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Health 2023年第2期15卷 177-185页

作者： glenn melnick June O’Leary Sol Price School of Public Policy University of Southern California Los Angeles CA USA

The topic of the long-term effects of COVID-19, so-called “long-COVID”, has gained increased attention. The US federal government announced plans to develop an interagency national research action plan to uncover more insights into the long-term effects of COVID-19. This study contributes to our understanding of the long-term effects of COVID-19 by quantifying patterns of healthcare utilization up to 360 days after an initial COVID-19 diagnosis occurring during the beginning of the pandemic (March-August 2020) in a very large nationally representative population of insured adults. We quantify actual COVID-19-related utilization (as opposed to reported symptoms) by accessing claims data to calculate average medical visits per patient per month by type of encounter (e.g. inpatient stay, physician visit). In contrast to many recent reports in the media, our results show that COVID-19-related utilization declines substantially after the first-month post-diagnosis and continues to decline throughout the study period to very low levels.

关键词： COVID-19 Utilization Long-COVID Utilization

Shock effects on the upper limit of the collision weld process window

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Advances in Manufacturing 2024年第2期12卷 365-378页

作者： Blake Barnett Anupam Vivek glenn Daehn Department of Materials Science and Engineering The Ohio State UniversityColumbusOH43210USA Army Research Directorate Army Research LaboratoryDEVCOMAberdeen Proving GroundHarfordMD21005USA

The maximum flyer impact velocity based on a dynamic solidification cracking mechanism is proposed to describe the upper limit of collision welding process ***,the upper limit of the weld window is governed by the evolution of dynamic stresses and temperatures at the weld *** formulations for the upper limit of the collision weld window assume that both the flyer and target are made of the same material and approximate stress propagation velocities using the acoustic velocity or the shear wave velocity of the weld ***,collision welding fundamentally depends on the impacts that generate shockwaves in weld members,which can dominate the stress propagation velocities in thin weld ***,this study proposes an alternative weld window upper limit that approximates stress propagation using shock velocities calculated from modified 1-D Rankine-Hugoniot *** shock upper limit is validated against the experimental and simulation data in the collision welding literature,and offers a design tool to rapidly predict more accurate optimal collision weld process limits for similar and dissimilar weld couples compared to existing models without the cost or complexity of high-fidelity simulations.

关键词： Collision welding Solid-state welding Shock impact Weld process modelling Explosive bonding Laser impulse welding(LIW)

The Evolving Structure of Multi-Hospital Systems in the US: Focus on California

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Health 2021年第7期13卷 757-765页

作者： glenn melnick June F. O’Leary Sol Price School of Public Policy University of Southern California Los Angeles CA USA

Objectives: Hospital consolidation and the growth of multi-hospital systems are generating media headlines in the US. While there is a growing literature on the role of multi-hospital systems in the US health care system, it is still quite limited. This study helps fill the gap by documenting and describing the structure and evolution of multi-hospital systems in California over a recent 18-year period. Methods: Descriptive analysis of a hospital level longitudinal database covering the period 2002-2019 in California. Results: The total number of hospitals declined by 40 hospitals, from 445 to 405, over the study period and the total number of multi-hospital systems increased substantially from 14 systems in 2002 to 30 systems in 2019. As a result, the number and proportion of all California hospitals that were part of a multi-hospital system grew—from 177 in 2002 to 238 in 2019. By 2019, 59% of all hospitals were part of systems (compared to 40% in 2002). The size distribution of multi-hospital systems in California changed substantially over time. In the early period, larger systems dominated the system landscape. Now, half of all systems have 5 or fewer hospitals compared to 29% in 2002, while the percentage of systems with 25 or more members has declined from 25% to just 7%. Interestingly, the clinical service mix of hospital systems has changed substantially. In 2002, all 14 systems were largely acute care focused. By 2019, less than half of systems had acute care as their only and primary focus. Conclusions: Combined, these findings provide insight into the development, evolution and growing role of hospitals systems in our health care system and identify new areas for further research.

