bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expenditures in Young Adults with Hodgkin Lymphoma: NCI-Designated Comprehensive Cancer Centers versus Other Sites
Authors: Wolfson Julie A. , Bhatia Smita , Ginsberg Jill P. , Becker Laura , Bernstein David , Henk Henry J. , Lyman Gary H. , Nathan Paul C. , Puccetti Diane , Wilkes Jennifer J. , Winestone Lena E. , Kenzik Kelly M. 
Published: November 2021

Abstract

Background:
Outcomes among Hodgkin lymphoma (HL) patients diagnosed between 22 and 39 years are worse than among those diagnosed &lt;21 years, and have not seen the same improvement over time. Treatment at an NCI-designated Comprehensive Cancer Center (CCC) mitigates outcome disparities, but may be associated with higher expenditures.

Methods:
We examined cancer-related expenditures among 22- to 39-year-old HL patients diagnosed between 2001 and 2016 using deidentified administrative claims data (OptumLabs Data Warehouse; CCC: n = 1,154; non-CCC: n = 643). Adjusting for sociodemographics, clinical characteristics, and months enrolled, multivariable general linear models modeled average monthly health-plan paid (HPP) expenditures, and incidence rate ratios compared CCC/non-CCC monthly visit rates.

Results:
In the year following diagnosis, CCC patients had higher HPP expenditures ($12,869 vs. $10,688, P = 0.001), driven by higher monthly rates of CCC nontreatment outpatient hospital visits (P = 0.001) and per-visit expenditures for outpatient hospital chemotherapy ($632 vs. $259); higher CCC inpatient expenditures ($1,813 vs. $1,091, P = 0.001) were driven by 3.1 times higher rates of chemotherapy admissions (P = 0.001). Out-of-pocket expenditures were comparable (P = 0.3).

Conclusions:
Young adults with HL at CCCs saw higher health-plan expenditures, but comparable out-of-pocket expenditures. Drivers of CCC expenditures included outpatient hospital utilization (monthly rates of non-therapy visits and per-visit expenditures for chemotherapy).

Impact:
Higher HPP expenditures at CCCs in the year following HL diagnosis likely reflect differences in facility structure and comprehensive care. For young adults, it is plausible to consider incentivizing CCC care to achieve superior outcomes while developing approaches to achieve long-term savings.
Molecular and Pathology Features of Colorectal Tumors and Patient Outcomes Are Associated with Fusobacterium nucleatum and Its Subspecies animalis
Authors: Borozan Ivan , Zaidi Syed H. , Harrison Tabitha A. , Phipps Amanda I. , Zheng Jiayin , Lee Stephen , Trinh Quang M. , Steinfelder Robert S. , Adams Jeremy , Banbury Barbara L. , Berndt Sonja I. , Brezina Stefanie , Buchanan Daniel D. , Bullman Susan , Cao Yin , Farris Alton B. , Figueiredo Jane C. , Giannakis Marios , Heisler Lawrence E. , Hopper John L. , Lin Yi , Luo Xuemei , Nishihara Reiko , Mardis Elaine R. , Papadopoulos Nickolas , Qu Conghui , Reid Emma E.G. , Thibodeau Stephen N. , Harlid Sophia , Um Caroline Y. , Hsu Li , Gsur Andrea , Campbell Peter T. , Gallinger Steven , Newcomb Polly A. , Ogino Shuji , Sun Wei , Hudson Thomas J. , Ferretti Vincent , Peters Ulrike 
Published: November 2021

Abstract

Background:
Fusobacterium nucleatum (F. nucleatum) activates oncogenic signaling pathways and induces inflammation to promote colorectal carcinogenesis.

Methods:
We characterized F. nucleatum and its subspecies in colorectal tumors and examined associations with tumor characteristics and colorectal cancer–specific survival. We conducted deep sequencing of nusA, nusG, and bacterial 16s rRNA genes in tumors from 1,994 patients with colorectal cancer and assessed associations between F. nucleatum presence and clinical characteristics, colorectal cancer–specific mortality, and somatic mutations.

