bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Opioid Use and Readmissions Following Surgery
Authors: Tang Ruiqi , Santosa Katherine B. , Vu Joceline V. , Lin Lewei A. , Lai Yen-Ling , Englesbe Michael J. , Brummett Chad M. , Waljee Jennifer F. 
Published: March 2020

Objective:
To assess the association between preoperative opioid exposure and readmissions following common surgery.

Summary Background Data:
Preoperative opioid use is common, but its effect on opioid-related, pain-related, respiratory-related, and all-cause readmissions following surgery is unknown.

Methods:
We analyzed claims data from a 20% national Medicare sample of patients ages ≥ 65 with Medicare Part D claims undergoing surgery between January 1, 2009 and November 30, 2016. We grouped patients by the dose, duration, recency, and continuity of preoperative opioid prescription fills. We used logistic regression to examine the association between prior opioid exposure and 30-day readmissions, adjusted for patient risk factors and procedure type.

Results:
Of 373,991 patients, 168,579 (45%) filled a preoperative opioid prescription within 12 months of surgery, ranging from minimal to chronic high use. Preoperative opioid exposure was associated with higher rate of opioid-related readmissions, compared with naive patients [low: aOR=1.63, 95% CI=1.26–2.12; high: aOR=3.70, 95% CI=2.71–5.04]. Preoperative opioid exposure was also associated with higher risk of pain-related readmissions [low: aOR=1.27, 95% CI=1.23–1.32; high: aOR=1.62, 95% CI=1.53–1.71] and respiratory-related readmissions [low: aOR=1.10, 95% CI=1.05–1.16; high: aOR=1.44, 95% CI=1.34–1.55]. Low, moderate, and high chronic preoperative opioid exposures were predictive of all-cause readmissions (low: OR 1.09, 95% CI: 1.06–1.12); high: OR 1.23, 95% CI: 1.18–1.29).

Conclusions:
Higher levels of preoperative opioid exposure are associated with increased risk of readmissions after surgery. These findings emphasize the importance of screening patients for preoperative opioid exposure and creating risk mitigation strategies for patients.
Lymphovascular Infiltration, Not Depth of Invasion, is the Critical Risk Factor of Metastases in Early Colorectal Cancer
Authors: Rönnow Carl-Fredrik , Arthursson Victoria , Toth Ervin , Krarup Peter-Martin , Syk Ingvar , Thorlacius Henrik 
Published: March 2020

Objective:
To identify clinical and histopathological risk factors of LNM in T1 CRC.

Summary of Background Data:
The requisite of additional surgery after locally resected T1 CRC is dependent on the risk of LNM. Depth of submucosal invasion is used as a key predictor of lymphatic metastases although data are conflicting on its actual impact.

Methods:
Retrospective population-based cohort study on prospectively collected data on all patients with T1 CRC undergoing surgical resection in Sweden, 2009–2017 and Denmark 2016–2018. The Danish cohort was used for validation. Potential risk factors of LNM investigated were; age, sex, tumor location, submucosal invasion, grade of differentiation, mucinous subtype, lymphovascular, and perineural invasion.

Results:
One hundred fifty out of the 1439 included patients (10%) had LNM. LVI (P < 0.001), perineural invasion (P < 0.001), mucinous subtype (P = 0.006), and age <60 years (P < 0.001) were identified as independent risk factors whereas deep submucosal invasion was only a dependent (P = 0.025) risk factor and not significant in multivariate analysis (P = 0.075). The incidence of LNM was 51/882 (6%) in absence of the independent risk factors. The Danish validation cohort, confirmed our findings regarding the role of submucosal invasion, LVI, and age.

Conclusions:
This is a large study on LNM in T1 CRC, including validation, showing that LVI and perineural invasion, mucinous subtype, and low age constitute independent risk factors, whereas depth of submucosal invasion is not an independent risk factor of LNM. Thus, our findings provide a useful basis for management of patients after local excision of early CRC.
Long-term Outcomes After Controlled Oxygenated Rewarming of Human Livers Before Transplantation
Authors: Hoyer Dieter P. , Benkö Tamas , Manka Paul , von Horn Charlotte , Treckmann Juergen W. , Paul Andreas , Minor Thomas 
Published: March 2020

Background.
Controlled oxygenated rewarming (COR) has been shown to be a feasible and safe method in clinical practice and to reduce peak serum transaminases after liver transplantation. This study aimed to demonstrate further clinical experience of this method of now 18 clinical liver transplantations utilizing COR and demonstrate the long-term results.

