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Mortality and socio-economic outcomes among patients hospitalized for stroke and diabetes in the US: a recent analysis from the National Inpatient Sample.

Sci Rep 2021 Apr 15;11(1):8204. Epub 2021 Apr 15.

Research Department, Weill Cornell Medicine-Qatar, PO box 24144, Doha, Qatar.

The prevalence and incidence of diabetes mellitus (DM) are increasing worldwide. We aim to assess mortality and socio-economic outcomes among patients hospitalized for stroke and diabetes in the US and evaluate their recent trends. We examined: in-hospital mortality, length of stay (LoS), and overall hospital charges in diabetic patients over 18 years old who were hospitalized with a stroke from 2005 to 2014, included in the National Inpatient Sample. Read More

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In-patient outcomes of patients with diabetic ketoacidosis and concurrent protein energy malnutrition: A national database study from 2016 to 2017.

Postgrad Med 2021 Apr 16:1-6. Epub 2021 Apr 16.

Central Michigan University, College of Medicine, Saginaw, Michigan, USA.

Patients often present to the hospital with a well-known complication of diabetes mellitus, namely diabetic ketoacidosis (DKA). In this study, we assess the clinical outcomes of DKA hospitalizations with and without protein-energy malnutrition (PEM).This was a population-based, retrospective observational study using data gathered from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. Read More

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The effect of ion pairs on coacervate-driven self-assembly of block polyelectrolytes.

J Chem Phys 2021 Apr;154(14):144903

Beijing National Laboratory for Molecular Sciences, Department of Polymer Science and Engineering and Key Laboratory of Polymer Chemistry and Physics of Ministry of Education, College of Chemistry, Peking University, Beijing 100871, People's Republic of China.

The incorporation of oppositely charged polyelectrolytes into a block copolymer system can lead to formation of microphase separated nanostructures driven by the electrostatic complex between two oppositely charged blocks. It is a theoretical challenge to build an appropriate model to handle such coacervate-driven self-assembly, which should capture the strong electrostatic correlations for highly charged polymers. In this paper, we develop the self-consistent field theory considering the ion paring effect to predict the phase behavior of block polyelectrolytes. Read More

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Complications Following Robotic Hiatal Hernia Repair Are Higher Compared to Laparoscopy.

J Gastrointest Surg 2021 Apr 14. Epub 2021 Apr 14.

Center for Advanced Surgery, Baylor Scott and White Health, Dallas, TX, USA.

Background: The use of robotic platforms in surgery is becoming increasingly common in both practice and residency training. In this study, we compared the perioperative outcomes between robotic platforms and traditional laparoscopy in paraesophageal hernia repair.

Methods: A retrospective population-based analysis was performed using the National Inpatient Sample for the period of 2010-2015. Read More

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Textbook Outcome: Definition and Analysis of a Novel Quality Measure in Lung Transplantation.

Ann Surg 2021 Apr 9. Epub 2021 Apr 9.

School of Medicine, Duke University, Durham, NC, USA Department of Surgery, Duke University Medical Center, Durham, NC, USA.

Objective: To define textbook outcome (TO) for lung transplantation (LTx) using a contemporary cohort from a high-volume institution.

Summary Background Data: TO is a standardized, composite quality measure based on multiple postoperative endpoints representing the ideal "textbook" hospitalization.

Methods: Adult patients who underwent LTx at our institution between 2016-2019 were included. Read More

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The Value of Managing Acute Pancreatitis With Standardized Order Sets to Achieve "Perfect Care".

Pancreas 2021 Mar;50(3):293-299

Clinical Research Institute, Methodist Health System, Dallas, TX.

Objectives: We aimed to define perfect care index (PCI) metrics and to evaluate whether implementation of standardized order sets would improve outcomes without increasing hospital-based charges in patients with acute pancreatitis (AP).