Results:
F. nucleatum, which was present in 10.3% of tumors, was detected in a higher proportion of right-sided and advanced-stage tumors, particularly subspecies animalis. Presence of F. nucleatum was associated with higher colorectal cancer–specific mortality (HR, 1.97; P = 0.0004). This association was restricted to nonhypermutated, microsatellite-stable tumors (HR, 2.13; P = 0.0002) and those who received chemotherapy [HR, 1.92; confidence interval (CI), 1.07–3.45; P = 0.029). Only F. nucleatum subspecies animalis, the main subspecies detected (65.8%), was associated with colorectal cancer–specific mortality (HR, 2.16; P = 0.0016), subspecies vincentii and nucleatum were not (HR, 1.07; P = 0.86). Additional adjustment for tumor stage suggests that the effect of F. nucleatum on mortality is partly driven by a stage shift. Presence of F. nucleatum was associated with microsatellite instable tumors, tumors with POLE exonuclease domain mutations, and ERBB3 mutations, and suggestively associated with TP53 mutations.

Conclusions:
F. nucleatum, and particularly subspecies animalis, was associated with a higher colorectal cancer–specific mortality and specific somatic mutated genes.

Impact:
Our findings identify the F. nucleatum subspecies animalis as negatively impacting colorectal cancer mortality, which may occur through a stage shift and its effect on chemoresistance.
Validation of Self-reported Cancer Diagnoses Using Medicare Diagnostic Claims in the US Health and Retirement Study, 2000–2016
Authors: Mullins Megan A. , Kler Jasdeep S. , Eastman Marisa R. , Kabeto Mohammed , Wallner Lauren P. , Kobayashi Lindsay C. 
Published: November 2021

Abstract

Background:
The US Health Retirement Study (HRS) is an ongoing population-representative cohort of US adults ages &gt;50 with rich data on health during aging. Self-reported cancer diagnoses have been collected since 1998, but they have not been validated. We compared self-reported cancer diagnoses in HRS interviews against diagnostic claims from linked Medicare records.

Methods:
Using HRS–Medicare linked data, we examined the validity of first incident cancer diagnoses self-reported in biennial interviews from 2000 to 2016 against ICD-9 and ICD-10 diagnostic claim records as the gold standard. Data were from 8,242 HRS participants ages ≥65 with 90% continuous enrollment in fee-for-service Medicare. We calculated the sensitivity, specificity, and κ for first incident invasive cancer diagnoses (all cancers combined, and each of bladder, breast, colorectal/anal, uterine, kidney, lung, and prostate cancers) cumulatively over the follow-up and at each biennial study interview.

Results:
Overall, self-reports of first incident cancer diagnoses from 2000 to 2016 had 73.2% sensitivity and 96.2% specificity against Medicare claims (κ = 0.73). For specific cancer types, sensitivities ranged from 44.7% (kidney) to 75.0% (breast), and specificities ranged from 99.2% (prostate) and 99.9% (bladder, uterine, and kidney). Results were similar in sensitivity analyses restricted to individuals with 100% continuous fee-for-service Medicare enrollment and when restricted to individuals with at least 24 months of Medicare enrollment.

Conclusions:
Self-reported cancer diagnoses in the HRS have reasonable validity for use in population-based research that is maximized with linkage to Medicare.

Impact:
These findings inform the use of the HRS for population-based cancer and aging research.
Inhalational Versus Intravenous Anesthetic Conditioning for Subarachnoid Hemorrhage–Induced Delayed Cerebral Ischemia
Authors: Athiraman Umeshkumar , Lele Abhijit V. , Karanikolas Menelaos , Dhulipala Vasu Babu , Jayaraman Keshav , Fong Christine , Kentner Rainer , Sheolal Ravitha , Vellimana Ananth , Gidday Jeffrey M. , Dhar Rajat , Zipfel Gregory J. 
Published: November 2021

Background:
Inhalational anesthetics were associated with reduced incidence of angiographic vasospasm and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH). Whether intravenous anesthetics provide similar level of protection is not known.

Methods:
Anesthetic data were collected retrospectively for patients with SAH who received general anesthesia for aneurysm repair between January 1, 2014 and May 31, 2018, at 2 academic centers in the United States (one employing primarily inhalational and the other primarily intravenous anesthesia with propofol). We compared the outcomes of angiographic vasospasm, DCI, and neurological outcome (measured by disposition at hospital discharge), between the 2 sites, adjusting for potential confounders.

