Physical Sciences and Mathematics Commons^™

Great Expectations: Deconstructing The Process Pathways Underlying Beaver-Related Restoration, Caroline S. Nash, Gordon E. Grant, Susan Charnley, Jason B. Dunham, Hannah Gosnell, Mark B. Hausner, David S. Pilliod, Jimmy Taylor

United States Department of Agriculture Wildlife Services: Staff Publications

Beaver-related restoration is a process-based strategy that seeks to address wide-ranging ecological objectives by reestablishing dam building in degraded stream systems. Although the beaver-related restoration has broad appeal, especially in water-limited systems, its effectiveness is not yet well documented. In this article, we present a process-expectation framework that links beaver-related restoration tactics to commonly expected outcomes by identifying the set of process pathways that must occur to achieve those expected outcomes. We explore the contingency implicit within this framework using social and biophysical data from project and research sites. This analysis reveals that outcomes are often predicated on complex process …

Development Of 3d In Vitro Tissue Models For The Analysis Of Solar Radiation Damage Of Skin, Ulises Lopez Gonzalez

Doctoral

The aim of this work was to investigate changes to the molecular composition and conformation of HaCaT cells as a result of simulated solar radiation in a 3D in vitro skin model by Raman spectroscopy. The process to achieve this goal was performed in three main stages: (1) optimisation of the working concentration and volume of two 3D membranes, used as a structural support in the skin model; (2) the construction of the 3D in vitro skin model and; (3) the investigation of the dose-dependent effects of solar radiation on HaCaT cells in the skin model in comparison with the …

3d Printing Of Human Microbiome Constituents To Understand Spatial Relationships And Shape Parameters In Bacteriology, Jacques Izard, Teklu Kuru Gerbaba, Shara R. P. Yumul

Department of Food Science and Technology: Faculty Publications

Effective laboratory and classroom demonstration of microbiome size and shape, diversity, and ecological relationships is hampered by a lack of high-resolution, easy-to-use, readily accessible physical or digital models for use in teaching. Three-dimensional (3D) representations are, overall, more effective in communicating visuospatial information, allowing for a better understanding of concepts not directly observable with the unaided eye. Published morphology descriptions and microscopy images were used as the basis for designing 3D digital models, scaled at 20,000×, using computer-aided design software (CAD) and generating printed models of bacteria on mass-market 3D printers. Sixteen models are presented, including rod-shaped, spiral, flask-like, vibroid, …

Avian Visual Ecologists Should Consider Uv Absorbance And All Sensory Modalities: A Response To Wisenden Et Al. (2020), Sean T. O'Daniels, Scott J. Werner, Ken Yasukawa

United States Department of Agriculture Wildlife Services: Staff Publications

In a recent publication, Wisenden et al. (2020) examined responses of territorial male Red-winged Blackbirds (Agelaius phoeniceus) to models constructed with ultraviolet (UV)-reflective red epaulets for the purpose of determining if the addition of UV reflectance to epaulets ("UV+") changed the effectiveness of signals to receivers relative to "control" epaulets under field conditions. The authors hypothesized that "UV+epaulet coloration represents a visual signal with increased efficacy in territorial interactions." They presented behavioral data but no visual modeling data. Our aims in this commentary are to suggest alternative terms to those used by the authors, to express concern about the use …

Sars-Cov-2 Exposure In Escaped Mink, Utah, Usa, Susan A. Shriner, Jeremy W. Ellis, J. Jeffrey Root, Annette Roug, Scott R. Stopak, Gerald W. Wiscomb, Jared R. Zierenberg, Hon S. Ip, Mia Kim Torchetti, Thomas J. Deliberto

United States Department of Agriculture Wildlife Services: Staff Publications

In August 2020, outbreaks of coronavirus disease were confirmed on mink farms in Utah, USA. We surveyed mammals captured on and around farms for evidence of infection or exposure. Free-ranging mink, presumed domestic escapees, exhibited high antibody titers, suggesting a potential severe acute respiratory syndrome coronavirus 2 transmission pathway to native wildlife.

