bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative complications in individuals aged 70 and over undergoing elective surgery for colorectal cancer
Authors: Fagard K. , Casaer J. , Wolthuis A. , Flamaing J. , Milisen K. , Lobelle J.‐P. , Wildiers H. , Kenis C. 
Published: July 2017

AbstractAimThis study aims to describe the nature, incidence, severity and outcomes of in‐hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer.MethodPatients ≥ 70 years old were identified from a prospectively collected database (2009–2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien–Dindo (CD) grading system. The following outcomes were analysed comparing patients with and without CD ≥ 2 and CD ≥ 3 POCs: length of stay (LOS), transfer to the intensive care unit, 30‐day readmission rates, 30‐day and 1‐year mortality.ResultsIn the 190 patients included, medical POCs (40.5%) were more frequent than surgical POCs (17.9%), and 37.9% experienced CD ≥ 2 POCs. The most common medical POCs were infections (26.8%), transient confusion or altered mental function (12.1%), cardiac arrhythmia (4.7%), and ileus/gastroparesis/prolonged recovery of transit (4.7%). The most common surgical POCs were surgical site infections (12.1%), wound dehiscence/bleeding (4.7%), anastomotic leak (3.7%) and surgical site bleeding (3.7%). The reoperation rate was 7.9%. CD ≥ 2 POCs led to 11 intensive care unit admissions and increased median postoperative LOS by 114% (P < 0.0001 for both), but did not significantly alter 30‐day readmission and 30‐day and 1‐year mortality rates. CD ≥ 3 POCs increased LOS by 162% (P < 0.0001) and showed an increased 1‐year mortality (P = 0.07).ConclusionThis study shows that in‐hospital medical and surgical complications after surgery for colorectal cancer in patients ≥ 70 years old are frequent and that complications lead to less favourable outcomes.
Reduced risk of emergency admission for colorectal cancer associated with the introduction of bowel cancer screening across England: a retrospective national cohort study
Authors: Geraghty J. , Shawihdi M. , Devonport E. , Sarkar S. , Pearson M. G. , Bodger K. 
Published: July 2017

AbstractAimWe wanted to find out if roll‐out of the bowel cancer screening programme (BCSP) across England was associated with a reduced risk of emergency hospital admission for people presenting with colorectal cancer (CRC) during this period.MethodThis is a retrospective cohort study of 27 763 incident cases of CRC over a 1‐year period during the roll‐out of screening across parts of England. The primary outcome was the number of emergency (unplanned) hospital admissions during the diagnostic pathway. The primary exposure was to those living in an area where the BCSP was active at the time of diagnosis. Patients were categorized into three exposure groups: BCSP not active (reference group), BCSP active < 6 months or BCSP active ≥ 6 months.ResultsThe risk of emergency admission for CRC in England was associated with increasing age, female gender, comorbidity and social deprivation. After adjusting for these factors in logistic regression, the odds ratio (OR) for emergency admission in patients diagnosed ≥ 6 months after the start‐up of local screening was 0.83 (CI 0.76–0.90). The magnitude of risk reduction was greatest for cases of screening age (OR 0.75; CI 0.63–0.90) but this effect was apparent also for cases outside the 60–69‐year age group (OR 0.85; CI 0.77–0.94). Living in an area with active BCSP conferred no reduction in risk of emergency admission for people diagnosed with oesophagogastric cancer during the same period.ConclusionThe start‐up of bowel cancer screening in England was associated with a substantial reduction in the risk of emergency admission for CRC in people of all ages. This suggests that the roll‐out of the programme had indirect benefits beyond those related directly to participation in screening.
Predictors of early renal function decline in adults with Type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes and the Pittsburgh Epidemiology of Diabetes Complications studies
Authors: Bjornstad P. , Costacou T. , Miller R. G. , Maahs D. M. , Rewers M. J. , Orchard T. J. , Snell‐Bergeon J. K. 
Published: July 2017

