bluuebunny/crossref_metadata_2025_split huggingface dataset:
Academic Hospitals Discharge Fewer Patients to Postacute Care Facilities After Colorectal Resection
Authors: Kanters Arielle E. , Nikolian Vahagn C. , Kamdar Neil S. , Regenbogen Scott E. , Hendren Samantha K. , Suwanabol Pasithorn A. 
Published: March 2019

BACKGROUND:
Discharge to a nonhome destination (ie, skilled nursing facility, subacute rehabilitation, or long-term care facility) after surgery is associated with increased mortality and higher costs and is less desirable to patients than discharge to home.

OBJECTIVE:
We sought to identify modifiable hospital-level factors that may reduce rates of nonhome discharge after colorectal resection.

DESIGN:
This was a retrospective cohort study of patients undergoing colorectal resection in the Michigan Surgical Quality Collaborative (July 2012 to June 2015). Patient- and hospital-level characteristics were tested for association with nonhome discharge patterns.

SETTINGS:
Patients were identified using prospectively collected data from the Michigan Surgical Quality Collaborative, a statewide collaborative encompassing 63 community, academic, and tertiary hospitals.

PATIENTS:
Patients undergoing colon and rectal resections were included.

MAIN OUTCOME MEASURE:
The main outcome measure was hospital use patterns of nonhome discharge.

RESULTS:
Of the 9603 patients identified, 1104 (11.5%) were discharged to a nonhome destination. After adjustments for patient factors associated with nonhome discharge, we identified variability in hospital use patterns for nonhome discharge. Designation as a low utilizer hospital was associated with affiliation with a medical school (p = 0.020) and high outpatient volume (p = 0.028). After adjustments for all hospital factors, only academic affiliation maintained a statistically significant relationship (OR = 4.94; p = 0.045).

LIMITATIONS:
This study had a retrospective cohort design with short-term follow-up of sampled cases. Additionally, by performing our analysis on the hospital level, there is a decreased sample size.

CONCLUSIONS:
This population-based study shows that there is significant variation in hospital practices for nonhome discharge. Specifically, hospitals affiliated with a medical school are less likely to discharge patients to a facility, even after adjustment for patient and procedural risk factors. This study raises the concern that there may be overuse of subacute facility discharge in certain hospitals, and additional study is warranted. See Video Abstract at http://links.lww.com/DCR/A837.
Prognostic Impact of Tumor-Infiltrating Lymphocytes in Primary and Metastatic Colorectal Cancer: A Systematic Review and Meta-analysis
Authors: Kong Joseph C. , Guerra Glen R. , Pham Toan , Mitchell Catherine , Lynch A. Craig , Warrier Satish K. , Ramsay Robert G. , Heriot Alexander G. 
Published: March 2019

BACKGROUND:There is increasing literature emerging on the significance of tumor-infiltrating lymphocytes in colorectal cancer. However, there have been inconsistent findings, secondary to small patient numbers and varied methods for identifying these lymphocytes.OBJECTIVE:The aim of this study was to determine the prognostic and predictive power of tumor-infiltrating lymphocytes in colon, rectal (in neoadjuvant setting), and metastatic colorectal cancer.DATA SOURCES:A comprehensive search of PubMed and Embase was undertaken from January 2006 to December 2016.STUDY SELECTION:The inclusion criteria included a description of the tumor-infiltrating lymphocyte subset(s) assessed with reporting of associated short- and long-term outcomes.MAIN OUTCOME MEASURES:The main outcome measures, were disease-free and overall survival.RESULTS:A total of 25 studies were included, 15 for primary colorectal cancer (4719 patients), 7 for locally advanced rectal cancer (727 patients), and 3 studies for metastatic colorectal cancer (418 patients). High CD3+, CD8+, FoxP3+, and CD45RO+densities were associated with improved overall survival for primary colorectal cancer, with pooled estimated HRs of 0.88, 0.81, 0.70, and 0.63 (allp< 0.001) respectively. Furthermore, in locally advanced rectal cancer, the levels of CD8+cells were a significant predictor of good tumor regression grade after chemoradiotherapy.LIMITATIONS:The retrospective nature of included studies and the significant interstudy heterogeneity were limitations.CONCLUSIONS:There is increasing evidence that tumor-infiltrating lymphocytes play an important role in predicting prognosis in colorectal cancer and tumor regression after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Clinical researchers are now in a unique position to build on this work to identify robust predictive markers to stratify patients not only to currently available therapies but also to immunotherapy, which has demonstrated success in improving patient outcomes.
Effectiveness of Vascularized Lymph Node Transfer for Extremity Lymphedema Using Volumetric and Circumferential Differences
Authors: Ho Olivia A. , Chu Sung-Yu , Huang Yen-Ling , Chen Wen-Hui , Lin Chia-Yu , Cheng Ming-Huei 
Published: March 2019

