Association of Mobile Stroke Unit Care and Spending, Utilization, and Death in New York City.

Background: Transport by mobile stroke units (MSUs), which provide access to computed tomography scanning and intravenous blood pressure medications and thrombolytics, reduces time to treatment and may improve short-term functional outcomes for patients with acute stroke. The longer-term clinical and financial impacts remain incompletely understood. The aim of the study was to determine whether MSU care is associated with better health, utilization, and spending outcomes for patients with suspected acute stroke.

Use of and Steering to Pharmacies Owned by Insurers and Pharmacy Benefit Managers in Medicare.

Importance: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which pharmacy network protections may influence market dynamics.

Objective: To evaluate the prevalence of insurer-PBM-owned pharmacies and the extent to which insurer-PBMs steer patients to pharmacies they own in Medicare.

Practical Guide to Large Amplitude Fourier-Transformed Alternating Current Voltammetry-What, How, and Why.

Fourier-transformed alternating current voltammetry (FTacV) is a technique utilizing a combination of a periodic (frequently sinusoidal) oscillation superimposed onto a staircase or linear potential ramp. The advanced utilization of a large amplitude sine wave induces substantial nonlinear current responses. Subsequent filter processing (via Fourier-transformation, band selection, followed by inverse Fourier-transformation) generates a series of harmonics in which rapid electron transfer processes may be separated from non-Faradaic and competing electron transfer processes with slower kinetics.

Meeting The Needs Of Socially Vulnerable Patients: Views Of ACO Leaders On Moving From Intent To Action.

The Centers for Medicare and Medicaid Services has placed growing emphasis on social drivers of health, but little is known about how accountable care organizations (ACOs) aim to meet the needs of vulnerable patients. During September-December 2022, we interviewed leaders of forty-nine ACOs participating in the Medicare Shared Savings Program (MSSP). Participants were asked about strategies to identify socially vulnerable patients, programs that addressed their needs, and Medicare reforms that could support their efforts.

Understanding the Decamethylferrocene Fe Oxidation Process in Tris(pentafluoroethyl)trifluorophosphate-Containing Ionic Liquids at Glassy Carbon and Boron-Doped Diamond Electrodes.

Under voltammetric conditions, the neutral decamethylferrocene ([MeFc]) to cationic ([MeFc]) Fe process is a well-known reversible outer-sphere reaction. A companion cationic [MeFc] to dicationic [MeFc] Fe process has been reported under direct current (DC) cyclic voltammetric conditions at highly positive potentials in liquid SO at low temperatures and in a 1.5:1.

Molecular cascade reveals sequential milestones underlying hippocampal neural stem cell development into an adult state.

Quiescent adult neural stem cells (NSCs) in the mammalian brain arise from proliferating NSCs during development. Beyond acquisition of quiescence, an adult NSC hallmark, little is known about the process, milestones, and mechanisms underlying the transition of developmental NSCs to an adult NSC state. Here, we performed targeted single-cell RNA-seq analysis to reveal the molecular cascade underlying NSC development in the early postnatal mouse dentate gyrus.

Role of supply chain intermediaries in steering hospital product choice: Group Purchasing Organizations and biosimilars.

Over 95% of hospitals in the United States use pooling alliances, known as Group Purchasing Organizations (GPOs), to purchase medications, devices, and supplies. While GPOs create savings for hospitals through lowered prices and reduced administrative burden, critics allege that these supply chain intermediaries reduce competition, particularly if GPOs concentrate purchasing from larger, dominant manufacturers. Using a mixed-methods design, we studied whether GPOs influence hospital purchasing behavior and explored the contracting mechanisms used by GPOs.

Accountable Care Organization Leader Perspectives on the Medicare Shared Savings Program: A Qualitative Study.

Importance: The Medicare Shared Savings Program (MSSP) includes more than 400 accountable care organizations (ACOs) and is among the largest and longest running value-based payment efforts in the US. However, given recent program reforms and other changes in the health care system, the experiences and perspectives of ACO leaders remain incompletely characterized.

Objective: To understand the priorities, strategies, and challenges of ACO leaders in MSSP.

Vanadium-Containing Keggin-Type Polyoxometalates, [VMO] and [VVMO] (M = Mo, W): Structural Characterization and Voltammetric, NMR, and EPR Studies Related to Electrochemical Reduction at Framework and Central Vanadium Sites.

Vanadium is accommodated in both the framework (V) and central positions (V) in the Keggin-type polyoxometalates (POMs) [VVMO] (M = Mo, W; VVM) and in the central position in [VMO] (VM). The structures of the VVM class have been determined by X-ray crystallography and compared to those of VM reported previously. A major feature of interest with POMs is their capacity for very extensive reduction, particularly when protonation accompanies the electron transfer step.

Fluorine Substitution of TCNQ Alters the Redox-Driven Catalytic Pathway for the Ferricyanide-Thiosulfate Reaction.