Methods: This is a retrospective, pre-post, observational study measuring clinical quality, processes of care, and hospital-based charges at a single tertiary care center. The first data set included AP patients from August 2011 to December 2014 (n = 219) before the implementation of a standardized order set (Methodist Acute Pancreatitis Protocol [MAPP]) and AP patients after MAPP implementation from January 2015 to September 2018 (n = 417). Read More

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Evaluating the Effects of Enhanced Recovery Pathways in Craniosynostosis: National Trends in Hospitalization Charges and Length of Stay in Craniosynostosis Surgery.

Ann Plast Surg 2021 Mar 18. Epub 2021 Mar 18.

From the Case Western Reserve University School of Medicine, Cleveland, OH Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH.

Background: Enhanced Recovery After Surgery (ERAS) pathways are multimodal approaches aimed at minimizing postoperative surgical stress, reducing hospitalization time, and lowering hospitalization charges. Enhanced Recovery After Surgery is broadly and increasingly implemented in hospitals across the country. Early reports have shown ERAS to reduce length of stay (LOS) after commonly performed pediatric surgeries. Read More

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Trends in Emergency Department Utilization Among Women With Leiomyomas in the United States.

Obstet Gynecol 2021 Apr 8. Epub 2021 Apr 8.

Division of Reproductive Endocrinology and Infertility and the Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, and the Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan.

Objective: To describe trends in emergency department (ED) visits in the United States with a primary diagnosis of leiomyomas, subsequent admissions, and associated charges.

Methods: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database was used to retrospectively identify all ED visits from 2006 to 2017 among women aged 18-55 years with a primary diagnosis of leiomyomas as indicated by International Classification of Diseases (ICD) diagnosis codes. Trends in ED visits and subsequent admissions were analyzed and stratified by patient and hospital characteristics. Read More

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It is beyond remuneration: Bottom-up health workers' retention strategies at the primary health care system in Tanzania.

PLoS One 2021 8;16(4):e0246262. Epub 2021 Apr 8.

Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Although Tanzania is operating a decentralized health system, most of the health workers' retention strategies are designed at the central level and implemented at the local level. This study sought to explore the bottom-up health workers' retention strategies by analyzing experiences from two rural districts, Rombo and Kilwa in Tanzania by conducting a cross-sectional exploratory qualitative study in the said districts. Nineteen key informants were purposefully selected based on their involvement in the health workers' retention scheme at the district and then interviewed. Read More

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SAFT-γ-Mie Cross-Interaction Parameters from Density Functional Theory-Predicted Multipoles of Molecular Fragments for Carbon Dioxide, Benzene, Alkanes, and Water.

J Phys Chem B 2021 Apr 7. Epub 2021 Apr 7.

Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina, 27695, United States.

Determining unlike-pair interaction parameters, whether for group contribution equation of state or molecular simulations, is a challenge for the prediction of thermodynamic properties. As the number of components and their respective complexity increase, it becomes impractical to fit all the unlike interactions. Lorentz-Berthelot combining rules work well for systems, where the main interactions are dispersion forces, but they do not account for electrostatics. Read More

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A Nationwide Study Examining Deafness Among Hospitalized Adults.

Am J Audiol 2021 Apr 6:1-6. Epub 2021 Apr 6.

Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD.

Background It is unknown whether hospital outcomes differ among nonspeaking deaf patients compared to those without this disability. Objective This article aims to compare clinical outcomes and utilization data among patients with and without deafness. Design This study used a retrospective cohort study. Read More

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Hospitalization Cost and In-hospital Outcomes Following Type B Thoracic Aortic Dissection Repair.

Ann Vasc Surg 2021 Apr 2. Epub 2021 Apr 2.

