bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in Bariatric Surgery Costs and Complication Rates in the Military Health System
Authors: Luan William Patrick , Leroux Todd C , Olsen Cara , Robb Douglas , Skinner Jonathan S , Richard Patrick 
Published: December 2019

Abstract
Introduction: Within the Military Health System (MHS), facilities have struggled to meet minimum recommended volume thresholds for certain procedures. Understanding variations in complication rates and cost can help policymakers tailor policy to target improvement. Our objective was to quantify the variation in bariatric surgery complication rates and costs across a sample of military hospitals. Materials and Methods: We study a retrospective cohort of 38 military surgeons practicing in 21 military treatment facilities from 2007 to 2014 who performed 1,277 bariatric surgeries. Data from the Centralized Credentials and Quality Assurance System, which provides education and training characteristics of physicians, were linked to patient encounter data from the MHS Data Repository. Physicians were included if they performed at least five bariatric surgeries over the study period. Patients were included if they had a diagnosis of obesity (body mass index &gt; 30) and underwent a bariatric weight loss surgery. We calculated and summarized inpatient costs and complication rates across both surgeons and facilities using multivariable mixed-effects linear or logistic models. We used these models to calculate adjusted complication rates and average costs across both providers and hospitals to characterize variation in bariatric outcomes within the MHS. This study was considered exempt by the Uniformed Services University Institutional Review Board. Results: We find evidence of large variations in both complication rates and costs per admission. Overall, we found a 15.5% complication rate across the sample. When comparing averages across facilities, we find large variation in complications (49.4% coefficient of variation [CV]) and procedure costs (25.9% CV). Controlling for patient comorbidities, BMI, and year attenuates much of the variation (12.6% CV complications, 4.4% CV cost), but cannot completely explain differences across facilities. Our model suggests that complications cost 32% more than complication-free surgeries on average suggesting that quality improvement efforts could potentially yield large savings. Conclusions: We find large variations in complication rates even after controlling for patient health. Furthermore, surgical complications are a significant determinant of cost. Policymakers should target efforts to improve surgical quality across facilities and physicians. Surgical quality improvement initiatives could produce savings to the MHS through reduced complications and improved surgical readiness.
MusE GAs FLOw and Wind (MEGAFLOW) IV. A two sightline tomography of a galactic wind
Authors: Zabl Johannes , Bouché Nicolas F , Schroetter Ilane , Wendt Martin , Contini Thierry , Schaye Joop , Marino Raffaella A , Muzahid Sowgat , Pezzulli Gabriele , Verhamme Anne , Wisotzki Lutz 
Published: December 2019

ABSTRACTGalactic outflows are thought to eject baryons back out to the circumgalactic medium. Studies based on metal absorption lines (Mg ii in particular) in the spectra of background quasars indicate that the gas is ejected anisotropically, with galactic winds likely leaving the host in a bi-conical flow perpendicular to the galaxy disc. In this paper, we present a detailed analysis of an outflow from a z = 0.7 ‘green-valley’ galaxy [log (M*/M⊙) = 9.8; $\mbox{SFR}=0.5\, \mathrm{M}_{\odot }\, \mathrm{yr}^{-1}$] probed by two background sources from the MusE GAs FLOw and Wind (MEGAFLOW) survey. Thanks to a fortuitous configuration with a background quasar (SDSSJ1358 + 1145) and a bright background galaxy at z = 1.4, both at impact parameters of $\approx\! 15\, \hbox{kpc}$, we can – for the first time – probe both the receding and approaching components of a putative galactic outflow around a distant galaxy. We measure a significant velocity shift between the Mg ii absorption from the two sightlines ($84\pm 17\, \hbox{km~s$^{-1}$}$), which is consistent with the expectation from our simple fiducial wind model, possibly combined with an extended disc contribution.
A study of the physical properties of SB2s with both the visual and spectroscopic orbits
Authors: Piccotti Luca , Docobo José Ángel , Carini Roberta , Tamazian Vakhtang S , Brocato Enzo , Andrade Manuel , Campo Pedro P 
Published: December 2019

