Identification Code Research Articles

Research on the Application of Blockchain Technology in the Design of Analgesic Drug Supply Chain

The supply chain of analgesic drugs has many circulation links and trading levels, and the trading channels are complex; Information asymmetry and low logistics efficiency; Wholesale links account for a large proportion of costs. Too many trading links and complicated trading channels make the trading information asymmetric, opaque and disorderly, which will inevitably lead to the loss of efficiency and benefit in the circulation process. In this paper, the application of blockchain technology in the design of analgesic drug supply chain is studied. The analgesic drug data management center is maintained by the pharmaceutical enterprises themselves or the third party, which is mainly responsible for distributing the unique identification code of drugs, backing up all records of the whole cycle of drug production, storage, circulation and sales, and realizing the two-way traceability function of drugs. In the production process, pharmaceutical enterprises attach electronic labels from single products and outer packaging boxes to realize the traceability and anti-counterfeiting of drugs throughout their life cycle. Correspondingly, it also integrates the advantages and disadvantages of self-management and outsourcing. At this stage, enterprises can choose to subcontract non-core logistics business first, so that enterprises can focus on their core business and avoid wasting too much money and energy in logistics.

The Spanish-Moorish Mudekhar code in the Crimean cultural landscape

The subject of the study is the Spanish-Moorish Mudekhar code in the cultural landscape of the Crimea. The object of the study is the Spanish-Moorish stylistics in the decor of the architecture of the Crimea. The following methods are used in the work: culturological (ontological and semiotic) analysis in determining stylistic elements, the method of analysis of previous studies, the method of synthesis in identifying stylistic features of the Crimean architecture of the Modern period. The article reveals the following aspects of the topic: the features of the Spanish-Moorish Mudejar style and its application in the architecture of the Crimea of the Art Nouveau period, as well as the reasons for the popularization of this code in the cultural landscape of the Crimea are identified. The main conclusions of the study are: 1. The multiethnic Crimean cultural landscape is represented by the cultures of ethnic groups that inhabited the Crimea from ancient times to the present day. The main factor in the identification and self-identification of ethnic groups is religious affiliation, reflected in folk traditions. Folk art is the most characteristic example of the manifestation of ethnic identity. 2. The spread of the Spanish-Moorish Mudekhar style in Crimean architecture is not accidental, since the synthesis of eastern and Western features is organic for Crimea, which has been lying on the way "from the Varangians to the Greeks" since ancient times, at the intersection of trade routes from Europe to Asia. The Moorish style has become part of both the geographical and cultural landscape of the Crimea, organically entering the architecture of summer palaces and mansions. 3. A special contribution of the authors to the development of the topic is the identification and justification of the Mudekhar code as one of the most popular in the Crimean Art Nouveau style. The scientific novelty of the research consists in the identification and stylistic analysis of the Mudekhar code in the Crimean cultural landscape.

Challenges Introducing a Novel Health Assessment System in Disaster-prone Japan: Community-Oriented Approach for Comprehensive Healthcare in Emergency Situations (COACHES)

Introduction:Collecting real-time individual health data of all disaster-affected populations is usually considered impossible. The University of Kochi's team and its partners conceived a novel health assessment system named "Community Oriented Approach for Comprehensive Healthcare in Emergency Situations (COACHES)." It collects individual health data anonymously and records such data in a cloud-based database. The system runs on any personal mobile device by scanning a personal identification code (QR code). It is expected that anyone on site with qualifications in healthcare will run this system as a volunteer to ensure data reliability. The COACHES app development is in process, and its prototype is currently available. This study aimed to assess how people react to the novel system and see the feasibility of installation in Japan.Method:Two focus group interviews (FGI) were conducted in a small coastal village in western Japan. The village anticipates severe damages with days of isolation once a large-scale earthquake followed by a tsunami hits the area. The first FGI was held with nine purposively recruited participants. The second FGI was held one month after and included seven of the first FGI participants with one of the absent participants providing a written response. FGI was for one-hour each, with discussion following the system demonstration. The voice data during the FGI were recorded and analyzed. The research was approved by the University of Kochi IRB.Results:Some showed intense interest in the system, whereas concerns such as the privacy violation for using personal devices, the availability of healthcare personnel, or a fear that anonymous data collection may delay identifying a person in need of assistance.Conclusion:Further studies are proposed, particularly in recruiting volunteers, data storage in case of technical damage, and how to make people with limited IT literacy comfortable using the new system.