University of California San Diego, Department of Surgery, CA, USA. Electronic address:

Background: Several studies have reported lower mortality and morbidity after thoracic endovascular aortic repair (TEVAR) when compared to open surgical repair (OSR) in the treatment of type B aortic dissection (TbAD). However, there are few studies in the literature on the cost of both treatment options. Thus, the aim of this study is to focus on in-hospital outcomes and cost associated with TbAD repair procedures in a national database in the United States. Read More

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A description of children dependent on long term ventilation via tracheostomy and their hospital resource use.

J Pediatr Nurs 2021 Apr 1;61:96-101. Epub 2021 Apr 1.

Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America. Electronic address:

Purpose: To describe the proportion of children with an index hospitalization in 2014 who had established long-term invasive ventilator dependence (LTVD), and determine regional variation in hospital length of stay, charges, and readmissions.

Design And Methods: Multicenter, longitudinal, retrospective cohort study using a recently established algorithm to identify children with LTVD from the Pediatric Health Information System database with an index hospitalization at least once during 2014, excluding normal newborn care or chemotherapy, and the subset with established LTVD. Hospitals were grouped by geographic regions. Read More

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Competition between Cations via Classical Poisson-Nernst-Planck Models with Nonzero but Small Permanent Charges.

Authors:
Mingji Zhang

Membranes (Basel) 2021 Mar 26;11(4). Epub 2021 Mar 26.

Department of Mathematics, New Mexico Institute of Mining and Technology, Socorro, NM 87801, USA.

We study a one-dimensional Poisson-Nernst-Planck system for ionic flow through a membrane channel. Nonzero but small permanent charge, the major structural quantity of an ion channel, is included in the model. Two cations with the same valences and one anion are included in the model, which provides more rich and complicated correlations/interactions between ions. Read More

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Ambulatory Surgery vs Overnight Observation for Total Thyroidectomy: Cost Analysis and Outcomes.

OTO Open 2021 Jan-Mar;5(1):2473974X21995104. Epub 2021 Mar 10.

Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Objective: To compare financial impact between patients undergoing ambulatory (same-day discharge) vs overnight admission after total thyroidectomy while showing associated surgical outcomes.

Study Design: Retrospective review.

Setting: University of Alabama at Birmingham Medical Center from October 2011 and July 2017. Read More

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Prevalence and patterns of illicit drug use in people with human immunodeficiency virus infection in Korea.

PLoS One 2021 1;16(4):e0249361. Epub 2021 Apr 1.

Division of Infectious Disease, Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, Korea.

Background: Data on illicit drug use by Korean people infected with HIV are lacking. Here, we examined the prevalence and patterns of illicit drug use among people infected with HIV in Korea.

Material And Methods: In this cross-sectional study, we included all patients infected with HIV who visited a tertiary care hospital in Korea from January 1990 to May 2020. Read More

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One-stage versus two-stage management for acute cholecystitis associated with common bile duct stones: a retrospective cohort study.

Surg Endosc 2021 Mar 31. Epub 2021 Mar 31.

Department of General Surgery, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, 510220, China.

Background: Both one-stage [laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE)] and two-stage [endoscopic retrograde cholangiopancreatography (ERCP) followed by sequential LC] approaches are effective treatment for concomitant common bile duct (CBD) stones and gallstone. Although many studies compared one-stage with two-stage surgical approach for cholecysto-choledocholithiasis, there are very few studies compared the two management strategies for acute cholecystitis (AC) associated with CBD stones.

Methods: Between January 2014 and December 2019, patients with concomitant AC and CBD stones proposed to early surgery were retrospectively studied. Read More

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Four Generations of High-Dimensional Neural Network Potentials.

Authors:
Jörg Behler

Chem Rev 2021 Mar 29. Epub 2021 Mar 29.

Universität Göttingen, Institut für Physikalische Chemie, Theoretische Chemie, Tammannstraße 6, 37077 Göttingen, Germany.