关键词： Hospital Systems Consolidation Multi-Hospital Systems

Competitive market forces and trends in US hospital spending, 2001-2009

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Health 2013年第7期5卷 1195-1200页

作者： Vivian Y. Wu Yu-Chu Shen glenn melnick Naval Postgraduate School Monterey USA University of Southern California Los Angeles USA

Objectives: To investigate components of the rapidly increasing trend in hospital spending in the 2000’s and their relationship to market structure. Study Design: Aggregate time series and multivariate analysis are conducted to test whether hospital spending growth is driven by price or quantity and how recent hospital spending growth is related to health plan and hospital market structure. Method: Hospitals are grouped into strong and weak competitive markets based on the relative concentration of hospital and health plan markets as well as managed care penetration. Results: Inflation adjusted hospital spending grew much faster than gross domestic product (GDP) throughout the 2000s. Regression results show that rapid growth was observed across all hospital markets—even in those markets where price competitive market forces are the strongest and that rising hospital prices, and not utilization explain most of the increases in hospital spending. Conclusions: Hospital spending exceeded the consumer price index (CPI) by a substantial margin in the 2000’s due in part to weakening competitive market forces, which had a dampening effect on spending and especially prices. Unless competition is restored, the cost of health care for consumers, employers and public payers can be expected to increase.

关键词： Hospital Spending Prices Utilization Competitive Markets

Lessons from the Real World: Financial Incentives to Improve Glycemic Control in Patients with Type 2 Diabetes

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Health 2018年第2期10卷 171-180页

作者： June F. O’Leary Janelle Howe Jeremy Rich glenn melnick Sol Price School of Public Policy University of Southern California Los Angeles CA USA DaVita HealthCare Partners Medical Group El Segundo CA USA HealthCare Partners Institute for Applied Research and Education El Segundo CA USA

Objectives: While the value of glycemic control to minimize adverse health outcomes among patients with diabetes is clear, achieving hemoglobin A1c (A1c) goals remain a challenge. We evaluated the use of financial incentives to increase enrollment and improve glycemic control among patients invited to participate in a monthly diabetes group appointment (DGA) as part of their enrollment in DaVita HealthCare Partners, a large southern California managed care organization. Methods: Adult diabetes patients (≥18 years) with a currently uncontrolled hemoglobin A1c level (>8.0% if 9.0% if ≥ 65 years) were randomized to 1) no DGA, 2) DGA with no financial incentives (non-incentive DGA) or 3) DGA with financial incentives (incentive DGA). Results: Nine sites among four regions of the greater Los Angeles area participated. Each site offered one non-incentive DGA and one incentive DGA. Over 1500 patients were identified for recruitment and at the peak of enrollment, 299 patients were enrolled in 18 DGAs. On average, hemoglobin A1c values dropped more for patients participating in the incentive DGA (9.9% to 8.7%, -1.2%) versus non-incentive DGA (9.7% to 9.0%, -0.7%) versus no DGA group (9.1% to 8.7%, -0.4%). Several unexpected implementation challenges arose which complicated evaluation but provide important learning lessons. Conclusions: Management of chronic diseases like diabetes is challenging for patients and the primary care system alike. Continuing to implement and evaluate programs under “real-world” conditions can provide further insight into how best to support patients with diabetes and their primary care teams in order to achieve glycemic control and avoid preventable complications.

关键词： Diabetes Glycemic Control Financial Incentives Behavioral Economics Group Appointments

Advances in teleophthalmology and artificial intelligence for diabetic retinopathy screening:a narrative review

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Annals of Eye Science 2024年第2期9卷 24-37页

作者： Tanvi Chokshi Maria Jessica Cruz Jonathon Ross glenn Yiu Tschannen Eye Institute Department of OphthalmologyUniversity of CaliforniaDavis HealthSacramentoCAUSA Department of Research College of MedicineCalifornia Northstate UniversityElk GroveCAUSA

