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Identifying patients at risk for nonroutine discharge after surgery for cervical myelopathy: an analysis from the Quality Outcomes Database.

J Neurosurg Spine 2021 May 7:1-9. Epub 2021 May 7.

15Department of Neurological Surgery, University of Utah, Salt Lake City, Utah.

Objective: Optimizing patient discharge after surgery has been shown to impact patient recovery and hospital/physician workflow and to reduce healthcare costs. In the current study, the authors sought to identify risk factors for nonroutine discharge after surgery for cervical myelopathy by using a national spine registry.

Methods: The Quality Outcomes Database cervical module was queried for patients who had undergone surgery for cervical myelopathy between 2016 and 2018. Read More

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Access to healthcare services between insured and uninsured adults aged ≥50 years with diabetes in Mexico: the Mexican Health and Aging Study (MHAS-2018).

Public Health 2021 May 3;194:176-181. Epub 2021 May 3.

Health Care Department, Metropolitan Autonomous University-Xochimilco, Mexico City, Mexico.

Objectives: Analyze the association between health insurance coverage and the use of health care services, dentist visits, and self-medication in a national sample of Mexican adults aged ≥50 years with diabetes.

Methods: Participants with diabetes taken from a subsample of the Mexican Health and Aging Study (MHAS-2018) (n = 3667) were examined, with data pertaining to the frequency of their doctor and dentist visits, residence, years of education, self-medication, and health insurance coverage (insured/uninsured) also collected. A logistic regression model was used to identify the association between independent variables and health insurance coverage, whereas Poisson regression models were also estimated to ascertain whether health insurance coverage was associated with the number of doctor and dentist visits. Read More

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Influenza vaccination in congenital heart disease in the pre-COVID19 era: Coverage rate, patient characteristics and outcome.

Can J Cardiol 2021 May 4. Epub 2021 May 4.

Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium.

Background: Influenza vaccination is the most commonly recommended immune prevention strategy. However, data on influenza vaccination in patients with congenital heart disease (CHD) is scarce. In this study, our goals were to (i) measure vaccination coverage rates (VCR) for influenza in a large cohort of children, adolescents and adults with CHD, (ii) identity patient characteristics as predictors for vaccination, and (iii) investigate the impact of influenza vaccination on hospitalization. Read More

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Synergic effect of buccal fat pad pedicled flap and dermal acellular matrix for large cheek defect.

Ital J Dermatol Venerol 2021 Apr;156(2):244-247

Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Reconstruction of large defects of the upper cheek defects still remains a challenge for the surgeon, who can apply different techniques. We present a new method involving the use of a dermal regeneration template to achieve an improved, faster healing of pedicled buccal fat flap in a 75-year-old woman affected by melanoma of the upper-middle cheek. The tumor involved soft tissue, zygomatic arch and periocular fact. Read More

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Physician Palliative Education Associated With High Use of Hospice Care Service.

Am J Hosp Palliat Care 2021 May 7:10499091211014160. Epub 2021 May 7.

Superintendent Office & Division of Neurosurgery, Department of Surgery, 38010Taipei City Hospital, Taipei.

Background: Taiwan's National Health Insurance provides coverage for palliative and hospice care. The following 10 types of diseases have been added to the National Health Insurance reimbursement regulation: end-stage cancer, motor neuron disease, organic psychosis, brain degeneration, heart failure, chronic airway obstruction diseases, other lung diseases, chronic liver disease and cirrhosis, acute renal failure, and chronic renal failure.

Objective: This study aimed to determine the association between physicians' palliative education and use of hospice care in hospitalized patients at the end of life. Read More

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Implementation of the World Health Organization recommendation on the use of rotavirus vaccine without age restriction by African countries.

Vaccine 2021 May 3. Epub 2021 May 3.

World Health Organization (WHO), Regional Office for Africa, Brazzaville, Congo. Electronic address:

The World Health Organization (WHO) recommended the worldwide use of rotavirus vaccines initially in 2007 and 2009 applying a strict age restriction criterion due to the potential for age-related association with increased risk of intussusception in infants. The restriction was relaxed in the 2013 after detailed review of robust safety data generated in post-marketing surveillance studies. We assessed the status of the implementation of the 2013 recommendation to remove age restriction in the WHO African region (AFR). Read More

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Current Challenges and Future Possibilities for Immunization Information Systems.