Since their introduction about 25 years ago, machine learning (ML) potentials have become an important tool in the field of atomistic simulations. After the initial decade, in which neural networks were successfully used to construct potentials for rather small molecular systems, the development of high-dimensional neural network potentials (HDNNPs) in 2007 opened the way for the application of ML potentials in simulations of large systems containing thousands of atoms. To date, many other types of ML potentials have been proposed continuously increasing the range of problems that can be studied. Read More

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Frailty impact on postoperative complications and early mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review.

Arab J Urol 2020 Nov 2;19(1):9-23. Epub 2020 Nov 2.

Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland.

: To assess the prevalence of frailty, a status of vulnerability to stressors leading to adverse health events, in bladder cancer patients undergoing radical cystectomy (RC), and test the impact of frailty measurements on postoperative adverse outcomes. : A systematic review of English-language articles published up to April 2020 was performed. Electronic databases were searched to quantify the frailty prevalence in RC patients and assess the predictive ability of frailty indexes on RC-related outcomes as postoperative complications, early mortality, hospitalization length (LOS), costs, discharge dispositions, readmission rate. Read More

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November 2020

In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic.

JAMA Netw Open 2021 03 1;4(3):e212618. Epub 2021 Mar 1.

Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Importance: This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic.

Objectives: To document patterns and costs of ambulatory care in the US before and during the initial stage of the pandemic and to assess how patient, practitioner, community, and COVID-19-related factors are associated with telehealth adoption.

Design, Setting, And Participants: This is a cohort study of working-age persons continuously enrolled in private health plans from March 2019 through June 2020. Read More

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Evaluating the Impact of CYP3A5 Genotype on Post-Transplant Healthcare Resource Utilization in Pediatric Renal and Heart Transplant Recipients Receiving Tacrolimus.

Pharmgenomics Pers Med 2021 12;14:319-326. Epub 2021 Mar 12.

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, 48109, USA.

Purpose: genotype is a significant contributor to inter-individual tacrolimus exposure and may impact the time required to achieve therapeutic concentrations and number of tacrolimus dose adjustments in transplant patients. Increased modifications to tacrolimus therapy may indicate a higher burden on healthcare resources. The purpose of this study was to evaluate whether genotype was predictive of healthcare resource utilization in pediatric renal and heart transplant recipients. Read More

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Lichenoid Keratosis Skin Biopsy: A Case Report of Malignant Hospital Charges.

Cureus 2021 Feb 11;13(2):e13292. Epub 2021 Feb 11.

Stanford Graduate School of Business, Stanford University, Stanford, USA.

Skin cancers are the most common malignancy and are especially common among light-skinned individuals in sun-exposed areas. While in many cases, a characteristic or classic appearance of the lesion is sufficient to make a definitive diagnosis, shave biopsy remains an important procedure when diagnosing many such raised lesions. Over the span of two months, a 66-year-old Caucasian male noted the appearance of a small, raised pruritic scaly lesion over his right upper chest. Read More

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February 2021

Public Attitudes Toward Institutional Child Sexual Abuse in Israel: The Case of Malka Leifer.

Sex Abuse 2021 Mar 17:10790632211000368. Epub 2021 Mar 17.

The Hebrew University of Jerusalem, Israel.

This study examined Israeli public perceptions of institutional child sexual abuse (CSA) in the Malka Leifer case. Leifer is a Jewish ultra-Orthodox former Melbourne school principal who is wanted in Australia on CSA charges, after fleeing to Israel. Based on a qualitative analysis of 2,451 reader comments retrieved from four Israeli news websites and six public Facebook pages, the findings indicated diverse attitudes toward the alleged perpetrator, the ultra-Orthodox Jewish community, state authorities, and victims. Read More

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A Systematic Review of Motivational Interviewing to Address Substance Use with Justice-Involved Adults.

Subst Use Misuse 2021 16;56(5):639-649. Epub 2021 Mar 16.

College of Social Work, Florida State University Tallahassee, FL, USA.

