bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There a Role for Oral Antibiotic Preparation Alone Before Colorectal Surgery? ACS-NSQIP Analysis by Coarsened Exact Matching
Authors: Garfinkle Richard , Abou-Khalil Jad , Morin Nancy , Ghitulescu Gabriela , Vasilevsky Carol-Ann , Gordon Philip , Demian Marie , Boutros Marylise 
Published: June 2017

BACKGROUND:
Recent studies demonstrated reduced postoperative complications using combined mechanical bowel and oral antibiotic preparation before elective colorectal surgery.

OBJECTIVE:
The aim of this study was to assess the impact of these 2 interventions on surgical site infections, anastomotic leak, ileus, major morbidity, and 30-day mortality in a large cohort of elective colectomies.

DESIGN:
This is a retrospective comparison of 30-day outcomes using the American College of Surgeons National Surgical Quality Improvement Program colectomy-targeted database with coarsened exact matching.

SETTINGS:
Interventions were performed in hospitals participating in the national surgical database.

PATIENTS:
Adult patients who underwent elective colectomy from 2012 to 2014 were included.

INTERVENTIONS:
Preoperative bowel preparations were evaluated.

MAIN OUTCOME MEASURES:
The primary outcomes measured were surgical site infections, anastomotic leak, postoperative ileus, major morbidity, and 30-day mortality.

RESULTS:
A total of 40,446 patients were analyzed: 13,219 (32.7%), 13,935 (34.5%), and 1572 (3.9%) in the no-preparation, mechanical bowel preparation alone, and oral antibiotic preparation alone groups, and 11,720 (29.0%) in the combined preparation group. After matching, 9800, 1461, and 8819 patients remained in the mechanical preparation, oral antibiotic preparation, and combined preparation groups for comparison with patients without preparation. On conditional logistic regression of matched patients, oral antibiotic preparation alone was protective of surgical site infection (OR, 0.63; 95% CI, 0.45–0.87), anastomotic leak (OR, 0.60; 95% CI, 0.34–0.97), ileus (OR, 0.79; 95% CI, 0.59–0.98), and major morbidity (OR, 0.73; 95% CI, 0.55–0.96), but not mortality (OR, 0.32; 95% CI, 0.08–1.18), whereas a regimen of combined oral antibiotics and mechanical bowel preparation was protective for all 5 major outcomes. When directly compared with oral antibiotic preparation alone, the combined regimen was not associated with any difference in any of the 5 postoperative outcomes.

LIMITATIONS:
This study was limited by its retrospective design with heterogeneous data.

CONCLUSIONS:
Oral antibiotic preparation alone significantly reduced surgical site infection, anastomotic leak, postoperative ileus, and major morbidity after elective colorectal surgery. A combined regimen of oral antibiotics and mechanical bowel preparation offered no superiority when compared with oral antibiotics alone for these outcomes. See Video Abstract at http://links.lww.com/DCR/A358.
Repeat Revascularization after Minimally Invasive Coronary Artery Bypass Grafting
Authors: Rodriguez Maria L. , Lapierre Harry R. , Sohmer Benjamin F. , Ruel Marc A. 
Published: June 2017

