Medical loss ratio's role in the large group insurer market.

Objectives: To assess trends in the medical loss ratio (MLR) and understand how health insurance premiums in the large group market are driven by medical claims spending and insurer margins.

Study Design: Study of approximately 500 insurers covering more than 40 million lives annually in the large group market that submitted an MLR submission form (2014-2022).

Methods: We assessed trends in the MLR, premiums, medical claims spending, administrative costs, quality improvement spending, and margins among all insurers in the large group market.

High-intensity home-based rehabilitation in a Medicare accountable care organization.

Objectives: Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high. Especially for accountable care organizations (ACOs), home-based postacute rehabilitation offers a high-value option if outcomes are not compromised.

High Entropy: A General Strategy for Broadening the Operating Temperature of Magnetic Refrigeration.

Lattice distortion and disorder in the chemical environment of magnetic atoms within high-entropy compounds present intriguing issues in the modulation of magnetic functional compounds. However, the complexity inherent in high-entropy disordered systems has resulted in a relative scarcity of comprehensive investigations exploring the magnetic functional mechanisms of these alloys. Herein, we investigate the magnetocaloric effect (MCE) of the high-entropy intermetallic compound GdTbDyHoErCo.

Role of Glucagon-Like Peptide-1 Receptor Agonists in People With Infertility and Pregnancy.

Obesity is a chronic condition that causes significant morbidity and mortality in people in the United States and around the world. Traditional means of weight loss include diet, exercise, behavioral modifications, and surgery. New weight loss medications, glucagon-like peptide-1 receptor agonists, are revolutionizing the management of weight loss but have implications for fertility and pregnancy.

Evaluation and Management of Congenital Cytomegalovirus Infection.

The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary.

Refining Established Practices for Research Question Definition to Foster Interdisciplinary Research Skills in a Digital Age: Consensus Study With Nominal Group Technique.

Background: The increased use of digital data in health research demands interdisciplinary collaborations to address its methodological complexities and challenges. This often entails merging the linear deductive approach of health research with the explorative iterative approach of data science. However, there is a lack of structured teaching courses and guidance on how to effectively and constructively bridge different disciplines and research approaches.

Assessing Physician and Patient Agreement on Whether Patient Outcomes Captured in Clinical Progress Notes Reflect Treatment Success: Cross-Sectional Study.

Background: It remains unclear if there is agreement between physicians and patients on the definition of treatment success following orthopedic treatment. Clinical progress notes are generated during each health care encounter and include information on current disease symptoms, rehabilitation progress, and treatment outcomes.

Objective: This study aims to assess if physicians and patients agree on whether patient outcomes captured in clinical progress notes reflect a successful treatment outcome following orthopedic care.

Psyllium: A Nutraceutical and Functional Ingredient in Foods.

Psyllium is an excellent natural source of soluble and insoluble dietary fiber. It has been used as a nutraceutical and functional ingredient in foods. Many efforts have been made to understand and improve its physicochemical, biological, and functional properties to promote its food applications.

Usability and Usefulness of a Symptom Management Coaching System for Patients With Cancer Treated With Immune Checkpoint Inhibitors: Comparative Mixed Methods Study.

Background: The prognosis for patients with several types of cancer has substantially improved following the introduction of immune checkpoint inhibitors, a novel type of immunotherapy. However, patients may experience symptoms both from the cancer itself and from the medication. A prototype of the eHealth tool Cancer Patients Better Life Experience (CAPABLE) was developed to facilitate symptom management, aimed at patients with melanoma and renal cell carcinoma treated with immunotherapy.

Circuit Modules for Flexible Locomotion.

Locomotion, like all behaviors, possesses an inherent flexibility that allows for the scaling of movement kinematic features, such as speed and vigor, in response to an ever-changing external world and internal drives. This flexibility is embedded in the organization of the spinal locomotor circuits, which encode and decode commands from the brainstem and proprioceptive feedback. This review highlights our current understanding of the modular organization of these locomotor circuits and how this modularity endows them with intrinsic mechanisms to adjust speed and vigor, thereby contributing to the flexibility of locomotor movements.

Technologies for Interoperable Internet of Medical Things Platforms to Manage Medical Emergencies in Home and Prehospital Care: Scoping Review.