Background: Motivational Interviewing (MI) is widely used in substance abuse treatment, possibly due to the short sessions and the treatment's cost-effectiveness. Previous research has established the efficacy of MI among a broad range of populations and outcomes. However, there is a lack of a review of the knowledge about if MI works with justice-involved individuals who have substance use issues. Read More

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The Utility and Cost of Atypical Cultures in Revision Shoulder Arthroplasty.

J Shoulder Elbow Surg 2021 Mar 9. Epub 2021 Mar 9.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:

Background: At the time of revision shoulder arthroplasty, it is common practice to take cultures to evaluate for prosthetic joint infection even when an alternative cause of failure has been identified. Although isolation of fungal or acid-fast organisms is rare, it remains common practice to send all specimens for aerobic, anaerobic, and atypical (fungal and acid-fast) cultures. We hypothesize that the rate of positive atypical cultures at the time of revision shoulder arthroplasty is very low and routine use imposes a considerable financial burden on the healthcare system. Read More

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Pros and Cons of Performing Early Endoscopy in Geriatric Patients Admitted with Non-variceal Upper Gastrointestinal Bleeding: Analysis of the US National Inpatient Database.

Dig Dis Sci 2021 Mar 12. Epub 2021 Mar 12.

Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, 110 Francis St 8e Gastroenterology, Boston, MA, 02215, USA.

Background: Age greater than 65 years is a well-defined risk factor for increased mortality in patients with non-variceal upper gastrointestinal bleeding (NVGIB). Endoscopy is indicated in most patients at any age but presents unique risks in the elderly cohort, and ideal timing is unclear. This study examined the association between outcomes and early (within 24 h) esophagogastroduodenoscopy (EGD) among elderly patients with NVGIB. Read More

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Risk of In-Hospital Falls among Medications Commonly Used for Insomnia in Hospitalized Patients.

Sleep 2021 Mar 12. Epub 2021 Mar 12.

Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.

Study Objectives: To investigate the risk of in-hospital falls among patients receiving medications commonly used for insomnia in the hospital setting.

Methods: Retrospective cohort study of all adult hospitalizations to a large academic medical center from 1/2007 to 7/2013. We excluded patients admitted for a primary psychiatric disorder. Read More

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Effect of Cleft Palate Repair Timing on Inpatient Complication Rate: Review of a National Database.

J Craniofac Surg 2021 Mar-Apr 01;32(2):466-468

Carilion Clinic Otolaryngology, Roanoke, VA.

Objectives: Timing of cleft palate repair is controversial. We aim to assess whether timing of cleft palate repair affects rates of inpatient complications, length of stay (LOS), and cost of stay.

Methods: The Healthcare Cost and Utilization Project Kids' Inpatient Database 2009 was queried for all admissions with a primary diagnosis of cleft palate during which cleft palate repair was performed as a primary procedure. Read More

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Monocytosis Is a Biomarker of Severity in Inflammatory Bowel Disease: Analysis of a 6-Year Prospective Natural History Registry.

Inflamm Bowel Dis 2021 Mar 9. Epub 2021 Mar 9.

Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background: Inflammatory bowel disease (IBD) is associated with alterations of the innate and adaptive immune systems. Monocytes respond to inflammation and infection, yet the relationship between monocytosis and IBD severity is not fully understood. We aimed to characterize the prevalence of monocytosis in IBD and the association between monocytosis and disease severity and IBD-related health care utilization. Read More

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Prediction of Prolonged Intensive Care Unit Length of Stay Following Cardiac Surgery.

Semin Thorac Cardiovasc Surg 2021 Mar 6. Epub 2021 Mar 6.

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia. Electronic address:

Intensive care unit (ICU) costs comprise a significant proportion of the total inpatient charges for cardiac surgery. No reliable method for predicting intensive care unit length of stay following cardiac surgery exists, making appropriate staffing and resource allocation challenging. We sought to develop a predictive model to anticipate prolonged ICU length of stay (LOS). Read More

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