Objective Minimally invasive coronary artery bypass grafting (MICS CABG) via a small left thoracotomy is a novel technique for coronary revascularization that is increasingly used around the world. However, multivessel MICS CABG is difficult, and concerns about repeat revascularization (RR) have been raised. This longitudinal study describes the rates of RR among patients who have undergone MICS CABG and identifies targets for improvement. Methods A prospective observational study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015. Minimally invasive coronary artery bypass grafting was performed through a small left thoracotomy, using the in situ left internal mammary artery, ± a radial artery, and 1 to 3 saphenous veins anastomosed proximally to the aorta. Patients were followed annually. We examined the difference between the first half and second half of the series to ascertain the effects of a learning curve. Results Eighty percent of the procedures were performed off-pump. The median number of grafts performed were 2, and the left anterior descending, diagonals, obtuse marginals, and posterior interventricular artery were the distal targets in 94%, 12%, 44%, and 26%, respectively. The graftability index (#grafts/#diseased vessels) was 0.93. Revascularization of targets smaller than 1.5 mm decreased from 69% to 50% ( P = 0.002) between the series’ first and second halves. Overall, RR was needed in 21 patients (6.9%) and was performed at a mean ± SD of 1.7 ± 1.6 years postoperatively. The culprit lesion was attributed to the index surgical procedure (“graft-associated”) in 52%, to a stent stenosis or progression of native disease in 43%, and was unidentified in 5%. Patients with graft-associated RR had a lower graftability index at operation (0.73 vs 0.94) and more frequent involvement of the circumflex system (0.8 vs 0.3). The overall rate of RR at 3 years decreased from 11% in the first half to 2.6% in the second half ( P = 0.001). Conclusions The need for RR is part of the learning curve with MICS CABG, involves a graft in half of the cases, is more common in patients who had a lower graftability index at operation, and markedly improves with experience.
Comparing Population-based Risk-stratification Model Performance Using Demographic, Diagnosis and Medication Data Extracted From Outpatient Electronic Health Records Versus Administrative Claims
Authors: Kharrazi Hadi , Chi Winnie , Chang Hsien-Yen , Richards Thomas M. , Gallagher Jason M. , Knudson Susan M. , Weiner Jonathan P. 
Published: June 2017

Background:There is an increasing demand for electronic health record (EHR)–based risk stratification and predictive modeling tools at the population level. This trend is partly due to increased value-based payment policies and the increasing availability of EHRs at the provider level. Risk stratification models, however, have been traditionally derived from claims or encounter systems. This study evaluates the challenges and opportunities of using EHR data instead of or in addition to administrative claims for risk stratification.Methods:This study used the structured EHR records and administrative claims of 85,581 patients receiving outpatient care at a large integrated provider system. Common data elements for risk stratification (ie, age, sex, diagnosis, and medication) were extracted from outpatient EHR records and administrative claims. The performance of a validated risk-stratification model was assessed using data extracted from claims alone, EHR alone, and claims and EHR combined.Results:EHR-derived metrics overlapped considerably with administrative claims (eg, number of chronic conditions). The accuracy of the model, when using EHR data alone, was acceptable with an area under the curve of ∼0.81 for hospitalization and ∼0.85 for identifying top 1% utilizers using the concurrent model. However, when using EHR data alone, the predictive model explained a lower amount of variation in utilization-based outcomes compared with administrative claims.Discussion:The results show a promising performance of models predicting cost and hospitalization using outpatient EHR’s diagnosis and medication data. More research is needed to evaluate the benefits of other EHR data types (eg, lab values and vital signs) for risk stratification.
HIV preexposure prophylaxis for adolescents and young adults
Authors: Allen Emily , Gordon Allegra , Krakower Douglas , Hsu Katherine 
Published: June 2017

Purpose of review
The review describes the evidence for HIV preexposure prophylaxis (PrEP) with daily combined tenofovir disoproxil fumarate and emtricitabine for adolescents and young adults. Current recommendations are described, as are the unique medical, socioeconomic, and legal considerations regarding the use of PrEP for youth.

Recent findings
PrEP with daily oral tenofovir disoproxil fumarate–emtricitabine has been shown to help prevent new HIV infection among adults at substantial risk. Evidence suggests a protective benefit of PrEP for youth at risk for HIV, although low adherence is emerging as a barrier to effective use.

Summary
Effective use of antiretrovirals for PrEP represents a seminal development in HIV prevention efforts. Improving access and adherence to PrEP for youth has the potential to substantially reduce the incidence of HIV in this population.
Impact of an Obstetrical Hospitalist Program on the Safety Events in a Mid-Sized Obstetrical Unit
Authors: Decesare Julie Z. , Bush Suzanne Y. , Morton Ashley N. 
Published: June 2017

Objective
Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit.