AbstractAimDiabetic kidney disease is one of the leading complications of Type 1 diabetes, but its prediction remains a challenge. We examined predictors of rapid decline in estimated GFR (eGFR) in two Type 1 diabetes cohorts: the Coronary Artery Calcification in Type 1 Diabetes (CACTI) and the Pittsburgh Epidemiology of Diabetes Complications (EDC).MethodsA select subset of participants (CACTI: n = 210 and EDC: n = 98) diagnosed before 17 years of age with Type 1 diabetes duration ≥ 7 years, and follow‐up data on eGFR by CKD‐EPI creatinine for up to 8 years were included in the analyses. Early renal function decline was defined as annual decline in eGFR ≥ 3 ml/min/1.73 m2, and normal age‐related decline as eGFR ≤ 1 ml/min/1.73 m2. Parallel logistic regression models were constructed in the two cohorts.ResultsEarly renal function decline incidence was 36% in CACTI and 41% in EDC. In both cohorts, greater baseline eGFR (CACTI: OR 3.12, 95% CI 1.97–5.05; EDC: OR 1.92, 95% CI 1.17–3.15 per 10 ml/min/1.73 m2) and log albumin‐to‐creatinine (ACR) (CACTI: OR 3.24, 95% CI 1.80–5.83; EDC: OR 1.87, 95% CI 1.18–2.96 per 1 unit) predicted greater odds of early renal function decline in fully adjusted models. Conversely, ACE inhibition predicted lower odds of early renal function decline in women in CACTI, but similar relationships were not observed in women in EDC.ConclusionsA substantial proportion of people with Type 1 diabetes in the EDC and CACTI cohorts experienced early renal function decline over time. ACE inhibition appeared to be protective only in women in CACTI where the prevalence of its use was twofold higher compared with the EDC.
Levels of wound calprotectin and other inflammatory biomarkers aid in deciding which patients with a diabetic foot ulcer need antibiotic therapy (INDUCE study)
Authors: Ingram J. R. , Cawley S. , Coulman E. , Gregory C. , Thomas‐Jones E. , Pickles T. , Cannings‐John R. , Francis N. A. , Harding K. , Hood K. , Piguet V. 
Published: July 2017

AbstractAimsDeciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point‐of‐care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C‐reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation.MethodsIn a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers. Antibiotic prescribing decisions were based on clinicians’ baseline assessments and participants were reviewed 1 week later; ulcer infection was defined by clinicians’ overall impression from their two assessments.ResultsSome 363 potential participants were screened, of whom 67 were recruited, 29 with mildly infected diabetic foot ulcers and 38 with no infection. One participant withdrew early in each group. Ulcer area was 1.32 cm2 [interquartile range (IQR) 0.32–3.61 cm2] in infected ulcers and 0.22 cm2 (IQR 0.09–1.46 cm2) in uninfected ulcers. Baseline CRP for mild infection was 9.00 mg/ml and 6.00 mg/ml for uninfected ulcers; most procalcitonin levels were undetectable. Median calprotectin level in infected diabetic foot ulcers was 1437 ng/ml and 879 ng/ml in uninfected diabetic foot ulcers. Area under the receiver operating characteristic curve for a composite algorithm incorporating calprotectin, CRP, white cell count and ulcer area was 0.68 (95% confidence intervals 0.52–0.82), sensitivity 0.64, specificity 0.81.ConclusionsA composite algorithm including CRP, calprotectin, white cell count and ulcer area may help to distinguish uninfected from mildly infected diabetic foot ulcers. Venous procalcitonin is unhelpful for mild diabetic foot ulcer infection.
How could conditional cash transfer programme conditionalities reinforce vulnerability? Non‐compliers and policy implementation gaps in Uruguay's Family Allowances
Authors: Rossel Cecilia , Courtoisie Denise , Marsiglia Magdalena 
Published: July 2017