Design and Fabrication of Imprint Machine

Abstract: This Research Paper aimed at automating the process of marking serial numbers or identification codes on metal, wood, plastic components. This Machine accurately punch numbers onto metal, wood, plastic parts with varying sizes and thicknesses. The machine's design includes a robust frame, a pneumatic system, and a control system that allows for precise control of the number punching process. The punching mechanism consists of a series of hardened steel punches that can be easily replaced and adjusted to accommodate different numbers and character sizes. The control system allows operators to input the desired serial number or identification code, control the punching force, and regulate the individual spacing. The machine also includes safety to prevent injury to operators and damage to the metal parts. Overall, the design and fabrication of a imprint machine for metal parts will provide an innovative solution for manufacturers looking to streamline their product identification process.

Hydrolytic crack growth and embrittlement in poly(ethylene terephthalate)

Poly(ethylene terephthalate) (PET) is a thermoplastic of high-volume applications, and is identified as Number 1 in the Resin Identification Code on single-use packages. The ester bonds in the polymer chains are prone to hydrolysis, but the rate of hydrolysis is extremely low at room temperature. Here we show that hydrolysis causes PET to grow cracks even at room temperature and under low loads. The hydrolytic cracks greatly outrun erosion. When PET is submerged in water and subjected to a fixed load, the crack velocity increases with pH. At high loads, the crack grows rapidly, and hydrolysis is negligible, so that the crack grows with substantial plastic deformation and the fracture surface is rough. At low loads, the crack grows slowly and hydrolysis is fast enough, so that the crack grows with negligible plastic deformation and the fracture surface is smooth. These observations show that hydrolysis embrittles PET. Under development for sustainability and healthcare are biodegradable and biomass-derived polymers, many of which have hydrolysable groups in the main chains or crosslinks. They are all potentially susceptible to hydrolytic crack growth and embrittlement. It is hoped that this study will aid the development and applications of these polymers.

Application and realization of key technologies in China railway e-ticketing system

PurposeWith the yearly increase of mileage and passenger volume in China's high-speed railway, the problems of traditional paper railway tickets have become increasingly prominent, including complexity of business handling process, low efficiency of ticket inspection and high cost of usage and management. This paper aims to make extensive references to successful experiences of electronic ticket applications both domestically and internationally. The research on key technologies and system implementation of railway electronic ticket with Chinese characteristics has been carried out.Design/methodology/approachResearch in key technologies is conducted including synchronization technique in distributed heterogeneous database system, the grid-oriented passenger service record (PSR) data storage model, efficient access to massive PSR data under high concurrency condition, the linkage between face recognition service platforms and various terminals in large scenarios, and two-factor authentication of the e-ticket identification code based on the key and the user identity information. Focusing on the key technologies and architecture the of existing ticketing system, multiple service resources are expanded and developed such as electronic ticket clusters, PSR clusters, face recognition clusters and electronic ticket identification code clusters.FindingsThe proportion of paper ticket printed has dropped to 20%, saving more than 2 billion tickets annually since the launch of the application of E-ticketing nationwide. The average time for passengers to pass through the automatic ticket gates has decreased from 3 seconds to 1.3 seconds, significantly improving the efficiency of passenger transport organization. Meanwhile, problems of paper ticket counterfeiting, reselling and loss have been generally eliminated.Originality/valueE-ticketing has laid a technical foundation for the further development of railway passenger transport services in the direction of digitalization and intelligence.