Background: The aging global population and the rising prevalence of chronic disease and multimorbidity have strained health care systems, driving the need for expanded health care resources. Transitioning to home-based care (HBC) may offer a sustainable solution, supported by technological innovations such as Internet of Medical Things (IoMT) platforms. However, the full potential of IoMT platforms to streamline health care delivery is often limited by interoperability challenges that hinder communication and pose risks to patient safety.

Light-Harvesting Spin Hyperpolarization of Organic Radicals in a Metal-Organic Framework.

Light-driven spin hyperpolarization of organic molecules is a crucial technique for spin-based applications such as quantum information science (QIS) and dynamic nuclear polarization (DNP). Synthetic chemistry provides the design of spins with atomic precision and enables the scale-up of individual spins to hierarchical structures. The high designability and extended pore structure of metal-organic frameworks (MOFs) can control interactions between spins and guest molecules.

Evaluating the Acceptance and Usability of an Independent, Noncommercial Search Engine for Medical Information: Cross-Sectional Questionnaire Study and User Behavior Tracking Analysis.

Background: The internet is a key source of health information, but the quality of content from popular search engines varies, posing challenges for users-especially those with low health or digital health literacy. To address this, the "tala-med" search engine was developed in 2020 to provide access to high-quality, evidence-based content. It prioritizes German health websites based on trustworthiness, recency, user-friendliness, and comprehensibility, offering category-based filters while ensuring privacy by avoiding data collection and advertisements.

Microbial communities in Hudson Strait amidst rapid environmental changes.

Climate change is rapidly altering Arctic marine environments, leading to warmer waters, increased river discharge, and accelerated sea ice melt. The Hudson Bay Marine System (HBMS) experiences the fastest rate of sea ice loss in the Canadian North resulting in a prolonged open water season during the summer months. We examined microbial communities in the Hudson Strait using high throughput 16s rRNA gene sequencing during the peak of summer, in which the bay was almost completely ice-free, and air temperatures were high.

Steering Energy Transfer Pathways through Mn-Doping in Perovskite Nanocrystals.

Modulation of singlet and triplet energy transfer from excited semiconductor nanocrystals to attached dye molecules remains an important criterion for the design of light-harvesting assemblies. Whereas one can consider the selection of donor and acceptor with favorable energetics, spectral overlap, and kinetics of energy transfer as a means to direct the singlet and triplet energy transfer pathways, it is not obvious how to control the singlet and triplet characteristics of the donor semiconductor nanocrystal itself. By doping CsPb(ClBr) nanocrystals with Mn, we have now succeeded in increasing the triplet characteristics of semiconductor nanocrystals.

Obstacle contrast modulates gait behavior in younger and older adults.

Purpose: This study investigated how obstacle contrast altered gait behavior of healthy younger and older adults.

Methods: Twenty normally sighted adults, 11 older (mean [standard deviation] age, 68.1 [5.

Computational Study on the Dynamics of a Bis(benzoxazole)-Based Overcrowded Alkene.

Understanding and controlling molecular motions is of pivotal importance for designing molecular machinery and functional molecular systems, capable of performing complex tasks. Herein, we report a comprehensive theoretical study to elucidate the dynamic behavior of a bis(benzoxazole)-based overcrowded alkene displaying several coupled and uncoupled molecular motions. The benzoxazole moieties give rise to 4 different stable conformers that interconvert through single-bond rotations.

Exploring P-(Fe,V)-Codoped Metastable-Phase β-NiMoO for Improving the Performance of Overall Water Splitting.

It is especially essential to develop high-performance and low-cost nonprecious metal catalysts for large-scale hydrogen production. A large number of electrochemical catalysts composited by transition metal centers has been reported; however, it is still a great challenge to design and manipulate target electrocatalysts to realize high overall water-splitting activity at the atomic level. Herein, we develop totally new P-(Fe,V)-codoped metastable-phase β-NiMoO.

Effect of Temperature on Condensed State Structure and Conductivity Characteristics of Micron-Level Biaxially Oriented Polypropylene Films.

Polymer-based dielectric films are increasingly demanded for devices under high electric fields used in new energy vehicles, photovoltaic grid connections, oil and gas exploration, and aerospace. However, leakage current is one of the significant factors limiting the improvement of the insulation performance. This paper tested the leakage current and condensed state structure characteristics of biaxially oriented polypropylene (BOPP) films and obtained the nonlinear characteristics of leakage current of BOPP films in the range of 40-440 V/μm and 40-110 °C.

How Health Systems World-wide Fail Type 2 Diabetics.

For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease.