bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling the Cost-Effectiveness of Latent Tuberculosis Screening and Treatment Strategies in Recent Migrants to a Low-Incidence Setting
Authors: Dale Katie D , Abayawardana Milinda J , McBryde Emma S , Trauer James M , Carvalho Natalie 
Published: May 2021

Abstract
Many tuberculosis (TB) cases in low-incidence settings are attributed to reactivation of latent TB infection (LTBI) acquired overseas. We assessed the cost-effectiveness of community-based LTBI screening and treatment strategies in recent migrants to a low-incidence setting (Australia). A decision-analytical Markov model was developed that cycled 1 migrant cohort (≥11-year-olds) annually over a lifetime from 2020. Postmigration/onshore and offshore (screening during visa application) strategies were compared with existing policy (chest x-ray during visa application). Outcomes included TB cases averted and discounted cost per quality-adjusted life-year (QALY) gained from a health-sector perspective. Most recent migrants are young adults and cost-effectiveness is limited by their relatively low LTBI prevalence, low TB mortality risks, and high emigration probability. Onshore strategies cost at least $203,188 (Australian) per QALY gained, preventing approximately 2.3%–7.0% of TB cases in the cohort. Offshore strategies (screening costs incurred by migrants) cost at least $13,907 per QALY gained, preventing 5.5%–16.9% of cases. Findings were most sensitive to the LTBI treatment quality-of-life decrement (further to severe adverse events); with a minimal decrement, all strategies caused more ill health than they prevented. Additional LTBI strategies in recent migrants could only marginally contribute to TB elimination and are unlikely to be cost-effective unless screening costs are borne by migrants and potential LTBI treatment quality-of-life decrements are ignored.
Inconsistent Reporting of Discrimination Over Time Using the Experiences of Discrimination Scale: Potential Underestimation of Lifetime Burden
Authors: Van Dyke Miriam E , Kramer Michael R , Kershaw Kiarri N , Vaccarino Viola , Crawford Natalie D , Lewis Tené T 
Published: May 2021

Abstract
Studies documenting self-reported experiences of discrimination over the life course have been limited. Such information could be important for informing longitudinal epidemiologic studies of discrimination and health. We characterized trends in self-reports of racial, socioeconomic status, and gender discrimination over time measured using the Experiences of Discrimination Scale, with a focus on whether individuals’ reports of lifetime discrimination were consistent over time. Overall experiences of discrimination and the number of settings in which discrimination was reported in 1992, 2000, and 2010 were examined among 2,774 African-American and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Reports of “ever” experiencing discrimination decreased for all forms of discrimination across the 3 study visits. Approximately one-third (30%–41%) of the sample inconsistently reported ever experiencing any discrimination over time, which contributed to the observed decreases. Depending on the form of discrimination, inconsistent reporting patterns over time were more common among African-American, younger, less educated, and lower-income individuals and women—groups who are often most exposed to and severely impacted by the health effects of discrimination. Our findings highlight the possible underestimation of the lifetime burden of discrimination when utilizing the Experiences of Discrimination Scale to capture self-reports of discrimination over time.
The means and the good
Authors: Oliver Matthew 
Published: May 2021

Abstract
Are there moral constraints on the pursuit of the good? Our intuitions suggest that we may not use another person as a means to achieve a good outcome, even if that good outcome reduces the amount of using-as-a-means that occurs overall. These intuitions are assumed to be incompatible with consequentialism and to show the need for a deontological constraint on using others as a means. This assumption is a mistake. In this paper, I show that consequentialists can justify the same case-based intuitions that are thought to support a moral constraint on using others as a means.
Mental Health Problems as a Risk Factor for Workplace Bullying: The Protective Effect of a Well-Functioning Organization
Authors: Rosander Michael 
Published: May 2021

Abstract
This study examined a strain–stressor association, when mental health problems may lead to subsequent workplace bullying, and a mechanism of how this can happen. I hypothesized that the association between mental health problems and bullying depends on the perceived role clarity and order in the organization, and that sickness presenteeism (SP) mediates this association. The study is based on a longitudinal probability sample drawn from the total number of employees in Sweden. Workplace bullying, mental health, SP, and role clarity and order in the organization were assessed using a questionnaire. The results showed that mental health problems are associated with an increased risk for subsequent bullying, consistent with previous findings. However, this risk depends on the level of role clarity and order in the organization. The results also show a partial indirect effect via SP. This means that if one has mental health problems and persists in coming to work although one should have stayed at home, the risk of bullying increases. The indirect effect depends also on the level of order in the organization. The findings suggest that individual deficits, such as mental health problems, are associated with subsequent bullying only if organizational deficits are also present.
Safety Considerations of Fat Grafting in Buttock Augmentation
Authors: O’Neill Rebecca C , Hanson Summer E , Reece Edward , Winocour Sebastian 
Published: May 2021