Results:

We compared 179 patients with SAH receiving inhalational anesthetics at one institution to 206 patients with SAH receiving intravenous anesthetics at the second institution. The rates of angiographic vasospasm between inhalational versus intravenous anesthetic groups were 32% versus 52% (odds ratio, 0.49 [CI, 0.32–0.75];
P
=0.001) and DCI were 21% versus 40% (odds ratio, 0.47 [CI, 0.29–0.74];
P
=0.001), adjusting for imbalances between sites/groups, Hunt-Hess and Fisher grades, type of aneurysm treatment, and American Society of Anesthesiology status. No impact of anesthetics on neurological outcome at time of discharge was noted with rates of good discharge outcome between inhalational versus intravenous anesthetic groups at (78% versus 72%,
P
=0.23).

ConclusionS:
Our data suggest that those who received inhalational versus intravenous anesthetic for ruptured aneurysm repair had significant protection against SAH-induced angiographic vasospasm and DCI. Although we cannot fully disentangle site-specific versus anesthetic effects in this comparative study, these results, when coupled with preclinical data demonstrating a similar protective effect of inhalational anesthetics on vasospasm and DCI, suggest that inhalational anesthetics may be preferable for patients with SAH undergoing aneurysm repair. Additional investigations examining the effect of inhalational anesthetics on other SAH outcomes such as early brain injury and long-term neurological outcomes are warranted.
Temple Run
Authors: Enria Luisa 
Published: November 2021

Abstract
Amongst young people in Freetown, ‘Temple Run’, a mobile phone game that requires the player to run for their life across treacherous obstacles, is used as code for the perilous journey that an increasing number of young Sierra Leoneans made to Europe via Libya. Through ethnographic accounts, the article discusses the role of dreams of migration in Freetown youths’ articulations of a distinctive political imagination through which they at once critique and re-imagine their relation to the state and assert their identity and expectations as Sierra Leonean citizens. These narratives are rooted in everyday experiences of neglect and state violence but also embody a long history in the region of intersections between migration, insecurity, and contestations of power. Exploring migration as discourse, separate from practice, the paper shows how migration imageries become incorporated into expressions of presence rather than simply longings for absence and into normative ideas of citizenship.
Perceptual Organisation Affects Perception and Appreciation of Abstract Art: A Case Study with Black Square and Red Square by Kazimir Malevich
Authors: Sarami Arefe , Afhami Reza , Wagemans Johan 
Published: November 2021

Abstract
Perceptual organisation is hypothesised as a key in the perception and appreciation of abstract art. Here, we investigated how relational and compositional features affected the perception and aesthetic appreciation of Black Square and Red Square by Kazimir Malevich (1915). We studied how (i) the presence and obliquity of the red square and (ii) the relative configuration of the black and red square affected the detectability of the obliquity of the black square in this artwork. Results showed that the simultaneous presence and obliquity of the red square masked the obliquity of the original black square. The likelihood of the black square being incorrectly perceived as an exact square was always maximum in the original configuration and even slight alterations in the original configuration of the work resulted in the obliquity of the black square to be noticed. The original artwork was more aesthetically preferred compared to its alternatives. We argue that the artist may have intentionally set the configuration to mask the obliquity of the black square and maximise the aesthetic preference.
Structure of the secondary xylem and development of a cambial variant in Serjania mexicana (Sapindaceae)
Authors: Rajput Kishore S. , Gondaliya Amit D. , Moya Roger 
Published: November 2021

Summary
The lianas in the family Sapindaceae are known for their unique secondary growth which differs from climbing species in other plant families in terms of their cambial variants. The present study deals with the stem anatomy of self-supporting and lianescent habit, development of phloem wedges, the ontogeny of cambial variants and structure of the secondary xylem in the stems of Serjania mexicana (L.) Willd. Thick stems (15–20 mm) were characterized by the presence of distinct phloem wedges and tangentially wide neo-formed cambial cylinders. As the stem diameter increases, there is a proportional increase in the number of phloem wedges and neo-formed vascular cylinders. The parenchymatous (pericyclic) cells external to phloem wedges that are located on the inner margin of the pericyclic fibres undergo dedifferentiation, become meristematic and form small segments of cambial cylinders. These cambia extend tangentially into wide and large segments of neoformations. Structurally, the secondary xylem and phloem of the neo-formed vascular cylinders remain similar to the derivatives produced by the regular vascular cambium. The secondary xylem is composed of vessels (wide and narrow), fibres, axial and ray parenchyma cells. The occurrence of perforated ray cells is a common feature in both regular and variant xylem.
An Interdecadal Change in the Influence of ENSO on the Spring Tibetan Plateau Snow-Cover Variability in the Early 2000s
Authors: Wang Zhibiao , Wu Renguang , Yang Song , Lu Mengmeng 
Published: November 2021

