bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-vitro evaluation of commonly used beverages on tensile strength of different suture materials used in dental surgeries
Authors: Abullais Shahabe Saquib , Alqahtani Nabeeh Abdullah , Alkhulban Raed Mofarh , Alamer Sarah Hassan , Khan Abdul Ahad , Pimple Sandeep 
Published: November 2020

Abstract
Sutures are used for the approximation of incised flaps, assistance in primary healing, and hemorrhage control. In oral and periodontal surgery, the appropriate selection of suture material is vital for favorable healing.
The aim of the present in-vitro experiment was to evaluate the tensile strengths of 4 different types of suture materials (silk, polygalactine 910, polypropylene, chromic catgut) by simulating potential short-term intraoral exposure to various beverages (saliva, Arabic coffee, tea, cola).
A total of 280 suture specimens were prepared, out of which 10 specimens from each group were selected for pre-immersion testing. Remaining suture specimens were immersed in 4 different thermostatically controlled media (1 control [artificial saliva], 3 tests [Cola drink, Arabic coffee, Tea]). Tensile strength was measured at pre-immersion, 3, 7, and 14 days using a universal tensile testing machine. The maximum load required to break the suture material was recorded in Newton.
At day 3, tea caused significant reduction in tensile strength of silk and cola caused significant reduction in tensile strengths of polygalactine 910 and chromic catgut. Whereas, at day 7, silk and polypropylene retained their tensile strengths better than others.
The authors recommend precaution in the use of these beverages in the first postoperative week, to avoid adverse effect on the mechanical strength of sutures. When exposure to these beverages are anticipated, it is better to use polypropylene sutures that resists rapid fall in tensile strengths in the early postoperative period.
Analysis of Pediatric Oncology Nursing Research in Mainland China, 2008–2018
Authors: Luo Yuan-hui , Yin Shu-hui , Xu Jing , Challinor Julia 
Published: November 2020

Background
Up-to-date research from low- and middle-income countries is needed to inform local pediatric cancer nursing care and share best practices from these settings. Access to all current Chinese-language publications on pediatric oncology nursing research is limited because of a language barrier.

Objective
The aim of this study was to document the volume, type of research study, and yearly and geographical distribution of published pediatric oncology nursing research in Mainland China and evaluate their content and quality.

Methods
A systematic search was performed for published pediatric oncology research conducted by nurses in Mainland China (2008–2018), using 3 English databases and 3 Chinese databases. Included articles were evaluated using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal for strength and quality of evidence.

Results
A total of 133 articles were included: 106 in Chinese and 27 in English. Most studies showed level III evidence (88/133) and were rated as good quality (81/133). The most frequently researched topics were psychosocial care, clinical nursing practice, and psychometric testing, which accounted for 63.2% of all publications.

Conclusions
Progress in pediatric oncology nursing research capacity among Mainland China is promising. To gain higher-quality evidence and make existing evidence transferable for nursing practice, optimization of specific research topics is still needed.

Implications for Practice
In Mainland China, developing interventions to address the symptoms of children with cancer and caregivers’ psychosocial issues based on local nursing research should be prioritized. Some synthesized findings of this review may serve as guidance for the future of pediatric oncology nursing science in similar settings.
Rectus Fascia Versus Fascia Lata for Autologous Fascial Pubovaginal Sling: A Single-Center Comparison of Perioperative and Functional Outcomes
Authors: Peng Michelle , Sussman Rachael D. , Escobar Christina , Palmerola Ricardo , Pape Dominique M. , Smilen Scott S. , Rosenblum Nirit , Brucker Benjamin M. , Peyronnet Benoit , Nitti Victor W. 
Published: November 2020

(Abstracted from Female Pelvic Med Reconstr Surg 2020;26:493–497)
Worldwide, there has been a decline in the use of synthetic slings due to mesh-related complications and litigation. This has led to increased interest in native tissue prolapse repair using pubovaginal slings.
Effect of a Patient-Centered Decision Support Tool on Rates of Trial of Labor After Previous Cesarean Delivery: The PROCEED Randomized Clinical Trial
Authors: Kuppermann Miriam , Kaimal Anjali J. , Blat Cinthia , Gonzalez Juan , Thiet Mari-Paule , Bermingham Yamilee , Altshuler Anna L. , Bryant Allison S. , Bacchetti Peter , Grobman William A. 
Published: November 2020