ABSTRACT
The study of a selected set of 69 double-lined spectroscopic binaries (SB2) with well-defined visual and spectroscopic orbits was carried out. The orbital parallax, the mass, the colour, and the luminosity of each component were derived from observational data for almost all of these systems. We have also obtained an independent estimation of the component masses by comparing the colour–magnitude diagram (CMD) to the stellar evolution tracks reported by Pietrinferni. Nearly all of the observational points on the CMD are located between two tracks of slightly different mass or which fall very close to the one corresponding to a unique mass value. The masses obtained from the stellar model are in good agreement with their empirical values determined by parallax techniques (orbital, Gaia, and dynamical). This means that our adopted model is rather reliable and can therefore be used to infer further information, such as the age of each component in the studied systems. Our results indicate a fair correspondence between the age of primaries and secondary stars within 3σ. Nevertheless, we caution that these age indications suffer of uncertainties due to both inhomogeneities/low precision of the adopted photometric data and possible systematics. Finally, it is statistically shown that along with the orbital and trigonometric parallaxes, the dynamical parallax can serve as a reliable tool for distance estimates.
Rotation and spots in normal A and Am/Fm stars
Authors: Trust Otto , Jurua Edward , De Cat Peter , Joshi Santosh 
Published: December 2019

ABSTRACT
Frequency analysis of long-term ultraprecise photometry can lead to precise values of rotation frequencies of rotating stars with ‘hump and spike’ features in their periodograms. Using these features, we computed the rotation frequencies and amplitudes. The corresponding equatorial rotational velocity ($V_{\rm{rot}}$) and spot size were estimated. On fitting the autocorrelation functions of the light curves with the appropriate model, we determined the star-spot decay time-scale. The $\rm \mathit{ V}_{rot}$ agrees well with the projected rotational velocity ($\rm \nu ~sin$ i) in the literature. Considering a single circular and black spot, we estimate its radius from the amplitude of the ‘spike’. No evidence for a significant difference in the average ‘spike’ amplitude and spot radius was found for Am/Fm and normal A stars. Indeed, we derived an average value of $\rm \sim\! 21\pm 2$ and $\rm \sim\! 19\pm 2$ ppm for the photometric amplitude and of $\rm 1.01\, \pm \, 0.13$ and $\rm 1.16\, \pm \, 0.12$ $R_\mathrm{ E}$ for the spot radius (where $\rm \mathit{ R}_E$ is the Earth radius), respectively. We do find a significant difference for the average spot decay time-scale, which amounts to 3.6 ± 0.2 and 1.5 ± 0.2 d for Am/Fm and normal A stars, respectively. In general, spots on normal A stars are similar in size to those on Am/Fm stars, and both are weaker than previously estimated. The existence of the ‘spikes’ in the frequency spectra may not be strongly dependent on the appearance of star-spots on the stellar surface. In comparison with G, K, and M stars, spots in normal A and Am/Fm stars are weak, which may indicate the presence of a weak magnetic field.
Gas-dust correlations in nearby galaxies: a case study of NGC 3184 and NGC 7793
Authors: Saikia Gautam , Patra Narendra Nath , Roy Nirupam , Jog Chanda J 
Published: December 2019

ABSTRACT
The study of gas-dust interactions occurring in the interstellar medium of a galaxy is essential for understanding various physical processes taking place within it. A comparison of such events at different locations corresponding to diverse astrophysical environments provides more insight into the star formation as well as dust destruction conditions and time-scales. We present a case study for two galaxies: NGC 3184 and NGC 7793, which are typical examples of a ‘grand design spiral’ and a ‘flocculent spiral’, respectively. We investigate the gas-dust correlations at various spatially resolved locations within each galaxy, including spiral arms, using archival data. Moreover, we have segregated the neutral gas into wide (warm) and narrow (cold) velocity components to check the correlations with individual dust emission bands. We find a positive correlation between the gas and the dust, with the total atomic gas emission mainly dominated by its warm component in both the galaxies. We also find the dust population in NGC 7793 to have a greater fraction of emission coming from cold and diffuse, larger-sized dust particles as compared to NGC 3184. This nearby galaxy pilot study could serve as a template for similar studies of larger galaxy samples with analogous morphologies.
Novel phylogenetic methods are needed for understanding gene function in the era of mega-scale genome sequencing
Authors: Nagy László G , Merényi Zsolt , Hegedüs Botond , Bálint Balázs 
Published: December 2019