We report a wildlife epidemiologic investigation of mammals captured on or near properties in Utah, USA, where outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occurred in farmed mink. Mink farms are relatively common in the United States, and most are small family farms. The US …

Predictive Modeling And Estimation Of The Doubling Time Of Confirmed Cases Of Covid-19 In Niger, Ibrahim Sidi Zakari, Hadiza Galadima

Community & Environmental Health Faculty Publications

Modeling is increasingly used to assess scenarios and make projections on the future course of new coronavirus disease. This allows for better planning of care as well as a relaxation or tightening of the restrictive measures decreed by the government and the health authorities. The data analyzed in this study covers the period from March 19 to June 05, 2020 and allowed predictions of new cases of COVID-19 based on a growth model with a growth rate that changes linearly over time. In addition, we calculated and predicted the doubling time of the number of positive cases in each region …

Toxicity Of Sodium Nitrite-Based Vertebrate Pesticides For European Starlings (Sturnus Vulgaris), Scott J. Werner, Shelagh T. Deliberto, Hailey E. Mclean, Katherine E. Horak, Kirt C. Vercauteren

United States Department of Agriculture Wildlife Services: Staff Publications

In the 21st century, invasive animals rank second only to habitat destruction as the greatest threat to global biodiversity. Socially-acceptable and cost-effective strategies are needed to reduce the negative economic and environmental impacts of invasive animals. We investigated the potential for sodium nitrite (SN; CAS 7632-00-0) to serve as an avian toxicant for European starlings (Sturnus vulgaris L.). We also assessed the non-target hazard of an experimental formulation of SN that is being developed as a toxicant for invasive wild pigs (Sus scrofa L.). In gavage experiments with European starlings, we identified a lowest observed adverse effect level …

Enhancing Healthcare Professional And Caregiving Staff Informedness With Data Analytics For Chronic Disease Management, Na Liu, Robert John Kauffman

Research Collection School Of Computing and Information Systems

An important area in healthcare to which data analytics can be applied is chronic disease management. The chronic care model is mostly patient-centric, so patients have been considered as the end users of data analytics. The information needs of healthcare providers have been overlooked. Drawing upon the theory of informedness and the transtheoretical model of health behavior change, we use a multicase study approach to investigate the information needs of different caregiving stakeholders in the spectrum of chronic diseases, and how data analytics can be designed to meet the varying needs of professionals and staff to support their informedness.

Patterns And Determinants Of Open Defecation Among Urban People, Vera Yulyani, Christin Angelina Febriani, Shaharuddin Ms, Dessy Hermawan

Kesmas

At the present time, an estimated of 673 million people defecate in the open space, not in private. Indonesia is a densely populated country with a lot of open defecation (OD) both in urban (37%) and rural areas (43%). Tanjung Karang Pusat Subdistrict is an area in Bandar Lampung City with the highest percentage of OD practice (45%). This study aimed to explore and explain the patterns and determinants of OD among urban people in the Tanjung Karang Pusat Subdistrict in- volving 377 respondents for quantitative analysis. Quantitative data were analyzed using the chi square and regression analysis. After controlling …

Determinants Of Exclusive Breastfeeding Practices Of Female Healthcare Workers In Jakarta, Indonesia, Siti Rapingah, Nova Muhani, Besral Besral, Poppy Yuniar

Kesmas

The World Health Organization (WHO) recommended that mothers worldwide exclusively breastfeed their infants for the child's first six months to achieve optimal growth, development, and health. Indonesia had not fulfilled the global standard of breastfeeding rate so that there was low coverage of exclusive breastfeeding in East Jakarta, especially for female healthcare workers. This study aimed to determine the factors associated with exclusive breastfeeding practices of healthcare workers. This was a quantitative study using a cross-sectional design. The recruited sample consisted of 85 female public health center workers with infants aged 6-24 months. Data were collected using self-administered questionnaires. Logistic …

Evaluation Of Added Sugar And Sugar-Sweetened Beverage Consumption By University Students, Çağdaş Salih Meric, Nurcan Yabanci Ayhan, Hacı Ömer Yilmaz

