bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Physician Groups and Hospitals Participating in Bundled Payments Among Medicare Beneficiaries
Authors: Liao Joshua M. , Huang Qian , Wang Erkuan , Linn Kristin , Shirk Torrey , Zhu Jingsan , Cousins Deborah , Navathe Amol S. 
Published: December 2022

ImportanceHospital participation in bundled payment initiatives has been associated with financial savings and stable quality of care. However, how physician group practices (PGPs) perform in bundled payments compared with hospitals remains unknown.ObjectivesTo evaluate the association of PGP participation in the Bundled Payments for Care Improvement (BPCI) initiative with episode outcomes and to compare these with outcomes for participating hospitals.Design, Settings, and ParticipantsThis cohort study with a difference-in-differences analysis used 2011 to 2018 Medicare claims data to compare the association of BPCI participation with episode outcomes for PGPs vs hospitals providing medical and surgical care to Medicare beneficiaries. Data analyses were conducted from January 1, 2020, to May 31, 2022.ExposuresHospitalization for any of the 10 highest-volume episodes (5 medical and 5 surgical) included in the BPCI initiative for Medicare patients of participating PGPs and hospitals.Main Outcomes and MeasuresThe primary outcome was 90-day total episode spending. Secondary outcomes were 90-day readmissions and mortality.ResultsThe total sample comprised data from 1 288 781 Medicare beneficiaries, of whom 696 710 (mean [SD] age, 76.2 [10.8] years; 432 429 [59.7%] women; 619 655 [85.5%] White individuals) received care through 379 BPCI-participating hospitals and 1441 propensity-matched non−BPCI-participating hospitals, and 592 071 (mean [SD] age, 75.4 [10.9] years; 527 574 [86.6%] women; 360 835 [59.3%] White individuals) received care from 6405 physicians in BPCI-participating PGPs and 24 758 propensity-matched physicians in non−BPCI-participating PGPs. For PGPs, BPCI participation was associated with greater reductions in episode spending for surgical (difference, –$1368; 95% CI, –$1648 to –$1088) but not for medical episodes (difference, –$101; 95% CI, –$410 to $206). Hospital participation in BPCI was associated with greater reductions in episode spending for both surgical (–$1010; 95% CI, –$1345 to –$675) and medical (–$763; 95% CI, –$1139 to –$386) episodes.Conclusions and RelevanceThis cohort study and difference-in-differences analysis of PGPs and hospital participation in BPCI found that bundled payments were associated with cost savings for surgical episodes for PGPs, and savings for both surgical and medical episodes for hospitals. Policy makers should consider the comparative performance of participant types when designing and evaluating bundled payment models.
Association of Developmental Language Disorder With Comorbid Developmental Conditions Using Algorithmic Phenotyping
Authors: Nitin Rachana , Shaw Douglas M. , Rocha Daniel B. , Walters Courtney E. , Chabris Christopher F. , Camarata Stephen M. , Gordon Reyna L. , Below Jennifer E. 
Published: December 2022

