bluuebunny/crossref_metadata_2025_split huggingface dataset:
ESRD QIP Payment Reductions Are Associated with Mortality, Utilization, and Cost
Authors: Young E. , Ding Z. , Kapke A. , Houseal D. , Pearson J. , Turenne M. 
Published: August 2020

Research ObjectiveCMS launched the ESRD Quality Incentive Program (QIP) in 2010. The ESRD QIP adjusts Medicare payments to dialysis facilities based on their performance on a set of quality measures. The measures are revised in most years. We assessed whether the magnitude of ESRD QIP payment reductions was associated with several important patient outcomes that are not an intrinsic part of the QIP measure set.Study DesignWe compared mortality, utilization of health care services, and Medicare payments per patient‐year during 2015‐2017 for dialysis facilities in each ESRD QIP payment reduction category (0%, 0.5%, 1.0%, 1.5%, and 2.0%) corresponding to their QIP performance for the same year. The data sources include Medicare claims and enrollment files. Results were expressed as unadjusted averages and as modeled measures of association that adjusted for important patient factors (age, sex, race, ethnicity, diabetes, duration of ESRD, and dual eligibility).Population StudiedThe patient cohort consisted of Medicare fee‐for‐service beneficiaries receiving chronic dialysis for ESRD on the first day of each year. Patients were attributed to the first facility that provided treatment during the year.Principal FindingsMost patients were treated in facilities that did not receive an ESRD QIP payment reduction (Table). There was a stepwise increase in mortality, hospitalization, hospital days, and Medicare payments per year in facilities with successively larger payment reductions. The increase in Medicare payments was largely for inpatient services. All findings were statistically significant in adjusted regression models (shown in the Table for mortality and total payment).ConclusionsMortality, utilization, and Medicare payments were substantially higher for patients treated in facilities whose contemporaneous performance on ESRD QIP measures resulted in a payment reduction. Moreover, these outcome measures increased stepwise with the magnitude of facility payment reductions. The findings are consistent with the hypothesis that the ESRD QIP measures and scoring system capture meaningful determinants of health care quality and value.Implications for Policy or PracticeThe findings support the validity of ESRD QIP. The findings offer an approach to ongoing monitoring and validation of QIP measures.Primary Funding SourceThe study was funded by the Centers for Medicare and Medicaid Services.
On Abolition Ecologies and Making “Freedom as a Place”
Authors: Heynen Nik , Ybarra Megan 
Published: August 2020

AbstractThis introduction calls for political ecology to systematically engage with the ways that white supremacy shapes human relationships with land through entangled processes of settler colonialism, empire and racial capitalism. To develop the analytic of abolition ecology, we begin with the articulation of W.E.B. Du Bois’ abolition democracy together with Ruth Wilson Gilmore’s spatially attuned analytic of abolition geography. Rather than define communities by the violence they suffer, abolition ecologies call for attention to radical place‐making and the land, air and water based environments within which places are made. To that end, we suggest that an abolition ecology demands attention to the ways that coalitional land‐based politics dismantle oppressive institutions and to the promise of abolition, which Gilmore describes as making “freedom as a place”.
Effects of learning physics using Augmented Reality on students’ self‐efficacy and conceptions of learning
Authors: Cai Su , Liu Changhao , Wang Tao , Liu Enrui , Liang Jyh‐Chong 
Published: August 2020

AbstractThe Augmented Reality (AR)‐based learning environment not only provides educators with novel ways to present learning materials but also give learners the opportunity to spontaneously interact with the material. Previous studies have shown that AR has many advantages in education; however, few focuses on the mechanisms behind promoting inquiry motivation, such as the effect of AR on learners’ self‐efficacy and conceptions of learning. This study developed an AR‐based wave‐particle duality learning application, “AROSE,” to explore the effect of AR technology on students’ self‐efficacy and conceptions of learning physics. A quasi‐experimental study method was used, and 98 high school students aged between 16 and 18 were randomly assigned to experimental and control group. After a 4‐week intervention, it was found that integrating AR technology into physics classrooms can (1) significantly enhance students’ physics learning self‐efficacy, as indicated by understanding of concepts, higher‐level cognitive skills, practice and communication; (2) guide students to be more inclined to higher‐level conceptions of learning physics rather than lower ones; and (3) stimulates students’ motivation to learn more deeply.
CE‐DIFF: An Approach to Identifying and Coping with Irregular Ratings in Collaborative Decision Making
Authors: Yu Li , Zhang Dongsong , Fu Zhe 
Published: August 2020