AbstractInfluential research shows that conditionalities could incentivize recipients of conditional cash transfer programmes (CCTs) to send their children to school and to regular health check‐ups. However, a growing literature is elucidating the risks of conditional transfers, from both a philosophical and an empirical perspective. This article highlights the varied deficits that have accompanied the implementation process in some Latin American countries, as well as the consequences that these deficits might have on the beneficiaries. In particular, it suggests that, rather than reducing vulnerability by improving access to services, conditionalities could be reinforcing vulnerability among non‐compliers if non‐compliance leads to the immediate suspension of the cash transfer and if this sanction is poorly implemented.While this hypothesis has gained attention and is part of both an academic and a political debate, empirical research around it is scarce. This article is an attempt to start filling this gap by focusing on the implementation process of conditionalities in a CCT programme in Uruguay (Family Allowances) and how this is experienced by a group of recipients who failed to comply with the conditionalities and were sanctioned with the suspension of the benefit. In particular, it identifies the main reasons why these beneficiaries did not comply, how they experience the sanction and how they managed—when they do—to apply for the benefit to be restored.Based on a qualitative design of in‐depth interviews, it provides empirical evidence to unpack causal relationships linking conditionalities to increased vulnerability among non‐compliers. Our findings offer evidence on the role played by the conditionalities in reinforcing vulnerability and the possible causal mechanisms that could be operating between both phenomena. This picture of policy implementation constraints that could lead conditionalities to reinforce vulnerability among recipients could be relevant to policy‐makers having to deal with non‐compliance and managing sanctions in CCTs.
Species packing in eco‐evolutionary models of seasonally fluctuating environments
Authors: Kremer Colin T. , Klausmeier Christopher A. 
Published: July 2017

AbstractAs ecology and evolution become ever more entwined, many areas of ecological theory are being re‐examined. Eco‐evolutionary analyses of classic coexistence mechanisms are yielding new insights into the structure and stability of communities. We examine fluctuation‐dependent coexistence models, identifying communities that are both ecologically and evolutionarily stable. Members of these communities possess distinct environmental preferences, revealing widespread patterns of limiting similarity. This regularity leads to consistent changes in the structure of communities across fluctuation regimes. However, at high amplitudes, subtle differences in the form of fluctuations dramatically affect the collapse of communities. We also show that identical fluctuations can support multiple evolutionarily stable communities – a novel example of alternative stable states within eco‐evolutionary systems. Consequently, the configuration of communities will depend on historical contingencies, including details of the adaptive process. Integrating evolution into the study of coexistence offers new insights, while enriching our understanding of ecology.
Retinyl propionate and climbazole combination demonstrates clinical improvement to the appearance of hyperpigmentation and deep wrinkling with minimal irritation
Authors: Hawkins S. , Adamus J. , Chiang C.‐y. , Covell E. , O'Leary J. , Lee J.‐m. 
Published: July 2017

AbstractObjectiveTo evaluate a combination of retinyl propionate and climbazole (RPC) compared to 0.1% retinol for its efficacy, tolerance and ageing appearance.MethodForty‐five healthy Caucasian females, ages 40–70, with moderately photodamaged facial skin, were recruited for a 16‐week randomized, double‐blind, IRB‐approved facial study. The efficacy of RPC treatment was compared to 0.1% retinol, in the same product base formulation, with twice daily, split‐face product application. Changes in overall photodamage, fine lines and wrinkles, pigmentation and irritation were visually evaluated and measured by instrumentation. Subjective appraisal of efficacy was self‐assessed from images where subjects were blinded to treatment and time point. Irritancy potential was also evaluated in a 5‐day randomized, double‐blind, IRB‐approved patch study.ResultsTreatment with RPC resulted in significant (P < 0.05) improvement in ageing attributes compared to 0.1% retinol treatment, with minimal irritation. More than 50% of subjects showed improvement to deep wrinkles in the crow's feet area after 5 weeks of product application, and continued improvement to deep wrinkles was observed throughout the course of the study. Similarly, improvement was observed for the appearance of lines and wrinkles in the nasolabial fold (NLF) and for mottled hyperpigmentation. The results from subjective self‐assessment confirmed in vivo clinical assessments. In a separate patch study, significantly less irritation was observed with the RPC product as compared to the 0.1% retinol control product.ConclusionRPC delivered significant skin anti‐ageing benefits comparable or greater than 0.1% retinol, with minimal irritation.
Identity at Work: An Enquiry‐based Approach to Therapeutically Inspired Management
Authors: Beech Nic 
Published: July 2017

