ng the level of automation of the emergency operating procedures in a nuclear power plant and provide support for the optimization of a corresponding HRA (Human Reliability Analysis) model.

Two major sets of exposure limits for radiofrequency (RF) radiation, those of the International Commission on Nonionizing Radiation Protection (ICNIRP 2020) and the Institute of Electrical and Electronics Engineers (IEEE C95.1-2019), have recently been revised and updated with significant changes in limits above 6 GHz through the millimeter wave (mm-wave) band (30-300 GHz). This review compares available data on thermal damage and pain from exposure to RF energy above 6 GHz with corresponding data from infrared energy and other heat sources and estimates safety factors that are incorporated in the IEEE and ICNIRP RF exposure limits. The benchmarks for damage are the same as used in ICNIRP IR limits minimal epithelial damage to cornea and first-degree burn (erythema in skin observable within 48 h after exposure). The data suggest that limiting thermal hazard to skin is cutaneous pain for exposure durations less than ≈20 min and thermal damage for longer exposures. Limitations on available data and thermal morks for damage are the same as used in ICNIRP IR limits minimal epithelial damage to cornea and first-degree burn (erythema in skin observable within 48 h after exposure). The data suggest that limiting thermal hazard to skin is cutaneous pain for exposure durations less than ≈20 min and thermal damage for longer exposures. Limitations on available data and thermal models are noted. However, data on RF and IR thermal damage and pain thresholds show that exposures far above current ICNIRP and IEEE limits would be required to produce thermally hazardous effects. This review focuses exclusively on thermal hazards from RF exposures above 6 GHz to skin and the cornea, which are the most exposed tissues in the considered frequency range.

The paper is concerned with the issue of achieving the radiological equivalence (the equivalence of radiation risks) of radioactive waste of nuclear reactors and corresponding mass of natural uranium, taking into account the different migration ability of radionuclides in geological formations and soil. This migration radiological equivalence is being investigated for the deep burial of radioactive waste in the case of the development of a two-component nuclear power system with the concurrent use of thermal neutron reactors and fast neutron reactors. Calculations were performed of radiation doses and radiation risks of cancer death arising from consumption of drinking water from a well above a disposal site. The radiation risk relating to a two-component nuclear power system is lower than that from natural uranium; i.e., after reaching the radiological equivalence (100 y of storage) over the timescale of 109 y, the principle of migration radiological equivalence is satisfied. It would take 106 y after radiactive waste.

This study examined receipt of services for mental health conditions and non-opioid substance use disorders (SUDs) among privately insured adolescents and young adults (ie, youth) with subsequent clinically diagnosed opioid use disorder (OUD) or opioid poisoning.

Among individuals aged 12 to 25 years (N = 4926), healthcare service utilization claims for the 2 years before a newly clinically diagnosed OUD or opioid poisoning were assessed for mental health and nonopioid SUD service visits.

Over half (60.6%) of the youth with clinically diagnosed OUD or opioid poisoning received mental health or nonopioid SUD services in the 2 years before the opioid poisoning or OUD diagnosis.

Many adolescents and young adults with clinically diagnosed OUD or opioid poisoning interacted with the healthcare system to receive services for mental health conditions and nonopioid SUDs before the OUD or opioid poisoning being diagnosed. Opportunities exist to design better intervention strategies to prevent OUD or opioid poisoning among adolescents and young adults.

Many adolescents and young adults with clinically diagnosed OUD or opioid poisoning interacted with the healthcare system to receive services for mental health conditions and nonopioid SUDs before the OUD or opioid poisoning being diagnosed. Opportunities exist to design better intervention strategies to prevent OUD or opioid poisoning among adolescents and young adults.

Title 42 Code of Federal Regulations Part 2 (42 CFR Part 2 or Part 2) was enacted in 1975 to protect patients receiving treatment for substance use disorders. A scoping review on Part 2 characterized published work.

Seven databases were searched. Studies were categorized based on date of publication, primary objectives, methods, and findings. A thematic analysis was conducted using article titles and abstracts.

Of the 36 studies identified, the majority (78%) were opinions or legal reviews, (22%) employed quantitative and/or qualitative methods to study the impact of Part 2, and over half (58%) were published in the past 5 years. Only 8% of studies reported stakeholder involvement in Part 2 studies and no study included patients or patient advocates. No study discussed the efforts to align Part 2 with Health Insurance Portability and Accountability Act or provided evidence of the benefit of this alignment. Three main themes emerged from the review care delivery (46.6%), law and ethics (27.6%), and technology (25.9%). There were no studies focusing on stigma and its effect on substance use treatment and Part 2.

Despite the significance of Part 2, the literature is sparse. It is time to initiate a new era of scholarly research that focuses on the impact of statutes and policies that govern substance use disorder data sharing. Specifically, we recommend research on Part 2 and Health Insurance Portability and Accountability Act alignment, the effects of Part 2 on patients, as well as providers and other stakeholder perceptions on the regulation.