ABSTRACTA key to collaborative decision making is to aggregate individual evaluations into a group decision. One of its fundamental challenges lies in the difficulty in identifying and dealing with irregular or unfair ratings and reducing their impact on group decisions. Little research has attempted to identify irregular ratings in a collaborative assessment task, let alone develop effective approaches to reduce their negative impact on the final group judgment. In this article, based on the synergy theory, we propose a novel consensus‐based collaborative evaluation (CE) method called Collaborative Evaluation based on rating DIFFerence (CE‐DIFF) for identifying irregular ratings and mitigating their impact on collaborative decisions. CE‐DIFF determines and assigns different weights automatically to individual evaluators or ratings based on the level of consistency of one's ratings with the group assessment outcome through continuous iterations. We conducted two empirical experiments to evaluate the proposed method. The results show that CE‐DIFF has higher accuracy in dealing with irregular ratings than existing CE methods, such as arithmetic mean and trimmed mean. In addition, the effectiveness of CE‐DIFF is independent of group size. This study provides a new and more effective method for collaborative assessment, as well as novel theoretical insights and practical implications on how to improve collaborative assessment.
Compliance of atrial fibrillation treatment with the ABC pathway in patients with concomitant diabetes mellitus in the Middle East based on the Gulf SAFE registry
Authors: Domek Magdalena , Gumprecht Jakub , Li Yan‐Guang , Proietti Marco , Rashed Wafa , Al Qudaimi Ahmed , Gumprecht Janusz , Zubaid Mohammad , Lip Gregory Y. H. 
Published: August 2020

AbstractIntroductionAtrial fibrillation (AF) and diabetes mellitus (DM) constitute a heavy burden on healthcare expenditure due to their negative impact on clinical outcomes in the Middle East. The Atrial fibrillation Better Care (ABC) pathway provides a simple strategy of integrated approach of AF management: A—Avoid stroke; B—Better symptom control; C—Cardiovascular comorbidity risk management.AimsEvaluation of the AF treatment compliance to ABC pathway in DM patients in the Middle East. Assessment of the impact of ABC pathway adherence on all‐cause mortality and the composite outcome of stroke/systemic embolism, all‐cause death and cardiovascular hospitalisations.MethodsFrom 2043 patients in the Gulf SAFE registry, 603 patients (mean age 63; 48% male) with DM were included in an analysis of ABC pathway compliance: A—appropriate use of anticoagulation according to CHA2DS2‐VASc score; B—AF symptoms management according to the European Heart Rhythm Association (EHRA) scale; C—Optimised cardiovascular comorbidities management.Results86 (14.3%) patients were treated in compliance with the ABC pathway. During 1‐year follow‐up, 207 composite outcome events and 87 deaths occurred. Mortality was significantly lower in the ABC group vs non‐ABC (5.8% vs 15.9%, P = .0014, respectively). On multivariate analysis, ABC compliance was associated with a lower risk of all‐cause death and the composite outcome after 6 months (OR 0.18; 95% CI: 0.42‐0.75 and OR 0.54; 95% Cl: 0.30‐1.00, respectively) and at 1 year (OR 0.30; 95% Cl: 0.11‐0.76 and OR 0.57; 95% Cl: 0.33‐0.97, respectively) vs the non‐ABC group.ConclusionsCompliance with the ABC pathway care was independently associated with the reduced risk of all‐cause death and the composite outcome in DM patients with AF, highlighting the importance of an integrated approach to AF management.
The trend is an analyst's friend: Analyst recommendations and market technicals
Authors: Flugum Ryan 
Published: August 2020

AbstractIn this paper, I assess the empirical relation between analyst recommendation decisions and market technicals. Research shows market technicals have predictive content that leads to abnormal returns. Recent survey evidence, however, shows analysts' rank technical signals as having relatively little usefulness in forming their recommendations, leading them to underweight the information content of technical signals. I find lagged positive stock price trends are associated with a greater likelihood of consensus recommendation upgrade. Furthermore, I show market technicals enhance the investment value of consensus recommendations. Overall, I demonstrate that market technicals are an important complement to analyst recommendations.
Private Equity and the COVID‐19 Economic Downturn: Opportunity for Expansion?
Authors: Haarmeyer David 
Published: August 2020