Methods.
In this extended series of 18 patients, cold-stored livers were subjected to machine-assisted slow COR for ≈120 minutes before transplantation. A cohort of 178 patients transplanted during the same period with similar clinical characteristics were used for comparison of key outcomes.

Results.
All livers were perfused in accordance to the COR protocol without incidences and transplanted successfully. Early allograft dysfunction was observed in 2 (11.1%) cases after COR. Liver elasticity measurements indicated normal healthy liver parenchyma at the last follow-up. Graft survival demonstrated excellent outcomes after COR. The 1-, 3-, and 5-year patient survival rates were 100%, 100%, and 93.8% compared with 84.5%, 82.0%, and 75.8% in the control group (P = 0.12).

Conclusions.
The present study demonstrates excellent clinical outcomes after COR before liver transplantation. Comparison with a control cohort shows superiority of graft survival. Further evidence is needed to assess this promising method to improve organ preservation, finally.
Identification of Subtle Verbal Memory Deficits in Premanifest Huntington Disease Using the California Verbal Learning Test
Authors: Holden Heather M. , Tierney Savanna M. , Graves Lisa V. , Beltran-Najera Ilex , Woods Steven Paul , Snell Chase M. , Delis Dean C. , Corey-Bloom Jody , Gilbert Paul E. 
Published: March 2020

Background:
Verbal memory impairment in individuals with Huntington disease (HD) is well-documented; however, the nature and extent of verbal memory impairment in individuals with premanifest HD (pre-HD) are less understood.

Objective:
To evaluate verbal memory function in individuals with pre-HD by comparing their performance on the California Verbal Learning Test to that of individuals with a clinical diagnosis of HD and that of a demographically similar group of adults with no family history of, or genetic risk for, HD, thereby reducing possible complications of psychiatric difficulties commonly experienced by individuals who are at risk for HD but are gene negative.

Methods:
Participant groups included 77 adults with a diagnosis of HD, 23 premanifest gene carriers for HD (pre-HD), and 54 demographically similar, healthy adults. The California Verbal Learning Test—Second Edition (CVLT–II) was used to evaluate the participants’ immediate and delayed recall, recognition, learning characteristics, errors, and memory retention.

Results:
The pre-HD group performed significantly worse than the healthy group, yet significantly better than the HD group, on Short and Long Delay Recall (Free and Cued) and Recognition Discriminability. On Total Immediate Recall, Learning Slope, Semantic Clustering, and Intrusions, the pre-HD group performed similarly to the healthy group and significantly better than the HD group. None of the groups differed in their performance on Repetitions and a measure of retention.

Conclusions:
Subtle memory deficits can be observed during the premanifest stage of HD with use of a subset of indices from the CVLT–II.
Effect of Compound Muscle Action Potential After Peripheral Nerve Stimulation Normalization on Anesthetic Fade of Intraoperative Transcranial Motor-Evoked Potential
Authors: Tanaka Satoshi , Watanabe Tomoko , Takanashi Junko , Oka Hidehiro , Hashimoto Ryo , Akimoto Jiro 
Published: March 2020

Purpose:
Anesthetic fade refers to the time-dependent decrease in the amplitude of the intraoperative motor-evoked potential. It is thought to be caused by the accumulation of propofol. The authors examined whether normalization by the compound muscle action potential (CMAP) after peripheral nerve stimulation could compensate for anesthetic fade.

Methods:
In 1,842 muscles in 578 surgeries, which did not exhibit a motor-neurologic change after the operation, the motor-evoked potential amplitude was normalized by the CMAP amplitude after peripheral nerve stimulation, and the CMAP amplitude and operation times were analyzed.

