Daphnids can safeguard the use of alternative bioassays to the acute fish toxicity test: A focus on neurotoxicity.

Assessment of potential impacts of chemicals on the environment traditionally involves regulatory standard data requirements for acute aquatic toxicity testing using algae, daphnids and fish (e.g., OECD test guidelines (TG) 201, 202, and 203, respectively), representing different trophic levels.

A benchmark dataset for machine learning in ecotoxicology.

The use of machine learning for predicting ecotoxicological outcomes is promising, but underutilized. The curation of data with informative features requires both expertise in machine learning as well as a strong biological and ecotoxicological background, which we consider a barrier of entry for this kind of research. Additionally, model performances can only be compared across studies when the same dataset, cleaning, and splittings were used.

Effects of microplastics mixed with natural particles on Daphnia magna populations.

The toxicity of microplastics on Daphnia magna as a key model for freshwater zooplankton is well described. While several studies predict population-level effects based on short-term, individual-level responses, only very few have validated these predictions experimentally. Thus, we exposed D.

Real-World Considerations for Implementing Pediatric Quality Measures: Insights From Key Stakeholders.

Objective: Since its inception, the Pediatric Quality Measures Program has focused on the development and implementation of new and innovative pediatric quality measures (PQM) for both public and private use. Building the evidence base related to measure usability and feasibility is central to increasing measure uptake and, thereby, to increased performance monitoring and quality improvement (QI) for children in Medicaid or the Children's Health Insurance Program. This paper describes key stakeholder insights focused on measure implementation and increasing the uptake of PQM.

Design and Implementation of the Pediatric Quality Measures Program 2.0.

The Pediatric Quality Measures Program (PQMP) was established in response to the Children's Health Insurance Program Reauthorization Act of 2009, aiming to measure and improve health care quality and outcomes for the nation's children. This brief report describes the PQMP 2.0 and its components.

Incubation in Wastewater Reduces the Multigenerational Effects of Microplastics in .

The aging of microplastics in the environment changes their physicochemical properties. While this may affect their toxicity, comparative data on the effects of aged compared to pristine microplastics are scarce. One of those aging processes is the sorption of chemicals, which has mainly been studied for individual pollutants present in marine ecosystems.

Microplastics but not natural particles induce multigenerational effects in Daphnia magna.

Several studies have investigated the effects of nano- and microplastics on daphnids as key freshwater species. However, while information is abundant on the acute toxicity of plastic beads, little is known regarding the multigenerational effects of irregular microplastics. In addition, a comparison of microplastics to naturally occurring particles is missing.

Laboratory-to-field extrapolation: Increase in carbamazepine toxicity in a higher tier, multiple-stress experiment.

The toxicity and environmental risk of chemicals, such as the antiepileptic drug carbamazepine (CBZ), is commonly assessed using standardized laboratory tests and laboratory-to-field extrapolation. To investigate the toxicity of CBZ to aquatic key organisms in a more complex and environmentally relevant scenario, we conducted a 32-day multiple-stress experiment in artificial indoor streams. We exposed the non-biting midge Chironomus riparius, the blackworm Lumbriculus variegatus, and the New Zealand mud snail Potamopyrgus antipodarum to 80 and 400 μg CBZ/L in six artificial indoor streams.

When Fluorescence Is not a Particle: The Tissue Translocation of Microplastics in Daphnia magna Seems an Artifact.

Previous research reported the translocation of nano- and microplastics from the gastrointestinal tract to tissues in Daphnia magna, most prominently of fluorescent polystyrene beads to lipid droplets. For particles >300 nm, such transfer is biologically implausible as the peritrophic membrane retains these in the daphnid gut. We used confocal laser scanning microscopy to study tissue transfer applying the setup from a previous study (neonates exposed to 20 and 1000 nm polystyrene beads at 2 µg L for 4 and 24 h), the same setup with a fructose-based clearing, and a setup with a 1000-fold higher concentration (2 mg L ).

Physicians In Medicare ACOs Offer Mixed Views Of Model For Health Care Cost And Quality.

Physicians' willingness to change how care is delivered is a key component of the ability of accountable care organizations (ACOs) to transform patient care. Yet physicians participating in Medicare ACOs are only moderately convinced that ACOs are an effective model for delivering cost-effective care.

The Effects of Natural and Anthropogenic Microparticles on Individual Fitness in Daphnia magna.

Concerns are being raised that microplastic pollution can have detrimental effects on the feeding of aquatic invertebrates, including zooplankton. Both small plastic fragments (microplastics, MPs) produced by degradation of larger plastic waste (secondary MPs; SMPs) and microscopic plastic spheres used in cosmetic products and industry (primary MPs; PMPs) are ubiquitously present in the environment. However, despite the fact that most environmental MPs consist of weathered plastic debris with irregular shape and broad size distribution, experimental studies of organism responses to MP exposure have largely used uniformly sized spherical PMPs.