Kesmas

Today, increased intake of sugar and sugar-sweetened beverages is seen today as an important factor in the growing prevalence of chronic diseases, such as obesity, obesity-related diabetes, and coronary heart diseases. This study involved 214 university students from the Department of Nutrition and Dietetics of Ankara University, Faculty of Health Science, which was intended to evaluate the consumption of sugar and sugar-sweetened beverages. The frequency of student consumption of beverages and the quantities and amounts of sugar taken with beverages were questioned. The average total amount of sugar added to drinks by the students was 4.69 ± 6.35 gram, while …

Analysis Of Measles Vaccination Refusal On Social Media (Facebook) Among Anti-Vaccine Communities In Indonesia, Dwi Meilani, Evi Martha, Hadi Pratomo, Indah Jamiatun Hasanah, Somporn Rungreangkulkij

Kesmas

Measles is one of the main causes of global mortality in the under-fives. The existence of groups that reject immunization caused a decrease in immunization coverage. Anti-vaccine messages are widely delivered on social media. Identification of vaccine rejection behavior can be used as the basis to formulate effective program strategies. The design of this study used rapid assessment procedures (RAP). The informants were from two anti-vaccine communities in the Facebook group. In-depth interviews and observations were done for data collection, and data analysis was performed using the Framework Method. The results found that determinants, such as knowledge, beliefs in health …

Parity And Marital Status As Factors Influencing Contraceptive Use Among Adolescents In Indonesia, Anni Fithriyatul Mas'udah, Terry Yr Pristya, Sulistyo Andarmoyo

Kesmas

Adolescent pregnancy has a higher health risk compared to adult pregnancy. One approach to control pregnancy among adolescents is through contraceptive use. The data on contraceptive use has increased in 2018 and is still controversial among adolescents. Thus, it is necessary to determine the factors encou - rag ing the use of contraceptives among adolescents. This study aimed to determine the relation of parity and marital status on contraceptive use among adolescents. This quantitative study used a cross-sectional design. The population of this study was adolescents aged 15–19 years in Indonesia. The total sample of 936 adolescents was selected from …

Exclusive Breastfeeding History Risk Factor Associated With Stunting Of Children Aged 12–23 Months, Nurhalina Sari, Marlida Yuliza Manjorang, Zakiyah Zakiyah, Madeleine Randell

Kesmas

Stunting (low height-for-age) remains a global and national health problem because it increases the risk of disturbances in growth and development and mortality. Banjar Margo District, Tulang Bawang Regency, has the second-highest prevalence in Lampung Province, Indonesia. This study aimed to analyze the association of exclusive breastfeeding history and stunting in children aged 12–23 months in Banjar Margo District. This study used a cross-sectional design on 193 children aged 12–23 months. It was primary data conducted between April and May 2018 with a questionnaire. Data analysis was performed using the chi-square test and multiple logistic regression. The result showed that …

Assessment Of Characteristics And Conditions Before The End Of Lockdown, David San-Martín-Roldán, Francisca Rojo-Lazo, Aracelis Calzadilla-Núñez, Pablo San-Martín-Roldán, Patricia Díaz-Calzadilla, Víctor P. Díaz-Narváez

Kesmas

After months of blockades and restriction, the decision of the best time to end the lockdown after the first wave of the COVID-19 pandemic is the big question for health rectors. This study aimed to evaluate the characteristics and conditions for ending the blockade after the first wave of COVID-19. Data on the variables of interest were subjected to linear and non-linear regression studies to determine the curve that best explains the data. The coefficient of determination, the standard deviation of y in x, and the observed curve of the confidence interval were estimated. Regression which was estimated subsequently revealed …

Low Knowledge And Unawareness Of The Health Promotion As The Determinant Factors In Non-Compliance To The Mass Drug Administration Program, Nissa Noor Annashr, Icca Stella Amalia, Hoa Thi Phuong Dinh

