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Article ; Online: Thousands Of Lives Could Be Saved In The US During The COVID-19 Pandemic If States Exchanged Ventilators.

Adelman, Daniel

2020 Volume 39, Issue 7, Page(s) 1247–1252

Abstract: It is thought that there are not enough mechanical ventilators in the United States for every patient who may need one during the novel coronavirus disease (COVID-19) pandemic. However, there has been no analysis that measures the potential magnitude of ... ...

Abstract	It is thought that there are not enough mechanical ventilators in the United States for every patient who may need one during the novel coronavirus disease (COVID-19) pandemic. However, there has been no analysis that measures the potential magnitude of the problem or proposes a solution. In this article I combine the pandemic forecasting model used by the federal government with estimates of ventilator availability from the literature to assess the expected shortage under various scenarios. I then propose that the federal government organize a national effort for ventilators to be exchanged between states to take advantage of the intertemporal differences in demand peaks. I evaluate versions of this proposal, including use of the national stockpile, to estimate the potentially substantial number of lives that could be saved. In the absence of other viable solutions, the government should begin this effort in earnest, or else make preparations for such coordination should the country face another pandemic in the future.
MeSH term(s)	COVID-19 ; Cause of Death ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Critical Illness/mortality ; Critical Illness/therapy ; Female ; Health Care Surveys ; Humans ; Intensive Care Units/supply & distribution ; Male ; Outcome Assessment, Health Care ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Prevalence ; Risk Assessment ; Strategic Stockpile/legislation & jurisprudence ; Survival Analysis ; Survivors/statistics & numerical data ; United States/epidemiology ; Ventilators, Mechanical/supply & distribution
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2020.00505
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Article: Thousands Of Lives Could Be Saved In The US During The COVID-19 Pandemic If States Exchanged Ventilators

Adelman, Daniel

Health Aff (Millwood)

Abstract	It is thought that there are not enough mechanical ventilators in the United States for every patient who may need one during the novel coronavirus disease (COVID-19) pandemic. However, there has been no analysis that measures the potential magnitude of the problem or proposes a solution. In this article I combine the pandemic forecasting model used by the federal government with estimates of ventilator availability from the literature to assess the expected shortage under various scenarios. I then propose that the federal government organize a national effort for ventilators to be exchanged between states to take advantage of the intertemporal differences in demand peaks. I evaluate versions of this proposal, including use of the national stockpile, to estimate the potentially substantial number of lives that could be saved. In the absence of other viable solutions, the government should begin this effort in earnest, or else make preparations for such coordination should the country face another pandemic in the future.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #155341
Database	COVID19

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Article ; Online: Primary Care Continuity, Frequency, and Regularity Associated With Medicare Savings.

Sonmez, Dilara / Weyer, George / Adelman, Daniel

JAMA network open

2023 Volume 6, Issue 8, Page(s) e2329991

Abstract: Importance: Reducing Medicare expenditures is a key objective of Medicare's transition to value-based reimbursement models. Improving access to primary care is an important way to reduce expenditures, yet less is known about how visits should be ... ...

Abstract	Importance: Reducing Medicare expenditures is a key objective of Medicare's transition to value-based reimbursement models. Improving access to primary care is an important way to reduce expenditures, yet less is known about how visits should be organized to maximize savings. Objective: To examine the association between Medicare savings and primary care visit patterns. Design, setting, and participants: This retrospective cohort study used data from a 5% sample of traditional Medicare claims from 2016 to 2019. Participants had at least 3 primary care visits with at least 180 days between the first and the last visit, were not enrolled in Medicare Advantage, did not have end-stage kidney disease, and were not institutionalized. Data were analyzed from June 2022 to April 2023. Exposures: Primary care visit patterns: visit frequency, regularity, continuity of care. Main outcomes and measures: Savings in Medicare expenditures; risk-adjusted Medicare expenditures, number of emergency department (ED) visits, and hospitalizations. Results: Among 504 471 beneficiaries (298 422 [59.16%] women; mean [SD] age, 74.26 [10.41] years), temporally regular visits with higher continuity were associated with the highest savings. For these patients, the savings increased with increasing visit frequencies, with peak savings observed at higher visit frequencies as clinical complexity increased. As regularity and continuity decreased, the association between savings and visit frequencies progressively inverted. The group with a regular and highly continuous pattern was associated with greater savings (175.87%; 95% CI, 167.40% to 184.33%; P < .001), lower risk-adjusted expenditures (-16.61%; 95% CI, -16.73% to -16.48%; P < .001), fewer risk-adjusted ED visits (-40.49%; 95% CI, -40.55% to -40.43%; P < .001), and fewer risk-adjusted hospitalizations (-53.32%; 95% CI, -53.49% to -53.14%; P < .001) compared with the irregular noncontinuous group. Conclusions and relevance: In this cohort study, savings in Medicare expenditures and improvements in acute care utilization were associated with visit frequency, regularity, and continuity in primary care in an interrelated fashion such that optimization of primary care visit patterns along each axis were associated with the largest improvement in outcomes. Demonstrating the magnitude and interdependence of these associations is useful for health care professionals and policymakers as Medicare continues its transition to value-based reimbursement models.
MeSH term(s)	United States ; Humans ; Aged ; Female ; Male ; Medicare ; Cohort Studies ; Retrospective Studies ; Continuity of Patient Care ; Critical Care
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.29991
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Book: How effective are food for education programs?

