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Outpatient paediatric hand surgery: strategy in healthcare implementation and cost-efficient manner.

Musculoskelet Surg 2021 Jul 22. Epub 2021 Jul 22.

Hand Surgery and Microsurgery Department, AOU Policlinico of Modena, L.Go del Pozzo, 71, 41124, Modena, Italy.

The increasingly cost of health care is a relevant problem as well as prolonged waiting time for admission also in emergencies. Effective cost containment measures and expenditure controls are needed to achieve and maintain clinical and organizational appropriateness. Outpatient management has proven to be the most useful method for lower-cost treatment in less severe pathologies, requiring surgery without hospitalization. Read More

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Physical activity, sedentary behavior, and incidence of obstructive sleep apnea in three prospective US cohorts.

Eur Respir J 2021 Jul 21. Epub 2021 Jul 21.

Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Reduced physical activity and increased sedentary behavior may independently contribute to development of obstructive sleep apnea (OSA) through increased adiposity, inflammation, insulin resistance and body fluid retention. However, epidemiologic evidence remains sparse, and is primarily limited to cross-sectional studies.We prospectively followed 50 332 women from the Nurses' Health Study (2002-2012), 68 265 women from the Nurses' Health Study II (1995-2013), and 19 320 men from the Health Professionals Follow-up Study (1996-2012). Read More

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Are hematopoietic cell transplant recipients with Gram-negative bacteremia spending more time outpatient while on intravenous antibiotics? Addressing trends over 10 years at a single center.

Immun Inflamm Dis 2021 Jul 21. Epub 2021 Jul 21.

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Introduction: The increasing proportion of outpatient allogeneic hematopoietic cell transplants (HCTs) coupled with increased access of once-daily broad-spectrum antibiotics and evidence that outpatient antibiotic treatment may be safer and less costly than inpatient treatment, suggest that allogeneic HCT recipients with Gram-negative rod bacteremia (GNRBs) are increasingly being treated in ambulatory care settings.

Methods: Using data from the first GNRB event that occurred within the first 100 days posttransplantation among allogeneic HCT recipients transplanted at a single center between 2007 and 2016, we estimated the temporal trends in GNRB incidence and treatment management of GNRBs and identified if patient or infection characteristics impacted observed trends.

Results: A total of 11% (238/2165) of the observed allogeneic HCT recipients experienced ≥1 GNRB with available resistance data and contributed antibiotic treatment time. Read More

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Resting state dynamic functional connectivity in children with Attention Deficit/Hyperactivity Disorder.

J Neural Eng 2021 Jul 21. Epub 2021 Jul 21.

faculty of Medicine, University of Picardy Jules Verne, 3 rue des Louvels, Amiens, Hauts-de-France, 80025, FRANCE.

Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity and impulsivity. In this study, we investigated group differences in dynamic functional connectivity between 113 children with inattentive (46 ADHDI) and combined (67 ADHDC) ADHD and 76 typically developing (TD) children using resting state fMRI data. For dynamic connectivity analysis, the data were first decomposed into 100 independent components, among which 88 were classified into eight well-known resting state networks. Read More

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Measuring Catastrophic Costs Due to Tuberculosis in Myanmar.

Trop Med Infect Dis 2021 Jul 14;6(3). Epub 2021 Jul 14.

TB Unit, WHO, Yangon 11201, Myanmar.

Background: This is the first survey to use the World Health Organization (WHO) methodology to document the magnitude and main drivers of tuberculosis (TB) patient costs in order to guide policies on cost mitigation and to produce a baseline measure for the percentage of TB-affected households experiencing catastrophic costs in Myanmar.

Methods: A nationally representative cross-sectional survey was administered to 1000 TB patients in health facilities from December 2015 to February 2016, focusing on costs of TB treatment (direct and indirect), household income, and coping strategies. A total cost was estimated for each household by extrapolating reported costs and comparing them to household income. Read More

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A general theory of polymer ejection tested in a quasi two-dimensional space.

Sci Rep 2021 Jul 19;11(1):14721. Epub 2021 Jul 19.

Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan, Republic of China.

A general ejection theory of polymer is developed in a two- and three-dimensional space. A polymer is confined initially in a cavity and ejects spontaneously to the outer space through a nanopore channel without the help of any external stimulus. A reflective wall boundary is set at the pore entrance to prevent the falling of the head monomer of chain into the cavity. Read More

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The impact of dengue illness on social distancing and caregiving behavior.

PLoS Negl Trop Dis 2021 Jul 19;15(7):e0009614. Epub 2021 Jul 19.

Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.