AbstractEl Niño–Southern Oscillation (ENSO) and the Tibetan Plateau snow cover are important factors in interannual climate variability. The relationship between ENSO and the Tibetan Plateau snow variation is still undetermined. While some studies suggested that ENSO is a key factor of changes in snow cover over the Tibetan Plateau, other studies noted independence between the two. The present study revealed a prominent interdecadal change in the relationship between ENSO and the spring Tibetan Plateau snow-cover variation in the early 2000s. There is a significant positive correlation between ENSO and the spring Tibetan Plateau snow-cover variation in the period 1988–2003, but an obvious negative relationship is detected in the period 2004–19. The interdecadal change in the ENSO–snow relationship is related to the distinct pathway of ENSO influence on the spring Tibetan Plateau snow-cover variation during the two periods. In the period 1988–2003, ENSO induces anomalous convection over the tropical western North Pacific that in turn causes atmospheric circulation and moisture anomalies over the Tibetan Plateau. The resultant winter snow anomalies over the central-eastern Tibetan Plateau persist to the following spring. In the period 2004–19, ENSO induces North Atlantic sea surface temperature (SST) anomalies in winter that are maintained to the following spring. The North Atlantic SST anomalies then stimulate the atmospheric circulation anomalies extending to the Tibetan Plateau that induce snow-cover anomalies there in spring. The different processes of ENSO influence lead to opposite anomalies of spring snow cover over the Tibetan Plateau in the two periods.
Age as a Barrier to Surgical Stabilization of Rib Fractures in Patients with Flail Chest
Authors: Wang Naomi , Bachman Katelynn C. , Linden Philip A. , Ho Vanessa P. , Moorman Matthew L. , Worrell Stephanie G. , Argote-Greene Luis M. , Towe Christopher W. 
Published: November 2021

Introduction Although randomized trials demonstrate a benefit to surgical stabilization of rib fractures (SSRF), SSRF is rarely performed. We hypothesized older patients were less likely to receive SSRF nationally. Methods The 2016 National Inpatient Sample was used to identify adults with flail chest. Comorbidities and receipt of SSRF were categorized by ICD-10 code. Univariable testing and Multivariable regression were performed to determine the association of demographic characteristics and comorbidities to receipt of SSRF. Results 1021 patients with flail chest were identified, including 244 (23.9%) who received SSRF. Patients ≥70 years were less likely to receive SSRF. (<70 yrs 201/774 [26.0%] vs ≥70 43/247 [17.4%], P = .006) and had higher risk of death (<70 yrs 39/774 [5.0%] vs ≥70 33/247 [13.4%], P < .001) In multivariable modeling, only age ≥70 years was associated with SSRF (OR .591, P = .005). Conclusion Despite guideline-based support of SSRF in flail chest, SSRF is performed in <25% of patients. Age ≥70 years is associated with lower rate of SSRF and higher risk of death. Future study should examine barriers to SSRF in older patients.
Diagnostic Laparoscopy in Patients With Peritoneal Carcinomatosis Is Safe and Does Not Delay Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy
Authors: Hanna David N. , Ghani Muhammad O. , Hermina Andrew , Mina Alexander , Bailey Christina E. , Idrees Kamran , Magge Deepa 
Published: November 2021