AbstractIdentity studies reveal many issues and problems for individuals and organizations and from these I select three topics which connect to management practice: performance and its barriers; the self and others; and boundaries and transitions. I argue for an enquiry‐based approach to management practice which focuses not on prescriptive answers but on engaging questions which can draw on theory as a resource and promote thought‐infused action. Because much of the identity literature would be sceptical about normative theory ‘implications for practice’ tend to be somewhat thin. An enquiry‐based approach removes normative expectations along with the hierarchical expectation that theory is first and practice is second. Rather, practice‐relevant questions can be refined and developed through theoretical engagement. An enquiry that has practical relevance is also likely to draw resource from across disciplinary boundaries, and in this case I draw on ideas from therapeutic theory to challenge and support management practice.
Chronic kidney disease as a risk factor for recurrence and progression in patients with primary non‐muscle‐invasive bladder cancer
Authors: Kobatake Kohei , Hayashi Tetsutaro , Black Peter C , Goto Keisuke , Sentani Kazuhiro , Kaneko Mayumi , Yasui Wataru , Mita Koji , Teishima Jun , Matsubara Akio 
Published: July 2017

ObjectivesTo investigate the relationship between chronic kidney disease and primary non‐muscle‐invasive bladder cancer.MethodsDisease outcomes were analyzed in 418 patients treated with transurethral resection for primary non‐muscle‐invasive bladder cancer, and were correlated to traditional risk factors as well as chronic kidney disease stage according to estimated glomerular filtration rate: ≥60 (G1–2), 45–59 (G3a) or <45 (G3b–5).ResultsThe median follow‐up time was 40.0 months. There were 287 (68.7%), 98 (23.4%), and 33 (7.9%) patients with G1–2, G3a and G3b–5 chronic kidney disease, respectively. T1 tumor was present in 29.6% of G1–2, 43.9% of G3a and 51.4% of G3b–5 chronic kidney disease (P = 0.004). The proportion of histological grade 3 non‐muscle‐invasive bladder cancer was higher in G3a and G3b–5 than G1–2 (P < 0.001). Higher chronic kidney disease stage was associated with worse recurrence‐free (P < 0.001) and progression‐free survival (P = 0.017). In multivariable analysis, G3b–5 was found to be an independent predictor for recurrence (hazard ratio 1.87; P = 0.004) and progression (hazard ratio 2.96; P = 0.019). Chronic kidney disease stage was also strongly associated with the European Association of Urology bladder cancer risk groups (P < 0.001), and with shorter time to recurrence and progression in each group.ConclusionsChronic kidney disease predicts the clinical outcome of primary non‐muscle‐invasive bladder cancer. Adding chronic kidney disease to the conventional risk factors might increase the accuracy of risk stratification.
Association between androgen deprivation therapy and anxiety among 78 000 patients with localized prostate cancer
Authors: Dinh Kathryn T , Yang David D , Nead Kevin T , Reznor Gally , Trinh Quoc‐Dien , Nguyen Paul L 
Published: July 2017

ObjectivesTo examine whether any androgen deprivation therapy use or longer duration is associated with an increased risk of anxiety in patients with prostate cancer.MethodsWe identified 78 552 men aged ≥66 years with stage I–III prostate cancer using the Surveillance, Epidemiology, and End Results‐Medicare linked database from 1992 to 2006, excluding patients with psychiatric diagnoses within the year prior or 6 months after prostate cancer diagnosis. Multivariable Cox regression was used to examine the association between pharmacological androgen deprivation therapy and diagnosis of anxiety.ResultsThe 43.1% (33 882) of patients who received androgen deprivation therapy experienced a higher 3‐year cumulative incidence of anxiety compared with men who did not (4.1% vs 3.5%, P < 0.001). Any androgen deprivation therapy use was associated with a nearly significant increased risk of anxiety (adjusted hazard ratio 1.08, 95% confidence interval 1.00–1.17, P = 0.054). There was a significant trend between a longer duration of therapy and increased risk of anxiety (P‐trend = 0.012), with a 16% higher risk for ≥12 months (adjusted hazard ratio 1.16, 95% confidence interval 1.04–1.29, P = 0.010).ConclusionsAndrogen deprivation therapy was associated with an elevated risk of anxiety in this cohort of elderly men with localized prostate cancer, with the risk higher with a longer duration of treatment. Anxiety should be considered among the possible psychiatric effects of androgen deprivation therapy and discussed before initiating treatment, particularly if a long course is anticipated.
Setting up a pediatric robotic urology program: A USA institution experience
Authors: Murthy Prithvi B , Schadler Eric D , Orvieto Marcelo , Zagaja Gregory , Shalhav Arieh L , Gundeti Mohan S 
Published: July 2017