Adelman, Sarah / Gilligan, Daniel / Lehrer, Kim

A critical assessment of the evidence from developing countries

(Food policy review ; 9)

2008

Author's details	Sarah W. Adelman, Daniel O. Gilligan, and Kim Lehrer
Series title	Food policy review ; 9
Collection
Language	English
Size	XVI, 69 S., graph. Darst.
Publisher	Internat. Food Policy Research Inst
Publishing place	Washington, DC
Publishing country	United States
Document type	Book
Note	Includes bibliographical references ; Erscheinungsjahr in Vorlageform:c 2008 ; The structure and scope of food for education programs -- Economic rationale for food for education programs -- Method for reviewing the empirical literature -- Empirical evidence of the impacts on education -- Empirical evidence on the impacts on food consumption and nutrition -- Other programs providing schooling inputs
HBZ-ID	HT015724643
ISBN	978-0-89629-509-4 ; 0-89629-509-5
Database	Catalogue ZB MED Nutrition, Environment, Agriculture

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088/1401	available for loan (reading room)	Freihandmagazin (U1)

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Article ; Online: Oral Immunotherapy for Peanut Allergy.

Vickery, Brian P / Hourihane, Jonathan O / Adelman, Daniel C

The New England journal of medicine

2019 Volume 380, Issue 7, Page(s) 691–692

MeSH term(s)	Arachis ; Desensitization, Immunologic ; Humans ; Immunotherapy ; Peanut Hypersensitivity
Language	English
Publishing date	2019-01-30
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc1817331
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Article ; Online: Novel Application of a Dynamic, In-room Survey Platform to Measure Surgical Team Satisfaction.

Witmer, Hunter D D / Morris-Levenson, Joshua A / Keçeli, Çağla / Godley, Frederick A / Dhiman, Ankit / Adelman, Daniel / Turaga, Kiran K

Annals of surgery

2023 Volume 279, Issue 1, Page(s) 71–76

Abstract: Objective: To elucidate the potential usage of continuous feedback regarding team satisfaction and correlations with operative performance and patient outcomes.: Background: Continuous, actionable assessment of teamwork quality in the operating room ( ...

Abstract	Objective: To elucidate the potential usage of continuous feedback regarding team satisfaction and correlations with operative performance and patient outcomes. Background: Continuous, actionable assessment of teamwork quality in the operating room (OR) is challenging. This work introduces a novel, data-driven approach to prospectively and dynamically assess health care provider satisfaction with teamwork in the OR. Methods: Satisfaction with teamwork quality for each case was assessed utilizing a validated prompt displayed on HappyOrNot Terminals placed in all ORs, with separate panels for circulators, scrub nurses, surgeons, and anesthesia providers. Responses were cross-referenced with OR log data, team familiarity indicators, efficiency parameters, and patient safety indicator events through continuous, semiautomated data marts. Deidentified responses were analyzed through logistic regression modeling. Results: Over a 24-week period, 4123 responses from 2107 cases were recorded. The overall response rate per case was 32.5%. Greater scrub nurse specialty experience was strongly associated with satisfaction (odds ratio: 2.15, 95% CI: 1.53-3.03, P < 0.001). Worse satisfaction was associated with longer than expected procedure time (odds ratio: 0.91, 95% CI: 0.82-1.00, P = 0.047), nighttime (0.67, 95% CI: 0.55-0.82, P < 0.001), and add-on cases (0.72, 95% CI: 0.60-0.86, P < 0.001). Higher material costs (22%, 95% CI: 6-37, P = 0.006) were associated with greater team satisfaction. Cases with superior teamwork ratings were associated with a 15% shorter length of hospital stay (95% CI: 4-25, P = 0.006). Conclusions: This study demonstrates the feasibility of a dynamic survey platform to report actionable health care provider satisfaction metrics in real-time. Team satisfaction is associated with modifiable team variables and some key operational outcomes. Leveraging qualitative measurements of teamwork as operational indicators may augment staff engagement and measures of performance.
MeSH term(s)	Humans ; Surveys and Questionnaires ; Surgeons ; Health Personnel ; Operating Rooms ; Patient Care Team
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005993
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Article ; Online: Malignant primary tumors of scalp with cranial extension: multidisciplinary surgical strategies and outcomes.