Kesmas

From the total population of the community in Kuningan District, 78.61% were taking filariasis drugs in the Mass Drug Administration (MDA) program in 2017. Cilimus Subdistrict became a filariasis-endemic area in Kuningan with 72.39% of the MDA program coverage in 2017 (government target >86%). The purpose of this study was to analyze the determinant factors of compliance with the MDA program. The study was an analytical study with a cross-sectional design and conducted from May to June 2018. The sample of 106 people was taken from the population living in Cilimus Subdistrict, Kuningan District, using a simple random sampling technique. …

Junk Food Consumption And Symptoms Of Mental Health Problems: A Meta-Analysis For Public Health Awareness, Muhammad Hafizurrachman, Risky Kusuma Hartono

Kesmas

Junk food consumption increases the risk of having symptoms of mental health problems. This study aimed to conduct a meta-analysis to assess the association between junk food and symptoms of mental health problems. Six researchers, two primary researchers, and four assistant researchers, from October to December 2020 conducted a systematic literature review. The data sources were selected from Pubmed and Science Direct articles published from 2010 to 2020. Those websites were check-marked for text availability for original articles, using keywords for junk foods and mental health. This study had inclusion criteria for selecting and organizing articles using the Preferred Reporting …

Risk Perception For Developing Erectile Dysfunction Among Malaysian Men With Type 2 Diabetes Mellitus, Anuar Mohamad, Hizlinda Tohid, Saharuddin Ahmad, Seng Fah Tong, Mahadir Ahmad

Kesmas

Risk perception for developing erectile dysfunction (ED) is an appreciation of the susceptibility to having ED and its severity. This study examined this risk perception and its associated factors among 180 men with type 2 diabetes mellitus (T2DM), who claimed not to have ED. This cross sectional study was conducted at a public health clinic using a validated self-administered questionnaire, which assessed participant characteristics, perceived susceptibility to developing ED, perceived severity of ED, and knowledge on risk factors for ED. About 71.1% had an inaccurate perception of susceptibility to developing ED and their perception on its severity was moderate (median …

Limitations Of Transformers On Clinical Text Classification, Shang Gao, Mohammed Alawad, Michael Todd Young, John Gounley, Noah Schaefferkoetter, Hong-Jun Yoon, Xiao-Cheng Wu, Eric B. Durbin, Jennifer Doherty, Antoinette Stroup, Linda Coyle, Georgia D. Tourassi

Kentucky Cancer Registry Faculty Publications

Bidirectional Encoder Representations from Transformers (BERT) and BERT-based approaches are the current state-of-the-art in many natural language processing (NLP) tasks; however, their application to document classification on long clinical texts is limited. In this work, we introduce four methods to scale BERT, which by default can only handle input sequences up to approximately 400 words long, to perform document classification on clinical texts several thousand words long. We compare these methods against two much simpler architectures -- a word-level convolutional neural network and a hierarchical self-attention network -- and show that BERT often cannot beat these simpler baselines when classifying …

Rural Residents' Perspectives On An Mhealth Or Personalized Health Coaching Intervention: Qualitative Study With Focus Groups And Key Informant Interviews, Nancy Schoenberg, Madeline Dunfee, Hannah Yeager, Matthew Rutledge, Angela Pfammatter, Bonnie Spring

Behavioral Science Faculty Publications

BACKGROUND: Compared with national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.

OBJECTIVE: This study aims to gather perspectives on whether a healthy lifestyle intervention, specifically an app originally designed for urban users, may be feasible and acceptable to rural residents. In addition to a smartphone app, this program-Make Better Choices 2-consists of personalized health coaching, accelerometer use, and financial incentives.

