An entropy weighting-based index model for rapid assessment of agricultural non-point source pollution potential in Jiangsu's plain river network.

The assessment of agricultural non-point source (AGNPS) in plain river network areas has always been a challenge due to its complex water regulation and storage mechanisms. It is urgent to construct a simple and accurate method for assessing AGNPS pollution in plain river network areas. In this study, an entropy weight method-based index model (EWM-APPI) was constructed to assess AGNPS pollution potential in the plain river network areas in Jiangsu Province.

Impact of the 2023 Centers for Medicare & Medicaid Services policy change on carotid artery stenting use among Medicare beneficiaries.

Objective: On 11 October 2023, the Centers for Medicare & Medicaid Services expanded the indications for carotid artery stenting to include standard risk patients with symptomatic ≥50% and asymptomatic ≥70% carotid artery stenosis, providing surgeons an option between carotid endarterectomy and carotid artery stenting. This decision followed arguments both for and against the change by various professional societies, including opposition by the Society for Vascular Surgery. We sought to examine the impact of the change in policy with use of carotid artery stenting versus carotid endarterectomy.

Early peripheral vascular intervention for treating patients with claudication: A decision analysis using national administrative claims data.

Objectives: Claudication, a symptom commonly associated with peripheral artery disease, affects approximately 30-40% of adults in the United States. A decision analysis is needed to integrate data, information, and knowledge from multiple sources about the stages of a patient's journey in this condition to assess the optimal treatment approach.

Methods: We designed a decision model including patient perspective and outcomes of claudication, peripheral vascular intervention, open surgical bypass, chronic limb-threatening ischemia, and amputation.

Trends in Patient, Surgeon, and Procedural Characteristics of Intraocular Lens Exchange among Medicare Beneficiaries 2011-2020.

Purpose: To assess trends in prevalence and patient/surgeon characteristics of IOL exchange surgery in the United States and to evaluate the surgical complication rates.

Setting: Medicare beneficiaries.

Design: Retrospective cross-sectional analysis.

Endophthalmitis After Retinal Surgery: A 8-Year Medicare Analysis.

Purpose: Determine endophthalmitis incidence among Medicare beneficiaries undergoing retina surgery and assess patient and surgeon-related risk factors for developing postoperative endophthalmitis.

Methods: Retrospective, cross-sectional of Medicare beneficiaries who underwent retina surgery between 2016 and 2022. Individuals who underwent surgery during the 2-year look-back period, those with an endophthalmitis diagnosis 12 months prior to index procedure, those with any intraocular procedure or intravitreal injection 3 months prior to PPV and missing laterality information were excluded.

Validation of Codes to Distinguish Between Claudication and Chronic Limb-Threatening Ischemia in Patients Undergoing Peripheral Vascular Intervention Using Medicare-Matched Registry Data.

Background: The accuracy of contemporary administrative claims codes to discriminate between different phenotypes of peripheral artery disease is not well defined. We aimed to validate a predefined set of , codes used to distinguish between claudication and chronic limb-threatening ischemia (CLTI) and to optimize their diagnostic accuracy using a supervised machine-learning approach.

Methods: We included all patients who underwent a peripheral vascular intervention for claudication or CLTI in the US Medicare-matched VQI-VISION (Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network) registry database between January 2016 and December 2019.

Use of Intravascular Ultrasound during Peripheral Vascular Interventions for Claudication Is Not Associated with Improved Outcomes.

Background: The efficacy of intravascular ultrasound (IVUS) for improving outcomes of peripheral vascular interventions (PVIs) has not been well studied. We aimed to evaluate the association of IVUS with long-term outcomes in patients undergoing PVI for claudication.

Methods: We conducted a two-cohort study using data from 100% of Medicare fee-for-service claims (2018-2022) and the Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network (VISION; 2016-2019).

Effect of Sodium Sulfate Solution Coupled with Wetting-Drying Cycles on the Properties of Nano-Alumina-Modified Concrete.

The degradation of concrete caused by sulfate attack poses a significant challenge to its durability. Using nanomaterials to enhance the mechanical and durability properties of concrete is a promising solution. A study of the durability of nano-alumina (NA)-modified concrete by sulfate erosion was carried out.

Geographic Distribution of US Ophthalmic Surgical Subspecialists.

Importance: While urban counties maintain higher densities of ophthalmologists than rural counties, the geographic distribution of ophthalmic surgical subspecialists has not yet been elucidated. A potential workforce discrepancy may impact the burden of care faced by rural surgeons.

Objective: To assess the geographic distribution of the ophthalmic subspecialist surgeon workforce and evaluate factors associated with practicing in rural areas.

Fenestrated and Branched Endovascular Aortic Repair and Mortality at Hospitals Without Investigational Device Trials.

Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).

Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.

Surgeon adoption of immediate sequential bilateral cataract surgery in the United States from 2018 to 2022.