Acad Pediatr 2021 May-Jun;21(4S):S57-S64

American Immunization Registry Association (R Coyle, MB Kurilo, and E Abbott), Washington, DC.

Immunizations have proven to be an important tool for public health and for reducing the impact of vaccine preventable diseases. To realize the maximum benefits of immunizations, a coordinated effort between public policy, health care providers and health systems is required to increase vaccination coverage and to ensure high-quality data are available to inform clinical and public health interventions. Immunization information systems (IIS) are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area. Read More

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Estimating the Period Prevalence of Publicly Funded Abortion to Space Live Births, 1999 to 2014.

J Prim Care Community Health 2021 Jan-Dec;12:21501327211012182

American Association of Pro-Life Obstetricians and Gynecologists, Eau Claire, MI, USA.

Introduction/objectives: Although a majority of women who have an abortion report having 1 or more children, there is no published research on the number of abortions which occur between live births, after a first child but before the last. The objectives of this research, therefore, were to estimate the period prevalence of an induced abortion separating live births in a population of Medicaid eligible enrollees and to identify the characteristics of enrollees significantly associated with the use of abortion to enable child spacing.

Methods: A retrospective, cross-sectional, longitudinal analysis of the pregnancy outcome sequences of eligible enrollees over age 13 from the 17 states where Medicaid included coverage of all abortions, with at least one identifiable pregnancy outcome between 1999 and 2014. Read More

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High burden of soil-transmitted helminth infections, schistosomiasis, undernutrition, and poor sanitation in two Typhoon Haiyan-stricken provinces in Eastern Philippines.

Pathog Glob Health 2021 May 6:1-11. Epub 2021 May 6.

Eastern Samar Provincial Health Office Eastern Samar, The Philippines.

This study aimed to describe: 1) soil-transmitted helminthiasis (STH) and schistosomiasis prevalence and intensity in preschool-age children (PSAC) and school-age children (SAC), 2) schistosomiasis seroprevalence in SAC, 3) undernutrition prevalence in SAC, 4) sanitary toilet coverage in households, and 5) association between STH, exposure, nutritional status, and sanitation. PSAC and SAC in two -stricken provinces were examined using Kato-Katz technique and ELISA Antibody test. Anthropometric and hemoglobin measurements were also obtained. Read More

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Effects of the Affordable Care Act Medicaid Expansion on the Distribution of New General Internists Across States.

Med Care 2021 Mar 12. Epub 2021 Mar 12.

*Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA †Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA ‡American Medical Association, Chicago, IL §RAND Corporation, Pittsburgh, PA ∥Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.

Background: Some states expanded Medicaid under the Affordable Care Act, boosting their low-income residents' demand for health care, while other states opted not to expand.

Objective: The objective of this study was to determine whether the Medicaid expansion influenced the states selected by physicians just completing graduate medical education for establishing their first practices.

Research Design: Using 2009-2019 data from the American Medical Association Physician Masterfile and information on states' Medicaid expansion status, we estimated conditional logit models to compare where new physicians located during the 6 years following implementation of the expansion to where they located during the 5 years preceding implementation. Read More

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Two Synthetic 18-Way Outcrossed Populations of Diploid Budding Yeast with Utility for Complex Trait Dissection.

Genetics 2020 Jun;215(2):323-342

Department of Ecology and Evolutionary Biology, School of Biological Sciences, University of California, Irvine, California 92697-2525.

Advanced-generation multiparent populations (MPPs) are a valuable tool for dissecting complex traits, having more power than genome-wide association studies to detect rare variants and higher resolution than F2 linkage mapping. To extend the advantages of MPPs in budding yeast, we describe the creation and characterization of two outbred MPPs derived from 18 genetically diverse founding strains. We carried out de novo assemblies of the genomes of the 18 founder strains, such that virtually all variation segregating between these strains is known, and represented those assemblies as Santa Cruz Genome Browser tracks. Read More

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Consultation-liaison psychiatry in Japan: a nationwide retrospective observational study.

BMC Psychiatry 2021 May 5;21(1):235. Epub 2021 May 5.

Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 1138519, Japan.

Background: Consultation-liaison psychiatry (CLP)-professional psychiatric care provided to coordinate with surgical or medical treatment of inpatients with psychiatric disorders-was included in universal health coverage in Japan in 2012. Despite evidence of benefits of CLP, basic data and geographic distribution information regarding CLP at the national level remain unclear. This study aimed to 1) identify the geographic disparity of CLP in Japan and 2) investigate the association between number of consultations per CLP patient and region. Read More

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Dealing with missing delirium assessments in prospective clinical studies of the critically ill: a simulation study and reanalysis of two delirium studies.