AbstractAutologous fat grafting for buttock augmentation is one of the fastest growing plastic surgery procedures, but has also received significant publicity for the relatively high mortality rate secondary to fat emboli. The literature has grown exponentially in the past 5 years on this subject, helping to clarify our knowledge and providing recommendations to minimize risks, including avoiding intramuscular injections, placing the patient in the jackknife position, and utilizing larger-bore cannulas. Since the application of these recommendations, the rate of pulmonary fat embolism has decreased from 0.097% to 0.04%, with a current mortality of 1 in 14,921, making it statistically safer than abdominoplasty. Despite the evolution in our knowledge, techniques, and outcomes, it remains of utmost importance to properly select and educate patients about the safety of fat grafting for buttock augmentation.Level of Evidence: 4
PCLasso: a protein complex-based, group lasso-Cox model for accurate prognosis and risk protein complex discovery
Authors: Wang Wei , Liu Wei 
Published: May 2021

AbstractFor high-dimensional expression data, most prognostic models perform feature selection based on individual genes, which usually lead to unstable prognosis, and the identified risk genes are inherently insufficient in revealing complex molecular mechanisms. Since most genes carry out cellular functions by forming protein complexes—basic representatives of functional modules, identifying risk protein complexes may greatly improve our understanding of disease biology. Coupled with the fact that protein complexes have been shown to have innate resistance to batch effects and are effective predictors of disease phenotypes, constructing prognostic models and selecting features with protein complexes as the basic unit should improve the robustness and biological interpretability of the model. Here, we propose a protein complex-based, group lasso-Cox model (PCLasso) to predict patient prognosis and identify risk protein complexes. Experiments on three cancer types have proved that PCLasso has better prognostic performance than prognostic models based on individual genes. The resulting risk protein complexes not only contain individual risk genes but also incorporate close partners that synergize with them, which may promote the revealing of molecular mechanisms related to cancer progression from a comprehensive perspective. Furthermore, a pan-cancer prognostic analysis was performed to identify risk protein complexes of 19 cancer types, which may provide novel potential targets for cancer research.
ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION NUMERIC AND EXPERIMENTAL ANALYSES: INFLUENCE OF TRABECULAR BONE CONSTITUTIVE MODEL
Authors: Quintana Barcia C , Rodríguez González C , Betegón Biempica C , Álvarez Díaz G , Maestro A 
Published: May 2021

Abstract

INTRODUCTION
The number of variables that influence the success of an ACL reconstruction is such that, the use of numerical tools becomes increasingly necessary. In this work, a finite element model is developed to simulate the ACL reconstruction in its tibial insertion.

MATERIAL AND METHODS
Tibiae and ligaments porcine samples were used in this work. As the tibial fixation, an interference screw with a nominal diameter of 7mm and a length of 25mm is used.
The plasty which replace the injured ligament was characterize using tensile tests. Uniaxial and confined compression tests, as well as indentation tests, were used for characterizing trabecular bone. Finite element methods were used for the implementation of the ACL reconstruction simulation, which studies the effect in the knee joint of all the elements involved (plasty, bone and interference screw).

RESULTS
None of the models available for the description of the trabecular bone behavior (von Mises, Hill and Crushable Foam), is capable of doing it in a completely proper manner. The use of one or the other constitutive model does not greatly influence the numerical simulation results.

CONCLUSIONS
As trabecular bone has a strongly anisotropic and non-symmetric mechanical behavior, none of the constitutive models available in the finite element code used is capable of fully describing it. Thus, the use of von Mises criterion is recommended, as it is the easiest to define and the one that requires the least numerical resources (lower computational cost).
MALIGNANT SMALL BOWEL OBSTRUCTION: OUTCOMES OF PALLIATIVE SURGERY
Authors: Turrado-Rodríguez V , Termes Serra R , Besa A , Chullo Llerena G , Viladot M , Morales Sevillano X 
Published: May 2021

Abstract

INTRODUCTION
Surgical management of malignant bowel obstruction (MBO) represents a surgical challenge associated with high morbidity and mortality, readmission and re-obstruction rates. The aim of this study is to describe the postoperative outcomes of palliative surgery for MBO in order to provide a guide for oncologists, surgeons and patients.

MATERIAL AND METHODS
Retrospective descriptive study in a tertiary referral centre of all the patients operated of an acute bowel obstruction or bowel perforation due to peritoneal carcinomatosis between January 2015 and December 2019.