Methods
From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor. A full-time OB hospitalist program was implemented in October 2014.

Results
From October 2014 to December 2016, there was 1 safety event associated with labor and delivery.

Conclusion
It has been speculated that implementation of an OB hospitalist model would be associated with improved maternal and neonatal outcomes; our regional OB referral hospital demonstrated a statistically significant decrease in OB safety events after the OB hospitalist program implementation.
A Nasal Brush-based Classifier of Asthma Identified by Machine Learning Analysis of Nasal RNA Sequence Data
Authors: Pandey Gaurav , Pandey Om P. , Rogers Angela J. , Ahsen Mehmet E. , Hoffman Gabriel E. , Raby Benjamin A. , Weiss Scott T. , Schadt Eric E. , Bunyavanich Supinda 
Published: June 2017

ABSTRACTAsthma is a common, under-diagnosed disease affecting all ages. We sought to identify a nasal brush-based classifier of mild/moderate asthma. 190 subjects with mild/moderate asthma and controls underwent nasal brushing and RNA sequencing of nasal samples. A machine learning-based pipeline identified an asthma classifier consisting of 90 genes interpreted via an L2-regularized logistic regression classification model. This classifier performed with strong predictive value and sensitivity across eight test sets, including (1) a test set of independent asthmatic and control subjects profiled by RNA sequencing (positive and negative predictive values of 1.00 and 0.96, respectively; AUC of 0.994), (2) two independent case-control cohorts of asthma profiled by microarray, and (3) five cohorts with other respiratory conditions (allergic rhinitis, upper respiratory infection, cystic fibrosis, smoking), where the classifier had a low to zero misclassification rate. Following validation in large, prospective cohorts, this classifier could be developed into a nasal biomarker of asthma.
Altered neurocognitive processing of tactile stimuli in patients with Complex Regional Pain Syndrome (CRPS)
Authors: Kuttikat Anoop , Noreika Valdas , Chennu Srivas , Shenker Nicholas , Bekinschtein Tristan , Brown Christopher A. 
Published: June 2017

AbstractChronic pain in CRPS has been linked to tactile misperceptions and deficits in somatotopic representation of the affected limb. Here, we identify altered cognitive processing of tactile stimuli in CRPS patients that we propose marks heterogeneity in tactile decision-making mechanisms. In a case-control design, we compared middle and late-latency somatosensory-evoked potentials (SEPs) in response to pseudo-randomised mechanical stimulation of the digits of both hands (including CRPS-affected and non-affected sides) between 13 CRPS patients and 13 matched healthy controls. During a task to discriminate the digit simulated, patients (compared to controls) had significantly lower accuracy and slowed response times but with high between-subject variability. At middle latencies (124-132 ms), tactile processing in patients relative to controls showed decrements in superior parietal lobe and precuneus (that were independent of task demands) but enhanced activity in superior frontal lobe (that were task-dependent). At late latencies, patients showed an augmented P300-like response under task demands that localised to supplementary motor area (SMA). Source activity in SMA correlated with slowed response times, while its scalp representation intriguingly correlated with better functioning of the affected limb, suggesting a compensatory mechanism. Future research should investigate the clinical utility of these putative markers of tactile decision-making mechanisms in CRPS.DisclosuresThe research was supported by funding from Cambridge Arthritis Research Endeavour (CARE). The study was sponsored by Cambridge University Hospitals NHS Foundation Trust and supported by its Rheumatology department. The authors report no conflicts of interest.PerspectiveWe present evidence of altered but highly variable cognitive processing (124 - 268ms latency) in response to mechanical tactile stimuli in patients with CRPS compared to healthy controls. Such mid-to-late latency responses could potentially provide convenient and robust biomarkers of abnormal perceptual decision-making mechanisms in CRPS to aid in clinical detection and treatment.
Placental gene expression mediates the interaction between obstetrical history and genetic risk for schizophrenia
Authors: Ursini Gianluca , Punzi Giovanna , Chen Qiang , Marenco Stefano , Robinson Joshua F. , Porcelli Annamaria , Hamilton Emily G. , Mitjans Marina , Maddalena Giancarlo , Begemann Martin , Seidel Jan , Yanamori Hidenaga , Jaffe Andrew E. , Berman Karen F. , Egan Michael F. , Straub Richard E. , Colantuoni Carlo , Blasi Giuseppe , Hashimoto Ryota , Rujescu Dan , Ehrenreich Hannelore , Bertolino Alessandro , Weinberger Daniel R. 
Published: June 2017