METHODS: We convened 4 focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this …

Factors Leading To Successful Island Rodent Eradications Following Initial Failure, Araceli Samaniego, Peter Kappes, Keith Broome, Steve Cranwell, Richard Griffiths, Grant Harper, Pete Mcclelland, Russell Palmer, Gerard Rocamora, Keith Springer, David Will, Shane Siers

United States Department of Agriculture Wildlife Services: Staff Publications

Island rodent eradications are increasingly conducted to eliminate the negative impacts of invasive rodents. The success rate in the tropics has been lower than in temperate regions, triggering research and reviews. Environmental factors unique to the tropics (e.g., land crabs and year-round rodent breeding) have been associated with eradication failure. Operational factors have also been important, but these have not been comprehensively assessed. The environmental and operational factors using global cases where rodent eradication initially failed and subsequent attempts occurred were compared. It was determined whether operational factors explained the initial failures, whether operational improvements explained subsequent successes, and whether …

A High-Precision Machine Learning Algorithm To Classify Left And Right Outflow Tract Ventricular Tachycardia, Jianwei Zhang, Guohua Fu, Islam Abudayyeh, Magdi Yacoub, Anthony Chang, William Feaster, Louis Ehwerhemuepha, Hesham El-Askary, Xianfeng Du, Bin He, Mingjun Feng, Yibo Yu, Binhao Wang, Jing Liu, Hai Yao, Hulmin Chu, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

Introduction: Multiple algorithms based on 12-lead ECG measurements have been proposed to identify the right ventricular outflow tract (RVOT) and left ventricular outflow tract (LVOT) locations from which ventricular tachycardia (VT) and frequent premature ventricular complex (PVC) originate. However, a clinical-grade machine learning algorithm that automatically analyzes characteristics of 12-lead ECGs and predicts RVOT or LVOT origins of VT and PVC is not currently available. The effective ablation sites of RVOT and LVOT, confirmed by a successful ablation procedure, provide evidence to create RVOT and LVOT labels for the machine learning model.

Methods: We randomly sampled training, validation, and testing …

Real World Clinicopathologic Observations Of Patients With Metastatic Solid Tumors Receiving Immune Checkpoint Inhibitor Therapy: Analysis From Kentucky Cancer Registry, Aasems Jacob, Jianrong Wu, Jill M. Kolesar, Eric B. Durbin, Aju Mathew, Susanne Arnold, Aman Chauhan

Biostatistics Faculty Publications

The state of Kentucky has the highest cancer incidence and mortality in the United States. High‐risk populations such as this are often underrepresented in clinical trials. The study aims to do a comprehensive analysis of molecular landscape of metastatic cancers among these patients with detailed evaluation of factors affecting response and outcomes to immune checkpoint inhibitor (ICI) therapy. We performed a retrospective analysis of metastatic solid tumor patients who received ICI and underwent molecular profiling at our institution.

Sixty nine patients with metastatic solid tumors who received ICI were included in the study. Prevalence of smoking and secondhand tobacco exposure …

Maternal Dietary Quality, Inflammatory Potential And Childhood Adiposity: An Individual Participant Data Pooled Analysis Of Seven European Cohorts In The Alphabet Consortium, Ling-Wei Chen, Adrien M. Aubert, Nitin Shivappa, Jonathan Y. Bernard, Sara M. Mensink-Bout, Aisling A. Geraghty, John Mehegan, Matthew Suderman, Kinga Polanska, Wojciech Hanke, Agnieszka Jankowska, Caroline L. Relton, Sarah R. Crozier, Nicholas C. Harvey, Cyrus Cooper, Mark Hanson, Keith M. Godfrey, Romy Gaillard, Liesbeth Duijts, Barbara Heude, James Hébert Scd, Fionnuala M. Mcauliffe, Cecily Kelleher, Catherine M. Phillips

Faculty Publications

Background

Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity.

Methods

We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity …

Whole-Exome Sequencing And Hipsc Cardiomyocyte Models Identify Myrip, Trappc11, And Slc27a6 Of Potential Importance To Left Ventricular Hypertrophy In An African Ancestry Population, Marguerite R. Irvin, Praful Aggarwal, Steven A. Claas, Lisa De Las Fuentes, Anh N. Do, C. Charles Gu, Andrea Matter, Benjamin S. Olson, Amit Patki, Karen Schwander, Joshua D. Smith, Vinodh Srinivasasainagendra, Hemant K. Tiwari, Amy J. Turner, Deborah A. Nickerson, Dabeeru C. Rao, Ulrich Broeckel, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Indices of left ventricular (LV) structure and geometry represent useful intermediate phenotypes related to LV hypertrophy (LVH), a predictor of cardiovascular (CV) disease (CVD) outcomes.

