What explains very poor Yelp reviews of oral and maxillofacial surgeons in private practice?

OBJECTIVE: Websites that maintain online physician ratings, such as Yelp.com, have been growing in popularity throughout the United States. The purpose of this study was to determine which factors increase the risk for very poor reviews (1 out of 5 stars) on Yelp.com for oral and maxillofacial surgeons (OMSs) in private practice. STUDY DESIGN: A retrospective cohort study was conducted using data on OMSs from Yelp.com. Predictor variables included clinician characteristics, practice characteristics, and review characteristics. The primary outcome variable was a very poor review. Logistic regression was used to determine risk factors for a very poor review. RESULTS: The final sample consisted of 3802 reviews. Relative to male clinicians, female clinicians were 2.7 times (P < .01) more likely to receive a very poor review. Clinicians who completed residency during the 1970s were over 4.5 times (P < .01) more likely to receive a very poor review relative to clinicians who completed residency during the 2010s. Relative to clinical reviews, nonclinical reviews were more likely (odds ratio = 2.6, P < .01) to be very poor and clinical and nonclinical reviews were less likely (odds ration = 0.5, P < .01) to be very poor. CONCLUSIONS: Nonclinical reviews were more likely to be very poor relative to clinical reviews. Several clinician factors, including female sex and completing OMS residency during the 1970s, were risk factors for receiving a very poor review.

An analysis of African Swine Fever consequences on rural economies and smallholder swine producers in Haiti.

African Swine Fever (ASF) causes high mortality and often results in strict culling policies for affected pigs and international market restrictions. It took more than 25 years for swine inventories in Haiti and the Dominican Republic to recover from an ASF outbreak that took place from 1978 to 1984. The 2021 outbreaks in the Dominican Republic and Haiti pose threats to animal health, livestock markets, and producer livelihoods. A partial equilibrium Haitian pig sector model (HPM-2021) was developed to assess the economic impacts of a 2021 Haitian ASF outbreak of a similar size to the 1980s outbreak. The dynamic model examines ASF impacts from 2021 to 2024, through 100 iterations of stochastic supply shocks, and three specific demand shocks. Recovery alternatives are assessed through 2030, and outbreaks and recovery outcomes are compared to a baseline reflecting 2019 trends. The analysis includes economic effects on national pork and maize in Haiti, the Dominican Republic, the rest of the Caribbean, and the rest of the world. Findings demonstrate higher vulnerabilities of the traditional sector to ASF-related disruptions. The inflated prices generated by pork production shortfalls are an opportunity to accelerate income growth for remaining traditional pig producers. When there is no consumer avoidance, the production losses caused by ASF generate high prices and contribute to a minimum of 49% increase in traditional sector revenue, and a minimum of 2.22% revenue growth in the commercial sector from the 2019 base year. Nevertheless, the potential for consumer avoidance of pork cause prices to decrease and offset those gains by as much as 90% in the traditional sector and 44% in the commercial sector. Smaller commercial sector impacts derive from different elasticities. ASF-induced high prices also lead to increased consumer expenditure losses by up to 200% over the outbreak period. Nevertheless, consumer expenditures tend to recover instantaneously with ASF eradication. Due to persisting demand shocks, producers will earn up to 0.3% lower than baseline levels income from 2027 to 2030. Few models evaluate the economic impacts of health response policies in less developed countries like Haiti. HPM-2021 results highlight ASF impacts on prices, which can benefit certain producers and disincentivize on-farm disease reporting. Slow recovery and consumer avoidance of pork are detrimental to long-term swine industry survival, producer livelihoods, and the overall rural economy.

Right Testicular Seminoma With Bilateral Testicular Atrophy in a 44-Year-Old Infertility Patient.

Testicular cancer is common but curable when diagnosed early. Testicular cancer is often characterized by a painless unilateral testicular mass discovered incidentally. In rare cases, testicular cancer is manifested as testicular atrophy. This case study concerns a 44-year-old patient diagnosed with right testicular seminoma complicated by infertility with bilateral testicular atrophy. In countries where sperm cryopreservation is not feasible for everyone, early detection of testicular atrophy by transscrotal ultrasound could prove effective for rapid intervention to preserve patient fertility in those with asymptomatic intratesticular cancer.