Managing comorbidities in chronic kidney disease reduces utilization and costs.

Background: Effective management of comorbid diabetes and hypertension in patients with chronic kidney disease (CKD) is important for optimal outcomes. However, little is known about this relationship from a health plan perspective. The objective of this study was to evaluate the association of effective management of comorbid diabetes and/or hypertension with healthcare resource utilization (HCRU) in patients with chronic kidney disease (CKD).

Transition-to-dialysis planning, health care use, and mortality in end-stage renal disease.

Objectives: To evaluate the association of dialysis transition planning factors (eg, nephrologist care, vascular access placement, place of dialysis) with inpatient (IP) stays, emergency department (ED) visits, and mortality.

Study Design: Retrospective cohort study.

Methods: We used the Humana Research Database to identify 7026 patients with a diagnosis of end-stage renal disease (ESRD) in 2017 who were enrolled in a Medicare Advantage Prescription Drug plan with at least 12 months preindex enrollment, with first ESRD evidence as the index date.

Assessing Contamination of Stream Networks near Shale Gas Development Using a New Geospatial Tool.

Chemical spills in streams can impact ecosystem or human health. Typically, the public learns of spills from reports from industry, media, or government rather than monitoring data. For example, ∼1300 spills (76 ≥ 400 gallons or ∼1500 L) were reported from 2007 to 2014 by the regulator for natural gas wellpads in the Marcellus shale region of Pennsylvania (U.

Model-Based Clustering of Nonparametric Weighted Networks with Application to Water Pollution Analysis.

Water pollution is a major global environmental problem, and it poses a great environmental risk to public health and biological diversity. This work is motivated by assessing the potential environmental threat of coal mining through increased sulfate concentrations in river networks, which do not belong to any simple parametric distribution. However, existing network models mainly focus on binary or discrete networks and weighted networks with known parametric weight distributions.

Direct intramolecular carbon(sp)-nitrogen(sp) reductive elimination from gold(iii).

The reactivity of bidentate AuIII-Cl species, [(C^N)AuCl2], with a bisphosphine or carbon donor ligands results in reductive elimination. Combined experimental and computational investigations lead to the first evidence of a direct intramolecular C(sp2)-N(sp2) bond formation from a monomeric [(C^N)AuCl2] gold(iii) complex. We show that bidentate ligated Au(iii) systems bypass transmetallation to form C(sp2)-N(sp2) species and NHC-Au-Cl.

Assessing changes in groundwater chemistry in landscapes with more than 100 years of oil and gas development.

With recent improvements in high-volume hydraulic fracturing (HVHF, known to the public as fracking), vast new reservoirs of natural gas and oil are now being tapped. As HVHF has expanded into the populous northeastern USA, some residents have become concerned about impacts on water quality. Scientists have addressed this concern by investigating individual case studies or by statistically assessing the rate of problems.

Asymmetric Flows in the Intercellular Membrane during Cytokinesis.

Eukaryotic cells undergo shape changes during their division and growth. This involves flow of material both in the cell membrane and in the cytoskeletal layer beneath the membrane. Such flows result in redistribution of phospholipid at the cell surface and actomyosin in the cortex.

Detecting the effects of coal mining, acid rain, and natural gas extraction in Appalachian basin streams in Pennsylvania (USA) through analysis of barium and sulfate concentrations.

To understand how extraction of different energy sources impacts water resources requires assessment of how water chemistry has changed in comparison with the background values of pristine streams. With such understanding, we can develop better water quality standards and ecological interpretations. However, determination of pristine background chemistry is difficult in areas with heavy human impact.

Bayesian approach of nearfield acoustic reconstruction with particle filters.

This paper demonstrates that inverse source reconstruction can be performed using a methodology of particle filters that relies primarily on the Bayesian approach of parameter estimation. In particular, the proposed approach is applied in the context of nearfield acoustic holography based on the equivalent source method (ESM). A state-space model is formulated in light of the ESM.