Background:
Circumferential difference of lymphedematous limbs at designated anatomic distances has been the primary mode for measuring lymphedematous extremities. Computed tomography (CT) imaging produces accurate, consistent, hygienic volume measurements and a direct limb representation. This study compares these 2 main modalities and assesses their correlation.

Methods:
CT and circumferential difference measurements, costs, and correlation of patient limbs that received vascularized lymph node transfer were compared.

Results:
Mean circumferential difference by tape measurement pre- and postoperatively was 31.4% ± 19.1% and 17.4% ± 8.8% for upper limbs and 43.2% ± 16.1% and 22.4% ± 12% for the lower limbs, respectively. Mean CT volumetric difference pre- and postoperatively were 36.1 ± 4.1% and 27.2 ± 2.8% for the upper limb and 46.2 ± 3.2% and 33.2 ± 2.1% for the lower limbs, respectively. CT volume measurements significantly correlated with their respective circumferential difference with Pearson correlation coefficient of r = +0.7, which was statistically significant (P = 0.03), indicating a strong positive correlation between circumferential difference and actual limb volume changes as determined by CT imaging. Circumferential differences are more cost effective than CT volume assessments in the domains of measurement frequency (P = 0.03), fee (P < 0.01), time (P = 0.03), total cost per year (P < 0.01), and cost/minute (P = 0.03).

Conclusions:
Standardized circumferential differences that are currently used are comparable to unbiased CT volumetric measurements and can be used as a reliable, reproducible, minimally invasive, low cost, and accurate method of measuring the lymphedematous limbs.
Evaluating Postoperative Narcotic Use in Prepectoral Versus Dual-plane Breast Reconstruction Following Mastectomy
Authors: Copeland-Halperin Libby R. , Yemc Louisa , Emery Erica , Collins Devon , Liu Chang , Mesbahi Ali N. , Venturi Mark L. 
Published: March 2019

Background:
The majority of postmastectomy breast reconstruction performed in the United States is device-based. Typically, a tissue expander or implant is placed in the dual-plane (ie, subpectoral). Prepectoral breast reconstruction with acellular dermal matrices following mastectomy is a relatively new technique that has favorable outcomes with minimal complications and satisfactory aesthetic results. Few studies have compared opioid use between the 2 approaches. This study compares duration of postoperative opioid use among patients undergoing prepectoral device-based breast reconstruction with those in whom dual-plane devices were placed.

Methods:
We reviewed the records of adult female patients aged 18 years or older who underwent prepectoral or dual-plane device-based breast reconstructions following mastectomy by one of the 2 plastic surgeons (A.M. or M.V.) from 2015 to 2017 at a large tertiary care hospital. Patients with a history of substance abuse, chronic pain, or who were already receiving opioid medication were excluded. Electronic medical records were reviewed and patient surveys were conducted during postoperative visits to determine postoperative opioid requirements.

Results:
During the study period, 58 patients underwent dual-plane breast reconstruction and 94 underwent prepectoral reconstruction. Demographics and comorbidities of the groups were similar. By multivariate regression analysis, the prepectoral reconstruction group required 33% fewer days on opioid analgesic medication (P = 0.016) and were 66% less likely to require opioid prescription refills (P = 0.027). There were no statistically significant differences in other outcomes or complications.

