Payments For Acute Myocardial Infarction Episodes Of Care By Hospital Interventional Capability

It is not known whether hospitals with percutaneous coronary intervention (PCI) capability provide more costly care than hospitals without PCI capability for patients admitted for acute myocardial infarction (AMI). The growing number of PCI-capable hospitals and higher rate of PCI use at technologically advanced hospitals may result in higher costs for episodes of care initiated at PCI hospitals. However, higher rates of transfers and post-acute care procedures may result in higher costs for episodes of care initiated at non-PCI hospitals. We identified all AMI admissions in 2008 among Medicare fee-for-service beneficiaries and classified hospitals as PCI- or non-PCI-capable based on hospitals\u27 2007 PCI performance. We added all payments from the time of admission through 30 days post-admission, including payments to hospitals other than the admitting hospital. We calculated and compared risk- standardized payment for PCI and non-PCI hospitals using 2-level hierarchical generalized linear models that adjust for patient demographics and clinical characteristics. PCI hospitals had a slightly higher mean 30-day risk-standardized payment than non-PCI hospitals ($20,340 v.$19,713, P\u3c0.001). Patients presenting to PCI hospitals had higher PCI rates (39.2% v. 13.2%, P\u3c0.001) and higher coronary artery bypass graft (CABG) rates (9.5% v. 4.4%, P\u3c0.001) during index AMI admissions, lower transfer rates (2.2% v. 25.4%, P\u3c0.001), and lower revascularization rates within 30 days (0.15% v. 0.27%, P\u3c0.0001) than those presenting to non- PCI hospitals. Despite higher PCI and CABG rates for patients who began their 30-day episode of care at PCI hospitals, PCI hospitals were only $627 more costly than non-PCI hospitals for the treatment of patients with AMI

Rapid Organocatalytic Formation of Carbon Monoxide: Application towards Carbonylative Cross Couplings

Herein, the first organocatalytic method for the transformation of non‐derivatized formic acid into carbon monoxide (CO) is introduced. Formylpyrrolidine (FPyr) and trichlorotriazine (TCT), which is a cost‐efficient commodity chemical, enable this decarbonylation. Utilization of dimethylformamide (DMF) as solvent and catalyst even allows for a rapid CO generation at room temperature. Application towards four different carbonylative cross coupling protocols demonstrates the high synthetic utility and versatility of the new approach. Remarkably, this also comprehends a carbonylative Sonogashira reaction at room temperature employing intrinsically difficult electron‐deficient aryl iodides. Commercial 13C‐enriched formic acid facilitates the production of radiolabeled compounds as exemplified by the pharmaceutical Moclobemide. Finally, comparative experiments verified that the present method is highly superior to other protocols for the activation of carboxylic acids

Doing an ethnobotanical survey in the life sciences classroom

On the basis of an ethnobotanical survey that we conducted on plant use by descendents of the Khoi-San people in the Northern Cape Province in South Africa, we introduce biology teachers to an adapted rapid-appraisal methodology that can be followed in the life sciences classroom. Such a project addresses a number of the content standards in the National Science Education Standards, such as science as a human endeavour, the nature of science, and the history of science. We also shed light on ethical considerations when engaging in an ethnobotanical survey, and address, among other issues, intellectual property rights. Examples are provided of how teachers in the United States can sensitize students to the rich ethnobotanical heritage of their country

SIDOD: a synthetic image dataset for 3D object pose recognition with distractors

We present a new, publicly-available image dataset generated by the NVIDIA Deep Learning Data Synthesizer intended for use in object detection, pose estimation, and tracking applications. This dataset contains 144k stereo image pairs that synthetically combine 18 camera viewpoints of three photorealistic virtual environments with up to 10 objects (chosen randomly from the 21 object models of the YCB dataset ) and flying distractors. Object and camera pose, scene lighting, and quantity of objects and distractors were randomized. Each provided view includes RGB, depth, segmentation, and surface normal images, all pixel level. We describe our approach for domain randomization and provide insight into the decisions that produced the dataset.Published versio

Engaging African American Men as Citizen Scientists to Validate a Prostate Cancer Biomarker: Work-in-Progress

African American men (AAM) are underrepresented in prostate cancer (PCa) research despite known disparities. Screening with prostate-specific antigen (PSA) has low specificity for high-grade PCa leading to PCa over diagnosis. The Prostate Health Index (PHI) has higher specificity for lethal PCa but needs validation in AAM. Engaging AAM as citizen scientists (CSs) may improve participation of AAM in PCa research

Preliminary Evaluation of a Citizen Scientist Educational Curriculum Aimed at Engaging Black Men in Lung Cancer Early Detection Screening

This article describes an educational program to engage African American men as citizen scientists (CSs) and future research partners in a lung cancer screening project. We provide an overview of the curriculum used, the structure and format of the educational sessions, and associated educational outcomes. Furthermore, we describe lessons learned in the engagement of African American men as CS in community-based lung-health equity research. The CS educational program included five group-based sessions delivered through zoom. The educational curriculum was adapted from the University of Florida Citizen Scientist program and tailored to address lung health and the contextual experiences of African American men. Each session lasted 90 minutes. Pre- and post-test measures were collected to examine changes in knowledge, comfort, health literacy, research interests, and medical mistrust. Eight African American men completed the CS educational program. Attendance rates were high for each session (100%). Seven participants completed additional human subject research certification. Improvements were observed from pre- to post-test in participants’ level of knowledge, comfort, and health literacy but not medical mistrust. CS reported the most interest in participating in research aimed to identify important community strengths and problems. Study findings suggest that it was feasible to deliver an online citizen scientist educational program designed to prepare participants to serve as partners in a lung cancer screening intervention for African American men. Results suggest the educational program has the potential to improve key outcomes including completion of regulatory training and increased research-related knowledge, comfort, and health literacy

Society of Behavior Medicine (SBM) Urges Congress to Ensure Affordable Care Act Coverage of Prostate Cancer Screening Support Services for High-Risk Men

Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces risk of mortality. The United States Preventive Services Task Force (USPSTF) issued an updated recommendation statement on serum Prostate Specific Antigen (PSA)-based screening for PCa. Specifically, in 2012, the USPSTF recommended against PSA-based screening due to risk for overdiagnosis and overtreatment. However, the updated 2018 guidelines recommend consideration of screening for certain at risk men and revised the recommendation rating from “D” to “C.” This new guideline recommends providers to educate high-risk men on the benefits and harms of PSA-based PCa screening so that they can make an informed decision. The Affordable Care Act (ACA) includes provisions of service coverage for patient navigators who can help patients decide whether screening is appropriate, given potential risks and benefits, and training of health care providers in shared-decision regarding screening/treatment. These services can be utilized to support health care providers to better adhere to the new guideline. However, recommendations that are given a C rating or lower are not consistently reimbursed through many plans, including those offered through the ACA marketplace. The Society of Behavioral Medicine (SBM) supports the USPSTF guideline for the consideration of prostate cancer screening for high-risk men between the ages of 55 and 69. SBM encourages policymakers to include provisions for coverage of patient navigation services in the ACA to facilitate shared decision-making between providers and patients regarding screening