Scaling up quality in an anesthesia practice.

The resources necessary to improve anesthesia quality and meet reimbursement and regulatory thresholds are scarce, particularly for smaller practices. We examined how small practice integration into a firm with greater resources can facilitate improvements. A mixed-methods analysis was conducted using the data from the US Anesthesia Partners data warehouse, Merit-based Incentive Payment System (MIPS), commercial insurers' surgery length of stay (LOS) databases, anesthesia-specific patient satisfaction surveys, and interviews with practice leadership before and after integration.

Chronic wasting disease undermines efforts to control the spread of brucellosis in the Greater Yellowstone Ecosystem.

Wildlife diseases pose a substantial threat to the provisioning of ecosystem services. We use a novel modeling approach to study the potential loss of these services through the imminent introduction of chronic wasting disease (CWD) to elk populations in the Greater Yellowstone Ecosystem (GYE). A specific concern is that concentrating elk at feedgrounds may exacerbate the spread of CWD, whereas eliminating feedgrounds may increase the number of elk on private ranchlands and the transmission of a second disease, brucellosis, from elk to cattle.