Background: Human mobility among residential locations can drive dengue virus (DENV) transmission dynamics. Recently, it was shown that individuals with symptomatic DENV infection exhibit significant changes in their mobility patterns, spending more time at home during illness. This change in mobility is predicted to increase the risk of acquiring infection for those living with or visiting the ill individual. Read More

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A Survey of Community Dermatologists Reveals the Unnecessary Impact of Trial-and-Error Behavior on the Psoriasis Biologic Treatment Paradigm.

Dermatol Ther (Heidelb) 2021 Jul 18. Epub 2021 Jul 18.

Baylor University Medical Center, Dallas, TX, USA.

Introduction: In the USA, psoriasis affects approximately 3% of the population and costs more than $110 billion annually. The development of targeted biologics has revolutionized psoriasis management, but at an increasing cost. According to Joint AAD/NPF guidelines, an important need exists to identify biomarkers that can predict the appropriate biologic agent for patients. Read More

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Trends of Negotiated Targeted Anticancer Medicines Use in China: An Interrupted Time Series Analysis.

Int J Health Policy Manag 2021 Jun 9. Epub 2021 Jun 9.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.

Background: In order to relieve the financial burden of the patients in China, the Ministry of Health (MoH) conducted the first national price negotiation and successfully negotiated three expensive medicines including 2 targeted anticancer medicines (TAMs), icotinib and gefitinib. However, little evidence was available to demonstrate the impact of the national negotiation on TAMs use. The purpose of the study is to evaluate the implementation of the national price negotiation policy in China on TAMs use. Read More

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Anther Culture of the Gametophytic Self-Incompatible Species Physalis ixocarpa Brot.

Methods Mol Biol 2021 ;2288:319-326

Departamento de Ingeniería Genética, Unidad Irapuato, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Guanajuato, Mexico.

Here we present an optimized protocol for in vitro embryo formation and plant regeneration through anther culture of the Mexican husk tomato (Physalis ixocarpa Brot.). This protocol relies on the application of an anther thermal shock at a specific developmental stage prior to the in vitro culture, ensures embryo formation from anthers without callus formation, and allows spending less time to regenerate doubled haploid complete plants. Read More

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January 2021

The Prevalence and Correlative Factors of Depression Among Chinese Teachers During the COVID-19 Outbreak.

Front Psychiatry 2021 29;12:644276. Epub 2021 Jun 29.

The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

Epidemiological data on outbreak-associated depression of Chinese teachers are not available. This study aimed to investigate the prevalence and correlates of depression among teachers during the coronavirus disease 2019 (COVID-19) outbreak in mainland China. A large cross-sectional online survey was conducted during the COVID-19 outbreak. Read More

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The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China.

BMJ Glob Health 2021 Jul;6(7)

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.

Introduction: New targeted therapies have changed cancer treatment in the past decades. However, high prices of targeted anticancer medications have increased economic burden for both patients and health insurance systems. In July 2017, China implemented combined medication price negotiation and mandatory reimbursement policies for 15 targeted anticancer medications. Read More

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Impact of COVID-19 on Radiology Faculty - An Exacerbation of Gender Differences in Unpaid Home Duties and Professional Productivity.

Acad Radiol 2021 May 25. Epub 2021 May 25.

NYU Grossman School of Medicine, 160 East 34th St, 3rd Floor, New York, New York 10016. Electronic address:

Rationale And Objectives: The COVID-19 pandemic stresses the tenuous balance between domestic obligations and academic output for women across professions. Our investigation aims to evaluate the impact of the pandemic on the home duties and workplace productivity of academic radiologists with respect to gender.

Materials And Methods: A 49-question survey was distributed to 926 members of Association of University Radiologists in October 2020. Read More

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Determinants of the number of days people in the general population spent at home during end-of-life: Results from a population-based cohort analysis.

PLoS One 2021 15;16(7):e0253483. Epub 2021 Jul 15.

Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.

Background: The number of days spent at home in the last six months of life has been proposed as a comprehensive indicator of high-value patient-centered care; however, information regarding the determinants of this outcome is scarce, particularly among the general population. We investigated the determinants of spending time at home within the six months preceding death.

Methods: Population-based, retrospective analysis of administrative databases of the Catalan government. Read More

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Oral Hygiene Instructions and Methods: A Comparative Survey of European General Dentists, Periodontists and Dental Hygienists.

Oral Health Prev Dent 2021 Jan;19(1):327-337

Purpose: To study the practices of general dentists, periodontists and dental hygienists who are members of the European Federation of Periodontology, regarding oral hygiene education, plaque control assessment, recommended dental and interdental hygiene tools, and antimicrobial agents.