RESULTS
Fifty-one patients were included in the study. Time from index surgery to clinical recurrence as MBO was 21±27 months. The indication for surgery was acute obstruction in 92.2% and bowel perforation in 7.8% of the patients. Intraoperative complications were found in 24% of the patients. Postoperative complications were found in 71% of the patients. Postoperative mortality was 16%. Length of stay was 31±26 days with a median postoperative stay of 20±16 days. Time to reobstruction in the whole series was 216±240 days.
90-day mortality was 31%. The median overall survival of patients that survived the first 90 postoperative days was 286.45±281.14 days (9.5 months). Most of the patients who survived the 90-postoperative days received systemic treatment (66%).

CONCLUSIONS
Palliative surgery for MBO is associated with high rates of postoperative complications and mortality. Well-selected patients that survive the first 90 postoperative days may have a long symptom-free period and longer survival.
IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE
Authors: Fernández Candela A , Sánchez-Guillén L , García Catalá L , Curtis Martínez C , Bosch Ramírez M , Lario Pérez S , Lillo García C , Arroyo Sebastián A 
Published: May 2021

Abstract

INTRODUCTION
The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality.

MATERIAL AND METHODS
We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included.

RESULTS
The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia).
The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression.

CONCLUSION
Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.
WALL STRESS IN ASCENDING AORTA ANEURYSMS AS A PREDICTIVE FACTOR OF BREAKAGE
Authors: Burgos Lázaro R J , Burgos Frías N , Serrano-Fiz García S , Ospina Mosquera V , Rojo Pérez F , Atienza Riera J M , Forteza Gil A , Guinea Tortuero G 
Published: May 2021

Abstract

INTRODUCTION
The surgical indication for ascending aortic aneurysms (AAA) is established when the maximum diameter &gt; 50 mm; It responds to Laplace's Law (T wall = P × r / 2e). The aim of the study is to define wall stress in AAA.

MATERIAL AND METHODS
218 ascending aortic walls have been studied: 96 from organ donors, and 122 from AAA: Marfán 58 (47.5%), bicuspid aortic valve 26 (21.4%), and atherosclerosis 38 (31.1%). The samples were studied "in vitro", according to the model Young's (relationship between stress and deformed area), by means of the mechanical traction test (Tension = Force / Area). The analysis was performed with the stress-elongation curve (d Tension / d Elongation).

RESULTS
The stress of the aortic wall, classified from highest to lowest according to pathology and age was: cystic necrosis of the middle layer, arteriosclerosis, age &gt; 60 years, between 35 and 59, and &lt; 34 years. The stress of “control aortas” wall increased directly in relation to the age of the donors.

CONCLUSIONS
The maximum diameter of the ascending aorta, the patient's type of pathology and age are factors that affect the maximum tension of the aortic wall and resistance, factors that allow differentiation and prediction of the risk of rupture of the AAA. The validation of the results obtained through numerical simulation was significant and the uniaxial analysis has modeled the response of the vessels to their internal pressure.
INFLUENCE OF NUTRITIONAL STATUS ON THE SURVIVAL OF PATIENTS UNDERGOING GASTRIC CANCER SURGERY
Authors: Garrosa Muñoz S , López Sánchez J , Abdel-Lah Fernández O , Hernández Cosido I , Jiménez Vaquero I , Carrero García S , Muñoz-Bellvís l , Parreño Manchado F C 
Published: May 2021

Abstract

INTRODUCTION
Preoperative nutritional status is a predictive modifiable factor of survival in gastrointestinal oncology surgery. The aim of the study was to analyze the influence of nutritional risk (NR) on survival in patients undergoing gastric cancer (GC) surgery.

MATERIAL AND METHODS
Retrospective study of 50 patients with gastric adenocarcinoma who underwent surgery over a 2-year period. To identify patients with malnutrition, the malnutrition criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were followed, and the nutritional risk was calculated with The nutritional Risk Screening (NRS2002). Patients were divided into two groups: NR (NRS≥3) and non-NR (NRS≤2), and survival was compared between the two.

RESULTS
The 5-year survival of GC patients was 22%, with a median survival of 15.8 months [SEM: 4.760, 95% CI = (6.473-25.132)]. NR patients had lower 5-year survivals (14% vs 57%, p = 0.004). Additionally, they had 4.4 times [95% CI = (1.714-11.495)] higher risk of mortality during oncological follow-up than patients without NR.

CONCLUSIONS
NR patients undergoing GC surgery have lower long-term survival. The preoperative NR can be considered a prognostic factor for survival and it should be evaluated preoperatively in gastrointestinal cancer surgery.
RETROSPECTIVE COHORT STUDY: DIFFERENCES AND SIMILARITIES BETWEEN SPORADIC AND FAMILIAL PAPILLARY THYROID CARCINOMA
Authors: López de Lerma Martínez de Carneros C , López Morales P , Martínez Sanz N , Giménez Francés C , Medina Manuel E , Albarracín Marin-Blázquez A , Candel Arenas M F 
Published: May 2021

Abstract

INTRODUCTION
There is a lot of controversy around the study of the familial papillary thyroid carcinoma (CPFT), which has a different behaviour than sporadic. The aim of this investigation is to establish the differences and similarities between sporadic papillary thyroid carcinoma and the familial one in order to determine if the familial type is a more aggressive clinical entity than sporadic.