Results:
The amplitudes of both motor-evoked potential and CMAP increased over time after peripheral nerve stimulation because of the disappearance of muscle-relaxant action. Especially, after peripheral nerve stimulation, CMAP significantly increased from the beginning to the end of the operation. Anesthetic fade in transcranial motor-evoked potential monitoring seemed to occur at more than 235 minutes of surgery based on the results of a receiver operating characteristic analysis of the operation time and relative amplitudes. Although the mean amplitude without CMAP normalization at more than 235 minutes was significantly lower than that at less than 235 minutes, the mean amplitude with normalization by CMAP after peripheral nerve stimulation at more than 235 minutes was not significantly different from that at less than 235 minutes.

Conclusions:
Compound muscle action potential after peripheral nerve stimulation normalization was able to avoid the effect of anesthetic fade. Anesthetic fade was seemed to be caused by a decrease in synaptic transmission at the neuromuscular junction because of propofol accumulation by this result.
Drug checking to detect fentanyl and new psychoactive substances
Authors: Palamar Joseph J. , Salomone Alberto , Barratt Monica J. 
Published: March 2020

Purpose of review
Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation of new psychoactive substances (NPS). We aim to provide information regarding the current state of drug checking in relation to analysis methods, adulteration rates, and behavioral responses to results.

Recent findings
Various technologies are being used to detect the presence of fentanyl, its analogs, and other NPS in drug samples. Proxy drug checking, which we define as biospecimen testing for drug exposure postconsumption, is also becoming common. However, there appears to a dichotomy between research focusing on populations at high risk for fentanyl exposure and to exposure to NPS such as synthetic cathinones.

Summary
Drug checking research and services largely focus on opioid consumers and nightclub and dance festival attendees, but more focus may be needed on the general population. Drug checking results can inform surveillance efforts, and more research is needed to overcome barriers to drug checking and to focus on whether test results indeed affect behavior change.
Association between device measured and self-reported sitting in relation to depression: the 1970 British Cohort Study
Authors: Webster Andrew , Batty G David , Pearson Natalie , Stamatakis Emmanuel , Hamer Mark 
Published: March 2020

AbstractAimsWhile physical activity appears to confer protection against depression, the relationship between sedentary behaviour and mental health is uncertain. Self-reported methods provide information about context although there may be error in the quantification of sedentary behaviour. Accordingly, we examined associations of both device-measured and self-reported sedentary behaviour with depression.MethodParticipants (n=4,704; 52.4% Female; aged 46-48) were drawn from the 1970 British Cohort Study. Sitting time and moderate-vigorous physical activity was measured using a thigh-worn accelerometer device (ActivPAL) over a seven day period. A range of self-reported sedentary behaviours was measured to provide context. Depression diagnosis was captured using a combination of self-reported consultation with a physician and use of anti-depressant medication. Malaise inventory was used to assess depressive symptoms.ResultsRelative to those who spent <8 hr/d sitting, those in the highest tertile of device measured sitting (>10 hr/d) had increased odds of depression diagnosis (odds ratio= 1.48 [95% confidence interval 1.05-2.08]). There was no association between self-reported TV viewing and depression diagnosis (1.07; 0.71-1.63). We observed protective associations between moderate-vigorous physical activity and depression diagnosis (highest tertile vs. the lowest tertile; 0.70;0.49-1.00). Associations of sitting time and physical activity with depression were mutually independent. Relative to <1 hours of internet usage, 2-3 and >3 hours of internet weekday usage were associated with increased odds of depressive symptoms (1.60;1.30-1.97 and 1.63;1.32-2.03, respectively).ConclusionDevice-measured sitting is associated depression diagnosis, although less consistent associations are observed with self-reported sedentary behaviours. Regular physical activity and reducing sedentary time may be beneficial for prevention of depression.
Newborn Differential DNA Methylation and Subcortical Brain Volumes as Early Signs of Severe Neurodevelopmental Delay in a South African Birth Cohort Study
Authors: Hüls Anke , Wedderburn Catherine J , Groenewold Nynke A , Gladish Nicole , Jones Meaghan , Koen Nastassja , MacIsaac Julia L , Lin David TS , Ramadori Katia E , Epstein Michael P , Donald Kirsten A. , Kobor Michael S , Zar Heather J , Stein Dan J 
Published: March 2020