AbstractDefining the environmental context in which genes enhance susceptibility can provide insight into the pathogenesis of complex disorders, like schizophrenia. Here we show that the intrauterine and perinatal environment modulates the association of schizophrenia with genomic risk, as measured with polygenic risk scores (PRS) based primarily on GWAS significant variants. Genomic risk interacts with intrauterine and perinatal complications (Early Life Complications, ELCs) in each of three independent samples from USA, Italy and Germany (overall n= 1693, p= 6e-05). In each sample, the liability of schizophrenia explained by PRS is nominally more than five times greater in the presence of a history of ELCs compared with its absence. In each sample, patients with positive ELC histories have higher PRS than patients without ELCs, which is further confirmed in two additional patient samples from Germany and Japan (overall n=2038, p= 1e-04). The gene set based on the schizophrenia loci interacting with ELCs is highly expressed in multiple placental compartments and dynamically regulated in placenta from complicated in comparison with normal pregnancies. The same genes are differentially up-regulated in placentae from male compared with female offspring. The interaction between genomic risk and ELCs is mainly driven by GWAS significant loci enriched for genes highly expressed in the various placenta samples. Molecular pathway analyses based on the genes not driving this interaction reflect previous analyses about schizophrenia risk-genes, while genes highly and differentially expressed in placentae implicate an orthogonal biology involving cellular stress. These results suggest that the most significant genetic variants detected by current schizophrenia GWAS contribute to risk in part by converging on a developmental trajectory sensitive to events affecting placentation, which may underlie the male preponderance of schizophrenia and offer new insights into primary prevention.
Effects of progesterone on the reproductive physiology in zebrafish
Authors: Zhong Chunyun , Xiong Kewen , Wang Xin 
Published: June 2017

AbstractRecent studies have investigated that the synthetic progestins may lead to health issues to the aquatic organisms. Progesterone is a steroidal progestin and has been used as a contraceptive drug, which is detected in the aquatic ecosystem. However, the potential effects of progesterone on the fish reproduction are largely unclear. Here, we tested the effects of progesterone on the fish reproductive and endocrine systems. Adult zebrafish were exposed to progesterone for 10 days at environmental concentrations. The production of eggs was reduced in the exposed fish, and the circulating concentrations of estradiol (E2) and testosterone (T) in female fish or 11-keto testosterone (11-KT) in male fish were significantly diminished. Our results suggested that progesterone may cause adverse health effects on fish by disrupting the endocrine system, and short-term exposure to progesterone could overt affect the fish reproduction.
Insights on lean gamification for higher education
Authors: Deif Ahmed 
Published: June 2017

