International medical tourism of US cancer patients for alternative cancer treatments: Financial, demographic, and clinical profiles of online crowdfunding campaigns.

BACKGROUND: Previous research has found that individuals may travel outside their home countries in pursuit of alternative cancer therapies (ACT). The goal of this study is to compare individuals in the United States who propose plans for travel abroad for ACT, compared with individuals who seek ACT domestically. METHODS: Clinical and treatment data were extracted from campaign descriptions of 615 GoFundMe® campaigns fundraising for individuals in the United States seeking ACT between 2011 and 2019. We examined treatment modalities, treatment location, fundraising metrics, and online engagement within campaign profiles. Clinical and demographic differences between those who proposed international travel and those who sought ACT domestically were examined using two-sided Fisher's exact tests. Differences in financial and social engagement data were examined using two-sided Mann-Whitney tests. RESULTS: Of the total 615 campaigns, 237 (38.5%) mentioned plans to travel internationally for ACT, with the majority (81.9%) pursuing travel to Mexico. Campaigns that proposed international treatment requested more money ($35,000 vs. $22,650, p < 0.001), raised more money ($7833 vs. $5035, p < 0.001), had more donors (57 vs. 45, p = 0.02), and were shared more times (377 vs. 290.5, p = 0.008) compared to campaigns that did not. The median financial shortfall was greater for campaigns pursuing treatments internationally (-$22,640 vs. -$13,436, p < 0.003). CONCLUSIONS: Campaigns proposing international travel for ACT requested and received more money, were shared more online, and had more donors. However, there was significantly more unmet financial need among this group, highlighting potential financial toxicity on patients and families.

Assessment of alteration of reproductive system in vivo induced by subchronic exposure to benzo(a)pyrene via oral administration.

The objective of this study was to assess whether subchronic exposure to benzo(a)pyrene (BaP) via oral ingestion alter endpoints of the reproductive system of mice. Hsd: ICR (CD1) 10-week-old males (n = 8) were randomly assigned to the exposure group and control group. Mice were administered BaP for 30 and 60 days by daily gavage at doses of 1, 10, 50, and 100 mg/kg body weight per day. At the end of the experiments, mice were anesthetized and reproductive organs, including testes, seminal vesicles, prostate, and cauda epididymis, were removed and examined. Spermatozoa quality and DNA strand breaks were assessed-1 and 10 mg/kg/day of BaP for 30 and 60 days did not significantly induce altered morphology or weights of testes, prostate, seminal vesicle, and epididymis, and spermatozoa quality of mice; 100 mg/kg/day of BaP for 60 days decreased weights of testes, seminal vesicle, and cauda epididymis. BaP exposure also significantly decreased motility, normal head morphology, vitality, and concentration of mature spermatozoa. In addition, BaP exposure induced a significant increase in DNA strand breaks.

Preparing for ICD-10-CM/PCS: one payer's experience with general equivalence mappings (GEMs).

The International Classification of Diseases, Tenth Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) has been mandated as the new code set to be used for medical coding in the United States beginning on October 1, 2013, replacing the use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). To assist in the transition from ICD-9-CM to ICD-10-CM/PCS, the National Center for Health Statistics developed bidirectional general equivalent mappings (GEMs) between the old and new code sets. This article looks at how the GEMs have been leveraged by Health Care Service Corporation (HCSC) to achieve the goal of transition to ICD-10-CM/PCS. The analysis examines the questions asked and lessons learned in the practical application of the GEMs for the translation of business rules and processes in order to promote a deeper understanding of the data issues involved in the transition from ICD-9-CM to ICD-10-CM/PCS from a payer's perspective.