(Abstracted from JAMA 2020;323:2151–2159)
Reducing cesarean delivery rates is an important health goal, given its association with maternal morbidity: as cesarean delivery rates increase, so does maternal morbidity. Contributing to the rising rate of cesarean delivery is the less frequent use of the trial-of-labor approach among pregnant women after previous cesarean delivery.
Meta-analysis on Serial Intervals and Reproductive Rates for SARS-CoV-2
Authors: Hussein Mohammad , Toraih Eman , Elshazli Rami , Fawzy Manal , Houghton August , Tatum Danielle , Killackey Mary , Kandil Emad , Duchesne Juan 
Published: November 2020

Objective:
The aim of this study was to systematically review and meta-analyze all literature reporting the basic reproductive number (R0), effective reproductive number (Re or Rt), and the serial interval (SI) values of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection.

Summary Background Data:
To assess the rate at which an infectious disease can spread in a population, the 2 measures, R0 and Re or Rt, are widely used. One of the parameters which influence the calculations is the SI, the period between symptom onset in an infector and an infectee.

Methods:
Web of Science, PubMed, Scopus, and Science Direct searching up to May 10, 2020, was performed. A continuous random-effect model was applied using the DerSimonian-Laird (inverse variance) method. Heterogeneity and publication bias were assessed.

Results:
A total of 39 articles met the eligibility criteria. Our results demonstrated the mean SI was 5.45 days, with the 95% confidence interval (CI) of 4.23 to 6.66. Pooled estimates for reproduction rates was 3.14 (95% CI: 2.69–3.59) for R0 and 3.18 (95% CI: 2.89–3.47) for Rt. Subgroup analysis by geographical region and date of publication revealed variations over both time and geography in calculated R0 and Rt values. As time has progressed, predicted R0 and Rt values had decreased globally.

Conclusions:
The study findings indicate that one SARS-CoV-2-infected person is likely to infect 3 persons, supporting that COVID-19 is a highly contagious disease. As an essential objective metrics implied in risk assessment for this emerging pandemic, monitoring R0 and Re is necessary to indicate the effectiveness or failures of mitigation efforts.
Preoperative Hepatic and Regional Arterial Chemotherapy in Patients Who Underwent Curative Colorectal Cancer Resection
Authors: Zhu Dexiang , Xia Jianguo , Gu Yan , Lin Jianjiang , Ding Kefeng , Zhou Bo , Liang Fei , Liu Tianshu , Qin Chunzhi , Wei Ye , Ren Li , Zhong Yunshi , Wang Jianhua , Yan Zhiping , Cheng Jiemin , Chen Jingwen , Chang Wenju , Zhan Shaokang , Ding Yongbin , Huo Haizhong , Liu Fanlong , Sun Junhui , Qin Xinyu , Xu Jianmin 
Published: November 2020

Objective:
To evaluate the effects of the addition of preoperative hepatic and regional arterial chemotherapy (PHRAC) on prognosis of stage II and III colorectal cancer (CRC) in a multicenter setting.

Summary of Background Data:
Our previous single-center pilot trial suggested that PHRAC in combination with surgical resection could reduce the occurrence of liver metastasis (LM) and improve survival in CRC patients.

Methods:
A prospective multi-center randomized controlled trial was conducted from December 2008 to December 2012 at 5 hospitals in China. Eligible patients with clinical stage II or III CRC who underwent curative resection were randomized to receive PHRAC plus adjuvant therapy (PHRAC arm) or adjuvant therapy alone (control arm). The primary endpoint was DFS. Secondary endpoints were cumulative LM rates, overall survival (OS), and safety (NCT00643877).