The coronavirus‐related global economic downturn poses a significant risk to PE portfolio companies, but also represents a significant opportunity to purchase quality companies at a discount. Because the industry is today much larger, as well as more diversified and experienced, than at the time of the 2008 downturn, it is better positioned not only to weather the severe economic storm, but emerge with an even larger and stronger asset base.Compared with PE at the time of the global financial crisis, today's $3.9 trillion private equity industry has considerably more dry powder, with more heavily capitalized strategies, including private credit and “secondaries,” more permanent capital, and stronger operational capabilities. In contrast with the pre‐crisis hyper‐competitive market environment in which purchase multiples were at record highs and returns faced significant downward pressure, the fear and uncertainty that characterize current market conditions have put PE in a position to grow its asset base at bargain prices. The advantages of scale, diversification, adaptability, and access to longer‐term capital are all expected to help today's larger alternative asset groups, which have in recent years achieved greater diversification in terms of strategy as well as geography and investors.
Characteristics of Long‐Term Care Residents That Predict Adverse Events after Hospitalization
Authors: Kapoor Alok , Field Terry , Handler Steven , Fisher Kimberly , Saphirak Cassandra , Crawford Sybil , Fouayzi Hassan , Johnson Florence , Spenard Ann , Zhang Ning , Gurwitz Jerry H. 
Published: August 2020

BACKGROUND/OBJECTIVESAdverse events (AEs) occur frequently in long‐term care (LTC) residents transitioning from the hospital back to an LTC facility. Measuring the association between resident characteristics and AEs can inform AE risk reduction strategies.DESIGNProspective cohort analysis.SETTINGA total of 32 nursing homes from six New England states.PARTICIPANTSA total of 555 LTC residents contributing 762 transitions from the hospital back to LTC.MEASUREMENTSWe measured the association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC and demographic variables, hospital length of stay (LOS), Charlson Comorbidity Index (CCI) (0–1, 2–3, 4–5 and ≥6), dependency in activities of daily living (ADLs) using the Minimum Data Set Long Form Scale (in quintiles 0–12, 13–15, 16, 17–18, and ≥19), and number of regularly scheduled medications (0–9, 10–13, 14–17, and ≥18). To understand the independent association of each resident characteristic with AEs and preventable AEs, we constructed multiple Cox proportional hazards models.RESULTSThere were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of an AE included hospital LOS 9 or more days (hazard ratio [HR] = 1.49; 95% confidence interval [CI] = 1.02–2.17); CCI of 4 to 5 (HR = 1.74; 95% CI = 1.13–2.67) or 6 or higher (HR = 1.58; 95% CI = 1.01–2.46); 18 or more regularly scheduled medications (HR = 1.53; 95% CI = 1.07–2.18); and 19 and above on ADL dependency (HR = 1.78; 95% CI = 1.21–2.62). Results from models with preventable AEs were similar to those with all AEs.CONCLUSIONIncreased LOS, higher comorbidity burden, greater dependency in ADLs, and polypharmacy were the resident characteristics most strongly associated with risk of AEs and preventable AEs. We recommend heightened vigilance in the care of LTC residents with these characteristics transitioning back to LTC. We also recommend research to assess strategies to reduce the risk of AEs.
Feasibility, acceptability and cost efficiency of using webinars to deliver first‐line patient education for people with Irritable Bowel Syndrome as part of a dietetic‐led gastroenterology service in primary care
Authors: Williams M. , Barclay Y. , Harper L. , Marchant C. , Seamark L. , Hickson M. 
Published: August 2020

AbstractBackgroundIrritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. International research suggests dietary intervention as a first‐line approach, although dietetic services are struggling to cope with demand. Digital technology may offer a solution to deliver appropriate patient education. The present study aimed to assess the feasibility, acceptability and cost efficiency of using webinars to deliver first‐line IBS advice to patients as part of a dietetic‐led gastroenterology service in primary care.MethodsPatients were directed to an IBS First Line Advice webinar on a specialist NHS website. Data were collected from patients pre‐ and post‐webinar use using an online survey.ResultsIn total, 1171 attendees completed the pre‐webinar survey and 443 completed the post‐webinar survey. Attendees ranged from under 17 years to over 75 years. Of the attendees, 95% found the webinar easy to access and 91% were satisfied with the content of the webinar. Those with excellent or good knowledge rose from 25% pre‐webinar to 67% post‐webinar, and confidence in managing their condition improved for 74% of attendees. Using the webinars led to a 44% reduction in referrals for one‐to‐one appointments with a specialist dietitian in the first year of use. The value of the clinical time saved is estimated at £3593 per annum. The one‐off cost of creating the webinar was £3597.ConclusionsThe use of webinars is a feasible, acceptable and cost‐efficient way of delivering first‐line patient education to people suffering with Irritable Bowel Syndrome as part of a dietetic‐led gastroenterology service in primary care.
Trust in the nurse: Findings from a survey of hospitalised children
Authors: Sheehan Rosemarie , Fealy Gerard 
Published: August 2020

AbstractAims and objectivesTo measure hospitalised children's trust in the nurse.BackgroundTrust is central to the therapeutic relationship between the nurse and the patient. There can be no trusting relationship between the nurse and child if the parents have no trust or block the relationship (Bricher [Journal of Clinical Nursing, 8: 452, 1999]).DesignThis study was a cross‐sectional, correlational descriptive design using a self‐complete questionnaire to measure children's trust in nurses, to examine the relationship between children's trust and their parents, and the correlations between trust and medication adherence, fear and interactions with the nurse.MethodsA modified version of the Children's Trust in General Nurses Scale designed by Rotenberg et al. (Journal for Specialists in Pediatric Nursing, 20: 298, 2015) was used. This Scale is a short self‐report questionnaire designed to elicit information on children's beliefs in, and attitudes to, trust in nurses. The Strengthening the Reporting of Observational Studies in Epidemiology statement for observational studies was applied (von Elm [British Medical Journal, 335: 806, 2007]).ResultsThe results indicated high levels of trust beliefs in the nurse. The children's and parents’ trust beliefs were found to be correlated. Gender did not influence trust beliefs. Younger children had higher levels of trust than older children, particularly in relation to the perceived honesty of the nurse. Trust beliefs in the nurse lessened with previous exposure to the hospital setting. One‐fifth of children reported fear of the nurse. Positive interaction with the nurse was shown to be positively related to adherence to care.Relevance to clinical practiceChildren's level of trust in the nurse can be measured. A trusting child is likely to be less fearful and experience clinical procedures as less threatening and is more likely to adhere to treatment. Children's nurses should recognise that trust can change with age and with multiple hospital admissions.
On collective self‐healing and traces: How can swarm intelligence help us think differently about team adaptation?
Authors: Cristancho Sayra M. 
Published: August 2020

AbstractBackgroundHealth care teams are increasingly forced to navigate complex challenges to achieve their collective aim of delivering high‐quality, safe patient care. The teamwork literature has struggled to develop strategies that promote effective adaptive behaviours among health care teams. In part, this challenge stems from the fact that truly collective adaptive behaviour requires members of the teams to abandon the human urge to act self‐sufficiently. Nature contains striking examples of collective behaviour as seen in social insects, fish and bird colonies. This collective behaviour is known as Swarm Intelligence (SI). SI remains poorly described in the health care team literature and its potential benefits hidden.ObjectiveIn this cross‐cutting edge paper, I explore the principles of SI as they pertain to systemic or collective adaptation in human teams. In particular, I consider the principles of trace‐based communication and collective self‐healing and what they might offer to team adaptation researchers in medical education.ResultsFrom a SI perspective, a solution to a problem emerges as a result of the collective action of the members of the swarm, not the individual action. This collective action is achieved via four principles: direct and indirect communication, awareness, self‐determination and collective self‐healing. Among those principles, trace‐based communication and collective self‐healing have been purposefully used by other industries to foster team adaptation. Trace‐based communication relies on leaving ‘traces’ in the environment to drive the behaviour of others. Collective self‐healing is the ability of the swarm to cope with failure and adapt to changes by permitting swarm members to be interchangeable.ConclusionsWhile allowing teams to rely on indirect communication and to be interchangeable might create discomfort to our ways of thinking, teams outside health care are demonstrating their value to advance human teamwork. SI offers a helpful analogy and a constructive language for thinking about team adaptation.
Functional characterization of PETIOLULE‐LIKE PULVINUS (PLP) gene in abscission zone development in Medicago truncatula and its application to genetic improvement of alfalfa
Authors: Du Juan , Lu Shaoyun , Chai Maofeng , Zhou Chuanen , Sun Liang , Tang Yuhong , Nakashima Jin , Kolape Jaydeep , Wen Zhaozhu , Behzadirad Marjan , Zhong Tianxiu , Sun Juan , Zhang Yunwei , Wang Zeng‐Yu 
Published: August 2020