ImportanceDevelopmental language disorder (DLD) is a common (with up to 7% prevalence) yet underdiagnosed childhood disorder whose underlying biological profile and comorbidities are not fully understood, especially at the population level.ObjectiveTo identify clinically relevant conditions that co-occur with DLD at the population level.Design, Setting, and ParticipantsThis case-control study used an electronic health record (EHR)–based population-level approach to compare the prevalence of comorbid health phenotypes between DLD cases and matched controls. These cases were identified using the Automated Phenotyping Tool for Identifying Developmental Language Disorder algorithm of the Vanderbilt University Medical Center EHR, and a phenome enrichment analysis was used to identify comorbidities. An independent sample was selected from the Geisinger Health System EHR to test the replication of the phenome enrichment using the same phenotyping and analysis pipeline. Data from the Vanderbilt EHR were accessed between March 2019 and October 2020, while data from the Geisinger EHR were accessed between January and March 2022.Main Outcomes and MeasuresCommon and rare comorbidities of DLD at the population level were identified using EHRs and a phecode-based enrichment analysis.ResultsComorbidity analysis was conducted for 5273 DLD cases (mean [SD] age, 16.8 [7.2] years; 3748 males [71.1%]) and 26 353 matched controls (mean [SD] age, 14.6 [5.5] years; 18 729 males [71.1%]). Relevant phenotypes associated with DLD were found, including learning disorder, delayed milestones, disorders of the acoustic nerve, conduct disorders, attention-deficit/hyperactivity disorder, lack of coordination, and other motor deficits. Several other health phenotypes not previously associated with DLD were identified, such as dermatitis, conjunctivitis, and weight and nutrition, representing a new window into the clinical complexity of DLD.Conclusions and RelevanceThis study found both rare and common comorbidities of DLD. Comorbidity profiles may be leveraged to identify risk of additional health challenges, beyond language impairment, among children with DLD.
Acupuncture for the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome
Authors: Qi Ling-Yu , Yang Jing-Wen , Yan Shi-Yan , Tu Jian-Feng , She Yan-Fen , Li Ying , Chi Li-Li , Wu Bang-Qi , Liu Cun-Zhi 
Published: December 2022

ImportanceAcupuncture is a promising therapy for irritable bowel syndrome (IBS), but the use of subjective scales as an assessment is accompanied by high placebo response rates.ObjectivesTo preliminarily test the feasibility of using US Food and Drug Administration (FDA)–recommended end points to evaluate the efficacy of acupuncture in the treatment of IBS.Design, Setting, and ParticipantsThis pilot, multicenter randomized clinical trial was conducted in 4 tertiary hospitals in China from July 1, 2020, to March 31, 2021, and 14-week data collection was completed in March 2021. Individuals with a diagnosis of IBS with diarrhea (IBS-D) were randomized to 1 of 3 groups, including 2 acupuncture groups (specific acupoints [SA] and nonspecific acupoints [NSA]) and a sham acupuncture group (non-acupoints [NA]) with a 1:1:1 ratio.InterventionsPatients in all groups received twelve 30-minute sessions over 4 consecutive weeks at 3 sessions per week (ideally every other day).Main Outcomes and MeasuresThe primary outcome was the response rate at week 4, which was defined as the proportion of patients whose worst abdominal pain score (score range, 0-10, with 0 indicating no pain and 10 indicating unbearable severe pain) decreased by at least 30% and the number of type 6 or 7 stool days decreased by 50% or greater.ResultsNinety patients (54 male [60.0%]; mean [SD] age, 34.5 [11.3] years) were enrolled, with 30 patients in each group. There were substantial improvements in the primary outcomes for all groups (composite response rates of 46.7% [95% CI, 28.8%-65.4%] in the SA group, 46.7% [95% CI, 28.8%-65.4%] in the NSA group, and 26.7% [95% CI, 13.0%-46.2%] in the NA group), although the difference between them was not statistically significant (P = .18). The response rates of adequate relief at week 4 were 64.3% (95% CI, 44.1%-80.7%) in the SA group, 62.1% (95% CI, 42.4%-78.7%) in the NSA group, and 55.2% (95% CI, 36.0%-73.0%) in the NA group (P = .76). Adverse events were reported in 2 patients (6.7%) in the SA group and 3 patients (10%) in NSA or NA group.Conclusions and RelevanceIn this pilot randomized clinical trial, acupuncture in both the SA and NSA groups showed clinically meaningful improvement in IBS-D symptoms, although there were no significant differences among the 3 groups. These findings suggest that acupuncture is feasible and safe; a larger, sufficiently powered trial is needed to accurately assess efficacy.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2000030670
Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania
Authors: Ramos de Oliveira Clariana Vitória , Sudfeld Christopher Robert , Muhihi Alfa , McCoy Dana Charles , Fawzi Wafaie W. , Masanja Honorati , Yousafzai Aisha K. 
Published: December 2022

ImportanceApproximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children’s socioemotional development; however, there is limited evidence on these outcomes.ObjectiveTo examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development.Design, Setting, and ParticipantsThis study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020.ExposuresLifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey.Main Outcomes and MeasuresChild socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments.ResultsA total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, −0.022; 95% CI, −0.045 to −0.006) and physical and sexual IPV (mean difference, −0.045; 95% CI, −0.077 to −0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, −0.073; 95% CI, −0.103 to −0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors.Conclusions and RelevanceThe findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.
Use of Single-Arm Trials for US Food and Drug Administration Drug Approval in Oncology, 2002-2021
Authors: Agrawal Sundeep , Arora Shaily , Amiri-Kordestani Laleh , de Claro R. Angelo , Fashoyin-Aje Lola , Gormley Nicole , Kim Tamy , Lemery Steven , Mehta Gautam U. , Scott Emma C. , Singh Harpreet , Tang Shenghui , Theoret Marc R. , Pazdur Richard , Kluetz Paul G. , Beaver Julia A. 
Published: December 2022

ImportanceSingle-arm trials have allowed for transformative therapies to be made available to patients expeditiously. However, using single-arm trials to support drug approval presents several challenges that must be carefully considered.ObservationsBetween January 1, 2002, and December 31, 2021, the US Food and Drug Administration granted 176 new malignant hematology and oncology indications based on single-arm trials, including 116 accelerated approvals (AAs) and 60 traditional approvals. Overall, 87 approvals (49%) were for new molecular entities or original biologics and 89 (51%) were supplemental indications. Response rate (RR) was the most common end point used to support approval in these single-arm trials (173 of 176 [98%]). Of the 116 AAs based on single-arm trials, 45 (38%) fulfilled their postmarketing requirement to verify clinical benefit, 61 (52%) are pending verification of benefit, and 10 (9%) were withdrawn from the market as of December 31, 2021. Most (56 of 61 [92%]) AAs based on single-arm trials pending verification of benefit occurred during the previous 5 years and have ongoing confirmatory trials as of December 2021.Conclusions and RelevanceSingle-arm trials have been a common development strategy to support regulatory approval as early-stage expansion cohorts with promising durable RRs have become more prevalent. In the appropriate context, single-arm trials using durable RRs can allow patients expedited access to novel therapies and will continue to serve a role in advancing drug development in oncology. However, single-arm trials have a smaller noncomparative safety data set, inability to use time-to-event end points, and other limitations that require careful consideration within the context of the disease and available therapies. The randomized clinical trial remains the preferred approach in clinical investigation.
Target‐Catalyzed Self‐Assembly of DNA‐Streptavidin Nanogel for Enzyme‐Free miRNA Assay
Authors: Park Jae Chul , Na Hyebin , Choi Saehan , Jeon Huiju , Nam Yoon Sung 
Published: December 2022

AbstractRapid, sensitive, specific, and user‐friendly microRNA (miRNA) assays are in high demand for point‐of‐care diagnosis. Target‐catalyzed toehold‐mediated strand displacement (TMSD) has received increasing attention as an enzyme‐free molecular tool for DNA detection. However, the application of TMSD to miRNA targets is challenging because relatively weak DNA/RNA hybridization leads to failure in the subtle kinetic control of multiple hybridization steps. Here, a simple method is presented for miRNA assay based on the one‐pot self‐assembly of Y‐shaped DNAs with streptavidin via an miRNA‐catalyzed TMSD cascade reaction. A single miRNA catalyzes the opening cycle of DNA hairpin loops to generate multiple Y‐shaped DNAs carrying biotin and a quencher at the end of their arms. Introducing a single base‐pair mismatch near the toehold facilitates RNA‐triggered strand displacement while barely disturbing nonspecific reactions. The Y‐shaped DNAs are self‐assembled with fluorescently labeled streptavidin (sAv), which produces nanoscale DNA‐sAv nanogel particles mediating efficient Förster resonance energy transfer in their 3D network. The enhancing effect dramatically reduces the detection limit from the nanomolar level to the picomolar level. This work proves that TMSD‐based DNA nanogel with a base‐pair mismatch incorporated to a hairpin structure is a promising approach towards sensitive and accurate miRNA assay.
Microenvironment‐Adaptive Nanozyme for Accelerating Drug‐Resistant Bacteria‐Infected Wound Healing
Authors: Yu Lei , Sun Yiping , Niu Yusheng , Zhang Pengfei , Hu Jun , Chen Zhong , Zhang Gong , Xu Yuanhong 
Published: December 2022