NFT Mart

Non Fungible Tokens which are commonly known as NFT’s are digital items such as audios, Videos, Photographs etc. NFT’s are unique cryptographic tokens that exist on a blockchain and cannot be replicated. All Non Fungible Tokens have unique identification codes and metadata that differentiate each token from each other.

Design of Meat Product Safety Information Chain Traceability System Based on UHF RFID.

As a result of the current imperfection of the meat traceability system, there have been numerous food safety events with serious consequences. In this paper, a meat product information traceability system is designed to efficiently prevent such problems. This system develops an identification tag information reader based on ultra-high frequency (UHF) Radio Frequency Identification (RFID). It is compatible with LoRa wireless, USB serial port, RS485, and RJ45 Ethernet connection. Among them, the efficiency analysis of the Q-value algorithm finds that the recognition rate of the system reaches a maximum of about 0.367 when the number of tags n is about the frame length. The multi-tag anti-collision algorithm design based on the algorithm improves the efficiency of information collection in production and distribution links. The traceability code identification scheme is designed to effectively match various links, and the platform of system is built using LabVIEW2014 software, which has five sub-modules including user management, farm management, slaughter management, logistics management, and sales management. The system uses MySQL databases to store traceability information so that users can complete their queries by entering the traceability code on the system platform. The system not only has a low cost and a broad range of applications, but it also realizes the tracking record of meat product traceability information from breeding to selling, completes the function from information collection to information inquiry, and solves the problem of the incomplete traceability information chain. In addition, the system not only enhances the informational transparency of meat products in the product supply chain but also provides information for the regulatory authorities to effectively monitor safety.

Investigation of Information Printed on The Blister Pack of Loxoprofen Sodium Tablets

Introduction: Loxoprofen sodium was selected as a commonly used medicine. The loxoprofen sodium tablets are marketed by 22 companies in Japan. The 22 different packaging types for this single active ingredient are served. We investigated the specifications printed on the 10-tablet blister pack. Methods: Regarding specifications printing, using the 22 loxoprofen sodium products, the survey items included how many times each of the specific printing was printed on the 10-tablet blister pack. About the questionnaire survey, a question I assessed the desired number of specifications. Question II assessed the direct printing of the drug name on each of the tablets and the size of tablet. The target population of the survey consisted of prescribing doctors, nurses, pharmacists, and non-healthcare workers. Result: The number of instances in which the drug name was listed ranged from 3 to 22 on the 10-tablet blister pack. The tablet identification code was printed ranged 0 - 10. Eleven products had no medical effect information on the pack. The expiration date was printed on two products. The serial number was not printed on one product. On the questionnaire survey, the desired number of instances that the standard dose was printed was significantly higher for nurses and pharmacists than for prescribing doctors and non-healthcare workers. Nurses considered information about medical effects to be important. Pharmacists demanded more barcodes. Several identification codes were requested by health care professionals. Although many of the tablets were 9 mm in size, the respondents desired smaller tablets. Conclusion: There were gaps between the amount of information printed on the pack and that was considered desirable by healthcare professionals and non-healthcare workers. Our findings indicate that multiple items are considered useful for developing packages for oral drugs marketed in the future as well as in ensuring safe and secure pharmacological therapy

A Method for Managing ADS-B Data Based on a 4D Airspace-Temporal Grid (GeoSOT-AS)

With the exponential increase in the volume of automatic dependent surveillance-broadcast (ADS-B), and other types of air traffic control (ATC) data containing spatiotemporal attributes, it remains uncertain how to respond to immediate ATC data access within a target area. Accordingly, an original multi-level disaggregated framework for airspace, and its corresponding information management is proposed. Further, a multi-scale grid modeling and coding mapping method of airspace information represented by ADS-B is put forth. Finally, tests on the validity of the 4D airspace-temporal grid we named as the GeoSOT-AS framework were conducted across key areas based on the development of an effective data organization method for ADS-B, or an effective algorithm for extracting relevant spatiotemporal data. Experimentally, it was demonstrated that GeoSOT-AS conforms to the existing Chinese specification of civil aeronautical charting and is advantageous for its low deformation and high practicality; furthermore, the airspace grid identification code modeling was less costly, and improved performance by >80% when used for ADS-B data extraction. GeoSOT-AS can thus provide effective reference and practical information for existing airspace data management methods represented by ADS-B and can subsequently be extended to other forms of airspace management scenarios.