BMC Med Res Methodol 2021 May 6;21(1):97. Epub 2021 May 6.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: In longitudinal critical care studies, researchers may be interested in summarizing an exposure over time and evaluating its association with a long-term outcome. For example, the number of days a patient has delirium (i.e. Read More

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Association of Drug Rebates and Competition With Out-of-Pocket Coinsurance in Medicare Part D, 2014 to 2018.

JAMA Netw Open 2021 May 3;4(5):e219030. Epub 2021 May 3.

Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles.

Importance: Prior research has documented the increase in prescription drug rebates and the coincident increase in out-of-pocket burden for patients paying coinsurance tied to list prices.

Objective: To describe the out-of-pocket burden on patients with coinsurance and assess its association with pharmaceutical competition, which increases payers' leverage to seek higher rebates.

Design, Setting, And Participants: This retrospective cohort study used branded prescription drugs with US sales reported by publicly traded companies. Read More

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Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study.

Dental Press J Orthod 2021 30;26(2):e2119244. Epub 2021 Apr 30.

Universidade Federal de Santa Maria, Departamento de Estomatologia, Faculdade de Odontologia (Santa Maria/RS, Brazil).

Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL).

Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Read More

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Overcorrection of the acetabular roof angle or anterior center-edge angle may cause decrease of range of motion after curved periacetabular osteotomy.

J Hip Preserv Surg 2020 Aug 21;7(3):583-590. Epub 2020 Dec 21.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.

The aim of this study was to evaluate the relationship between the correction of radiographic parameters and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Sixty-nine patients with hip dysplasia were enrolled and underwent curved PAO. The pre- and post-operative 3D center-edge (CE) angles, total anteversion (acetabular and femoral anteversion), and radiographic acetabular roof angle were measured and compared with the post-operative ROM. Read More

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Shift of Dominant Species in Plant Community and Soil Chemical Properties Shape Soil Bacterial Community Characteristics and Putative Functions: A Case Study on Topographic Variation in a Mountain Pasture.

Microorganisms 2021 Apr 29;9(5). Epub 2021 Apr 29.

National Institute of Agricultural Sciences, RDA, Wanju 55365, Korea.

Reducing management intensity according to the topography of pastures can change the dominant plant species from sown forages to weeds. It is unclear how changes in species dominance in plant community drive spatial variation in soil bacterial community characteristics and functions in association with edaphic condition. Analysing separately the effects of both plant communities and soil chemical properties on bacterial community is crucial for understanding the biogeographic process at a small scale. Read More

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Is There An Association Between Bundled Payments and "Cherry Picking" and "Lemon Dropping" in Orthopaedic Surgery? A Systematic Review.

Clin Orthop Relat Res 2021 04 30. Epub 2021 Apr 30.

D. N. Bernstein, R. W. Poolman, Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Background: The goal of bundled payments-lump monetary sums designed to cover the full set of services needed to provide care for a condition or medical event-is to provide a reimbursement structure that incentivizes improved value for patients. There is concern that such a payment mechanism may lead to patient screening and denying or providing orthopaedic care to patients based on the number and severity of comorbid conditions present associated with complications after surgery. Currently, however, there is no clear consensus about whether such an association exists. Read More

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Measuring pure health inequality and mobility during a health insurance expansion: Evidence from Mexico.

Health Econ 2021 May 4. Epub 2021 May 4.

Department of Social Policy, London School of Economics and Political Science (LSE), London, UK.

The association of insurance expansions and the distribution of health status is still a matter we know little about. This paper draws upon new measures of pure (univariate) inequality and mobility which accommodate categorical data to understand how an expansion of public insurance may be related to both health inequality and mobility. These measures require a definition of individual's status that is either "downward looking" or "upward looking". Read More

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Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis.

BMC Womens Health 2021 May 3;21(1):186. Epub 2021 May 3.

Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.

Background: Tennessee women experience the 12th highest breast cancer mortality in the United States. We examined the geographic differences in breast cancer incidence in Tennessee between Appalachian and non-Appalachian counties from 2005 to 2015.

Methods: We used ArcGIS 10. Read More

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Opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States, 2007-2015.