Materials And Methods: A web-based survey was sent to 13,622 members of the European Federation of Periodontology (EFP) through its 29 national member societies. It targeted general dentists (GD), specialists in periodontology (DSP) and dental hygienists (DH). Read More

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January 2021

An Audit of Interim Analyses of Randomized Controlled Trials [RCTs] Published in Three High Impact Factor Medical Journals over a seven-year period [2012-2018].

Rev Recent Clin Trials 2021 Jul 13. Epub 2021 Jul 13.

Seth GS Medical College & KEM Hospital, Mumbai - 400012, India.

Background: An interim analysis is an integral component of clinical research and drug development in particular and helps reduce 'time to market' for intervention or stop further development of unsafe and ineffective interventions. In this audit, we evaluated the extent of the use of interim analyses in published RCTs in three leading journals and their impact on regulatory approval.

Methodology: RCTs published in JAMA, NEJM, and Lancet in the year 2012 to 2018 were extracted. Read More

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Long-Term Effects of the Comprehensive Primary Care Model on Health Care Spending and Utilization.

J Gen Intern Med 2021 Jul 8. Epub 2021 Jul 8.

Center for Medicare and Medicaid Innovation, Baltimore, MA, USA.

Background: The Centers for Medicare & Medicaid Services launched the 4-year Comprehensive Primary Care Initiative (CPC Classic) in 2012 and its 5-year successor, CPC Plus (CPC+), in 2017 to test whether improving primary care delivery in five areas-and providing practices with financial and technical support-reduced spending and improved quality. This is the first study to examine long-term effects of a primary care practice transformation model.

Objective: To test whether long-term primary care transformation-the 4-year CPC Classic and the first 2 years of its successor, CPC+-reduced hospitalizations, emergency department (ED) visits, and spending over 6 years. Read More

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Virtual Interviews During COVID-19 Pandemic: A Survey of Applicants to Fellowships in Female Pelvic Medicine and Reconstructive Surgery.

Female Pelvic Med Reconstr Surg 2021 Jan 11. Epub 2021 Jan 11.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Mount Sinai Hospital at Icahn School of Medicine, New York City, NY †Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC.

Objectives: The objective was to assess female pelvic medicine and reconstructive surgery (FPMRS) fellowship applicants' perspectives on the effectiveness of the virtual interview format for creating their rank lists.

Methods: This was an anonymous internet-based survey study of applicants to the FPMRS fellowships in the United States, conducted from July 21, 2020, to August 5, 2020. A 34-item questionnaire queried applicants on satisfaction with interviews, comfort with creating a rank list and time, and financial cost of interviews. Read More

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January 2021

COVID-19 mental health consequences on medical students worldwide.

J Community Hosp Intern Med Perspect 2021 10;11(3):296-298. Epub 2021 May 10.

Rea Mittal, 130A University Manor East Hershey PA 17033, Hershey, USA.

: The COVID-19 epidemic has impacted medical education for medical students worldwide. As medical students are already vulnerable to poor psychological well-being, the mental health of medical students may be significantly affected by the changes caused by COVID-19. : In this article, we discuss the curriculum and mental health ramifications of the COVID-19 epidemic on the international medical school population : In this review, we analyzed 13 studies evaluating the impact of COVID-19 on medical school curriculum, medical student mental health, and subsequent medical student coping strategies. Read More

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Alone Together: Computer-Mediated Communication in Leisure Time During and After the COVID-19 Pandemic.

Front Psychol 2021 21;12:666655. Epub 2021 Jun 21.

Department of Psychology, University of Cologne, Cologne, Germany.

In spring 2020, the COVID-19 outbreak was declared a global pandemic and several lockdowns were followed in Germany. To weaken the spread of the virus, SARS-CoV-2, people were required to reduce their face-to-face contact with others. Computer-mediated communication (CMC) offers opportunities to stay in touch with important people and still meets social needs. Read More

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Spend time outdoors for your brain - an in-depth longitudinal MRI study.

World J Biol Psychiatry 2021 Jul 7:1-7. Epub 2021 Jul 7.

Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, Hamburg, Germany.

Objectives: The effects of nature on physical and mental health are an emerging topic in empirical research with increasing influence on practical health recommendations. Here we set out to investigate the association between spending time outdoors and brain structural plasticity in conjunctions with self-reported affect.

Methods: We established the Day2day study, which includes an unprecedented in-depth assessment of variability of brain structure in a serial sequence of 40-50 structural magnetic resonance imaging (MRI) acquisitions of each of six young healthy participants for 6-8 months ( = 281 MRI scans in total). Read More

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Cost-effectiveness of Emollients in the Prevention of Relapse among French Patients with Atopic Dermatitis.

Acta Derm Venereol 2021 Jul 7. Epub 2021 Jul 7.