Background and Objective:Advances in teleophthalmology and artificial intelligence(AI)for diabetic retinal screening is of growing public health ***,only 30–40%of patients with diabetes adhere to recommended diabetes screening *** enhance early detection and reduce vision threatening complications,there has been a growing number of teleophthalmology programs and novel AI algorithms with the aim to improve eye care *** purpose of this review is to assess current literature on teleophthalmology and AI for use in diabetic retinopathy(DR)screening,and to discuss advances and barriers to these innovative ***:Literature review involving teleophthalmology and AI for DR screening,with focus on the past *** Content and Findings:Teleophthalmology has demonstrated the ability to increase DR screening rates,enable earlier eye care access,and reduce healthcare *** AI-based DR screening programs appear accurate and effective,but detection of other ocular pathologies is still under development and not yet approved in the United ***,technological,financial,and legal barriers limit widespread adoption and long-term sustainability of teleophthalmology ***:The use of teleophthalmology and AI algorithms expands eye care access and helps prevent vision loss from DR and potentially other sight threatening *** in the process utilized for arriving at a particular diagnosis or decision to refer,often referred to as the“black box”,remains a multifaceted issue within the field of telemedicine for developing trust and improving patient-centered outcomes.

关键词： Teleophthalmology artificial intelligence(AI) diabetic retinopathy(DR) screening public health

Antisense oligonucleotides provide optimism to the therapeutic landscape for tauopathies

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Neural Regeneration Research 2025年第3期20卷 803-804页

作者： glenn A.Harris Lauren R.Hirschfeld Rainwater Charitable Foundation Fort WorthTXUSA

Tauopathies are a group of neurodegenerative diseases characterized by abnormal metabolism of the misfolded tau protein. Tau is encoded by the microtubule-associated protein tau gene(MAPT) and can be classified as either 3-repeat(3R) or 4-repeat(4R) based on the number of repeat domains from alternative splicing of exon 10 of the MAPT gene.

关键词： tau metabolism diseases

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用微机电系统制造更好的手表

科技纵览 2024年第2期 10-11页

作者： glenn Zorpette 不详

新型手表电机技术试图超越智能手表。半个多世纪以来,一直是计时市场支柱的指针式石英手表终于要进行高技术改造了?法国贝桑松的初创公司SilMach正在大力推进这一进程。该公司表示,他们使用硅微机电系统(MEMS)生产了一种用于指针式手表... 详细信息

新型手表电机技术试图超越智能手表。半个多世纪以来,一直是计时市场支柱的指针式石英手表终于要进行高技术改造了?法国贝桑松的初创公司SilMach正在大力推进这一进程。该公司表示,他们使用硅微机电系统(MEMS)生产了一种用于指针式手表的全新手表电机,与目前手表中使用的标准步进电机相比,其尺寸缩小一半,效率大约是前者的3倍。

关键词：指针式初创公司智能手表电机技术步进电机贝桑松大力推进

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技术突破可实现无稀土电动汽车

科技纵览 2024年第5期 12-13页

作者： glenn Zorpette 不详

磁性材料有助于打破垄断。随着全球制造的电动汽车和卡车越来越多,围绕建造性能卓越、绿色的理想汽车的竞争正在展开。竞争目标是研制一种牵引电机,其功率、可靠性和重量至少与当今行业标准的稀土永磁同步电机一样,但不含稀土元素。钕... 详细信息

磁性材料有助于打破垄断。随着全球制造的电动汽车和卡车越来越多,围绕建造性能卓越、绿色的理想汽车的竞争正在展开。竞争目标是研制一种牵引电机,其功率、可靠性和重量至少与当今行业标准的稀土永磁同步电机一样,但不含稀土元素。钕和等稀土元素带来了高昂的环境成本和供应链风险,而中国对这些元素持有近乎垄断的份额。

关键词：供应链风险稀土永磁同步电机电动汽车行业标准全球制造牵引电机磁性材料稀土元素

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下一代功率晶体管

科技纵览 2024年第3期 7-9页

作者： glenn Zorpette 不详

过去十年里,半导体领域里最半导体SEMICONDUCTORS大的事件之一就是传统硅在电力电子领域黯然失色,碳化硅(SiC)禾和镓氮化物(GaN)占据了数十亿美元的市场份额。随着这些新材料在重要领域的应用,自然而然地出现了一个问题:下一代新的功率... 详细信息

过去十年里,半导体领域里最半导体SEMICONDUCTORS大的事件之一就是传统硅在电力电子领域黯然失色,碳化硅(SiC)禾和镓氮化物(GaN)占据了数十亿美元的市场份额。随着这些新材料在重要领域的应用,自然而然地出现了一个问题:下一代新的功率半导体会是什么材料?

关键词：功率晶体管功率半导体半导体领域电力电子氮化物市场份额 SEMICON 下一代