Geographic variability of Medicaid acceptance among allergists in the US.

Objective: To determine the geographic variability of Medicaid acceptance among allergists in the US.

Study Design: Geospatial analysis predicted Medicaid acceptance across space, and a multivariable regression identified area-level population demographic variables associated with acceptance.

Methods: We used the National Plan & Provider Enumeration System database to identify allergists.

Ammonium Ion-Pre-Intercalated MnO on Carbon Cloth for High-Energy Density Asymmetric Supercapacitors.

With the continuous development of green energy, society is increasingly demanding advanced energy storage devices. Manganese-based asymmetric supercapacitors (ASCs) can deliver high energy density while possessing high power density. However, the structural instability hampers the wider application of manganese dioxide in ASCs.

The good, the bad, and the red: implicit color-valence associations across cultures.

Cultural differences-as well as similarities-have been found in explicit color-emotion associations between Chinese and Western populations. However, implicit associations in a cross-cultural context remain an understudied topic, despite their sensitivity to more implicit knowledge. Moreover, they can be used to study color systems-that is, emotional associations with one color in the context of an opposed one.

Can synthetic data be a proxy for real clinical trial data? A validation study.

Objectives: There are increasing requirements to make research data, especially clinical trial data, more broadly available for secondary analyses. However, data availability remains a challenge due to complex privacy requirements. This challenge can potentially be addressed using synthetic data.

Optimizing the synthesis of clinical trial data using sequential trees.

Objective: With the growing demand for sharing clinical trial data, scalable methods to enable privacy protective access to high-utility data are needed. Data synthesis is one such method. Sequential trees are commonly used to synthesize health data.

Determinants of neoadjuvant chemotherapy use in muscle-invasive bladder cancer.

Purpose: Cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard of care for muscle-invasive bladder cancer (MIBC). However, NAC is used in less than 20% of patients with MIBC. Our goal is to investigate factors that contribute to underutilization NAC to facilitate more routine incorporation into clinical practice.

MD-MAC: A Distributed TDMA Protocol Based on Desynchronization for Multi-Hop Topologies.

Communication resource allocation and collision detection are important for the Ad Hoc network. Considering the existing TDMA-MAC protocol, the allocation way based on fixed time slot is mostly adapted, which cannot guarantee the performance and be not flexible about the business for different nodes in the distributed network. Desynchronization, as a biological term, can be utilized in the Ad Hoc network.

Complications associated with perioperative use of tyrosine kinase inhibitor in cytoreductive nephrectomy.

Recent clinical trials have investigated the benefit of combining tyrosine kinase inhibitors (TKIs) and cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma. Our goal is to determine whether the perioperative use of TKIs increases the postoperative morbidity following CN in renal cell carcinoma patients. We identified 627 patients with Stage IV renal cell carcinoma who underwent CN from 2007-2010 utilizing the SEER-Medicare database.

Medicaid Expansion and Disparity Reduction in Surgical Cancer Care at High-Quality Hospitals.

Background: The Affordable Care Act's Medicaid expansion has been heavily debated due to skepticism about Medicaid's ability to provide high-quality care. Particularly, little is known about whether Medicaid expansion improves access to surgical cancer care at high-quality hospitals. To address this question, we examined the effects of the 2001 New York Medicaid expansion, the largest in the pre-Affordable Care Act era, on this disparity measure.

Why Do Long-Distance Travelers Have Improved Pancreatectomy Outcomes?

Background: Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason for this association remains largely unknown.

Did Pre-Affordable Care Act Medicaid Expansion Increase Access to Surgical Cancer Care?

Background: Although the Affordable Care Act (ACA) expanded Medicaid access, it is unknown whether this has led to greater access to complex surgical care. Evidence on the effect of Medicaid expansion on access to surgical cancer care, a proxy for complex care, is sparse. Using New York's 2001 statewide Medicaid expansion as a natural experiment, we investigated how expansion affected use of surgical cancer care among beneficiaries overall and among racial minorities.

Do hospital factors impact readmissions and mortality after colorectal resections at minority-serving hospitals?

Background: Minority-serving hospitals have greater readmission rates after operative procedures including colectomy; however, little is known about the contribution of hospital factors to readmission risk and mortality in this setting. This study evaluated the impact of hospital factors on readmissions and inpatient mortality after colorectal resections at minority-serving hospitals in the context of patient- and procedure-related factors.

Methods: More than 168,000 patients who underwent colorectal resections in 374 California hospitals (2004-2011) were analyzed using the State Inpatient Database and American Hospital Association Hospital Survey data.