SummaryAlfalfa (Medicago sativa L.) is one of the most important forage crops throughout the world. Maximizing leaf retention during the haymaking process is critical for achieving superior hay quality and maintaining biomass yield. Leaf abscission process affects leaf retention. Previous studies have largely focused on the molecular mechanisms of floral organ, pedicel and seed abscission but scarcely touched on leaf and petiole abscission. This study focuses on leaf and petiole abscission in the model legume Medicago truncatula and its closely related commercial species alfalfa. By analysing the petiolule‐like pulvinus (plp) mutant in M. truncatula at phenotypic level (breakstrength and shaking assays), microscopic level (scanning electron microscopy and cross‐sectional analyses) and molecular level (expression level and expression pattern analyses), we discovered that the loss of function of PLP leads to an absence of abscission zone (AZ) formation and PLP plays an important role in leaflet and petiole AZ differentiation. Microarray analysis indicated that PLP affects abscission process through modulating genes involved in hormonal homeostasis, cell wall remodelling and degradation. Detailed analyses led us to propose a functional model of PLP in regulating leaflet and petiole abscission. Furthermore, we cloned the PLP gene (MsPLP) from alfalfa and produced RNAi transgenic alfalfa plants to down‐regulate the endogenous MsPLP. Down‐regulation of MsPLP results in altered pulvinus structure with increased leaflet breakstrength, thus offering a new approach to decrease leaf loss during alfalfa haymaking process.
Fungicide resistance in Cercospora species causing cercospora leaf blight and purple seed stain of soybean in Argentina
Authors: Sautua Francisco J. , Doyle Vinson P. , Price Paul P. , Porfiri Alejandro , Fernandez Paula , Scandiani Maria M. , Carmona Marcelo A. 
Published: August 2020

AbstractCercospora species cause cercospora leaf blight (CLB) and purple seed stain (PSS) on soybean. Because there are few resistant soybean varieties available, CLB/PSS management relies heavily upon fungicide applications. Sensitivity of 62 Argentinian Cercospora isolates to demethylation inhibitor (DMI), methyl benzimidazole carbamate (MBC), quinone outside inhibitor (QoI), succinate dehydrogenase inhibitor (SDHI) fungicides, and mancozeb was determined in this study. All isolates were sensitive to difenoconazole, epoxiconazole, prothioconazole, tebuconazole, and cyproconazole (EC50 values ranged from 0.006 to 2.4 µg/ml). In contrast, 51% of the tested isolates were sensitive (EC50 values ranged from 0.003 to 0.2 µg/ml), and 49% were highly resistant (EC50 > 100 µg/ml) to carbendazim. Interestingly, all isolates were completely resistant to azoxystrobin, trifloxystrobin, and pyraclostrobin, and insensitive to boscalid, fluxapyroxad, and pydiflumetofen (EC50 > 100 µg/ml). The G143A mutation was detected in 82% (53) of the QoI‐resistant isolates and the E198A mutation in 97% (31) of the carbendazim‐resistant isolates. No apparent resistance mutations were detected in the succinate dehydrogenase genes (subunits sdhB, sdhC, and sdhD). Mancozeb completely inhibited mycelial growth of the isolates evaluated at a concentration of 100 µg/ml. All Argentinian Cercospora isolates were sensitive to the DMI fungicides tested, but we report for the first time resistance to QoI and MBC fungicides. Mechanism(s) other than fungicide target‐site modification may be responsible for resistance of Cercospora to QoI and MBC fungicides. Moreover, based on our results and on the recent introduction of SDHI fungicides on soybean in Argentina, Cercospora species causing CLB/PSS are insensitive (naturally resistant) to SDHI fungicides. Insensitivity must be confirmed under field conditions.