Hospital-physician integration and Medicare spending: Evidence from stable angina.

Objective: To examine the association between hospital-cardiologist integration and Medicare spending for stable angina patients.

Data Sources And Study Setting: This study used Medicare Standard Analytic Files from 2013 to 2020 and the Centers for Medicare and Medicaid Services National Downloadable File for accompanying physician data.

Study Design: This was a retrospective cohort study of Medicare beneficiaries with a new diagnosis of stable angina between 2013 and 2020.

Unmet Need in Early-Onset Parkinson's Disease: Deep Brain Stimulation and Pregnancy.

Pregnancy in women with early-onset Parkinson's disease (PD) is likely to have a higher frequency given the trend toward increasing maternal age, thus resulting in a greater overlap time between childbearing age and PD risk. Deep brain stimulation (DBS) therapy is nowadays offered to PD patients at earlier stage of the disease, when women can still be pre-menopausal. However, few data are available about DBS safety during pregnancy.

Unveiling the invisible: a qualitative interview study on the impact of young onset Parkinson's disease on (ex-partners).

Introduction: Living with young onset Parkinson's disease (YOPD) not only affects the persons with YOPD, but also their families. Although caregiver burden has been researched in Parkinson's disease in general, little is known about the specific impact of having an (ex-)partner with YOPD. This exploratory study aimed to explore the impact of having an (ex-)partner with YOPD on daily life.

Long-Term Follow-Up of the LEAP Study: Early Versus Delayed Levodopa in Early Parkinson's Disease.

Background And Objective: The Levodopa in EArly Parkinson's disease study showed no effect of earlier versus later levodopa initiation on Parkinson's disease (PD) progression over 80 weeks. We now report the effects over 5 years.

Methods: The Levodopa in EArly Parkinson's disease study randomly assigned patients to levodopa/carbidopa 300/75 mg daily for 80 weeks (early start) or to placebo for 40 weeks followed by levodopa/carbidopa 300/75 mg daily for 40 weeks (delayed start).

Treatment Approaches for Altered Facial Expression: A Systematic Review in Facioscapulohumeral Muscular Dystrophy and Other Neurological Diseases.

Background: Facial weakness is a key feature of facioscapulohumeral muscular dystrophy (FSHD) and may lead to altered facial expression and subsequent psychosocial impairment. There is no cure and supportive treatments focus on optimizing physical fitness and compensation of functional disabilities.

Objective: We hypothesize that symptomatic treatment options and psychosocial interventions for other neurological diseases with altered facial expression could be applicable to FSHD.

Age and gender differences in non-motor symptoms in people with Parkinson's disease.

Background: Non-motor symptoms of Parkinson's disease (PD) are highly prevalent and heterogenic. Previous studies aimed to gain more insight on this heterogeneity by investigating age and gender differences in non-motor symptom severity, but findings were inconsistent. Furthermore, besides examining the single effects of age and gender, the interaction between them in relation to non-motor functioning has -as far as we know- not been investigated before.

Physician selection for hospital integration: Theoretical considerations and empirical findings.

Background: The U.S. health care system has seen an increase in hospital-physician integration, with hospitals acquiring increasing numbers of physician practices.

Psychosocial functioning in patients with altered facial expression: a scoping review in five neurological diseases.

Purpose: To perform a scoping review to investigate the psychosocial impact of having an altered facial expression in five neurological diseases.

Methods: A systematic literature search was performed. Studies were on Bell's palsy, facioscapulohumeral muscular dystrophy (FSHD), Moebius syndrome, myotonic dystrophy type 1, or Parkinson's disease patients; had a focus on altered facial expression; and had any form of psychosocial outcome measure.

Movement Disorders in Patients With Genetic Developmental and Epileptic Encephalopathies.

Background And Objectives: Movement disorders (MDs) are underrecognized in the developmental and epileptic encephalopathies (DEEs). There are now more than 800 genes implicated in causing the DEEs; relatively few of these rare genetic diseases are known to be associated with MDs. We identified patients with genetic DEEs who had MDs, classified the nature of their MDs, and asked whether specific patterns correlated with the underlying mechanism.

Hospital-physician Integration and Value-based Payment: Early Results From MIPS.

Background: Hospital-physician integration is often justified as a driver of clinical quality improvement due to joint resources covering a broad spectrum of care. Value-based programs, such as the Medicare Merit-Based Incentive Payment System (MIPS), are intended to tie financial incentives to clinical quality, which may confer an advantage on such integrated practices.

Objectives: We assessed the relationship between hospital-physician integration and MIPS performance by comparing hospital-integrated practices and independent practices.

"I'd rather wait and see what's around the corner": A multi-perspective qualitative study of treatment escalation planning in frailty.

