Accurately identifying incident cases of venous thromboembolism in the electronic health record: Performance of a novel phenotyping algorithm.

Background: Accurate identification of incident venous thromboembolism (VTE) for quality improvement and health services research is challenging. The purpose of this study was to evaluate the performance of a novel incident VTE phenotyping algorithm defined using standard terminologies, requiring three key indicators documented in the electronic health record (EHR): VTE diagnostic code, VTE-related imaging procedure code, and anticoagulant medication code.

Methods: Retrospective chart reviews were conducted to assess the performance of the algorithm using a random sample of phenotype(+) and phenotype(-) diagnostic encounters from primary care practices and acute care sites affiliated with five hospitals across a large integrated care delivery system in Massachusetts.

The Impact of Community-Based Testing Sites and Gift Incentives on COVID-19 Testing Uptake in Maryland, April 29 - May 9, 2021.

Purpose: Information on incentives for COVID-19 testing is needed to understand effective practices that encourage testing uptake. We describe characteristics of those who received an incentive after performing a rapid antigen test.

Design: Cross-sectional descriptive analysis of survey data.

Multi-Site Testing of an Opioid Prescribing Electronic Clinical Quality Measure Following Elective Primary Total Hip and/or Total Knee Arthroplasties.

As the United States faces the third wave of the ongoing opioid epidemic, development of measures which report on prolonged opioid prescribing (POP) rates, specifically following orthopedic surgeries, are needed to better understand and improve prescribing practices at the clinician group level. Brigham and Women's Hospital (BWH) has been contracted by the Centers for Medicare and Medicaid Services (CMS) to create a novel electronic clinical quality measure (eCQM) to quantify the prolonged opioid prescribing rate of opioid episodes lasting > 42 days in patients aged 18+ years following elective primary total hip arthroplasties (THA) and/or total knee arthroplasties (TKA) for use in the Merit-Based Incentive Payment System (MIPS). When this measure was tested on two geographically distinct sites, it was found that the THA rate was 3.

Testing a Novel Inpatient Respiratory Depression Electronic Clinical Quality Measure (eCQM) for Orthopedic Practice in Two Large U.S. Health Systems.

The objective of this study was to assess the feasibility of using an electronic clinical quality measure (eCQM) to assess inpatient respiratory depression rates following elective primary total hip or total knee arthroplasty using data routinely collected in electronic health records. Measure testing was conducted at two large urban, academic health systems - Mass General Brigham and a geographically distant system in southern U.S.

Predicting hospitalization of COVID-19 positive patients using clinician-guided machine learning methods.

Objectives: The coronavirus disease 2019 (COVID-19) is a resource-intensive global pandemic. It is important for healthcare systems to identify high-risk COVID-19-positive patients who need timely health care. This study was conducted to predict the hospitalization of older adults who have tested positive for COVID-19.

Development of four electronic clinical quality measures (eCQMs) for use in the Merit-based Incentive Payment System (MIPS) following elective primary total hip and knee arthroplasty.

The Centers for Medicare & Medicaid Services (CMS) supported Brigham and Women's Hospital (BWH) Center for Patient Safety, Research, and Practice to retool one existing National Quality Forum (NQF) endorsed clinical quality measure (CQM) measure into an electronic clinical quality measure (eCQM) and develop three new eCQMs related to orthopedic care. This manuscript details the iterative process of measure development through environmental scans and stakeholder feedback prior to testing at two geographically different sites. The four measures under development are the: Risk Standardized Complication Rate (RSCR), Risk Standardized Venous Thromboembolism and Major Bleeding Rate (VTE/Bleeding), Risk Standardized Prolonged Opioid Prescribing Rate (POP), and the Risk Standardized Inpatient Respiratory Depression Rate (IRD).

Testing of a Risk-Standardized Major Bleeding and Venous Thromboembolism Electronic Clinical Quality Measure for Elective Total Hip and/or Knee Arthroplasties.

Brigham and Women's Hospital has received funding from the Centers for Medicare and Medicaid Services to develop a novel electronic clinical quality measure to assess the risk-standardized major bleeding and venous thromboembolism (VTE) rate following elective total hip and/or knee arthroplasty. There are currently no existing measures that evaluate both the bleeding and VTE events following joint arthroplasty (TJA). Our novel composite measure was tested within two academic health systems with 17 clinician groups meeting the inclusion criteria.

Testing of a Risk-Standardized Complication Rate Electronic Clinical Quality Measure (eCQM) for Total Hip and/or Total Knee Arthroplasty.