Purpose: To assess 5-year trends in the rate of immediate sequential bilateral cataract surgery (ISBCS) and surgeon characteristics associated with performing ISBCS.

Setting: 100% Medicare Fee-For-Service beneficiaries from 2018 to 2022.

Design: Cross-sectional study.

Wide variation in mitral valve repair rates among US surgeons: Analysis of Medicare claims data.

Objective: Mitral valve repair is the preferred treatment for primary mitral regurgitation and offers significant short- and long-term advantages over valve replacement. This study was designed to evaluate the contemporary national mitral valve surgery practice patterns, focusing on the impact of surgeon-specific factors, such as operative volume and years of practice, on repair rates.

Methods: A retrospective analysis was conducted using 100% Medicare fee-for-service claims data over a 3-year period (January 2020 to December 2022).

Association between Regional Market Competition and Early Femoropopliteal Interventions for Claudication.

Background: Regional market competition is known to impact practice patterns in surgical care. We aimed to investigate the association of regional market competition with the utilization of early peripheral vascular interventions (PVIs) for the treatment of claudication, and the subsequent impact on clinical outcomes.

Methods: We conducted a retrospective analysis of 100% Medicare fee-for-service claims data from January 2019 to December 2021 to identify patients with a new diagnosis of claudication.

CrysFormer: Protein structure determination via Patterson maps, deep learning, and partial structure attention.

Determining the atomic-level structure of a protein has been a decades-long challenge. However, recent advances in transformers and related neural network architectures have enabled researchers to significantly improve solutions to this problem. These methods use large datasets of sequence information and corresponding known protein template structures, if available.

Open Globe Injury Repairs Among Medicare Beneficiaries from 2011 to 2020.

Purpose: To explore patient and surgeon characteristics for open globe injury repairs (OGRs) and rates of subsequent operations.

Methods: Using a retrospective cohort design, eyes of patients ≥18 years who underwent OGR among 100% Medicare Fee-For-Service dataset from 2011 to 2020 were included. Current Procedural Terminology (CPT®) codes were used to identify OGR.

Practice patterns of peripheral vascular interventions for peripheral artery disease in the office-based laboratory setting versus outpatient hospital.

Objective: Controversy exists regarding the value and limitations of different sites of service for peripheral artery disease treatment. We aimed to examine practice patterns associated with peripheral vascular interventions (PVIs) performed in the office-based laboratory (OBL) vs outpatient hospital site of service using a nationally representative database.

Methods: Using 100% Medicare fee-for-service claims data, we identified all patients undergoing PVI for claudication or chronic limb-threatening ischemia (CLTI) between January 2017 and December 2022.

Infrapopliteal Endovascular Interventions for Claudication Are Associated with Poor Long-Term Outcomes in Medicare-Matched Registry Patients.

Background: There are limited data supporting or opposing the use of infrapopliteal peripheral vascular interventions (PVI) for the treatment of claudication.

Objectives: We aimed to evaluate the association of infrapopliteal PVI with long-term outcomes compared with isolated femoropopliteal PVI for the treatment of claudication.

Methods: We conducted a retrospective analysis of all patients in the Medicare-matched Vascular Quality Initiative database who underwent an index infrainguinal PVI for claudication from January 2004-December 2019 using Cox proportional hazards models.

Expectations of preventative benefits and risk behaviors in a randomized trial evaluating oral HIV preexposure prophylaxis candidates.

When participants enrolled in an HIV prevention trial hold a preventive misconception (PM) - expectations that experimental interventions will confer protection from HIV infection - they may engage in behaviors that increase their risk of acquiring HIV. This can raise ethical concerns about whether those enrolled in the trial understand the nature of participation and their safety. Consequently, we systematically evaluated the prevalence of PM and its association with risk behaviors in a trial examining three candidate regimens for oral HIV pre-exposure prophylaxis in which all participants received at least one antiretroviral agent.

Appropriateness of Care Measures: A Novel Approach to Quality.

The clinical judgment of a physician is one of the most important aspects of medical quality, yet it is rarely captured with quality measures in use today. We propose a novel approach using individualized physician benchmarking that measures the appropriateness of care that a physician delivers by looking at their practice pattern in a specific clinical situation. A prime application of our novel approach to appropriateness measures is the surgical management of peripheral artery disease and claudication.

5-Year Follow-Up of a Physician Performance Feedback Report Intervention to Reduce Overuse and Excess Cost: A National Cohort Study.

Background: Mohs micrographic surgery efficiently treats skin cancer through staged resection, but surgeons' varying resection rates may lead to higher medical costs.

Objective: To evaluate the cost savings associated with a quality improvement.

Materials And Methods: The authors conducted a retrospective cohort study using 100% Medicare fee-for-service claims data to identify the change of mean stages per case for head/neck (HN) and trunk/extremity (TE) lesions before and after the quality improvement intervention from 2016 to 2021.