AbstractObjectiveThe first two years of life are a critical period of rapid brain development. Since early neurodevelopment is influenced by prenatal risk factors and genetics, neonatal biomarkers can potentially provide the opportunity to detect early signs of neurodevelopmental delay. We analyzed associations between DNA methylation (DNAm) levels from cord blood, neonatal magnetic resonance imaging (MRI) neuroimaging data, and neurodevelopment at two years of age.MethodsNeurodevelopment was assessed in 161 children from the South African Drakenstein Child Health Study at two years of age using the Bayley Scales of Infant and Toddler Development III. We performed an epigenome-wide association study of neurodevelopmental delay using DNAm levels from cord blood. A mediation analysis was conducted in 51 children to analyze if associations between differential DNAm and neurodevelopmental delay were mediated by altered neonatal brain volumes.ResultsWe found epigenome-wide significant associations between differential DNAm at the SPTBN4 locus (cg26971411, p-value=3.10×10−08), an intergenic region on chromosome 11 (cg00490349, p-value=2.41×10−08) and a differentially methylated region on chromosome 1 (FDR p-value for the region=9.06×10−05) and severe neurodevelopmental delay. While these associations were not mediated by neonatal brain volume, neonatal caudate volumes were independently associated with neurodevelopmental delay, particularly in language (p=0.0443) and motor (p=0.0082) domains.ConclusionDifferential DNAm levels from cord blood and increased neonatal caudate volumes were independently associated with severe neurodevelopmental delay at two years of age. These findings suggest that neurobiological signals for severe developmental delay may be detectable in very early life with implications for identification and intervention design.
Combined Utility of 25 Disease and Risk Factor Polygenic Risk Scores for Stratifying Risk of All-Cause Mortality
Authors: Meisner Allison , Kundu Prosenjit , Zhang Yan Dora , Lan Lauren V. , Kim Sungwon , Ghandwani Disha , Choudhury Parichoy Pal , Berndt Sonja I. , Freedman Neal D. , Garcia-Closas Montserrat , Chatterjee Nilanjan 
Published: March 2020

ABSTRACTWhile genome-wide association studies have identified susceptibility variants for numerous traits, their combined utility for predicting broad measures of health, such as mortality, remains poorly understood. We used data from the UK Biobank to combine polygenic risk scores (PRS) for 13 diseases and 12 mortality risk factors into sex-specific composite PRS (cPRS). These cPRS were moderately associated with all-cause mortality in independent data within the UK Biobank: the estimated hazard ratios per standard deviation were 1.10 (95% confidence interval: 1.05, 1.16) and 1.15 (1.10, 1.19) for women and men, respectively. Differences in life expectancy between the top and bottom 5% of the cPRS were estimated to be 4.79 (1.76, 7.81) years and 6.75 (4.16, 9.35) years for women and men, respectively. These associations were substantially attenuated after adjusting for non-genetic mortality risk factors measured at study entry (i.e., middle age for most participants). The cPRS may be useful in counseling younger individuals at higher genetic risk of mortality on modification of non-genetic factors.
Correcting under-reported COVID-19 case numbers: estimating the true scale of the pandemic
Authors: Jagodnik Kathleen M. , Ray Forest , Giorgi Federico M. , Lachmann Alexander 
Published: March 2020

The COVID-19 virus has spread worldwide in a matter of a few months, while healthcare systems struggle to monitor and report current cases. Testing results have struggled with the relative capabilities, testing policies and preparedness of each affected country, making their comparison a non-trivial task. Since severe cases, which more likely lead to fatal outcomes, are detected at a higher rate than mild cases, the reported virus mortality is likely inflated in most countries. Lockdowns and changes in human behavior modulate the underlying growth rate of the virus. Under-sampling of infection cases may lead to the under-estimation of total cases, resulting in systematic mortality estimation biases. For healthcare systems worldwide it is important to know the expected number of cases that will need treatment. In this manuscript, we identify a generalizable growth rate decay reflecting behavioral change. We propose a method to correct the reported COVID-19 cases and death numbers by using a benchmark country (South Korea) with near-optimal testing coverage, with considerations on population demographics. We extrapolate expected deaths and hospitalizations with respect to observations in countries that passed the exponential growth curve. By applying our correction, we predict that the number of cases is highly under-reported in most countries and a significant burden on worldwide hospital capacity.The full analysis workflow and data is available at: https://github.com/lachmann12/covid19
Temporal relationship between outbound traffic from Wuhan and the 2019 coronavirus disease (COVID-19) incidence in China
Authors: Shi Zaixing , Fang Ya 
Published: March 2020

ABSTRACTBackgroundThe city of Wuhan is the epicenter of the 2019 coronavirus disease (COVID-19) outbreak and a central Chinese hub for transportation and industry. Mass migration prior to the Chinese New Year may have accelerated the spread of COVID-19 across China. This analysis investigated the temporal relationship between daily outbound traffic from Wuhan and the incidence of COVID-19 in 31 Chinese provinces during January-February 2020.MethodsWe collected incidence of confirmed COVID-19 cases from National and Provincial Health Committee reports from January 10 to February 29, 2020. Volume of outbound traffic from Wuhan to other provinces was measured by Baidu Migration Index, a widely used metric that tracks migration based on cellphone location. We used cross-correlation function and autoregressive integrated moving average (ARIMA) model to examine time-lagged association between traffic volume and COVID-19 incidence by province. Contributors to the provincial variation in the temporal associations were investigated. Additionally, we estimated the reduction in cumulative incidence of COVID-19 cases following the travel ban for Wuhan.ResultsCross-correlation function analyses suggested that the volume of outbound traffic from Wuhan was positively associated with COVID-19 incidence in all provinces, with correlation coefficients between 0.22-0.78 (all P<0.05). Approximately 42% of provinces showed <1 week of lag between traffic volume and COVID-19 incidence, 39% with 1 week, and 19% with 2-3 weeks. Migration had more prolonged impacts in provinces closer to Wuhan and with more passenger influx from Wuhan, but affected economically advantaged provinces to a lesser extent. We further estimated that the travel ban may have prevented approximately 19,768 COVID-19 cases (95% CI: 13,589, 25,946) outside of Wuhan by February 29, 2020.ConclusionsOutflowing migration from Wuhan facilitated the COVID-19 transmission to other parts of China with varying time-lagged effects dependent on provincial characteristics. The travel ban led to a significant reduction in COVID-19 outside of Wuhan.
Estimating unobserved SARS-CoV-2 infections in the United States
Authors: Perkins T. Alex , Cavany Sean M. , Moore Sean M. , Oidtman Rachel J. , Lerch Anita , Poterek Marya 
Published: March 2020

AbstractBy March 2020, COVID-19 led to thousands of deaths and disrupted economic activity worldwide. As a result of narrow case definitions and limited capacity for testing, the number of unobserved SARS-CoV-2 infections during its initial invasion of the US remains unknown. We developed an approach for estimating the number of unobserved infections based on data that are commonly available shortly after the emergence of a new infectious disease. The logic of our approach is, in essence, that there are bounds on the amount of exponential growth of new infections that can occur during the first few weeks after imported cases start appearing. Applying that logic to data on imported cases and local deaths in the US through March 12, we estimated that 22,876 (95% posterior predictive interval: 7,451 - 53,044) infections occurred in the US by this date. By comparing the model’s predictions of symptomatic infections to local cases reported over time, we obtained daily estimates of the proportion of symptomatic infections detected by surveillance. This revealed that detection of symptomatic infections decreased throughout February as exponential growth of infections outpaced increases in testing. Between February 21 and March 12, we estimated an increase in detection of symptomatic infections, which was strongly correlated (median: 0.97, 95% PPI: 0.85 - 0.98) with increases in testing. These results suggest that testing was a major limiting factor in assessing the extent of SARS-CoV-2 transmission during its initial invasion of the US.Significance StatementCountries across the world observed dramatic rises in COVID-19 cases and deaths in March 2020. In the United States, delays in the availability of diagnostic testing prompted questions about the extent of unobserved community transmission. Using a simulation model informed by reported cases and deaths, we estimated that tens of thousands of people were infected by the time a national emergency was declared on March 13. Our results indicate that fewer than 20% of locally acquired, symptomatic infections in the US were detected over a period of a month. The existence of a large, unobserved reservoir of infection argues for the necessity of large-scale social distancing that went into effect to mitigate the impacts of SARS-CoV-2 on the US.