Introduction: People living with frailty risk adverse outcomes following even minor illnesses. Admission to hospital or the intensive care unit is associated with potentially burdensome interventions and poor outcomes. Decision-making during an emergency is fraught with complexity and potential for conflict between patients, carers and clinicians.

Influence of caregiver input and language experience on the production of coda laterals by English-Malay bilingual preschoolers in multi-accent Singapore.

Linguistic input in multi-lingual/-cultural contexts is highly variable. We examined the production of English and Malay laterals by fourteen early bilingual preschoolers in Singapore who were exposed to several allophones of coda laterals: Malay caregivers use predominantly clear-l in English and Malay, but their English coda laterals can also be l-less (vocalised/deleted) and in formal contexts, velarised. Contrastingly, the English coda laterals of the Chinese majority are typically l-less.

Hospital-physician integration and clinical volume in traditional Medicare.

Objective: To test the effect of hospital-physician integration on primary care physicians' (PCP) clinical volume in traditional Medicare.

Data Sources And Study Setting: Nationwide retrospective longitudinal study using Medicare claims and other data sources from 2010 to 2016.

Study Design: We identified 70,000 PCPs, some of whom remained non-integrated and some who became hospital-integrated during this study period.

Hospital-Physician Integration Is Associated With Greater Use Of Cardiac Catheterization And Angioplasty.

In the US in recent years, hospital-physician integration has become a dominant form of consolidation in health care. This transition away from independent practice has raised questions about whether hospital-employed physicians may be more likely than independent physicians to refer patients to high-intensity, hospital-based services. We used Medicare claims data from the period 2013-20 to identify patients who received a new diagnosis of stable angina, a common cardiovascular condition that entails clinical discretion in treatment choice.

Temporal lobe perceptual predictions for speech are instantiated in motor cortex and reconciled by inferior frontal cortex.

Humans use predictions to improve speech perception, especially in noisy environments. Here we use 7-T functional MRI (fMRI) to decode brain representations of written phonological predictions and degraded speech signals in healthy humans and people with selective frontal neurodegeneration (non-fluent variant primary progressive aphasia [nfvPPA]). Multivariate analyses of item-specific patterns of neural activation indicate dissimilar representations of verified and violated predictions in left inferior frontal gyrus, suggestive of processing by distinct neural populations.

Additively Manufactured NdFeB Polyphenylene Sulfide Halbach Magnets to Generate Variable Magnetic Fields for Neutron Reflectometry.

Halbach arrays are the most efficient closed structures for generating directed magnetic fields and gradients, and are widely used in various electric machines. We utilized fused deposition modeling-based Big Area Additive Manufacturing technology to print customized, compensated concentric Halbach array rings, using polyphenylene sulfide-bonded NdFeB permanent magnets for polarized neutron reflectometry. The Halbach rings could generate a 0 ≤  0.

Phonetic and Phono-Lexical Accuracy of Non-Native Tone Production by English-L1 and Mandarin-L1 Speakers.

Lexical tones are known to be a challenging aspect of speech to acquire in a second language, but several factors are known to affect tone learning facility, such as L1 tonal status (whether a learner's L1 is tonal or not), tone type (the shape of the tones to be acquired), and individual extralinguistic factors (such as musicianship, pitch aptitude, and working memory). Crucially, most of our knowledge of the effect of these factors is based on evidence from perception. The production side of tone learning and the origins of individual variability in learning facility remain relatively understudied.

Commonly Missed Findings on Chest Radiographs: Causes and Consequences.

Chest radiography (CXR) continues to be the most frequently performed imaging examination worldwide, yet it remains prone to frequent errors in interpretation. These pose potential adverse consequences to patients and are a leading motivation for medical malpractice lawsuits. Commonly missed CXR findings and the principal causes of these errors are reviewed and illustrated.

A comparison of cancer vaccine adjuvants in clinical trials.

Cancer treatment has come a long way in increasing overall survival; however, evasion of the immune system continues to be a challenge in treating individuals with established disease burdens. Due to the difficulty in stimulating an immune response against cancer, approaches utilizing combination adjuvants with different mechanisms may be beneficial. A combination of these adjuvants with other adjuvants or other treatments has demonstrated synergistic effects in the form of a robust and sustained immune response, demonstrating the importance of further development.

Trial of Deferiprone in Parkinson's Disease.

Background: Iron content is increased in the substantia nigra of persons with Parkinson's disease and may contribute to the pathophysiology of the disorder. Early research suggests that the iron chelator deferiprone can reduce nigrostriatal iron content in persons with Parkinson's disease, but its effects on disease progression are unclear.

Methods: We conducted a multicenter, phase 2, randomized, double-blind trial involving participants with newly diagnosed Parkinson's disease who had never received levodopa.