Results:
A total of 688 patients from 5 centers in China were randomly assigned (1:1) to each arm. The five-year DFS rate was 77% in the PHRAC arm and 65% in the control arm (HR = 0.61, 95% CI 0.46–0.81; P = 0.001). The 5-year LM rates were 7% and 16% in the PHRAC and control arms, respectively (HR = 0.37, 95% CI 0.22–0.63; P < 0.001). The 5-year OS rate was 84% in the PHRAC arm and 76% in the control arm (HR = 0.61, 95% CI 0.43–0.86; P = 0.005). There were no significant differences regarding treatment related morbidity or mortality between the two arms.

Conclusions:
The addition of PHRAC could improve DFS in patients with stage II and III CRC. It reduced the incidence of LM and improved OS without compromising patient safety.

Trial Registration:
ClinicalTrials.gov identifier: NCT00643877.
Distinct Genomic Profiles are Associated With Conversion to Resection and Survival in Patients With Initially Unresectable Colorectal Liver Metastases Treated With Systemic and Hepatic Artery Chemotherapy
Authors: Datta Jashodeep , Narayan Raja R. , Goldman Debra A. , Chatila Walid K. , Gonen Mithat , Strong James , Balachandran Vinod P. , Drebin Jeffrey A. , Kingham T. Peter , Jarnagin William R. , Schultz Nikolaus , Kemeny Nancy E. , D’Angelica Michael I. 
Published: November 2020

Objective:
To examine genomic correlates of conversion to resection (CTR and overall survival (OS) in patients with initially unresectable colorectal liver metastasis (IU-CRLM) treated with combination systemic and hepatic artery infusion (HAI) chemotherapy.

Background:
In patients presenting with IU-CRLM, combination systemic and HAI chemotherapy enables CTR with associated long-term OS in a subset of patients. Genomic correlates of CTR and OS in IU-CRLM have not been previously explored.

Methods:
Specimens from IU-CRLM patients receiving systemic/HAI chemotherapy (2003–2017) were submitted for next-generation sequencing. Fisher Exact test assessed associations with CTR, and Kaplan-Meier/Cox methods assessed associations with OS from HAI initiation.

Results:
Of 128 IU-CRLM patients, 51 (40%) underwent CTR at median 6 months (range: 3–35) from HAI initiation. CTR and persistently unresectable cohorts differed significantly in preoperative systemic chemotherapy exposure, node-positive primary status, and size of largest liver metastasis. Median and 5-year OS was 66 months and 51%. CTR was associated with prolonged survival (time-dependent HR 0.23,95% CI: 0.12–0.46, P < 0.001). The most frequently altered genes were APC (81%), TP53 (77%), and KRAS (37%). Oncogenic mutations in SOX9 and BRAF were associated with CTR. BRAF mutations, any RAS pathway alterations, and co-altered RAS/RAF-TP53 mutations were
associated with worse survival. Classification and regression tree analysis defined prognostically relevant clusters of genomic risk to reveal co-altered RAS/RAF-TP53 as the highest risk subgroup. Co-altered RAS/RAF-TP53 remained independently associated with worse survival (HR 2.52, 95% CI: 1.37–4.64, P = 0.003) after controlling for CTR, number of liver metastases, and preoperative extrahepatic disease.

Conclusions:
Distinct genomic profiles are associated with CTR and survival in patients with IU-CRLM treated with HAI/systemic chemotherapy. Presence of SOX9, BRAF, and co-altered RAS/RAF-TP53 mutations are promising biomarkers that, when validated in larger datasets, may impact treatment of IU-CRLM patients.
Variation in Risk-standardized Rates and Causes of Unplanned Hospital Visits Within 7 Days of Hospital Outpatient Surgery
Authors: Desai Mayur M. , Zogg Cheryl K. , Ranasinghe Isuru , Parzynski Craig S. , Lin Zhenqiu , Gorbaty Marianna , Merrill Angela , Krumholz Harlan M. , Drye Elizabeth E. 
Published: November 2020

Objectives:
The objectives of this study were to compare risk-standardized hospital visit ratios of the predicted to expected number of unplanned hospital visits within 7 days of same-day surgeries performed at US hospital outpatient departments (HOPDs) and to describe the causes of hospital visits.

