology, Biology, Physics
B Mawoyo, P Adebola, Abe S Gerrano, E O Amonsou
Amadumbe, known as taro is a traditional crop mainly grown for subsistence in Southern Africa. In this study, chemical composition and functional properties of nine amadumbe genotypes grown at two distinct locations were investigated. Carbohydrate contents (73-81%) of amadumbe genotypes were substantially high and varied with growth location. Protein contents ranged from 8-12% and fat was very low (less 1%) in all genotypes. Major minerals in flours were K, P, Mg and Ca, but these were present at varying levels depending on growth locations...
October 2017: Journal of Food Science and Technology
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