Background Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among patients with peritoneal carcinomatosis (PC) depend largely on the extent of peritoneal disease. Since PC is not reliably evaluated with cross-sectional imaging, tumor burden is often evaluated with diagnostic laparoscopy (DLS). The aims of this study are to evaluate the safety of DLS in patients with peritoneal disease and determine if DLS delays time to CRS-HIPEC. Methods We performed an institutional retrospective review of 145 patients who underwent CRS-HIPEC between 2013 and 2020. Patients were divided into 2 groups: those who underwent an electively scheduled DLS prior to CRS-HIPEC and those who did not. Intraoperative and postoperative complications associated with DLS were determined from the surgeon’s operative report. Time from diagnosis of PC to CRS-HIPEC was compared between the 2 groups. Results Of the 145 patients available for analysis, 47% (68) underwent DLS and 44% (64) did not. Of all the diagnostic laparoscopies performed, there was 1 (1.5%) intraoperative complication. The duration between diagnosis of peritoneal carcinomatosis and surgery was 4.9 months among patients who underwent DLS prior to CRS-HIPEC and 4.3 months among patients who did not ( P = .79). Conclusion In this retrospective analysis, diagnostic laparoscopy prior to CRS-HIPEC demonstrated a comparable rate of DLS-associated complications compared to other gastrointestinal malignancies and does not prolong time from diagnosis to CRS-HIPEC. Thus, in patients undergoing evaluation for CRS-HIPEC, diagnostic laparoscopy provides significant value in patient selection without incurring perioperative risk or delay in CRS-HIPEC.
Opioid-Free Thyroid and Parathyroid Operations: Are Patients Satisfied With Pain Control?
Authors: Leader Preston W. , Oyler Douglas R , Carter Tonya M , Damron Donna S. , Lee Cortney Y. , Sloan David A , Inabnet William B , Randle Reese W. 
Published: November 2021

Background The aim of this study was to evaluate pain control and patient satisfaction using an opioid-free analgesic regimen following thyroid and parathyroid operations. Methods Surveys were distributed to all postoperative patients following total thyroidectomy, thyroid lobectomy, and parathyroidectomy between January and April 2020. After surgery, patients were discharged without opioids except in rare cases based on patient needs and surgeon judgment. We measured patient-reported Numeric Rating Scale (NRS) pain scores and satisfaction categorically as either satisfied or dissatisfied. Results We received 90 of 198 surveys distributed, for a 45.5% response rate. After excluding neck dissections (n = 6) and preoperative opioid use (n = 4), the final cohort included 80 patients after total thyroidectomy (26.3%), thyroid lobectomy (41.3%), and parathyroidectomy (32.5%).The majority reported satisfaction with pain control (87.5%) and the entire surgical experience (95%). A similar proportion of patients reported satisfaction with pain control after total thyroidectomy (90.9%), thyroid lobectomy (90.5%), and parathyroidectomy (80.8%), indicating the procedure did not significantly impact satisfaction with pain control ( P = .47). Patients who reported dissatisfaction with pain control were more likely to receive opioid prescriptions (30% vs 2.9%, P < .01), but the majority still reported satisfaction with their entire operative experience (70%). Discussion Even with an opioid-free postoperative pain regimen, most patients report satisfaction with pain control after thyroid and parathyroid operations, and those who were dissatisfied with their pain control generally reported satisfaction with their overall surgical experience. Therefore, an opioid-free postoperative pain control regimen is well tolerated and unlikely to decrease overall patient satisfaction.
Open Cholecystostomy Under Local Anesthesia for Acute Cholecystitis in the Elderly and High-Risk Surgical Patients
Authors: Slama Eliza M. , Hosseini Motahar , Staszak Ryan M. , Setya Viney R. 
Published: November 2021

Background The morbidity and mortality rates associated with cholecystectomy for acute cholecystitis are higher in the critically ill elderly population. As an alternative to cholecystectomy, we report the results of treatment of acute cholecystitis in the elderly after open cholecystolithotomy with cholecystostomy tube placement under local anesthesia. Methods A case series was performed on 5 patients from August 2007 to April 2010 who presented with acute cholecystitis and underwent an open cholecystolithotomy and tube placement. Thirty-day mortality, intra- and immediate-postoperative complications, clinical improvement after drainage, additional biliary procedures needed, and outcome after cholecystostomy tube removal were recorded. Results Open cholecystolithotomy and tube placement were performed successfully in all patients and permitted resolution of the acute attack in all after a mean period of 3.75 days. Thirty-day mortality was 0%. Patients did not experience any intraoperative complications. We observed 100% rate of successful short-term outcomes in our patients including resolution pain, and objectively, normalization of leukocytosis, and defervescence. None of the patients required emergency cholecystectomy. All patients had their cholecystostomy tubes removed at a mean postoperative day 27. There were no cases of biliary leakage or tube dislodgement. There were no recurrences of acute cholecystitis within the mean follow-up of 20.75 months. Discussion Emergency open cholecystolithotomy and cholecystostomy tube placement represent an effective, safe, and definitive alternative treatment strategy for acute gallstone cholecystitis in selected elderly patients with a mortality rate of 0% in the authors’ experience.