AbstractOngoing large-scale genome sequencing projects are forecasting a data deluge that will almost certainly overwhelm current analytical capabilities of evolutionary genomics. In contrast to population genomics, there are no standardized methods in evolutionary genomics for extracting evolutionary and functional (e.g. gene-trait association) signal from genomic data. Here, we examine how current practices of multi-species comparative genomics perform in this aspect and point out that many genomic datasets are under-utilized due to the lack of powerful methodologies. As a result, many current analyses emphasize gene families for which some functional data is already available, resulting in a growing gap between functionally well-characterized genes/organisms and the universe of unknowns. This leaves unknown genes on the ‘dark side’ of genomes, a problem that will not be mitigated by sequencing more and more genomes, unless we develop tools to infer functional hypotheses for unknown genes in a systematic manner. We provide an inventory of recently developed methods capable of predicting gene-gene and gene-trait associations based on comparative data, then argue that realizing the full potential of whole genome datasets requires the integration of phylogenetic comparative methods into genomics, a rich but underutilized toolbox for looking into the past.
Reno-duodenal fistula as a complication of longstanding renal tract calculus
Authors: Owen William J , Folkard Samuel S , Rohatgi Ashish , Watson Alan , Peters John L 
Published: December 2019

Abstract
We present a rare case detailing the investigations and subsequent treatment of a lady who presented with a reno-duodenal fistula and perinephric abscess as a complication of staghorn calculus and recurrent upper urinary tract infections. Treatment involved antibiotics, nephrostomy, endoscopic closure of the fistula tract with clips, radiological drain insertion and, ultimately, nephrectomy with primary omental patch closure of the duodenal defect. We discuss the incidence of fistula tract formation as a complication of staghorn calculi, as well as investigations and management strategies employed in the literature to treat such complications, which span from conservative treatment to nephrectomy and closure of the intestinal defect. We illustrate the post-operative complications such patients are prone to and discuss these in context of the case. Whilst such cases are rare clinicians should be vigilant for complications associated with chronic inflammatory processes occurring in the urinary tract and investigate accordingly.
Theoretical Advances in Our Understanding of Network Effectiveness
Authors: Smith Julia Grace 
Published: December 2019

AbstractNetwork effectiveness is heavily theorized in the public management and administration literatures. In this article, I synthesize the literature on network effectiveness and the role of organizational theory within this literature. The review illustrates a considerable amount of organization theorizing, which suggests that the subfield of organizational theory, while not always explicit, is very much alive and well. Next, I identify what the literature does well, areas for improvement, and recent work addressing those gaps. One such gap is the mismatch between the theory in its formulation and the methods used to test said theory. While theory is configurational, testing rarely makes use of configurational methods. Further, the majority of the literature treats networks as static despite widespread recognition that networks are in fact quite dynamic. Recent theoretical and methodological advancements have been made to address these shortcomings, but these efforts continue to be the aberration rather than the norm. Finally, I provide an example of one future direction for theorizing which builds upon recent advancements. More specifically, I provide two ideal type configurational paths to network effectiveness which account for one dynamic aspect of a network, namely the sequential introduction of actors into the network.
Hysteroscopic endometrial resection vs. hysterectomy for abnormal uterine bleeding: impact on quality of life and sexuality. Evidence from a systematic review of randomized controlled trials
Authors: Vitale Salvatore G. , Ferrero Simone , Ciebiera Michal , Barra Fabio , Török Péter , Tesarik Jan , Vilos George A. , Cianci Antonio 
Published: December 2019

Purpose of review
The aim of this systematic review is to summarize the current evidence regarding the effectiveness of hysterectomy and hysteroscopic endometrial resection in improving quality of life (QoL), sexual function and psychological wellbeing of women abnormal uterine bleeding.