Despite the significance of Part 2, the literature is sparse. It is time to initiate a new era of scholarly research that focuses on the impact of statutes and policies that govern substance use disorder data sharing. Specifically, we recommend research on Part 2 and Health Insurance Portability and Accountability Act alignment, the effects of Part 2 on patients, as well as providers and other stakeholder perceptions on the regulation.

Ocular surface disease is a prevalent, diverse group of conditions that cause patient discomfort and decreased visual acuity and present considerable expense to both patients and healthcare systems. Autologous serum eye drops are a topical treatment modality derived from the patient’s own blood. GSK4362676 Use of serum eye drops for ocular surface disease has been promising due to biochemical similarities to endogenous tears.

Use of serum eye drops for moderate to severe ocular surface diseases such as dry eye, corneal epithelial defects, and inflammatory conditions has become more prevalent. Recent studies have demonstrated that the use of serum eye drops is well-tolerated by patients and associated with improvement in patient-reported outcomes and objective dry eye parameters. Production of serum eye drops may vary, treatment costs can be significant, and the quality of evidence for serum eye drop use published from randomized controlled trials is modest, particularly for long-term treatment. Accessibility remains an area for improvement and may be complemented by allogeneic serum eye drops.

Serum eye drops are frequently used as a safe, well-tolerated, and effective treatment for ocular surface disease. Further research is needed to assess long-term outcomes and improve accessibility.

Serum eye drops are frequently used as a safe, well-tolerated, and effective treatment for ocular surface disease. Further research is needed to assess long-term outcomes and improve accessibility.

To determine out of pocket costs (OOPC) in patients undergoing thyroidectomy for benign and malignant conditions in a commercially insured US population.

Little is known about OOPC for thyroid surgery in the United States.

Retrospective cohort study using claims of patients undergoing thyroidectomy from the IBM Watson Marketscan database from 2008 to 2017. Out of pocket costs accrued from 90 days prior to surgery to 360 days after thyroid surgery were quantified. Costs were divided into expenditures for inpatient care, outpatient care and outpatient drug costs and over three time periods from 90 days preoperatively to 30 days post operatively, from 30 days post operatively to 90 days postoperatively, and from 90 days to 1 year after surgery.

A total of 45,971 commercially insured patients aged 18-95 who underwent thyroidectomy were identified after excluding patients who changed coverage and patients on capitated plans. The median OOPC per patient in the study period of 90 days prior to surgery to 360 days after surgery was $2,434 (IQR $1,273 – $4,226), the median insurance reimbursement was $15,520 (IQR $7,653 – $29,149). Patients undergoing thyroidectomy for malignant conditions had a median OOPC of $3,019 (IQR $1,596 to $5,021) compared to $2,271 (IQR $1,201 to 3,954) for benign conditions (P<0.0001).Patients with PPO coverage had a median OOPC of $2,624 (IQR $1,458 to $4,358) compared to HMO patients with a median OOPC of $1,529 (IQR $739 to 3,058), and high deductible health plans with a median OOPC of $4,265 (IQR $2,788 to $6,210) (P<0.0001).

Despite commercial insurance coverage, patients face substantial out of pocket costs in the surgical management of thyroid disease in the United States.

Despite commercial insurance coverage, patients face substantial out of pocket costs in the surgical management of thyroid disease in the United States.

Develop unifying definitions and paradigms for data-driven methods to augment postoperative resource intensity decisions.

Postoperative level-of-care assignments and frequency of vital sign and laboratory measurements (i.e., resource intensity) should align with patient acuity. Effective, data-driven decision-support platforms could improve value of care for millions of patients annually, but their development is hindered by the lack of salient definitions and paradigms.

Embase, PubMed, and Web of Science were searched for articles describing patient acuity and resource intensity after inpatient surgery. Study quality was assessed using validated tools. Thirty-five studies were included and assimilated according to PRISMA guidelines.

Perioperative patient acuity is accurately represented by combinations of demographic, physiologic, and hospital-system variables as input features in models that capture complex, non-linear relationships. Intraoperative physiologic data enriches these representations. Tra-driven patient acuity assessments augmented by models that accurately represent complex, non-linear relationships among risk factors.

To assess postoperative 90-day outcomes after minimally invasive (laparoscopic/robot-assisted) total pancreatectomy (MITP) in selected patients versus open total pancreatectomy (OTP) among European centers.

Minimally invasive pancreatic surgery is becoming increasingly popular but data on MITP are scarce and multicenter studies comparing outcomes versus OTP are lacking. It therefore remains unclear if MITP is a valid alternative.

Multicenter retrospective propensity-score matched study including consecutive adult patients undergoing MITP or OTP for all indications at 16 European centers in 7 countries (2008-2017). Patients after MITP were matched (11, caliper 0.02) to OTP controls. Missing data were imputed. The primary outcome was 90-day major morbidity (Clavien-Dindo ≥3a). Secondary outcomes included 90-day mortality, length of hospital stay, and survival.

Of 361 patients (99 MITP/262 OTP), 70 MITP procedures (50 laparoscopic, 15 robotic, 5 hybrid) could be matched to 70 OTP controls. After matching, MITP was associated with a lower rate of major morbidity (17% MITP vs 31% OTP, P = 0.