Conclusion:
Patients undergoing prepectoral tissue expander or implant-based reconstruction required fewer days of opioid pain medication than those managed with the dual-plane technique.
ASSOCIATION OF RETINAL VEIN OCCLUSION WITH CARDIOVASCULAR EVENTS AND MORTALITY
Authors: Wu Chris Y. , Riangwiwat Tanawan , Limpruttidham Nath , Rattanawong Pattara , Rosen Richard B. , Deobhakta Avnish 
Published: March 2019

Purpose:
Previous studies examining the association of retinal vein occlusion (RVO) and cardiovascular events have been inconsistent and have mostly focused on stroke and myocardial infarction. The goal of this study is to use meta-analysis to examine the available evidence examining the association of RVO with incident cardiovascular events and mortality.

Methods:
Systematic review and meta-analysis of all longitudinal cohort studies published in PubMed, Embase, and the Cochrane Library from inception to April 7, 2018, that evaluated the association of baseline RVO and incident cardiovascular events and/or mortality, that provided multivariate-adjusted risk estimates with 95% confidence intervals (95% CIs), and that had average follow-up ≥1 year. The Newcastle–Ottawa scale was used to assess study quality. Multivariate-adjusted risk estimates with 95% CI along with study characteristics were extracted from each study, and pooled risk ratios (RRs) with 95% CI were generated using a random-effects model with inverse-variance weighting to account for heterogeneity. Main outcomes were incident stroke (fatal or nonfatal), myocardial infarction, heart failure, peripheral arterial disease, all-cause mortality, and cardiovascular mortality.

Results:
Fifteen cohort studies with a total of 474,466 patients (60,069 with RVO and 414,397 without RVO) were included. Each study had Newcastle–Ottawa scale score ≥6, indicating moderate-to-high quality. Retinal vein occlusion was associated with increased risk of stroke (RR = 1.45; 95% CI, 1.31–1.60), myocardial infarction (RR = 1.26; 95% CI, 1.17–1.37), heart failure (RR = 1.53; 95% CI, 1.22–1.92), peripheral arterial disease (RR = 1.26; 95% CI, 1.09–1.46), and all-cause mortality (RR = 1.36; 95% CI, 1.02–1.81), but was not associated with increased risk of cardiovascular mortality (RR = 1.78; 95% CI, 0.70–4.48).

Conclusion:
This review suggests patients with RVO have an increased risk of cardiovascular events and all-cause mortality. More studies are needed to determine the highest risk periods for cardiovascular events and mortality after RVO and whether immediate cardiovascular evaluation and intervention will improve outcomes.
Reporting Guidelines for Use in Preparing Manuscripts for Nursing Journals
Authors: Oermann Marilyn H. , Eskew Michael S. , Conklin Jamie L. , Williams Dennis C. 
Published: March 2019

Abstract
For research to be used to build evidence and guide practice decisions, studies need to be reported accurately, completely, and without bias. Standardized reporting guidelines have been developed to improve the quality of manuscripts on different types of studies. Reporting guidelines are often in the form of a checklist, ensuring that authors include important elements in their manuscripts. Research has shown that authors who use standardized reporting guidelines submit higher quality manuscripts that include essential information. This article describes common reporting guidelines that can be used by nurse authors when preparing their manuscripts.
Surgical margins in oral squamous cell cancer: intraoperative evaluation and prognostic impact
Authors: Mannelli Giuditta , Comini Lara Valentina , Piazza Cesare 
Published: March 2019

Purpose of review
To summarize recent findings regarding surgical management of oral squamous cell cancer (OSCC) through analysis of different intraoperative techniques for assessment of margins, evaluate the pros and cons of each, and ensuing prognostic impact.

Recent findings
‘En bloc’ OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the ‘gold standard’ for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. The commonly applied evaluation of frozen sections still raises concerns regarding its efficacy and reproducibility; therefore, several ancillary diagnostic methods have entered the field of head and neck oncology in the last decades, aiming to support the surgeon in achieving tumor-free margins during ablative procedures.