Recent findings
We performed a systematic literature search in PubMed/MEDLINE and Embase for original studies written in English (registered in PROSPERO 2019 CRD42019133632), using the terms ‘endometrial ablation’, ‘endometrial destruction’, ‘endometrial resection’, ‘hysterectomy’, ‘menorrhagia’, ‘dysfunctional uterine bleeding’, ‘quality of life’, ‘sexuality’ published up to April 2019. Our literature search produced 159 records. After exclusions, nine studies were included showing the following results: both types of treatment significantly improve QoL and psychological wellbeing; hysterectomy is associated with higher rates of satisfaction; hysterectomy is not associated with a significant deterioration in sexual function.

Summary
Hysterectomy is currently more advantageous in terms of improving abnormal uterine bleeding and satisfaction rates than hysteroscopic endometrial destruction techniques. Furthermore, there is some evidence of a greater improvement in general health for women undergoing hysterectomy. However, high-quality prospective randomized controlled trials should be implemented to investigate the effectiveness of hysterectomy and endometrial ablation in the improvement of QoL outcomes in larger patient cohorts.
Structural equation model analysis for the evaluation of factors associated with overweight and obesity in menopausal women in RaNCD cohort study
Authors: Darbandi Mitra , Najafi Farid , Pasdar Yahya , Rezaeian Shahab 
Published: December 2019

Abstract

Objective:
Weight gain and increased body fat mass are among the common complications of menopause. In addition to hormonal changes, behavioral and environmental factors aggravate transition through this phase. This study uses a structural equation model (SEM) to evaluate factors associated with overweight and obesity in menopausal women.

Methods:
This is a cross-sectional study of 4,471 women (pre/perimenopausal 3,150, menopausal 1,321) from baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study in the west region of Iran in 2018. Obesity and overweight were the outcome variables. SEM was used to examine the relationships, using IBM SPSS, AMOS version 23.

Results:
The mean body fat percentage and visceral fat area in menopausal women was significantly greater than among pre/perimenopause women. The direct association of higher socioeconomic status (SES) with a healthy dietary pattern was stronger among pre/perimenopausal women than among menopausal women (ß = 0.574 vs ß = 0.552). In both groups, less physical activity was associated with depression and musculoskeletal disorders, and this association was stronger in menopausal women (ß = −0.174 vs ß = −0.215; P > 0.05). Overweight and obesity were directly decreased (ß = −0.011, P > 0.05) and indirectly increased (ß = 0.013, P > 0.05) in pre/perimenopausal women by sleep duration, but they were directly and indirectly decreased in menopausal women.

Conclusions:
The direct and indirect effects of well-known risk factors associated with overweight and obesity were found to be different in pre/perimenopausal and menopausal groups. Some risk factors showed stronger effects among menopausal women compared with the pre/perimenopausal women. Physical activity and healthy dietary pattern had a mediator impact in the two study groups.
Use of Micro-focused Ultrasound for Skin Tightening of Mid and Lower Face
Authors: Shome Debraj , Vadera Sapna , Ram M. Shiva , Khare Stuti , Kapoor Rinky 
Published: December 2019

Background:
The changes in the mid face and lower face are among the most prominent features of the aging process. Intense focused ultrasound, known as the Ulthera System (Ulthera Inc., Mesa, AZ, USA), was designed to correct this process. It employs micro-focused ultrasound to cause discrete focal heating of the dermis and stimulates neocollagenesis and elastin remodeling.

Methods:
This study enrolled 50 adult patients of Indian ethnicity who opted for correction of mid face and lower face sagging by Ulthera. The subjects were treated using Ulthera 3.0 mm probes which targets deep dermis and 4.5 mm, which targets the superficial muscular aponeurotic system. All patients were evaluated for allergic reactions and side effects like scarring and nerve/muscle dysfunction. Investigators Global Aesthetic Improvement Scales Scores and Patients Global Aesthetic Improvement Scales Scores were used for analysis at 30 days, 60 days, 3 months, 6 months, and 1 year. Photographs were taken for detailed facial evaluation. Patients were asked to fill a self-assessment questionnaire.

Results:
At the end of 6 months, improvements in mid face and lower face were reported in 93% patients by blinded reviewers and 85% patients found the results to be satisfactory. The same results were maintained at the end of 1 year.