Methods and Results: We conducted an exome-wide association study of LV mass (LVM) adjusted to height^2.7, LV internal diastolic dimension (LVIDD), and relative wall thickness (RWT) among 1,364 participants of African ancestry (AAs) in the Hypertension Genetic Epidemiology Network (HyperGEN). Both single-variant and gene-based sequence kernel association tests were performed to examine whether common and rare coding variants contribute to variation in echocardiographic traits in AAs. We then used a data-driven …

Review Of Chemoselective Reagent Based-Breath Analysis Techniques, Madeline F. Mccloud

Grawemeyer Colloquium Papers

Volatile organic compounds (VOCs) pose a threat due to the negative effects of many compounds on human health. VOCs of interest are specific carbonyl compounds produced exogenously and endogenously, resultant of industrial pollution and diseases such as cancer. High concentrations of these carbonyl compounds are found in exhaled breath are linked to cancer, therefore non-invasive breath tests would prove beneficial for cancer diagnosis. Usage of chemoselective cationic reagents allows for efficient testing of these concentrations. The development of these breath tests is detailed in the report.

Dietary Quality And Dietary Inflammatory Potential During Pregnancy And Offspring Emotional And Behavioral Symptoms In Childhood: An Individual Participant Data Meta-Analysis Of Four European Cohorts, Kinga Polanska, Pawel Kaluzny, Adrien M. Aubert, Liesbeth Duijts, Hanan El Marroun, Wojciech Hanke, James R. Hébert, Barbara Heude, Agnieszka Jankowska, Giulia Mancano, Sara M. Mensink-Bout, Caroline Relton, Nitin Shivappa Mbbs, Mph, Ph.D., Matthew Suderman, Elzbieta Trafalska, Ewelina Wesolowska, Raquel Garcia-Esteban, Mònica Guxens, Maribel Casas, Catherine M. Phillips

Faculty Publications

Background

The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age.

Methods

Individual participant data for 11,870 mother–child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression …

Creating An Organization To Support Sfa’S Women Employees, Heather K. Olson Beal, Sarah Sanchez, Lauren Brewer, Amanda Rudolph

Diversity Conference

The purpose of this session is two-fold. First, we wish to introduce the SFA OWLE (Organization for Women’s Leadership and Equity), the newly created professional women’s organization, to interested members of our campus community. Second, we wish to share experiences that we believe are relevant to others on our campus, in our community, and at other institutions, who might seek to create organizations through which to advocate for the unique needs of their marginalized or underrepresented group. To that end, this session will include a panel of female employees at SFA who have worked for more than a year to …

The Potential Of Raman Spectroscopy In The Diagnosis Of Dysplastic And Malignant Oral Lesions, Ola Ibrahim, M. Toner, Steven Flint, Hugh Byrne, Fiona Lyng

Articles

Early diagnosis, treatment and/or surveillance of oral premalignant lesions are important in preventing progression to oral squamous cell carcinoma (OSCC). The current gold standard is through histopathological diagnosis, which is limited by inter and intra observer and sampling errors. The objective of this work was to use Raman spectroscopy to discriminate between benign, mild, moderate and severe dysplasia and OSCC in formalin fixed paraffin preserved (FFPP) tissues. The study included 72 different pathologies from which 17 were benign lesions, 20 mildly dysplastic, 20 moderately dysplastic, 10 severely dysplastic and 5 invasive OSCC. The glass substrate and paraffin wax background were …

Measurement Matters: Changing Penalty Calculations Under The Hospital Acquired Condition Reduction Program (Hacrp) Cost Hospitals Millions, Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr, Teresa M. Waters

Biostatistics Faculty Publications

BACKGROUND: Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. We posit that some of this disconnect may be driven by frequent scoring updates. The sensitivity of the HACRP penalties to updates in the program's scoring methodology has not been independently evaluated.

METHODS: We used …