AbstractReactive oxygen species (ROS) are favorable for antibacterial infection but their overproduction results in serious inflammatory response and aggravates the hypoxic state of the wound tissue, which is detrimental to healing stages of proliferation and remodeling. Here, an atomic‐dispersion Fe‐doped oxygen‐deficient molybdenum oxide MoO3−X (ADFM) bifunctional nanozyme, featuring implanted peroxidase‐like and enhanced catalase‐like activity, is developed for decomposing H2O2 into strongly oxidizing hydroxyl radicals (•OH) for prevention of bacterial infection and into plentiful O2 for healing stages. Therein, the introduction of Fe into MoO3−X primarily produces an asymmetric electron density difference by elongating the bond length between metal atoms, synchronously stabilizing adsorption of •OH and weakening the adsorption of O2. ADFM also shows unimaginably high aqueous dispersity and pH‐adaptive ROS regulation in the wound microenvironment, both of which are favorable for ADFM to fully exert enzyme‐like activity for timely antibacterial and efficient wound‐healing action. ADFM thus achieves efficient healing of drug‐resistant bacteria‐infected wounds in vivo, at an ultralow dosage of 30 µg mL−1 against 106 CFU mL−1 extended spectrum β‐lactamases‐producing Escherichia coli, exhibiting a wound‐healing efficiency of ≈10 mm2 per day, which sets a benchmark among these noble‐metal‐free nanozyme‐based wound‐healing agents.
Laser‐Induced Hole Coherence and Spatial Self‐Phase Modulation in the Anisotropic 3D Weyl Semimetal TaAs
Authors: Huang Yixuan , Zhao Hui , Li Zhilin , Hu Lili , Wu Yanling , Sun Fei , Meng Sheng , Zhao Jimin 
Published: December 2022

AbstractLaser‐induced electron coherence is a fascinating topic in manipulating quantum materials. Recently, it has been shown that laser‐induced electron coherence in 2D materials can produce a third‐order nonlinear optical response spatial self‐phase modulation (SSPM), which has been used to develop a novel all‐optical switching scheme. However, such investigations have mainly focused on electron coherence, whereas laser‐induced hole coherence is rarely explored. Here, the observation of the optical Kerr effect in 3D Weyl semimetal TaAs flakes is reported. The nonlinear susceptibility (χ(3)) is obtained, which exhibits a surprisingly high value (with = 9.9 × 10−9 e.s.u. or 1.4 × 10−16 m2 V−2 at 532 nm). This cannot be explained by the conventional electron mobility, but can be well understood by the unique high anisotropic hole mobility of TaAs. The wind‐chime model and χ(3) carrier mobility correlation adequately explain the results, suggesting the crucial role of laser‐induced nonlocal ac hole coherence. These observations extend the understanding of SSPM from 2D to 3D quantum materials with anisotropic carrier mobility and from electron coherence to hole coherence.
Regulating Surface Oxygen Activity by Perovskite‐Coating‐Stabilized Ultrahigh‐Nickel Layered Oxide Cathodes
Authors: Wang Lifan , Liu Guicheng , Wang Rui , Wang Xindong , Wang Liguang , Yao Zhenpeng , Zhan Chun , Lu Jun 
Published: December 2022