Summary of Background Data:
More than half of procedures in the US are performed in outpatient settings, yet little is known about facility-level variation in short-term safety outcomes.

Methods:
The study cohort included 1,135,441 outpatient surgeries performed at 4058 hospitals between October 1, 2015 and September 30, 2016 among Medicare Fee-for-Service beneficiaries aged ≥65 years. Hospital-level, risk-standardized measure scores of unplanned hospital visits (emergency department visits, observation stays, and unplanned inpatient admissions) within 7 days of hospital outpatient surgery were calculated using hierarchical logistic regression modeling that adjusted for age, clinical comorbidities, and surgical procedural complexity.

Results:
Overall, 7.8% of hospital outpatient surgeries were followed by an unplanned hospital visit within 7 days. Many of the leading reasons for unplanned visits were for potentially preventable conditions, such as urinary retention, infection, and pain. We found considerable variation in the risk-standardized ratio score across hospitals. The 203 best-performing HOPDs, at or below the 5th percentile, had at least 22% fewer unplanned hospital visits than expected, whereas the 202 worst-performing HOPDs, at or above the 95th percentile, had at least 29% more post-surgical visits than expected, given their case and surgical procedure mix.

Conclusions:
Many patients experience an unplanned hospital visit within 7 days of hospital outpatient surgery, often for potentially preventable reasons. The observed variation in performance across hospitals suggests opportunities for quality improvement.
Implementation of Critical Care Response Teams in Ontario
Authors: Sapisochin Gonzalo , Muaddi Hala , Baxter Nancy N. , Stukel Therese A. , Lawless Bernard , Urbach David R. 
Published: November 2020

Objective:
To evaluate whether introduction of CCRTs reduced mortality rates among patients who developed a postoperative complication, also referred to as FTR.

Background:
CCRTs were introduced to improve patients’ postoperative outcomes. Its effect on FTR continues to be actively investigated.

Methods:
We conducted a population-based retrospective cohort study using administrative data from Ontario, Canada. We identified 810,279 patients admitted to hospital for major surgical procedures between January 2004 and December 2014, with a washout period consisting of the 9 months before and after the implementation of CCRTs in January 2007. Difference-in-differences analysis among patients who developed a postoperative complication (n = 148,882) was used to estimate the association between CCRT implementation and FTR before and after CCRT implementation in hospitals that did – versus did not – implement CCRT during the study period.

Results:
A total of 810,279 patients were included, of whom 148,882 (18.4%) developed a postoperative surgical complication. Among patients who developed a postoperative complication, the overall proportion of FTR was 9.2% (n = 13,659). Among patients in hospitals that introduced CCRT, the RR of FTR was 0.84, [95% confidence interval (CI) 0.78–0.90] after implementation of CCRT, while over the same time period, the RR was 0.85 (95% CI 0.80–0.91) in hospitals that did not implement CCRT. The RR ratio (difference-indifferences) was 0.99 (95% CI 0.89–1.09). Among patients undergoing orthopedic surgery, the RR ratio was 0.84 (95% CI 0.75–0.95).

Conclusion:
Although implementation of CCRTs in hospitals in Ontario, Canada, did not reduce FTR among all surgical patients having surgery, CCRTs may reduce the risk of FTR among patients having orthopedic surgery.
Alzheimer’s Dementia After Exposure to Anesthesia and Surgery in the Elderly
Authors: Silber Jeffrey H. , Rosenbaum Paul R. , Reiter Joseph G. , Hill Alexander S. , Jain Siddharth , Wolk David A. , Small Dylan. , Hashemi Sean , Niknam Bijan A. , Neuman Mark D. , Fleisher Lee A. , Eckenhoff Roderic 
Published: November 2020

Objective:
The aim of this study was to determine whether surgery and anesthesia in the elderly may promote Alzheimer disease and related dementias (ADRD).

Background:
There is a substantial conflicting literature concerning the hypothesis that surgery and anesthesia promotes ADRD. Much of the literature is confounded by indications for surgery or has small sample size. This study examines elderly patients with appendicitis, a common condition that strikes mostly at random after controlling for some known associations.

