Affordable Care Act Expansion and Orthopaedic Surgery: Over a Decade of Impact.

» Affordable Care Act Medicaid expansion increased orthopaedic surgery access and utilization among Medicaid patients, including for racial and ethnic minorities.» Despite improved coverage, Medicaid patients continue to face significant real-world barriers to orthopaedic care, including lower appointment success and longer wait times compared with privately insured patients.» Evidence on cost and quality impacts remains limited, with early signals of increased reimbursements, higher charges, and some quality improvements postexpansion.

Leveraging Contingency Management to Encourage Online Brain Training Among Economically Disadvantaged Seniors: A Pilot Study.

This pilot study evaluated the feasibility of using contingency management (CM) to encourage economically disadvantaged seniors to participate in an online brain training program. Of 100 residents at a Housing Authority apartment complex, 11 initially enrolled, incentivized by monetary rewards. Despite multiple follow-up events, only 2% continued to engage regularly in weekly exercises.

Association of quality of life with mortality in patients with adenoid cystic carcinoma using an internationally-validated QoL questionnaire (EQ-5D-5L).

Background/objectives: An evaluation of quality of life (QoL) is increasingly required for approval and reimbursement of new drug therapies. To support the evaluation of the impact of new drug therapies on QoL in single-arm studies in adenoid cystic carcinoma (ACC), we sought to determine the QoL baseline in a cohort of patients with ACC during routine follow up visits and to assess for associations with clinical or prognostic factors.

Methods: An internationally-validated QoL questionnaire (EQ-5D-5L) was completed by patients with ACC referred to an experimental medicine centre.

Fat grafting for pedal fat pad atrophy: A narrative review of the literature.

Introduction: Pedal fat pad atrophy involves the loss of shock-absorbing adipose tissue beneath the foot, causing pain, reduced mobility, and risk of skin breakdown. Autologous fat grafting has gained attention as a regenerative approach that restores natural cushioning rather than merely masking symptoms.

Methods: PubMed, Web of Science, and Google Scholar were searched through 02/01/2025 for studies on autologous fat grafting for pedal fat pad atrophy of any etiology.

Aryl Shift Rearrangement in Scholl-Type Reaction Toward Nanographene.

Oxidative dehydrogenation, known as Scholl reaction, is a powerful method for synthesizing many polycyclic aromatic hydrocarbons. Sometimes, unexpected rearrangements can lead to the formation of new structures that are usually difficult to obtain. Here, we discover a novel Scholl-type reaction involving both 1,4-aryl- and 1,2-aryl shift rearrangements, resulting in the production of armchair nanographene.

Determining the causal agents of Alternaria leaf blight and head rot affecting broccoli in the Eastern United States.

is the causal agent typically associated with Alternaria leaf blight and head rot (ABHR) disease in broccoli and related crops in the Eastern United States. Recently a new species, , has been reported as causing disease in broccoli and other vegetables in this region. We conducted a multi-state pathogen survey during the growing seasons of 2022 and 2023 to assess the distribution and occurrence of in relation to in five broccoli-producing states.

KDM6A, ARID1A and SETD2 loss-of-function mutations as prognostic biomarkers and their association with sites of metastatic progression in locally-advanced, recurrent or metastatic adenoid cystic carcinoma.

Objectives: Recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) is typically slow growing however, some patients have more rapid progression. We sought to classify mutations in chromatin regulating genes in ACC to determine the impact of chromatin regulatory disfunction on clinical outcomes.

Materials And Methods: Matched clinical-genomic data from 271 pts with non-resectable or R/M ACC were included in this study.

Medicaid Reimbursement for Common Orthopaedic Foot and Ankle Procedures Is Highly Inconsistent Among States, Ranging from 37% to 324% of Medicare Reimbursement.

Background: Medicaid reimbursement to physicians is often perceived to be lower than Medicare, but little is known about orthopaedic foot and ankle reimbursement. This study sought to compare Medicare and Medicaid reimbursement for the 20 most common foot and ankle procedures.

Methods: Medicare reimbursement rates for common foot and ankle codes were obtained from the online Centers for Medicare & Medicaid fee schedule, while Medicaid rates were found from individual state fee schedule websites.

Atrial fibrillation is associated with lower likelihood of first-pass effect in thrombectomy for medium vessel occlusion acute ischemic strokes.

BackgroundFirst-pass effect (FPE) in endovascular thrombectomy (EVT) is strongly associated with clinically favorable outcomes. Atrial fibrillation (AF)-related strokes have been shown to be associated with greater rates of FPE in acute large vessel occlusions (LVOs). In this study, we aimed to assess the association between AF and achieving FPE in medium vessel occlusions (MeVOs).

AI-guided framework for the design of materials and devices for magnetic-tunnel-junction-based true random number generators.

Emerging devices, such as magnetic tunnel junctions, are key for energy-efficient, performant future computing systems. However, designing devices with the desirable specification and performance for these applications is often found to be time-consuming and non-trivial. Here, we investigate the design and optimization of spin-orbit torque and spin transfer torque magnetic tunnel junction models as the probabilistic devices for true random number generation.

Increased Musculoskeletal Injury Risk Without Impact on Statistical In-Game Performance Within 90 Days From Concussion Among Professional Basketball Athletes.

Background: Concussions have previously been shown to have persistent neurological changes represented by altered reaction time and postural stability in high-level athletes. The effects of concussions on professional basketball players' performance and subsequent injuries during the 90 days after return to play (RTP) have not been investigated.

Purpose/hypothesis: the purpose of this study was to evaluate player statistical performance and risk of musculoskeletal (MSK) injury within 90 days of RTP from a diagnosed concussion.