Niclosamide from an anthelmintic drug to a promising adjuvant therapy for diabetic kidney disease: randomized clinical trial

BackgroundDiabetic kidney disease (DKD) is a serious complication that begins with albuminuria and often leads to a rapid progressive decline in renal function. Niclosamide is a potent inhibitor of the Wnt/β-catenin pathway, which controls the expression of multiple genes of the renin–angiotensin–aldosterone system (RAAS), which in turn is influences the progression of DKD. This study was conducted to evaluate the effect of niclosamide as adjuvant therapy on DKD.MethodsOut of 127 patients screened for eligibility, 60 patients completed the study. After randomization, 30 patients in the niclosamide arm received ramipril plus niclosamide, and 30 patients in the control arm received ramipril only for 6 months. The primary outcomes were the changes in urinary albumin to creatinine ratio (UACR), serum creatinine, and estimated glomerular filtration rate (eGFR). The secondary outcomes were measurements of urinary matrix metalloproteinase-7 (MMP-7), 8-hydroxy-2ʹ-deoxyguanosine (8-OHdG), and podocalyxin (PCX). Comparisons between the two arms were done using student t-test. Correlation analysis was done using Pearson correlation.ResultsNiclosamide decreased UACR by 24% (95% CI − 30 to − 18.3%) while there was a rise in UACR in the control arm by 11% (95% CI 4 to 18.2%) after 6 months (P < 0.001). Moreover, a significant reduction in MMP-7 and PCX was noticed in the niclosamide arm. Regression analysis revealed a strong association between MMP-7, which is a noninvasive biomarker predicting the activity of the Wnt/β-catenin signaling, and UACR. A 1 mg/dL decline in MMP-7 level was associated with a 25 mg/g lowering in UACR (B = 24.95, P < 0.001).ConclusionThe addition of niclosamide to patients with diabetic kidney disease receiving an angiotensin-converting enzyme inhibitor significantly reduces albumin excretion. Further larger-scale trials are needed to confirm our results.Trial registration: The study was prospectively registered on clinicaltrial.gov on March 23, 2020, with identification code NCT04317430.

Overlapping Surgeries From the Patient's Perspective

IntroductionOverlapping surgery (OS) occurs when a single surgeon is concurrently caring for patients in multiple operating rooms (OR) but is present for all critical portions of each surgery. Although this is common practice, most studies have found public disapproval of OS. This study aims to better understand attitudes toward OS of patients who gave informed consent for OS. MethodsParticipant interviews covered topics including trust, OR personnel roles, and attitudes toward OS. Four representative transcripts were distributed among researchers for independent code identification. These were aggregated into a codebook, applied by two coders. Iterative and emergent thematic analyses were done. ResultsTwelve participants were interviewed to reach thematic saturation. Three themes shaped how participants felt about OS: trust in their surgeon, worries about OS, and understanding of OR personnel roles. Factors contributing to trust included personal research and the surgeon's experience. Frequently cited concerns were unpredictability of complications during operations and the surgeon's divided attention. Two participants inaccurately understood personnel roles, believing the surgeon did most or all the hands-on work while trainees were observers. Most participants felt a high or neutral level of comfort toward OS and indicated trust as the reason. ConclusionsIn contrast to prior research, this study found that most participants had a neutral or positive view of OS. This suggests that a trusting relationship with their surgeon and informed consent are important factors in increasing comfort for OS. Participants who misunderstood OR roles felt less comfortable toward OS. This highlights an opportunity for patient education on trainee roles.