Conclusion:
Our study showed that substantial results can be achieved in overall aesthetic improvement of sagging of mid face and lower face with this modality using intense focused ultrasound which utilizes delivering of treatment at a single focal depth.
Reduction Mammaplasty in Adolescents: A Comparison of Wise and Vertical Incision Patterns
Authors: Kulkarni Kritika , Egro Francesco M. , Kenny Elizabeth M. , Stavros Alexander G. , Grunwaldt Lorelei J. 
Published: December 2019

Background:
Reduction mammaplasty was shown to ameliorate physical and psychological problems in adolescents suffering from macromastia. However, benefits of the Wise compared to the vertical incision pattern have not yet been established in this population. The aim of this study is to compare the outcomes of these 2 techniques in adolescents undergoing reduction mammaplasty.

Methods:
A retrospective study of adolescents undergoing breast reduction by a single surgeon between 2011 and 2017 was conducted. Wise and vertical reduction techniques were compared based on demographics, surgical outcomes, patient satisfaction, and aesthetic outcomes. Patient satisfaction was determined using the validated BREAST-Q survey, and aesthetic outcomes using the validated ABNSW system.

Results:
A total of 60 adolescents underwent reduction mammaplasty (Wise/inferior pedicle = 80.0%, Wise/superior medial pedicle = 1.7%, vertical/superior medial pedicle = 18.3%). Patients who reported preoperative pain (Wise = 95.9%, vertical = 72.7%, P = 0.039) were more likely to undergo Wise reduction. Patients with Wise reductions also were more likely to undergo bilateral reduction (Wise = 93.9%; vertical = 63.6%, P = 0.017). The major and minor complication rates were 1.7% (Wise = 2.0%, vertical = 0%, P = NS) and 23.3% (Wise = 20.4%, vertical = 36.4%, P = NS), respectively. Adolescents undergoing Wise incision demonstrated statistically significant improvement in NAC contour (Wise = 61%, vertical = 47%, P = 0.028) and overall aesthetic outcome (Wise = 25%, vertical = 17%, P = 0.008) with scarring not being a negative factor (Wise = −16%; vertical = −35%, P = 0.004). Patient satisfaction was comparable in both groups.

Conclusions:
Reduction mammaplasty is a safe, effective treatment for adolescent macromastia. The similarity in complication and satisfaction rates between Wise and vertical patterns suggests that both techniques can be safely performed in the adolescent population and allow for overall improvements in aesthetic outcomes.
Veritas in Immediate Implant-based Breast Reconstruction Is Associated with Higher Complications Compared with TiLOOP
Authors: Quah Gaik Si , French James R. , Cocco Annelise , Hsu Jeremy , Meybodi Farid , Elder Elisabeth 
Published: December 2019

Background:
Biologic and synthetic meshes are used in immediate implant-based breast reconstruction for coverage of the lower pole of the implant. This study aimed to compare outcomes of Veritas with TiLOOP bra (TiLOOP group [TG]).

Methods:
Retrospective study of skin- and nipple-sparing mastectomies in patients who underwent an implant-based reconstruction using either Veritas or TiLOOP bra between January 2014 and December 2016 was performed.

Results:
Thirty-six reconstructions (22 unilateral, 7 bilateral) using the Veritas mesh and 179 breast reconstructions (61 unilateral, 59 bilateral) using TiLOOP bra were identified. The Veritas group (VG) showed a higher rate of postoperative complications compared with the TG (VG = 54% versus TG = 14%, P < 0.01%), including higher rates of seroma, nonintegration of mesh (VG = 51.4% versus TG = 1.6%, P < 0.01), implant rotation (VG = 16.2% versus TG = 1.6%, P < 0.01), infection (VG = 18.9% versus TG = 2.1%, P < 0.01), and wound breakdown (VG = 10.8% versus TG = 0.5%, P < 0.01). The VG also had a higher rate of major interventions (VG = 35.1% versus TG = 7.8%, P < 0.01) and minor interventions (VG = 18.9% versus TG = 2.2%, P < 0.01) compared with TG, including a higher rate of implant loss and unplanned return to theater.

Conclusions:
Veritas mesh was associated with a significantly higher rate of postoperative complications compared with TiLOOP bra. Our data strongly question the safety profile of Veritas in implant-based breast reconstruction. Further studies in this area are warranted.