Summary
Poor prognosis of OSCC is strongly associated with residual tumor after surgery. Negative surgical margins are one of the strongest prognosticators for disease-free survival and locoregional control, but their intraoperative determination seems still to be suboptimal and needs better refinement. The most studied techniques to assess intraoperative margins include fluorescence, Raman spectroscopy, narrow band imaging, optical coherence tomography, and cytological bone margins analysis; each has its unique characteristics that are described in detail herein.
Rare Manifestation of Gout
Authors: IIliev Georgi , Ivanova Polina Petrova , Nedev Plamen , Popov Hristo 
Published: March 2019

Abstract
Gout is a disease characterized by abnormal metabolism of the uric acid, leading to undesired buildup of monosodium urate crystals affecting mainly the first metatarsal-phalangeal joint of the foot and less commonly other joints or the soft tissues of the body. The prevalence of the disease increases with age, and it is statistically more observed in men than in women.
We present the case of a 62-year-old male patient diagnosed as having gout 20 years ago. He came to the clinic with a nasal hump and a mass growing in his nose for the last 3 years, presenting as a nasal obstruction and facial deformity. Although the patient was treated with allopurinol and nonsteroidal anti-inflammatory drugs, surgical treatment was deemed necessary, and the patient was taken to receive a surgical resection of the nasal mass. The follow-up histopathology observation revealed deposits of urate crystals surrounded by a granulomatous inflammation. This confirmed the diagnosis—gouty tophi in the nose. In the follow-up period after the surgery, the patient reported overall improved breathing and aesthetic results.
Tophi can be found in atypical locations, which increases morbidities and deformities caused by the disease. We report on this peculiar case of tophaceus gout as it is—a rare manifestation of the disease with tophi located in the nasal region.
Can sleep protect memories from catastrophic forgetting?
Authors: González Oscar C. , Sokolov Yury , Krishnan Giri P. , Bazhenov Maxim 
Published: March 2019

AbstractContinual learning remains to be an unsolved problem in artificial neural networks. Biological systems have evolved mechanisms by which they can prevent catastrophic forgetting of old knowledge during new training and allow lifelong learning. Building upon data suggesting the importance of sleep in learning and memory, here we test a hypothesis that sleep protects memories from catastrophic forgetting. We found that training in a thalamocortical network model of a “new” memory that interferes with previously stored “old” memory may result in degradation and forgetting of the old memory trace. Simulating NREM sleep immediately after new learning leads to replay, which reverses the damage and ultimately enhances both old and new memory traces. Surprisingly, we found that sleep replay goes beyond recovering old memory traces that were damaged by new learning. When a new memory competes for the neuronal/synaptic resources previously allocated to the old memory, sleep replay changes the synaptic footprint of the old memory trace to allow for the overlapping populations of neurons to store multiple memories. Different neurons become preferentially supporting different memory traces to allow successful recall. We compared synaptic weight dynamics during sleep replay with that during interleaved training – a common approach to overcome catastrophic forgetting in artificial networks – and found that interleaved training promotes synaptic competition and weakening of reciprocal synapses, effectively reducing an ensemble of neurons contributing to memory recall. This leads to suboptimal recall performance compared to that after sleep. Together, our results suggest that sleep provides a powerful mechanism to achieve continual learning by combining consolidation of new memory traces with reconsolidation of old memory traces to minimize memory interference.
Demonstration of simultaneous biological sulphate reduction and partial sulphide oxidation in a hybrid linear flow channel reactor
Authors: Marais TS , Huddy RJ , Harrison STL , van Hille RP 
Published: March 2019

AbstractSemi-passive remediation systems have the potential to treat low-volume, sulphate-rich, mining impacted waters in a cost-effective and sustainable way. This paper describes the “proof of concept” evaluation of a hybrid linear flow channel reactor, capable of sustaining efficient biological sulphate reduction and partial oxidation of the sulphide product to elemental sulphur. Key elements include the presence of a sulphate-reducing microbial community, immobilised onto carbon fibres and the rapid development of a floating biofilm at the air-liquid interface. The biofilm consists of heterotrophic species and autotrophic sulphide oxidisers. It impedes oxygen mass transfer into the bulk volume and creates a suitable pH-redox microenvironment for partial sulphide oxidation. Demonstration of the concept was successful, with near 20 complete reduction of the sulphate in the feed (1 g/l), effective management of the sulphide generated (95-100% removal) and recovery of a portion of the sulphur by harvesting the elemental-sulphur-rich biofilm. The biofilm re-formed within 24 hours of harvesting, with no decrease in volumetric sulphate reduction rate during this period. Colonisation of the carbon microfibers by sulphate reducing bacteria ensured biomass retention, suggesting the reactor could remain effective at high volumetric flow rates.
Differences in Genetic Liability for Insomnia and Hypersomnia in Bipolar Disorder Subtypes
Authors: Lewis Katie J S , Richards Alexander , Leonenko Ganna , Jones Samuel E , Jones Hannah , Gordon-Smith Katherine , Forty Liz , Escott-Price Valentina , Owen Michael J , Weedon Michael N , Jones Lisa , Craddock Nick , Jones Ian , O’Donovan Michael C , Di Florio Arianna 
Published: March 2019