Vulnerable Hospitals and Cancer Surgery Readmissions: Insights into the Unintended Consequences of the Patient Protection and Affordable Care Act.

Background: Penalties from the Hospital Readmission Reduction Program can push financially strained, vulnerable patient-serving hospitals into additional hardship. In this study, we quantified the association between vulnerable hospitals and readmissions and examined the respective contributions of patient- and hospital-related factors.

Methods: A total of 110,857 patients who underwent major cancer operations were identified from the 2004-2011 State Inpatient Database of California.

Fragmentation of Care after Surgical Discharge: Non-Index Readmission after Major Cancer Surgery.

Background: Despite national emphasis on care coordination, little is known about how fragmentation affects cancer surgery outcomes. Our study examines a specific form of fragmentation in post-discharge care-readmission to a hospital different from the location of the operation-and evaluates its causes and consequences among patients readmitted after major cancer surgery.

Study Design: We used the State Inpatient Database of California (2004 to 2011) to identify patients who had major cancer surgery and their subsequent readmissions.

Multimorbidity and access to major cancer surgery at high-volume hospitals in a regionalized era.

Background: The Institute of Medicine has recently prioritized access of quality cancer care to vulnerable persons including multimorbid patients. Despite promotional efforts to regionalize major surgical procedures to high-volume hospitals (HVHs), little is known about change in access to HVH over time among multimorbid patients in need of major cancer surgery. We performed a time-trend appraisal of access of multimorbid persons to HVH for major cancer surgery within a large nationally representative cohort.

Medicaid beneficiaries undergoing complex surgery at quality care centers: insights into the Affordable Care Act.

Background: Medicaid beneficiaries do not have equal access to high-volume centers for complex surgical procedures. We hypothesize there is a large Medicaid Gap between those receiving emergency general vs complex surgery at the same hospital.

Methods: Using the Nationwide Inpatient Sample, 1998 to 2010, we identified high-volume pancreatectomy hospitals.

Cardiovascular toxicity after antiangiogenic therapy in persons older than 65 years with advanced renal cell carcinoma.

Background: Sorafenib and sunitinib are oral vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) approved in 2005 and 2006, respectively, for the treatment of patients with renal cell carcinoma (RCC). A population-based, observational cohort study of the cardiovascular risk of VEGFR TKI therapy in elderly RCC patients was conducted.

Methods: Using the Surveillance, Epidemiology, and End Results-Medicare database, this study analyzed patients who were 66 years old or older and were diagnosed with RCC from 2000 to 2009.

[Toxic effects of CdSe/ZnS QDs to zebrafish embryos].

The toxic effects of CdSe/ZnS QDs on zebrafish (Danio rerio) embryos at different developmental stages were investigated in this study. The voluntary movement frequency, body length, hatching rate, mortality and malformation rate, SOD activities, MDA contents, mRNA expression of metallothionein (MT) and heat stress protein 70 (Hsp70) were used as indicators. The results showed that the EC50 was 316.

Hospital-level resource use by the oldest-old for pancreaticoduodenectomy at high-volume hospitals.

Introduction: Owing to limited data on hospital resources consumed in caring for the oldest-old, we examined the use of pancreaticoduodenectomy (PD)-relevant hospital resources in patients of increasing age treated in high-volume hospitals participating in the University HealthSystem Consortium.

Methods: Perioperative outcomes, resource use, and direct costs were compared across increasing age groups in 12,766 PDs (<70 years, n = 8,564; 70-79 years, n = 3,302; ≥80 years, n = 900) performed in 79 high-volume hospitals between 2010 and 2014. Linear regression models with and without covariate adjustments were used to assess the impact of older age.

Type 2 Diabetes among 6 Asian Ethnic Groups in California: The Nexus of Ethnicity, Gender, and Generational Status.

Objectives: We examined associations between generational status and age-adjusted type 2 diabetes (T2DM) among Asians living in California.

Methods: We abstracted data on 7,188 Asian Americans of six ethnicities from the 2007 and 2009 California Health Interview Survey. Age-and ethnicity-specific logistic regression analyses were used to model prevalence of T2DM based on 29 generational status and language spoken at home.

Histone deacetylase cytoplasmic trapping by a novel fluorescent HDAC inhibitor.

Inhibitors of histone deacetylases (HDAC) are an important emerging class of drugs for the treatment of cancers. HDAC inhibitors are currently under evaluation in clinical trials as single agents and as sensitizers in combinations with chemotherapies and radiation therapy. Although these drugs have important effects on cancer cell growth and functions, the mechanisms underlying HDAC inhibitor activities remain to be fully defined.