PurposeThere is no argument that using games (gamification) is an efficient way of learning in higher education. The questions, though, are which gamification approach is most suitable at that level and how to assess its suitability? This paper aims to attempt to partially answer these two questions, in the context of lean thinking education.Design/methodology/approachThe paper offers an assessment criteria to investigate the impact of lean gamification based on the evaluation of motivational, cognitive and social processing during games. In addition, a study is conducted among selected games using these assessment criteria. The study included statistical as well as comparative analysis. The study was based on a sample of undergraduate students learning various lean thinking concepts through physical games over the course of six months.FindingsResults showed different interaction levels between the three evaluation criteria depending on the type and design of the lean game. The reported scores and analysis drew various lessons on how to use gamification in the context of lean teaching, outlined some best practices in lean games design and suggested recommendations in mapping lean games from industrial domain to higher education domain.Research limitations/implicationsThe scope of this research was bounded by the sample size of students as well as the selected nine lean thinking games. Larger pool of students as well as other lean thinking games can offer further insights and confirm the outlined ones.Practical implicationsThe presented work will help lean thinking educators in higher education to better understand the student dynamics associated with engaging them in this type pf pedagogical approach. It will help guiding lean thinking games’ designer on how to better cater for this segment of lean thinking learners. Finally, it will aid in promoting lean gamification as an effective learning tool.Social implicationsThe social impact is achieved through enhancing lean thinking education to a wide number of students. This will positively impact the society through the application of the effective lean tools at different stages, levels and places in these students’ life experiences.Originality/valueThis study offers one of the very few applications in gamification assessment in the context of lean thinking. Furthermore, it integrates the social processing criterion for the first time with the classical two other criteria (motivation and cognitive) used in games education assessment. Finally, it offers new insights for lean thinking game designers for higher education learners.
Understand, reduce, respond: project complexity management theory and practice
Authors: Maylor Harvey , Turner Neil 
Published: June 2017

Purpose
The purpose of this paper is to contribute to the understanding of complexity and its management from an OM perspective, building on and extending the systematic literature review published in this journal in 2011, and provide a foundation for exploring the interactions between complexities and responses.

Design/methodology/approach
The paper takes a subjective view of complexity, focusing on the “lived experience” of managers. It takes an updated systematic literature review, and demonstrates the comprehensiveness of a framework to classify complexities of projects. It reports the findings from 43 workshops with over 1,100 managers.

Findings
First, the complexity framework is effective in aiding understanding. Second, and somewhat unexpectedly, managers were able to identify strategies to reduce the majority of complexities that they faced. Third, the workshops identified a typology of responses to residual complexities.

Research limitations/implications
The framework has demonstrated its utility, and a gap in understanding emergent complexities is identified. The framework further presents the opportunity to explore the recursive nature of complexity and response.

Practical implications
This paper provides a framework that is both comprehensive and comprehensible. The authors demonstrate that complexities can be reduced and provide a means to assess responses to residual complexities, including potentially matching managers to projects.

Originality/value
This work extends the previous systematic review combined with extensive empirical data to generate findings that are having impact in practice, and have the potential to strengthen a relatively neglected area within OM. A research agenda is suggested to support this.
Linkages between firm innovation strategy, suppliers, product innovation, and business performance
Authors: Jajja Muhammad Shakeel Sadiq , Kannan Vijay R. , Brah Shaukat Ali , Hassan Syed Zahoor 
Published: June 2017

PurposeThe purpose of this paper is to use resource dependence theory to hypothesize that a buyer’s innovation strategy enhances supplier innovation focus and a buyer-supplier relationship that supports product innovation. These in turn positively impact buyer product innovation outcomes and business performance. Moreover, it is argued that the buyer-supplier relationship positively moderates the impact of supplier innovation focus on product innovation.Design/methodology/approachStructural equation modeling and hierarchical linear regression are used to test hypotheses.FindingsThe results support all hypotheses and suggest that company (buyer) age and variables related to buyer engagement with international markets directly influence performance. The results also indicate that the buyer-supplier relationship does not moderate the relationship between innovation strategy and innovation performance.Research limitations/implicationsThis study demonstrates that how a firm builds the conditions to effectively leverage the complementary resources and capabilities of suppliers directly influence innovation outcomes and business performance.Practical implicationsAn important factor in firms achieving their product innovation goals is the selection and management of suppliers that are strategically aligned with regard to innovation. While managers need to develop internal innovation capabilities, partnering with like-minded organizations, and creating conditions for effective cooperation are key drivers of innovation outcomes.Originality/valueIn contrast to prior research that has examined operational issues, this study shows how the strategic alignment of buyers and suppliers with regard to innovation is an antecedent of product innovation outcomes. Moreover, it adds to a limited literature on supply chain management practices in emerging markets.