Mechanistic variation in catalysis through substituent-based redox tuning is well established. Fluorination of TCNQ (TCNQ=tetracyanoquinodimethane) provides ~850 mV variation in the redox potentials of the and (n=0, 2, 4) processes. With , catalysis of the kinetically very slow ferrocyanide-thiosulfate redox reaction in aqueous solution occurs via a mechanism in which the catalyst is reduced to when reacting with which is oxidised to .

Oxidation of the Platinum(II) Anticancer Agent [Pt{(-BrCF)NCHCHNEt}Cl(py)] to Platinum(IV) Complexes by Hydrogen Peroxide.

Pt coordination complexes are of interest as prodrugs of Pt anticancer agents, as they can avoid deactivation pathways owing to their inert nature. Here, we report the oxidation of the antitumor agent [Pt(-BrCF)NCHCHNEt}Cl(py)], (py = pyridine) to dihydroxidoplatinum(IV) solvate complexes [Pt{(-BrCF)NCHCHNEt}Cl(OH)(py)].HO, with hydrogen peroxide (HO) at room temperature.

Revisiting the Catalysis Mechanism for the - / Redox Reaction.

The front cover artwork was done by Michelle Farrelly, a member of the Martin group at Monash University. The image represents a perspective of a cuvette in which the catalysis of the thiosulfate-ferricyanide reaction was achieved by a TCNQF -based redox reaction in aqueous solution. The primary method used to monitor these reactions was spectrophotometry.

The Role Of Financial Incentives In Biosimilar Uptake In Medicare: Evidence From The 340B Program.

Biosimilar drugs-lower-cost alternatives to expensive biologic drugs-have the potential to slow the growth of US drug spending. However, rates of biosimilar uptake have varied across hospital outpatient providers. We investigated whether the 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on drug purchases, inhibits biosimilar uptake.

Revisiting the TCNQF Catalysis Mechanism for the [Fe(CN) ] -S O /S O Redox Reaction.

Published data suggest that sparingly soluble metal complexes of , where n=0, 1, 2, 4, can act as heterogeneous catalysts for the kinetically very slow - / reaction in aqueous solution. This study shows that the coordination polymer , participates as a homogeneous catalyst via an extremely small concentration of dissolved . This finding suggests that the generally accepted mechanism of catalysis by based solids needs to be revisited to ascertain the role of homogeneous pathways.

Cell-type specific profiling of histone post-translational modifications in the adult mouse striatum.

Epigenetic gene regulation in the heterogeneous brain remains challenging to decipher with current strategies. Bulk tissue analysis from pooled subjects reflects the average of cell-type specific changes across cell-types and individuals, which obscures causal relationships between epigenetic modifications, regulation of gene expression, and complex pathology. To address these limitations, we optimized a hybrid protocol, ICuRuS, for the isolation of nuclei tagged in specific cell-types and histone post translational modification profiling from the striatum of a single mouse.

Alloying strategies for tuning product selectivity during electrochemical CO reduction over Cu.

Excessive reliance on fossil fuels has led to the release and accumulation of large quantities of CO into the atmosphere which has raised serious concerns related to environmental pollution and global warming. One way to mitigate this problem is to electrochemically recycle CO to value-added chemicals or fuels using electricity from renewable energy sources. Cu is the only metallic electrocatalyst that has been shown to produce a wide range of industrially important chemicals at appreciable rates.

Changes in Medicare Part B Spending for Biologic Drugs After Biosimilar Entry Into the Market.

This cross-sectional study describes changes in annual Medicare Part B spending for biologic drugs after biosimilar entry, focusing on the first 4 products to experience biosimilar competition: filgrastim, infliximab, epoetin alpha, and pegfilgrastim.

Hydrophobicity Graded Gas Diffusion Layer for Stable Electrochemical Reduction of CO.

To mitigate flooding associated with the gas diffusion layer (GDL) during electroreduction of CO , we report a hydrophobicity-graded hydrophobic GDL (HGGDL). Coating uniformly dispersed polytetrafluoroethylene (PTFE) binders on the carbon fiber skeleton of a hydrophilic GDL uniformizes the hydrophobicity of the GDL and also alleviates the gas blockage of pore channels. Further adherence of the PTFE macroporous layer (PMPL) to one side of the hydrophobic carbon fiber skeleton was aided by sintering.

Molecular landscapes of human hippocampal immature neurons across lifespan.

Immature dentate granule cells (imGCs) arising from adult hippocampal neurogenesis contribute to plasticity and unique brain functions in rodents and are dysregulated in multiple human neurological disorders. Little is known about the molecular characteristics of adult human hippocampal imGCs, and even their existence is under debate. Here we performed single-nucleus RNA sequencing aided by a validated machine learning-based analytic approach to identify imGCs and quantify their abundance in the human hippocampus at different stages across the lifespan.