Incidence of maxillofacial trauma related to kickboxing and the efficacy of protective equipment.

Introduction Kickboxing is a heavily participated combat sport within the UK. With the sport involving striking opponents, it is widely perceived to be associated with an elevated risk of maxillofacial injury. However, the research is limited, with gaps that require further investigation.

Kelvin Probe Force Microscopy Imaging of Plasticity in Hydrogenated Perovskite Nickelate Multilevel Neuromorphic Devices.

Ion drift in nanoscale electronically inhomogeneous semiconductors is among the most important mechanisms being studied for designing neuromorphic computing hardware. However, nondestructive imaging of the ion drift in operando devices directly responsible for multiresistance states and synaptic memory represents a formidable challenge. Here, we present Kelvin probe force microscopy imaging of hydrogen-doped perovskite nickelate device channels subject to high-speed electric field pulses to directly visualize proton distribution by monitoring surface potential changes spatially, which is also supported with finite element-based electric field distribution studies.

Femoral Nerve injury from slip and fall: A novel presentation of debilitating injury.

Introduction: Femoral nerve injury is a recognized complication of abdominal, pelvic, and orthopedic surgeries. It can also occur due to pelvic fractures, intra-abdominal trauma, and hip injuries. These injuries often result in pain, weakness, and difficulty with ambulation, significantly impacting a patient's quality of life.

Impact of Stress on Premenstrual Syndrome Among Young Women: A Cross-Sectional Study.

Background And Aims: Premenstrual syndrome (PMS) is a common condition affecting young women, characterized by emotional, behavioral, and physical symptoms. Stress is believed to exacerbate PMS symptoms, yet the relationship between stress and PMS remains underexplored in the Indian context, particularly among young women in urban areas like Ahmedabad. This study aims to assess the impact of stress on PMS among young women aged 18-21 years residing in Ahmedabad, Gujarat.

Demographics in the context of health-care delivery for C1 and C2 fractures.

Introduction: Atlas and axis fractures are the most severe cervical fractures which may result in complete paralysis or death. The purpose of the current study is to identify disparities regarding length of stay (LOS), mortality, and demographic factors in patients with the most serious cervical spine fractures utilizing a nationally representative database.

Materials And Methods: The Nationwide Emergency Department Sample was utilized to provide a representative sample for patients with a primary diagnosis of C1 or C2 fracture presenting to emergency departments in years from October 2015 to December 2019.

"Chopperlysis": The effect of helicopter transport on reperfusion and outcomes in large vessel occlusion strokes.

Background: In large vessel occlusion (LVO) stroke patients transferred to a comprehensive stroke center for thrombectomy, spontaneous reperfusion may occur during transport, and anecdotally more frequently in patients transferred via helicopter than by ground. This pattern has been more often observed in conjunction with tenecteplase (TNK) treatment prior to helicopter transport. We aim to explore the "chopperlysis" effect-how helicopter transport, particularly with thrombolytics, may affect reperfusion and clinical outcomes.

Zero-Dollar Copayment Impact on Adherence Scores for Centers for Medicare and Medicaid Services Star Ratings Generic Medications.

Introduction: The Centers for Medicare & Medicaid Services (CMS) Star Ratings system pushes Medicare Advantage health plans to achieve ever greater attainments in key metrics, including adherence to hydroxymethylglutaryl-CoA reductase inhibitor (statins), renin-angiotensin system (RAS) antagonist, and noninsulin antihyperglycemic (DM) medications. The purpose of this observational study was to evaluate the impact of expanding a $0 copayment (copay) benefit from mail order-only to mail order plus retail pharmacies on adherence to statin, RAS, and DM medications.

Methods: Medicare beneficiaries with and without a $0 copay expansion who received ≥ 1 dispensing of a generic, CMS Star Ratings RAS, statin, and/or DM medication during both 2021 and 2022 were included.

Arthroscopy Patients in Medicare Population Became Sicker While Reimbursement Decreased From 2013 to 2020.

Purpose: To assess surgeon reimbursement for common arthroscopic procedures, including arthroscopic meniscal debridement and arthroscopic rotator cuff repair, in patients with differing risk profiles within the Medicare population.

Methods: A publicly available Medicare database was used to identify all cases of arthroscopic meniscal debridement and arthroscopic rotator cuff repair procedures billed to Medicare from 2013 to 2020. The surgeon reimbursement from Medicare was collected and adjusted for inflation.

The Clinical Utilisation and Duration of Treatment with HER2-Directed Therapies in HER2-Positive Recurrent or Metastatic Salivary Gland Cancers.

Salivary gland cancers (SGC) are rare tumours with limited availability of systemic therapies. Some SGC subtypes overexpress HER2, and this represents a potential therapeutic target, but the evidence base is limited. This study sought to analyse real-world data on the efficacy of HER2-directed therapies in SGC.

Unveiling the evolving landscape of stroke care costs: A time-driven analysis.

Introduction: Stroke is a common cause of mortality in the United States. However, the economic burden of stroke on the healthcare system is not well known. In this study, we aim to calculate the annual cumulative and per-patient cost of stroke.

Cone-Beam CT of the Extremities in Clinical Practice.

Cone-beam CT (CBCT) is a promising tool with increasing applications in musculoskeletal imaging due to its ability to provide thin-section CT images of the appendicular skeleton and introduce weight bearing, which accounts for loading forces that typically interact with and affect this anatomy. CBCT devices include an x-ray source directly opposite a digital silicon detector panel that performs a single rotation around an object of interest, obtaining thin-section images. Currently, the majority of research has been focused on the utility of CBCT with foot and ankle pathologic abnormalities, due to the complex architectural arrangement of the tarsal bones and weight-bearing nature of the lower extremities.