Health Economics, Réseau d'Evaluation en Economie de la Santé, FR-75006 Paris, France. E-mail:

Atopic dermatitis affects up to 20% of children and quite frequently persists in adulthood. Follow-up, treatment, and prevention of relapses have an impact on healthcare spending. The aim of this study was to assess the cost-effectiveness of different emollients prescribed for patients with atopic dermatitis in France. Read More

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"The greedy I that gives"-The paradox of egocentrism and altruism: Terror management and system justification perspectives on the interrelationship between mortality salience and charitable donations amid the COVID-19 pandemic.

J Consum Aff 2021 May 31. Epub 2021 May 31.

Department of Psychology Boston College Chestnut Hill Massachusetts USA.

Why do people give and help others in face of their own mortality salience? The existential struggle with the awareness of death impacts the gamut of human cognition, emotion, and behavior. This multi-method research (Σ = 1,219) explains the psychosocial impact of COVID-19-related mortality salience on altruism. Drawing from terror management theory, two studies tested death-thought accessibility, mortality salience, and anxiety buffer hypotheses. Read More

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Energy drink consumption among Australian adolescents associated with a cluster of unhealthy dietary behaviours and short sleep duration.

Nutr J 2021 Jul 5;20(1):64. Epub 2021 Jul 5.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.

Background: Non-alcoholic energy drinks ('energy drinks') are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption. Read More

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A Nationwide Survey of Bereaved Family Members' Perception of the Place Patients Spent Their Final Days: Is the Inpatient Hospice Like or Unlike a Home? Why?

Palliat Med Rep 2020 3;1(1):174-178. Epub 2020 Dec 3.

Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

During end-of-life care, the place in which the patients spend time influences their quality of life. To clarify what it means to spend last days at home and in inpatient hospice. This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality of end-of-life care in Japan. Read More

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December 2020

Out-of-Hospital Cervical Ripening With a Synthetic Hygroscopic Cervical Dilator May Reduce Hospital Costs and Cesarean Sections in the United States-A Cost-Consequence Analysis.

Front Public Health 2021;9:689115. Epub 2021 Jun 18.

Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

Out-of-hospital (outpatient) cervical ripening prior to induction of labor (IOL) is discussed for its potential to decrease the burden on hospital resources. We assessed the cost and clinical outcomes of adopting an outpatient strategy with a synthetic hygroscopic cervical dilator, which is indicated for use in preinduction cervical ripening. We developed a cost-consequence model from the hospital perspective with a time period from IOL to post-delivery discharge. Read More

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Impact of Covid-19 containment on community pharmaceutical spending in Andalusia - Spain.

Pharm Pract (Granada) 2021 Apr-Jun;19(2):2346. Epub 2021 Jun 18.

Health Economics and Rational Use of Medicines. Department of Pharmacology and Clinical Therapeutics. Biomedical Research Institute of Malaga (IBIMA). University of Malaga. Malaga (Spain).

Background: In the field of health, the year 2020 will be remembered for testing (stressing) all health institutions and their forms of management (centralised and decentralised). The everyday activity of primary and hospital care was significantly altered by the introduction of telephone consultations, which reduce the number of visits to health centres or hospitals and are still relevant today in the face of successive waves of the pandemic.

Objective: To analyse whether population confinement due to the COVID-19 pandemic had an impact on the dispensing of medications in community pharmacies and the associated spending during the period March-July 2020 in Andalusia (Spain). Read More

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The Economic Consequences of Increasing Sleep Among the Urban Poor.

Q J Econ 2021 Aug 8;136(3):1887-1941. Epub 2021 Apr 8.

Harvard University, United States.

The urban poor in developing countries face challenging living environments, which may interfere with good sleep. Using actigraphy to measure sleep objectively, we find that low-income adults in Chennai, India, sleep only 5.5 hours a night on average despite spending 8 hours in bed. Read More

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Detecting bad actors in value-based payment models.

Health Serv Outcomes Res Methodol 2021 Jun 28:1-20. Epub 2021 Jun 28.

RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709 USA.

The U.S. federal government is spending billions of dollars to test a multitude of new approaches to pay for healthcare. Read More

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Do certified cancer centers provide more cost-effective care? A health economic analysis of colon cancer care in Germany using administrative data.

Int J Cancer 2021 Jul 2. Epub 2021 Jul 2.

Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Hospital certification has become an important measure to improve cancer care quality, with the potential effect of prolonging patient survival and reducing medical spending. However, yet to be explored is the cost-effectiveness of cancer care provided in certified hospitals, considering significant additional costs incurred from certification requirements. We performed a cost-effectiveness analysis (CEA) using two colon cancer populations (N=1,909) treated in different levels of certified hospitals (CHs) versus non-certified hospitals (NCHs) from a healthcare system's perspective. Read More

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