Supported by the Centers for Medicare & Medicaid Services (CMS), Brigham and Women's Hospital (BWH) has retooled the existing claims-based measures NQF1550 and NQF3493 into an electronic clinical quality measure (eCQM) to assess the risk-standardized complication rate (RSCR) following elective primary total hip (THA) and knee arthroplasty (TKA) at the clinician group level. This novel eCQM includes risk-adjustment for social determinants of health, includes all adult patients from all payers, leverages electronic health records (EHRs) rather than claims-based data, and includes both inpatient and outpatient procedures and complications which offers benefits compared to existing metrics. Following testing in two geographically different healthcare systems, the overall risk-standardized complication rate within 90 days following THA and TKA at the two sites was 3.

Epidemiologically Linked COVID-19 Outbreaks at a Youth Camp and Men's Conference - Illinois, June-July 2021.

On June 30, 2021, the Illinois Department of Public Health (IDPH) contacted CDC concerning COVID-19 outbreaks at two events sponsored by the same organization: a 5-day overnight church camp for persons aged 14-18 years and a 2-day men's conference. Neither COVID-19 vaccination nor COVID-19 testing was required before either event. As of August 13, a total of 180 confirmed and probable cases had been identified among attendees at the two events and their close contacts.

Re-tooling an Existing Clinical Quality Measure for Chronic Opioid Use to an Electronic Clinical Quality Measure (eCQM) for Post-Operative Opioid Prescribing: Development and Testing of Draft Specifications.

The objective was to re-tool the existing claims-based measure NQF2940 "Use of Opioids at High Dosage in Persons Without Cancer" to an electronic clinical quality measure (eCQM) for use by orthopedic practices to assess potentially inappropriate high-dose post-operative opioid prescribing practices. Measure specifications were revised based on stakeholder feedback, initial testing and a targeted review of the literature. The eCQM was developed and alpha tested on 9,108 opioid-naive patients who received an elective primary total hip or total knee arthroplasty at Mass General Brigham formerly Partners HealthCare System) from 2016 to 2018.

Development and Alpha Testing of Specifications for a Prolonged Opioid Prescribing Electronic Clinical Quality Measure (eCQM).

Brigham and Women's Hospital (BWH) has received funding from the Centers for Medicare and Medicaid Services (CMS) to design and implement an electronic clinical quality measure (eCQM) assessing the rate of prolonged opioid prescribing practices following Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA). Utilizing an existing guideline, 'prolonged prescribing' has been defined as opioid prescriptions that exceed 42 days (6 weeks) following surgery. This measure was tested on 12,803 Partners' Healthcare (PHS) patients.

Building Biosafety Capacity in Our Nation's Laboratories.

The 2014 Ebola outbreak revealed biosafety vulnerabilities across the United States. We distributed $24.1 million to health departments to support public health laboratories (PHLs) and sentinel clinical laboratory partners to improve biosafety practices.

Researching multiple publics through latent profile analysis: Similarities and differences in science and technology attitudes in China, Japan, South Korea and the United States.

How science and technology attitudes vary across the United States, China, South Korea and Japan - all of which top Bloomberg's list of high-tech centralization - is explored through data from the sixth wave of the World Values Survey (2010-2014). The following study examines the presence of different types of attitudinal groups using latent profile analysis. Not only do unique attitudinal groups exist in each country, but each group is uniquely influenced by select demographic characteristics, including education, age, gender, religiosity, employment status and individual interaction with technology.

The influence of school policies on smoking prevalence among students in grades 5-9, Canada, 2004-2005.

Introduction: School characteristics may account for some of the variation in smoking prevalence among schools. The purpose of this study was to investigate the relationships between characteristics of school tobacco policies and school smoking prevalence. We also examined the relationship between these characteristics and individual smoking status.

School smoking policy characteristics and individual perceptions of the school tobacco context: are they linked to students' smoking status?

The purpose of this study was to explore individual- and school-level policy characteristics on student smoking behavior using an ecological perspective. Participants were 24,213 (51% female) Grade 10-11 students from 81 schools in five Canadian provinces. Data were collected using student self-report surveys, written policies collected from schools, interviews with school administrators, and school property observations to assess multiple dimensions of the school tobacco policy.

Effect of the transition from high school to university on anthropometric and lifestyle variables in males.

The obesity epidemic in North America has focused attention on the health risks of excess weight gain. The transition from high school to university is a critical period for weight gain, commonly referred to as the Freshman 15. The purpose of this study was to investigate the effect of the transition from high school to university on anthropometrics and physical and sedentary activities in males.

How can the aromatic side-chains modulate the conductance of the gramicidin channel? A new approach using non-coded amino acids.