Comparative effectiveness research in the U.S.A.: when will there be an impact on healthcare decision-making?

Five annual surveys of healthcare decision-makers potentially affected by comparative effectiveness research (CER) indicate sustained recognition of its importance and potential impact. Initial expectations of immediate CER impact have over time turned to stakeholder assessments of little short-term impact. In successive surveys, they project a continuous horizon of 3-5 years for CER to have a moderate or substantial improvement in decision making.

Comparative effectiveness research in the USA: when will there be an impact on healthcare decision-making?

Five annual surveys of healthcare decision-makers potentially affected by comparative effectiveness research (CER) indicate sustained recognition of its importance and potential impact. Initial expectations of immediate CER impact have over time turned to stakeholder assessments of little short-term impact. In successive surveys, they project a continuous horizon of 3-5 years for CER to have a moderate or substantial improvement in decision making.

Annulated and bridged tetrahydrofurans from alkenoxyl radical cyclization.

4-Pentenoxyl radicals sharing two or more carbon atoms with a cycloalkane cyclize in a predictable manner stereoselectively and regioselectively to afford in solutions of bromotrichloromethane cycloalkyl-fused or -bridged 2-bromomethyltetrahydrofurans in up to 95% yield. Stereoselectivity in alkenoxyl radical ring closures arises from cumulative steric effects. The substituent positioned the closest to the alkene carbon, which is being attacked by the oxygen radical, exerts the strongest stereodirecting effect.

A national study of nurse leadership and supports for quality improvement in rural hospitals.

This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety and quality improvement (QI). A national sample of rural hospital nurse executives (n = 300) completed a survey measuring 4 domains related to patient safety and QI: (a) patient "Safety Culture," (b) adequacy of QI "Resources," (c) "Barriers" related to QI, and (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions of Safety Culture were strong but 47% of the Resources needed to carry out QI were inadequate, 29% of Barriers were moderate to major, and 25% of Nurse Leader Engagement activities were performed infrequently.

Gender differences in HIV knowledge and unsafe sexual behaviours among disabled people in South Africa.

Purpose: The international literature suggests that disabled people may be at increased risk for HIV infection. There is a growing increasing recognition of this in South Africa, although there remains a paucity of literature on how disabled people are affected by HIV/AIDS. This is a concern given the seriousness of the epidemic here.

Disabled persons' knowledge of HIV prevention and access to health care prevention services in South Africa.

The main research question in this article is how access to information about HIV/AIDS and level of HIV/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed that gender and level of education, together with geographical differences, are key predictors for access to information and knowledge about HIV/AIDS among disabled people.

Balancing access to health data and privacy: a review of the issues and approaches for the future.

Background: There has been a dramatic increase in the types of microdata, and this holds great promise for health services research. However, legislative efforts to protect individual privacy have reduced the flow of health care data for research purposes and increased costs and delays, affecting the quality of analysis.

Aim: This paper provides an overview of the challenges raised by concerns about data confidentiality in the context of health services research, the current methodologies used to ensure data security, and a description of one successful approach to balancing access and privacy.

Connecting the ivory tower to main street: setting research priorities for real-world impact.

Health care decisionmakers face increasing pressure to use health care resources more efficiently, but the information they need to assess policy options often is unavailable or not disseminated in a useful form. Findings from stakeholder meetings and a survey of private-sector health care decisionmakers in California begin to identify high-priority issues, the perceived adequacy of current information, and preferred formats and other desired attributes of research. This is a first step in establishing a systematic approach to linking the information priorities of private-sector decisionmakers with those who fund and conduct research.

Views on health care technology: Americans consider the risks and sources of information.

We conducted a survey to learn about Americans' familiarity with specific technologies, their sources of information, and their trust in those sources. Our findings indicate a high degree of familiarity with common devices and procedures as well as a high level of interest in better understanding them. Americans are broadly supportive of new technology, but there was not blanket acceptance of all technologies.

Rural hospitals: are you missing out on drug savings?

The 340B Drug Pricing Program requires drug manufacturers to offer outpatient drugs at a reduced price to certain safety net organizations that provide healthcare services to vulnerable populations. In a survey, participants reported pharmacy savings ranging from $600 to $158,000 per month, with a mean savings of $19,700 and a median savings of $10,000. The biggest challenge in administering the program is maintaining separate records for inpatient and outpatient drugs, according to participants.

Twenty-five years of health surveys: does more data mean better data?

Major increases in the resources devoted to the collection of health-related data and advances in survey methodology may be offset by more nonresponse and coverage bias resulting from privacy concerns, technological changes, and an increasingly complex health care environment. Hence, it is unclear whether policymakers today are basing their decisions on data that are of higher or even the same quality as those collected twenty-five years ago. We offer several recommendations for improving data quality, including changes related to Office of Management and Budget review, broad reexamination of the federal health survey portfolio, and greater investment in survey methods research.