SG-APSIC1132: BHQ isolation cart management at a Bangkok Hospital

Objectives: We aimed to provide sufficient equipment to effectively and efficiently track all equipment. Advanced management procedures are available for the treatment of any patients with infections or immunodeficiency as well as those who need special treatment or isolation from others. This management plan can be beneficial for the hospital by promoting process improvement and achieving cost effectiveness. Methods: The instruments used were surveyed in all departments of Bangkok Hospital and these data were analyzed. We used a plan–do–check–act (PDCA) strategy to improve the management by moving from a manual system to a collaborative innovation project that used 4 technological systems: (1) storage identification and identification codes for equipment; (2) request, return, and delivery using the Nsmart system; (3) transportation, receiving, and delivery; and (4) an HIS system for tracing and NSterile version 4.0 software for reporting. Results: The BHQ isolation cart management system helped the hospital control inventory and prevent infection and helped standardize patient services to improve quality at the hospital. Conclusions: This report confirms earlier findings that sufficient equipment can be made available to patients with no extra cost to management. Our findings can contribute to efforts to prevent the virus from spreading within the hospital.

A Powerful Joint Modulation and STBC Identification Algorithm for Multiuser Uplink SC-FDMA Transmissions

Owing to the rapid development and broad adoption of multiple antenna communication systems over the past few years, space-time block coding (STBC) identification has emerged as a crucial responsibility for smart radios. The majority of previous analysis of STBC identification assumed that the utilized modulation schemes for single-user and uncoded broadcasts were known. This paper investigates the challenge of joint STBC and modulation identification for uplink transmissions with numerous users in single-carrier frequency division multiple access (SC-FDMA) systems using coded transmissions. Multi-user channel estimation brings us one step closer to implementing the proposed design in real-world systems. We additionally employ the channel decoder’s deliverables, which are common in many real-world systems, to enhance the identifying and estimating procedures. Mathematical findings prove that a recursive approach can be utilized to tackle the maximum likelihood (ML) problem of simultaneous STBC and modulation identification with channel estimation. Distinguishing the superimposed signals that originate at the base-station (BS) is accomplished with the use of the space-alternating generalized expectation-maximization (SAGE) algorithm. After that, an expectation-maximization (EM) engine is deployed to make the necessary adjustments to the parameters being considered for each user. The success of the above-mentioned architecture for usage in practical applications is demonstrated by the simulation results obtained under various conditions.

The outcome of pregnancies after bariatric surgery: an observational study of pregnancies during 2004–2016 in Finland

PurposeOverweight and obesity are major risk factors for perinatal morbidity and mortality, and the need for bariatric surgery (BS) among fertile-aged women is increasing. This study evaluates the outcome of post-BS pregnancies and deliveries.MethodsAll 20–45-year-old patients delivering between 2004 and 2016 in Finland were included. Patients with previous BS were identified from the hospital discharge register, and the medical birth register was queried for data on pregnancies, deliveries, and perinatal outcomes. The data were matched using personal identification codes, and the outcomes of women with previous BS were compared with those of other pregnancies.ResultsWomen with previous BS (n = 314) constituted the bariatric group. When compared with the non-bariatric group (n = 750,019), they were older (p < 0.001), heavier (p < 0.001) and had more previous pregnancies (p < 0.001). The overall incidence of pregnancy-induced hypertension (p = 0.002), gestational diabetes (GDM) (p = 0.018), pre-term contractions (p = 0.023), pre-term delivery (p = 0.003), labour induction (p < 0.001), planned (p = 0.001) and unplanned (p = 0.036) caesarean sections and low birthweight infants (p < 0.001) were significantly higher in the bariatric group. When compared with body mass index–specific categories, the main outcomes were increased incidence of GDM and small for gestational age (SGA) newborns in the bariatric group.ConclusionBS can be considered a safe and advisable treatment for obesity among fertile-aged women. The pregnancy outcome is associated with post-BS weight, but the risk for GDM and small for gestational-age newborns is increased.