AbstractBackgroundInsomnia and hypersomnia are common in bipolar disorder (BD) but it is unclear whether genetic factors influence this association. Stratifying by bipolar subtypes could elucidate the nature of this association and inform research on sleep and BD. We therefore aimed to determine whether polygenic risk scores (PRS) for insomnia, daytime sleepiness and sleep duration differ according to bipolar subtypes (bipolar I disorder, BD-I or bipolar II disorder, BD-II).MethodsIn this case-control study, we used multinomial regression to determine whether PRS for insomnia, daytime sleepiness, and sleep duration were associated with risk of BD-I or BD-II when compared to each other and to controls. Cases (n=4672) were recruited within the United Kingdom from the Bipolar Disorder Research Network. Controls (n=5714) were recruited from the 1958 British Birth Cohort and UK Blood Service. All participants were of European ancestry. Clinical subtypes of BD were determined by semi-structured psychiatric interview (the Schedules for Clinical Assessment in Neuropsychiatry) and case notes.ResultsWithin cases, 3404 and 1268 met DSM-IV criteria for BD-I and BD-II, respectively. Insomnia PRS was associated with increased risk of BD-II (RR = 1.14, 95% CI = 1.07-1.21,P= 8.26 × 10−5) but not BD-I (RR = 0.98, 95% CI = 0.94-1.03,P= .409) relative to controls. In contrast, sleep duration PRS was associated with increased relative risk of BD-I (RR = 1.10, 95% CI = 1.06-1.15,P= 1.13 × 10−5), but not BD-II (RR = 0.99, 95% CI = 0.93-1.06,P= .818). Daytime sleepiness PRS was associated with an increased risk of BD-I (RR = 1.07, 95% CI = 1.02-1.11,P= .005) and BD-II (RR = 1.14, 95% CI = 1.07-1.22,P= 3.22 × 10−5) compared to controls, but did not distinguish subtypes from each other.ConclusionsBipolar subtypes differ in genetic liability to insomnia and sleep duration. Our findings provide further evidence that the distinction between BD-I and BD-II has biological and genetic validity. This distinction will be critical in the selection of participants for future research on the role of sleep disturbance in BD.
Retrospective inference as a form of bounded rationality, and its beneficial influence on learning
Authors: FitzGerald Thomas HB , Penny Will D. , Bonnici Heidi M , Adams Rick A 
Published: March 2019

AbstractProbabilistic models of cognition typically assume that agents make inferences about current states by combining new sensory information with fixed beliefs about the past, an approach known as Bayesian filtering. This is computationally parsimonious, but, in general, leads to suboptimal beliefs about past states, since it ignores the fact that new observations typically contain information about the past as well as the present. This is disadvantageous both because knowledge of past states may be intrinsically valuable, and because it impairs learning about fixed or slowly changing parameters of the environment. For these reasons, in offline data analysis it is usual to infer on every set of states using the entire time series of observations, an approach known as (fixed-interval) Bayesian smoothing. Unfortunately, however, this is impractical for real agents, since it requires the maintenance and updating of beliefs about an ever-growing set of states. We propose an intermediate approach, finite retrospective inference (FRI), in which agents perform update beliefs about a limited number of past states. (Formally, this represents online fixed-lag smoothing with a sliding window.) This can be seen as a form of bounded rationality in which agents seek to optimise the accuracy of their beliefs subject to computational and other resource costs. We show through simulation that this approach has the capacity to significantly increase the accuracy of both inference and learning, using a simple variational scheme applied to both randomly generated Hidden Markov models (HMMs), and a specific application of the HMM, in the form of the widely used probabilistic reversal task. Our proposal thus constitutes a theoretical contribution to normative accounts of bounded rationality, which makes testable empirical predictions that can be explored in future work.