BMC Pregnancy Childbirth 2021 May 3;21(1):350. Epub 2021 May 3.

Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.

Background: Little is known about benzodiazepine and opioid-benzodiazepine co-dispensing patterns among pregnant women. Understanding these patterns is necessary to mitigate high-risk medication use during pregnancy. Our objective in this analysis was to evaluate opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States. Read More

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Limited availability of global health opportunities in US orthopaedic trauma fellowship programs.

OTA Int 2019 Dec 24;2(4):e031. Epub 2019 Apr 24.

Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health.

Purpose: Orthopaedic residents are increasingly seeking international health electives (IHEs) during training, and many such experiences involve providing orthopaedic trauma care. However, little is known about the availability of IHEs during orthopaedic trauma fellowship training. The purpose of our study is to assess the global health opportunities available to US orthopaedic trauma fellows. Read More

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December 2019

The Role of Socio-Demographic Factors in the Coverage of Breast Cancer Screening: Insights From a Quantile Regression Analysis.

Front Public Health 2021 15;9:648278. Epub 2021 Apr 15.

Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

In Flanders, breast cancer (BC) screening is performed in a population-based breast cancer screening program (BCSP), as well as in an opportunistic setting. Women with different socio-demographic characteristics are not equally covered by BC screening. To evaluate the role of socio-demographic characteristics on the lowest 10th and highest 90th quantile levels of BC screening coverage. Read More

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Predictors of Covid-19 case fatality rate: An ecological study.

Ann Med Surg (Lond) 2021 May 27;65:102319. Epub 2021 Apr 27.

Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan.

Background: The outbreak of novel coronavirus (Covid-19) has a significant burden on global health and could be associated with significant mortality. Limited information exists about determinants of its fatality worldwide. Thus, this ecological study examined the association of various predictors with Covid-19 fatality. Read More

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Levetiracetam versus fosphenytoin as a second-line treatment after diazepam for status epilepticus: study protocol for a multicenter non-inferiority designed randomized control trial.

Trials 2021 May 2;22(1):317. Epub 2021 May 2.

Department of Emergency and Critical Care Medicine, Tsukuba University Hospital, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.

Background: Status epilepticus (SE) is an emergency condition for which rapid and secured cessation is important. Phenytoin and fosphenytoin, the prodrug of phenytoin with less severe adverse effects, have been recommended as second-line treatments. However, fosphenytoin causes severe adverse events, such as hypotension and arrhythmia. Read More

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The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model.

Hip Int 2021 May 2:11207000211013029. Epub 2021 May 2.

Division of Paediatric Orthopaedics, Rainbow Babies and Children's Hospitals at Case Western Reserve University, Cleveland, OH, USA.

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip.

Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. Read More

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Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer.

Cancer Rep (Hoboken) 2021 May 2:e1407. Epub 2021 May 2.

Harvard Medical School, Boston, Massachusetts, USA.

Background: Currently, little is known about the effect of the Patient Protection and Affordable Care Act's Medicaid expansion on care delivery and outcomes in cervical cancer.

Aim: We evaluated whether Medicaid expansion was associated with changes in insurance status, stage at diagnosis, timely treatment, and survival outcomes in cervical cancer.

Methods And Results: Using the National Cancer Database, we performed a difference-in-differences (DID) cross-sectional analysis to compare insurance status, stage at diagnosis, timely treatment, and survival outcomes among cervical cancer patients residing in Medicaid expansion and nonexpansion states before (2011-2013) and after (2014-2015) Medicaid expansion. Read More

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Health capabilities and the determinants of infant mortality in Brazil, 2004-2015: an innovative methodological framework.

BMC Public Health 2021 Apr 30;21(1):831. Epub 2021 Apr 30.

École de Santé Publique de l'Université de Montréal (ESPUM), 7101, Park Avenue, 3rd floor, Montreal (Québec) H3N 1X9, Canada.

Background: Despite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies.

Method: A series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. Read More

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Genome-wide variant-based study of genetic effects with the largest neuroanatomic coverage.

BMC Bioinformatics 2021 Apr 30;22(1):223. Epub 2021 Apr 30.

Computer and Information Science, IUPUI, 723 W Michigan St, Indianapolis, IN, 46202, USA.

Background: Brain image genetics provides enormous opportunities for examining the effects of genetic variations on the brain. Many studies have shown that the structure, function, and abnormality (e.g. Read More

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