With pulling ties, electoral participation flies: factors mobilising turnout among non-resident Finnish voters

Increasingly many citizens residing abroad maintain connections to their country of origin and follow its national elections. Considering that this group constitutes a growing share of the national electorate, it is essential to better understand factors that motivate electoral participation. In this study, we explore the role of economic, social and cultural ties in a unified analysis of turnout among Finnish citizens residing abroad. We rely on individual-level register data that cover the entire Finnish expatriate electorate (n = 96,290) and match their personal background characteristics (e.g. property ownership, length of stay abroad, language) with official turnout from the 2019 Finnish parliamentary elections on the bases of personal identification codes. In line with the theoretical expectations, the results provide strong empirical evidence that non-resident citizens who maintain connections to the country of origin are more likely to vote in homeland elections.

Early DSE and Automatic Generation of Coarse-grained Merged Accelerators

Post-Moore’s law area-constrained systems rely on accelerators to deliver performance enhancements. Coarse-grained accelerators can offer substantial domain acceleration, but manual, ad hoc identification of code to accelerate is prohibitively expensive. Because cycle-accurate simulators and high-level synthesis (HLS) flows are so time-consuming, the manual creation of high-utilization accelerators that exploit control and data flow patterns at optimal granularities is rarely successful. To address these challenges, we present AccelMerger, the first automated methodology to create coarse-grained, control- and data-flow-rich merged accelerators. AccelMerger uses sequence alignment matching to recognize similar function call-graphs and loops, and neural networks to quickly evaluate their post-HLS characteristics. It accurately identifies which functions to accelerate, and it merges accelerators to respect an area budget and to accommodate system communication characteristics like latency and bandwidth. Merging two accelerators can save as much as 99% of the area of one. The space saved is used by a globally optimal integer linear program to allocate more accelerators for increased performance. We demonstrate AccelMerger’s effectiveness using HLS flows without any manual effort to fine-tune the resulting designs. On FPGA-based systems, AccelMerger yields application performance improvements of up to 16.7× over software implementations, and 1.91× on average with respect to state-of-the-art early-stage design space exploration tools.

Validity of International Classification of Diseases (ICD)-10 Diagnosis Codes for Identification of Acute Heart Failure Hospitalization and Heart Failure with Reduced Versus Preserved Ejection Fraction in a National Medicare Sample.

Heart failure (HF) is a leading cause of hospitalization in older adults. Medicare data have been used to assess HF outcomes. However, the validity of ICD-10 diagnosis codes (used since 2015) to identify acute HF hospitalization or distinguish reduced (heart failure with reduced ejection fraction) versus preserved ejection fraction (HFpEF) is unknown in Medicare data. Using Medicare data (2015-2017), we randomly sampled 200 HF hospitalizations with ICD-10 diagnosis codes for HF in the first/second claim position in a 1:1:2 ratio for systolic HF (I50.2), diastolic HF (I50.3), and other HF (I50.X). The primary gold standards included recorded HF diagnosis by a treating physician for HF hospitalization, ejection fraction (EF)≤50 for heart failure with reduced ejection fraction, and EF>50 for HFpEF. If the quantitative EF was not present, then qualitative descriptions of EF were used for heart failure with reduced ejection fraction/HFpEF gold standards. Multiple secondary gold standards were also tested. Gold standard data were extracted from medical records using standardized forms and adjudicated by cardiology fellows/staff. We calculated positive predictive values with 95% CIs. The 200-chart validation sample included 50 systolic, 50 diastolic, 47 combined dysfunction, and 53 unspecified HF patients. The positive predictive values of acute HF hospitalization was 98% [95% CI, 95-100] for first-position ICD-10 HF diagnosis and 66% [95% CI, 58-74] for first/second-position diagnosis. Quantitative EF was available for ≥80% of patients with systolic, diastolic, or combined dysfunction ICD-10 codes. The positive predictive value of systolic HF codes was 90% [95% CI, 82-98] for EFs≤50% and 72% [95% CI, 60-85] for EFs≤40%. The positive predictive value was 92% [95% CI, 85-100] for HFpEF for EFs>50%. The ICD-10 codes for combined or unspecified HF poorly predicted heart failure with reduced ejection fraction or HFpEF. ICD-10 principal diagnosis identified acute HF hospitalization with a high positive predictive value. Systolic and diastolic ICD-10 diagnoses reliably identified heart failure with reduced ejection fraction and HFpEF when EF 50% was used as the cutoff.