Huntoon, Kristin M / Mayer, Rory R / Fahim, Daniel K / Kumar, Saloni / Adelman, David M / McCutcheon, Ian E

Journal of neurosurgery

2023 Volume 140, Issue 4, Page(s) 979–986

Abstract: Objective: Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal ... ...

Abstract	Objective: Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal resection and reconstruction. The authors present a retrospective analysis of patients with scalp malignancies who underwent resection and reconstruction. Methods: Patients presenting with scalp malignancies (1993-2021, n = 84) who required neurosurgical assistance for tumor resection were prospectively entered into a database. These data were retrospectively reviewed for this case series. The extent of neurosurgical resection was classified into four levels of involvement: scalp (level I), calvarial (level II), dural (level III), or intraparenchymal (level IV). Complications and evidence of local, locoregional, or regional recurrence were documented. Results: Patients underwent level I (n = 2), level II (n = 61), level III (n = 13), and level IV (n = 8) resections. Pathologies consisted of primarily squamous cell carcinoma (n = 50, 59.5%), basal cell carcinoma (n = 11, 13.1%), and melanoma (n = 9, 10.7%), with infrequent lesions including sarcoma, atypical fibroxanthoma, and malignant fibrous histiocytoma. For cases requiring a cranioplasty, 92.2% were done using titanium mesh and 7.8% with methylmethacrylate. At a mean follow-up of 35.5 ± 45.9 months, the overall survival was 48.8% (n = 41) and recurrence-free survival was 31.0% (n = 43). Scalp-based reconstruction involving plastic surgery was performed in 75 (89.3%) patients. The most commonly used free flap was a latissimus dorsi muscle flap (n = 46, 61.3%). One or more postoperative complications occurred in 21.4% of all patients, the most common being wound dehiscence or delayed wound healing in 13% (n = 11). Conclusions: A multidisciplinary approach with aggressive neurosurgical resection is associated with good outcomes in patients with primary malignant scalp tumors, despite invasive disease on presentation. This analysis suggests that aggressive resection (level II and higher) is effective at reducing locoregional recurrence and is not associated with a higher risk of complications relative to resection without craniectomy. As most patients require scalp reconstruction to close the postresection defect, usually with vascularized free tissue transfer, involving a plastic surgeon in the surgical planning and execution is essential.
MeSH term(s)	Humans ; Retrospective Studies ; Scalp/surgery ; Neoplasm Recurrence, Local/surgery ; Neoplasm Recurrence, Local/pathology ; Plastic Surgery Procedures ; Free Tissue Flaps/surgery ; Postoperative Complications/surgery
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.7.JNS23974
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Article: Binding Folate Receptor Alpha Autoantibody Is a Biomarker for Leucovorin Treatment Response in Autism Spectrum Disorder.

Frye, Richard E / McCarty, Patrick J / Werner, Brianna A / Scheck, Adrienne C / Collins, Heidi L / Adelman, Steven J / Rossignol, Daniel A / Quadros, Edward V

Journal of personalized medicine

2024 Volume 14, Issue 1

Abstract: Autism spectrum disorder (ASD) affects up to 1 in 36 children in the United States. It is a heterogeneous neurodevelopmental disorder with life-long consequences. Patients with ASD and folate pathway abnormalities have demonstrated improved symptoms ... ...