AbstractUltrahigh‐Ni layered oxides are proposed as promising cathodes to fulfill the range demand of electric vehicles; yet, they are still haunted by compromised cyclability and thermal robustness. State‐of‐the‐art surface coating has been applied to solve the instability via blocking the physical contact between the electrolyte and the highly active Ni4+ ions on the cathode surface, but it falls short in handling the chemo–physical mobility of the oxidized lattice oxygen ions in the cathode. Herein, a direct regulation strategy is proposed to accommodate the highly active anionic redox within the solid phase. By leveraging the stable oxygen vacancies/interstitials in a lithium and oxygen dual‐ion conductor (layered perovskite La4NiLiO8) coating layer, the reactivity of the surface lattice oxygen ion is dramatically restrained. As a result, the oxygen release from the lattice is suppressed, as well as the undesired irreversible phase transition and intergranular mechanical cracking. Meanwhile, the introduced dual‐ion conductor can also facilitate lithium‐ion diffusion kinetics and electronic conductivity on the particle surface. This work demonstrates that accommodating the anionic redox chemistry by dual‐ion conductors is an effective strategy for capacity versus stability juggling of the high‐energy cathodes.
Humidity‐Insensitive, Large‐Area‐Applicable, Hot‐Air‐Assisted Ambient Fabrication of 2D Perovskite Solar Cells
Authors: Meng Ke , Chen Bin , Xiao Mingyue , Zhai Yufeng , Qiao Zhi , Yu Runze , Pan Li , Zheng Liya , Chen Gang 
Published: December 2022

Abstract2D layered perovskites (LPs) have shown great potential to deliver high‐performance photovoltaic devices with long‐term stability. Despite many signs of progress being made in film quality and device performance, LP films are mainly processed in strict conditions and through non‐scalable techniques. Here, the hot‐air‐assisted ambient fabrication technique is introduced to prepare LP films for efficient and stable solar cells. The high‐quality LP films with good crystallinity, preferable orientation and desirable morphology are obtained by balancing the crystal nucleation and growth processes. Employing the synchrotron‐based in situ grazing‐incidence X‐ray diffraction technique, hot air induces the solidification of solutes and forms an intermediate at the air–liquid interface, which transforms into 3D‐like perovskite, followed by the growth of the 2D species toward the substrate. The optimal LP film delivers a device power conversion efficiency of 16.36%, the best value for the LP‐based solar cells prepared by the non‐spin‐coating techniques. The solar cell performance is insensitive to the film processing humidity and the device size is upscalable, which promises real‐world deployment of LP‐based optoelectronic devices.
Ultrathin, Graphene‐in‐Polyimide Strain Sensor via Laser‐Induced Interfacial Ablation of Polyimide
Authors: Yu Haiyang , Bian Jing , Chen Furong , Ji Jingjing , Huang YongAn 
Published: December 2022

AbstractLaser‐induced graphene sensors have attracted considerable interest in various fields; however, the low sensitivity and conformability limit their further applications in measuring soft, large deformable structures. Here, an innovative method of interface ablation is presented to convert the interfacial polyimide into graphene by nanosecond ultraviolet laser (308 nm). Significantly different from the traditional laser surface ablation, interface ablation demonstrates its unique capacity to produce high‐quality graphene with limited ablation depth, which benefits from the combined effect of highly concentrated temperature distribution, the confinement of reaction product, and a unique ablation mode dominated by heat conduction. Using this method, an ultrathin (8 µm), graphene‐in‐polyimide (GiP) strain sensor is obtained, which is six times thinner than that prepared by the traditional surface ablation. The ultrathin GiP sensors exhibit excellent conformability (small bending radius of 400 µm), high strain sensitivity (24.8), and high force sensitivity (4.2 N−1). Demonstrations of this GiP strain sensor in the deformation measurement of the morphing aircraft (e.g., bending, twisting, and impact) illustrate its powerful abilities in the health monitoring of equipment, thus providing engineering opportunities for smart devices requiring accurate deformation measurement.