MATERIAL AND METHODS
A retrospective cohort study in 231 patients with papillary thyroid carcinoma (CPT) from 2006 to 2018. One group was established according to the presence of two or more relatives as CPFT (n = 46) and the other group were the sporadic cases (n = 185). Throughout this study the clinical-pathological characteristics of both groups were compared based on the analysis of twenty-one variables.

RESULTS
After having carried out this investigation, statistically significant differences have only been found in the vascular invasion (p &lt; 0.001), presenting 3.8% in the sporadic group compared to the 21.7% found in the CPFT with an Odds Ratio of 7.6.

CONCLUSIONS
Based on our experience, patients with CPFT present a higher frequency of multifocal neoplasia, capsular invasion, vascular invasion, lymph node invasion and recurrence than sporadic CPT. However, these differences were only significant while analyzing the vascular invasion variable. Although the results of our study have been unable to prove that the CPFT is more aggressive than sporadic CPT, we recommend performing periodic ultrasounds such as the screening of the members of the families with CPFT. Finally, we conclude that more studies are needed.
GASTRODUODENAL PERFORATION, A FREQUENT SURGICAL EMERGENCY. REVIEW AND DESCRIPTIVE STUDY
Authors: Nuño Iglesias C , Fresnedo Pérez M R , Alonso Blanco R A , Soto Dopazo M , Pérez Prudencio E , Arango Bravo A , Mateos Palacios C , Fernández Fernández J C 
Published: May 2021

Abstract

INTRODUCTION
Perforated gastroduodenal ulcer represents a common surgical emergency and is associated with a morbimortality close to 40-50%. HP infection, tobacco and alcohol and some socioeconomic aspects represent the most commonly described risk factors.

MATERIAL AND METHODS
A descriptive and retrospective study was performed between 2018-2020. A total of 40 patients with a history of gastroduodenal perforation were selected. Data corresponding to: sex, age, ulcer location, treatment, tobacco and alcohol consumption, HP infection (presence or not of eradicating treatment) and other potential risk factors were collected and analysed. The aim of the study is to assess how new lifestyle changes, the evolution and improvement in the management of PH infection and the general decrease in smoking have modified the classic profile of patients with gastroduodenal perforations.

RESULTS
Gastroduodenal perforations predominated in the fifth/sixth decade of life (mean age 59 years). Although a predominance in men is described in the literature, in our sample no significant sex differences were found (1:1 ratio). The most frequent location was duodenal and the reference surgical treatment was primary suture + epipoplasty. Only one third of the patients had a known history of peptic ulcer.

CONCLUSIONS
Gastroduodenal perforations are a major problem for the on-call surgeon. It is essential to know the current risk factors and their potential relationship with morbimortality and postoperative evolution in order to guarantee the optimal management of these patients.
MALNUTRITION IN SURGICAL EMERGENCY PATIENTS: UN UNKOWN ISSUE
Authors: Diego Alonso E A , Abdel-Lah Fernández O , Hernández Cosido Lo , Jiménez Vaquero I , Carrero García S , Garrosa Muñoz S , Parreño Manchado F , Muñoz Bellvis L 
Published: May 2021

Abstract

INTRODUCTION
Malnutrition in hospitals is increasingly becoming more problematic, although its severity in surgical emergency patients has yet to be researched in depth. It entails higher rates of morbimortality as well as an increase in both days hospitalized and re-admissions which inflates health care-related costs.

MATERIAL AND METHODS
Using GLIM (Global Leadership Initiative on Malnutrition) criteria, we evaluated the nutritional state of 84 patients admitted through the emergency department in the Oesophago-Gastric and Bariatric Surgery Unit in our centre.

RESULTS
Of the total patients sampled, 57 (67,85%) were at risk of malnutrition. The percentage of patients suffering malnutrition was 44.04%, of which 15.8% were diagnosed with moderate malnutrition and 48.1% severe malnutrition.
Patients suffering malnutrition stay at hospital for 24 days on average, which implies a longer stay that those without malnutrition (13 days hospitalized on average), but no relation was found regarding any increase in overall complications.
After performing an analysis, malnutrition was significantly higher in oncological patients than in those who were admitted for other causes (58,3% vs 36.6%). However, the age analysis (over-70 vs under-70) showed no significant difference.

CONCLUSION
50% patients admitted through emergency services were diagnosed from malnutrition.
Oncological patients suffer greater risk and severity of malnutrition.
Malnutrition does imply longer stays at hospital; however there is no correlation with further complications.