Mapping the Institutional Healthcare Payer Mix for Total Hip and Knee Arthroplasty: Insight Into a Large Practice.

Background: As the demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) continues to grow exponentially, the economic burden on practices and healthcare payers simultaneously increases. Medicare accounts for over 60% of total joint arthroplasty (TJA) cases nationwide, and the reimbursements are worsening despite alternative payment models. Trending the active payers at an institution provides invaluable insight into the financial health of a practice and projects if annual run rates are sustainable.

Rising Costs and Diminishing Surgeon Reimbursement From Primary to Revision Total Hip and Knee Arthroplasty: An Analysis of Medicare Advantage and Commercial Insurance.

Background: Revision total joint arthroplasty (rTJA) is a resource-intensive procedure addressing failed primary total joint hip (total hip arthroplasty [THA]) and knee arthroplasty (total knee arthroplasty [TKA]). Despite predictions of increased demand, reimbursement for rTJA has not kept pace with increasing costs and may be insufficient compared with primary procedures. The study aimed to highlight the diminishing surgeon reimbursement between primary and revision THA (rTHA) and TKA.

Work stress and burnout among emergency physicians: a systematic review of last 10 years of research.

Aim Of The Study: First, to provide a synthesis and analysis of available scientific literature regarding the level of work stress and burnout among emergency physicians. Second, to identify the effect of the specific work situation-related factors.

Methods: A systematic search was performed in NCBI PubMed and Embase.

How the Shift in Arthroplasty Surgery Location Impacts the Relationship of Private Surgeons, Hospitals, and Ambulatory Surgery Centers.

The recent removal of total hip and knee arthroplasty from the Medicare inpatient-only list, COVID-19 pandemic, decreasing reimbursements, and bundled payment programs have all had tremendous impact on the practice of arthroplasty. Surgeons and practices must adapt to these challenges to achieve the ideal triad of quality patient care, low cost to payors, and sustainable financial margins for stakeholders. Here, we review institutional data and present our experience with the changing arthroplasty practice landscape.

Clearance monitoring using hand-held devices: operational implementation and challenges.

Clearance monitoring includes all measures taken and measurements performed to ensure that all pertinent regulatory conditions are met for clearance of waste material. For bulk material, only a limited number of monitoring techniques are feasible for providing the necessary proof of compliance in the time frames and at costs commensurate with operator and regulator expectations for decommissioning projects. Operationally, measurements using hand-held devices, such as contamination monitors using scintillator or proportional counter technology, might provide sufficiently short response times at acceptable accuracies to segregate the waste streams according to their level of contamination and allowing for a decision on their further processing.

Fatigue in British fishermen.

A survey was conducted to establish the extent of fatigue in British fishermen. Problems accessing the target population limited the sample to 81 people, highlighting the difficulty of conducting research in this area. Whilst the results cannot be considered representative of the British fishing population, the fact that 60% (n = 48) believed their personal safety had been at risk because of fatigue at work, 16% (n = 13) had been involved in a fatigue related accident, and 44% (n = 36) said they had worked to the point of exhaustion or collapse suggests a problem that requires further investigation.

Patterns of fatigue among seafarers during a tour of duty.

Background: Work-related fatigue is associated with sickness absence and mental and physical health problems, and may increase the risk of accidents and injuries at work. Relatively little is known about fatigue among seafarers, particularly during a tour of duty. The aim of this study was to describe the pattern of day to day fatigue among seafarers during a tour at sea.

Attitudes towards following meat, vegetarian and vegan diets: an examination of the role of ambivalence.

Vegetarianism within the U.K. is growing in popularity, with the current estimate of 7% of the population eating a vegetarian diet.

Developing occupational standards: a learning disabilities project.

Occupational standards are often seen as cumbersome and inappropriate to a vocational curriculum such as nursing. However, the term fitness for practice is once more being used to focus the minds of educationalists and practitioners in healthcare delivery on the goal in preparing practitioners for the future. The project reported here was guided jointly by staff from a higher education institution and an NHS trust and involved practitioners in designing occupational standards with a view to using them in practice and incorporating them into the preregistration curriculum.

An Escherichia coli plasmid vector system for high-level production and purification of heterologous peptides fused to active chloramphenicol acetyltransferase.

A very small plasmid vector system is described for construction and high-level production of C-terminal chloramphenicol acetyltransferase (CAT) fusion proteins in Escherichia coli. The only functional elements of the plasmid are a minimal region of the ColE1 origin of DNA replication and the Tn9 cat gene, both under control of a tac promoter. Since C-terminal fusion to CAT does not interfere with chloramphenicol (Cm) resistance, plasmids are maintained under Cm selection.

A general method for routine sequencing of cloned DNA fragments using commercial dye primers and its application in sequence analysis of Toxoplasma gondii RH genome fragments.

A generally applicable approach for amplification and subsequent sequencing using commercially available dye primers is described. The polymerase chain reaction primers, one of which is biotinylated, are tagged at their 5' end with sequences of commercial sequencing primers. After purification and strand separation on streptavidin-coated magnetic beads, both strands are sequenced automatically on an Applied Biosystems 373A DNA sequencer using the appropriate standard dye-labeled sequencing primers.