Latent Code Identification (LACOID): A Machine Learning-Based Integrative Framework [and Open-Source Software] to Classify Big Textual Data, Rebuild Contextualized/Unaltered Meanings, and Avoid Aggregation Bias

Labeling or classifying textual data and qualitative evidence is an expensive and consequential challenge. The rigor and consistency behind the construction of these labels ultimately shape research findings and conclusions. A multifaceted methodological conundrum to address this challenge is the need for human reasoning for classification that leads to deeper and more nuanced understandings; however, this same manual human classification comes with the well-documented increase in classification inconsistencies and errors, particularly when dealing with vast amounts of documents and teams of coders. An alternative to human coding consists of machine learning-assisted techniques. These data science and visualization techniques offer tools for data classification that are cost-effective and consistent but are prone to losing participants’ meanings or voices for two main reasons: (a) these classifications typically aggregate all texts configuring each input file (i.e., each interview transcript) into a single topic or code and (b) these words configuring texts are analyzed outside of their original contexts. To address this challenge and analytic conundrum, we present an analytic framework and software tool, that addresses the following question: How to classify vast amounts of qualitative evidence effectively and efficiently without losing context or the original voices of our research participants and while leveraging the nuances that human reasoning bring to the qualitative and mixed methods analytic tables? This framework mirrors the line-by-line coding employed in human/manual code identification but relying on machine learning to classify texts in minutes rather than months. The resulting outputs provide complete transparency of the classification process and aid to recreate the contextualized, original, and unaltered meanings embedded in the input documents, as provided by our participants. We offer access to the database ( González Canché, 2022e ) and software required ( González Canché, 2022a , Mac https://cutt.ly/jc7n3OT , and Windows https://cutt.ly/wc7nNKF ) to replicate the analyses. We hope this opportunity to become familiar with the analytic framework and software, may result in expanded access of data science tools to analyze qualitative evidence (see also González Canché 2022b , 2022c , 2022d , for related no-code data science applications to classify and analyze qualitative and textual data dynamically).

National Utilization, Reimbursement, and Urban Versus Rural Trends of Extracorporeal Shockwave Lithotripsy and Ureteroscopic Laser Lithotripsy

ObjectiveTo describe temporal utilization and reimbursement trends of extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) with laser lithotripsy. MethodsThe Medicare Provider Utilization and Payment Database was queried for all ESWL and URS performed between 2013 and 2020 using Current Procedural Terminology codes: ESWL – 50590; URS - 52352, 52353, 52356. Cases that lacked rural or urban identification codes were excluded. A total of 347,174 ESWL and 401,899 URS cases were identified. Linear regression was performed with statistical significance set to 95% confidence intervals. ResultsThere was a significant upward trend for URS utilization over the study period (R2 = 0.91, P <.001), but there was not a significant trend for ESWL utilization. In 2013, ESWL was used more frequently than URS, but by 2016, URS was used more frequently than ESWL. From 2013 to 2019, URS utilization increased by 241% and 168% by urban and rural urologists, respectively. URS was also associated with a slight increase in physician reimbursement over time (R2 = 0.87, P <.001), whereas there was no association between ESWL and physician reimbursement. For URS, rural and urban urologists were reimbursed an average of $312.07 (standard deviation [SD] $14.03) and $404.86 (SD $21.96), respectively. For ESWL, rural and urban urologists were reimbursed an average of $456.22 (SD $5.74) and $562.66 (SD $16.68), respectively. ConclusionAccording to the Medicare database, URS has surpassed ESWL in utilization, especially by urban urologists. Physician reimbursement for ESWL remained higher than URS reimbursement, though URS reimbursement increased slightly in recent years.