Methods:
A matched natural experiment of patients undergoing appendectomy for appendicitis versus control patients without appendicitis using Medicare data from 2002 to 2017, examining 54,996 patients without previous diagnoses of ADRD, cognitive impairment, or neurological degeneration, who developed appendicitis between ages 68 through 77 years and underwent an appendectomy (the ‘‘Appendectomy’’ treated group), matching them 5:1 to 274,980 controls, examining the subsequent hazard for developing ADRD.

Results:
The hazard ratio (HR) for developing ADRD or death was lower in the Appendectomy group than controls: HR = 0.96 [95% confidence interval (CI) 0.94–0.98], P < 0.0001, (28.2% in Appendectomy vs 29.1% in controls, at 7.5 years). The HR for death was 0.97 (95% CI 0.95–0.99), P = 0.002, (22.7% vs 23.1% at 7.5 years). The HR for developing ADRD alone was 0.89 (95% CI 0.86–0.92), P < 0.0001, (7.6% in Appendectomy vs 8.6% in controls, at 7.5 years). No subgroup analyses found significantly elevated rates of ADRD in the Appendectomy group.

Conclusion:
In this natural experiment involving 329,976 elderly patients, exposure to appendectomy surgery and anesthesia did not increase the subsequent rate of ADRD.
Variation in Surgical Spending Among the Highest Quality Hospitals for Cancer Surgery
Authors: Diaz Adrian , Nuliyalu Usha , Dimick Justin B. , Nathan Hari 
Published: November 2020

Objective:
This study evaluates the variation in spending by the highest-quality hospitals performing complex cancer surgery in the United States.

Summary Background Data:
As mortality rates for high-risk cancer surgery have improved, increased attention has focused on other elements of quality, such as complications. However, high-value surgical care requires both high-quality care and cost savings. Therefore, understanding any residual cost variation among high-quality hospitals is essential to better direct efforts to achieve efficient, high-value care.

Methods:
Medicare beneficiaries age 65 to 99 who underwent surgery for pancreas, esophageal, lung, rectal, and colon cancer from 2014 to 2016 were identified. The highest-quality hospitals were identified as those in the quintile with the lowest risk- and reliability-adjusted serious complication rates for each operation. Within this cohort of high-quality hospitals, 30-day total episode, index hospitalization, physician, postacute care, and readmis-sion spending were analyzed. Logistic regression models were utilized to estimate the probability of postoperative outcomes and post-discharge resource utilization.

Results:
A total of 43,007 Medicare patients underwent either pancreas, esophageal, lung, rectal, or colon resection for cancer at a hospital within the highest-quality quintile. Among the highest quality hospitals, total episode spending ranged from $18,712 for colectomy to $38,054 for esophagectomy. Spending between the lowest- and highest spending hospitals varied from $1207 [confidence intervals (CI95%) $1195–$1220] or 6.6% of total episode spending in the lowest tertile for colectomy to $5706 (CI95% $5,506–$5906) or 16.1% of total episode spending in the lowest tertile for esophagectomy. The largest component of variation was from postacute care spending followed by readmission. For all operations, the risk-adjusted rate of postacute care facility utilization was lower among the lowest spending hospitals compared to the highest spending hospitals. For example, for pancreas the lowest-spending hospitals on average discharged patients to a postacute care facility at a rate of 18,6% (CI95% 16.2–20.9) compared to 31.0% (CI95% 28.2–33.9) in the highest-spending hospitals. In all operations, the risk-adjusted readmission rate was lower among the lowest-spending hospitals compared to the highest-spending hospitals. For instance, within the esophagus cohort, the lowest-spending hospitals had an average risk-adjusted readmission rate of 17.3% compared to 29.4% in the highest spending hospitals (P < .001).

Conclusions and Relevance:
Even among the highest-quality hospitals, significant cost variation persists among cancer operations. Postacute care variation, rather than residual variation in complication rates, explains the majority of this variation and represents an immediately actionable target for increased cost-efficiency.