Abstract	Autism spectrum disorder (ASD) affects up to 1 in 36 children in the United States. It is a heterogeneous neurodevelopmental disorder with life-long consequences. Patients with ASD and folate pathway abnormalities have demonstrated improved symptoms after treatment with leucovorin (folinic acid), a reduced form of folate. However, biomarkers for treatment response have not been well investigated and clinical trials are lacking. In this retrospective analysis, a cohort of prospectively collected data from 110 consecutive ASD clinic patients [mean (SD) age: 10.5 (6.2) years; 74% male] was examined. These patients all underwent testing for folate receptor alpha autoantibodies (FRAAs) and soluble folate binding proteins (sFBPs) biomarkers and were treated with leucovorin, if appropriate. Analyses examined whether these biomarkers could predict response to leucovorin treatment as well as the severity of ASD characteristics at baseline. The social responsiveness scale (SRS), a measure of core ASD symptoms, and the aberrant behavior checklist (ABC), a measure of disruptive behavior, were collected at each clinic visit. Those positive for sFBPs had more severe ASD symptoms, and higher binding FRAA titers were associated with greater ABC irritability. Treatment with leucovorin improved most SRS subscales with higher binding FRAA titers associated with greater response. Leucovorin treatment also improved ABC irritability. These results confirm and expand on previous studies, underscore the need for biomarkers to guide treatment of folate pathways in ASD, and suggest that leucovorin may be effective for children with ASD.
Language	English
Publishing date	2024-01-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm14010062
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Article: Exploratory immunogenicity outcomes of peanut oral immunotherapy: Findings from the PALISADE trial.

Nilsson, Caroline / Vereda, Andrea / Borres, Magnus P / Andersson, Mats / Södergren, Eva / Rudengren, Magnus / Smith, Alex / Simon, Reyna J / Ryan, Robert / Fernández-Rivas, Montserrat / Adelman, Daniel / Vickery, Brian P

Clinical and translational allergy

2024 Volume 14, Issue 1, Page(s) e12326

Abstract: Background: Immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) to peanut and its components may influence the clinical reactivity to peanut. Allergen-specific immunotherapy is known for modifying both IgE and IgG4. Peanut oral immunotherapy may ... ...

Abstract	Background: Immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) to peanut and its components may influence the clinical reactivity to peanut. Allergen-specific immunotherapy is known for modifying both IgE and IgG4. Peanut oral immunotherapy may influence these serological parameters. Methods: Exploratory analyses of serological data from participants receiving peanut (Arachis hypogaea) allergen powder-dnfp (PTAH) and placebo in the double-blind, randomized, phase 3 PALISADE trial were conducted to evaluate potential relationships between peanut-specific and peanut component-specific (Ara h 1, Ara h 2, Ara h 3, Ara h 6, Ara h 8, and Ara h 9) IgE and IgG4 levels and clinical outcomes. Results: A total of 269 participants (PTAH, n = 202; placebo, n = 67) were analyzed. No relationship was observed between specific IgE and IgG4 levels at screening and maximum tolerated peanut protein dose during screening or response status during exit double-blind placebo-controlled food challenge (DBPCFC). In PTAH-treated participants, no relationship was observed between IgE and IgG4 levels at screening and maximum symptom severity during exit DBPCFC. Postscreening ratios (ie, postscreening/screening) in the PTAH group were significant at the end of updosing and exit visit for most components. Postscreening changes in specific IgE levels were more pronounced with PTAH versus placebo for most components. Conclusions: Specific IgE and IgG4 levels at screening are not correlated with screening or exit DBPCFC results, and are not predictive of clinical response to PTAH. Peanut (Arachis hypogaea) allergen powder-dnfp contains the relevant and immunodominant allergens, inducing immunological changes with the treatment. Clinical trial registration: ClinicalTrials.gov identifier: NCT02635776.
Language	English
Publishing date	2024-01-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2630865-4
ISSN	2045-7022
ISSN	2045-7022
DOI	10.1002/clt2.12326
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Article ; Online: Assessing Quality of Life in Patients with Common Variable Immunodeficiency: Why It Matters.

Adelman, Daniel C / Howard, Kellee

The journal of allergy and clinical immunology. In practice

2016 Volume 4, Issue 6, Page(s) 1180–1181

MeSH term(s)	Common Variable Immunodeficiency ; Humans ; Quality of Life
Language	English
Publishing date	2016-11-07
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2016.09.014
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