In order to elucidate the role of the aromatic side-chains in the mechanism of transduction of monovalent cations through the channel of linear gramicidin, two series of analogues containing non-coded aromatic amino acids were synthesized. In the first series, the four tryptophans were replaced by either four L-3-(8-quinolyl)alanyl or four L-3-(4-quinolyl)alanyl residues and single channel conductance measurements showed that these substitutions led to a strong lowering of the channel conductance, which is attributed to a modification of the orientation of the aromatic side-chains due to an increase of their hydrophobicity. In the second series, the analogues contained both tryptophyl and naphthylalanyl residues in various amounts and positions.

A common V delta 2-D delta 2-D delta 3 T cell receptor gene rearrangement in precursor B acute lymphoblastic leukaemia.

Despite their apparent commitment to the B lymphocytic lineage, human precursor B cell acute lymphoblastic leukaemias (ALL) frequently rearrange their T cell antigen receptor (TCR) alpha, beta and gamma chain genes. Since these three genes are active sites of rearrangement in precursor B cell neoplasms, it seemed that the recently discovered fourth TCR gene, delta, might be similarly rearranged. To investigate this possibility, a series of precursor B cell leukaemias was analysed for rearrangements at the delta chain gene locus, using probes of the variable, joining, and constant regions of the delta chain gene.

Effects of challenge with trichostrongylid nematode larvae on immunologically resistant grazing yearling sheep in South Australia.

Paddocks near Gawler, South Australia, were grazed by newly weaned sheep which received either no anthelmintic treatment, regular 3-weekly treatment or a single treatment in February. A decline in the faecal egg count of untreated sheep in autumn associated with the ingestion of infective larvae indicated that the sheep had developed a resistance to reinfection. At the end of the experiment, 10 sheep were experimentally infected with Trichostrongylus vitrinus larvae to demonstrate this resistance.

The effect of point mutations on energy profiles in a model of the nicotinic acetylcholine receptor (AChR) channel.

Energy profiles are calculated, using energy optimization computations, for a sodium cation in the AChR channel and four of its mutants, alpha E241D, beta E247Q, delta E255Q and alpha E241Q, using the model developed previously. The relative energy location of the calculated profiles confirms and specifies the role of each of the Glu residues found in the anionic ring at the bottom of the MII helices. The structural analysis of the results allows the understanding of the differences observed in the conductances for the wild-type and mutant alpha E241D, or for the mutants beta E247Q and delta E255Q in spite of the identity of the global charge of both channels in each couple.

A modified technique for the estimation of the number of infective nematode larvae present on pasture, and its application in the field under South Australian conditions.

A modified technique for the recovery of larvae from pasture is described involving two centrifugations of pasture washings in a solution of potassium iodide. On average, the technique recovered 96% of larvae and was simple to perform. At three sites in South Australia (rainfall 550-330 mm year-1), the numbers of larvae present on pasture each month using this technique was compared with results obtained using one or four tracer sheep.

The intrinsic molecular potential of glyceryl monooleate layers and its effect on the conformation and orientation of an inserted molecule: example of gramicidin A.

It is shown by explicit calculation that the distribution of the atomic charges in the constituent molecules of a lipid monolayer or bilayer of glyceryl monooleate creates an intrinsic potential difference between the head region and the hydrocarbon region which tends to repel positive charges towards the exterior and attract negative charges to the interior. The analogies and differences between a bilayer and a monolayer are analyzed. The possible consequences of the intrinsic potential gradient in a lipid layer on the preferred orientation and conformation of a polar neutral molecule are illustrated on the case of a gramicidin A monomer.

Gamma/delta lineage relationship within a consecutive series of human precursor T-cell neoplasms.

We analyzed the gene rearrangements associated with the newly described delta T-cell receptor (TCR) gene from a series of 19 consecutive precursor T-cell (lymphoblastic) neoplasms that represent discrete stages surrounding the TCR gene rearrangement process. Significantly, the delta TCR gene showed rearrangement in most (13 of 19) of these T cells, and in addition it was rearranged in two cells displaying no rearrangement for any other TCR gene. Our survey showed three types of delta gene rearrangements associated with cell-surface TCR expression that presumably represent usage of three V delta genes.

A possible model for the inner wall of the acetylcholine receptor channel.

A structural model of the inner wall of the acetylcholine receptor (AChR) channel is developed using assumptions derived from the results of the recent labelling experiments of the MII helices by noncompetitive blockers. The assumption of steric blocking of the channel by chlorpromazine (CPZ) in the neighbourhood of the labelled serines imposes the MII helices to be in contact at this level and allows the calculation of their minimal interaxial distance. The assumption that CPZ diffuses to this position through the upper crowded part of the channel imposes that the helices are more distant in this region and permits the determination of a tilt of about 7 degrees with respect to the central axis.