AbstractImplementing a robotic urological surgery program requires institutional support, and necessitates a comprehensive, detail‐oriented plan that accounts for training, oversight, cost and case volume. Given the prevalence of robotic surgery in adult urology, in many instances it might be feasible to implement a pediatric robotic urology program within the greater context of adult urology. This involves, from an institutional standpoint, proportional distribution of equipment cost and operating room time. However, the pediatric urology team primarily determines goals for volume expansion, operative case selection, resident training and surgical innovation within the specialty. In addition to the clinical model, a robust economic model that includes marketing must be present. This review specifically highlights these factors in relationship to establishing and maintaining a pediatric robotic urology program. In addition, we share our data involving robot use over the program's first nine years (December 2007–December 2016).
Corporate social responsibility and the assessment by auditors of the risk of material misstatement
Authors: LópezPuertas‐Lamy Mónica , Desender Kurt , Epure Mircea 
Published: July 2017

AbstractThis paper investigates whether, and how, firms’ corporate social responsibility (CSR) performance influences the auditor's assessment of the risk of material misstatement, whether due to fraud or error, at the financial statement level by analysing their pricing decision (i.e., audit fees). Using a panel data set of 12,330 firms from 28 countries over the period 2003–2012 and different measures of CSR performance, we find a U‐shaped relationship between firms’ CSR performance and audit fees. This result suggests that there is an optimal level of CSR performance that minimizes the auditor's assessment of the risk of material misstatement, which in turn lowers the need for greater auditor effort; that is why auditors charge firms significantly less when their CSR performance is at the optimal level. Finally, we also show that the optimal level of CSR performance varies with the degree of environmental dynamism, ownership concentration and leverage.
ENabling Reduction of Low‐grade Inflammation in SEniors Pilot Study: Concept, Rationale, and Design
Authors: Manini Todd M. , Anton Stephen D. , Beavers Daniel P. , Cauley Jane A. , Espeland Mark A. , Fielding Roger A. , Kritchevsky Stephen B. , Leeuwenburgh Christiaan , Lewis Kristina H. , Liu Christine , McDermott Mary M. , Miller Michael E. , Tracy Russell P. , Walston Jeremy D. , Radziszewska Barbara , Lu Jane , Stowe Cindy , Wu Samuel , Newman Anne B. , Ambrosius Walter T. , Pahor Marco ,   ENRGISE Pilot study investigators
Published: July 2017

ObjectivesTo test two interventions to reduce interleukin (IL)‐6 levels, an indicator of low‐grade chronic inflammation and an independent risk factor for impaired mobility and slow walking speed in older adults.DesignThe ENabling Reduction of low‐Grade Inflammation in SEniors (ENRGISE) Pilot Study was a multicenter, double‐blind, placebo‐controlled randomized pilot trial of two interventions to reduce IL‐6 levels.SettingFive university‐based research centers.ParticipantsTarget enrollment was 300 men and women aged 70 and older with an average plasma IL‐6 level between 2.5 and 30 pg/mL measured twice at least 1 week apart. Participants had low to moderate physical function, defined as self‐reported difficulty walking one‐quarter of a mile or climbing a flight of stairs and usual walk speed of less than 1 m/s on a 4‐m usual‐pace walk.InterventionParticipants were randomized to losartan, omega‐3 fish oil (ω‐3), combined losartan and ω‐3, or placebo. Randomization was stratified depending on eligibility for each group. A titration schedule was implemented to reach a dose that was safe and effective for IL‐6 reduction. Maximal doses were 100 mg/d for losartan and 2.8 g/d for ω‐3.MeasurementsIL‐6, walking speed over 400 m, physical function (Short Physical Performance Battery), other inflammatory markers, safety, tolerability, frailty domains, and maximal leg strength were measured.ResultsResults from the ENRGISE Pilot Study will provide recruitment yields, feasibility, medication tolerance and adherence, and preliminary data to help justify a sample size for a more definitive randomized trial.ConclusionThe ENRGISE Pilot Study will inform a larger subsequent trial that is expected to have important clinical and public health implications for the growing population of older adults with low‐grade chronic inflammation and mobility limitations.