bluuebunny/crossref_metadata_2025_split huggingface dataset:
A meta-analysis to derive literature-based benchmarks for readmission and hospital mortality after patient discharge from intensive care
Authors: Hosein F Shaun , Roberts Derek J , Turin Tanvir Chowdhury , Zygun David , Ghali William A , Stelfox Henry T 
Published: December 2014

Abstract
Introduction
We sought to derive literature-based summary estimates of readmission to the ICU and hospital mortality among patients discharged alive from the ICU.

Methods
We searched MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials from inception to March 2013, as well as the reference lists in the publications of the included studies. We selected cohort studies of ICU discharge prognostic factors that in which readmission to the ICU or hospital mortality among patients discharged alive from the ICU was reported. Two reviewers independently abstracted the number of patients readmitted to the ICU and hospital deaths among patients discharged alive from the ICU. Fixed effects and random effects models were used to estimate the pooled cumulative incidence of ICU readmission and the pooled cumulative incidence of hospital mortality.

Results
The analysis included 58 studies (n = 2,073,170 patients). The majority of studies followed patients until hospital discharge (n = 46 studies) and reported readmission to the ICU (n = 46 studies) or hospital mortality (n = 49 studies). The cumulative incidence of ICU readmission was 4.0 readmissions (95% confidence interval (CI), 3.9 to 4.0) per 100 patient discharges using fixed effects pooling and 6.3 readmissions (95% CI, 5.6 to 6.9) per 100 patient discharges using random effects pooling. The cumulative incidence of hospital mortality was 3.3 deaths (95% CI, 3.3 to 3.3) per 100 patient discharges using fixed effects pooling and 6.8 deaths (95% CI, 6.1 to 7.6) per 100 patient discharges using random effects pooling. There was significant heterogeneity for the pooled estimates, which was partially explained by patient, institution and study methodological characteristics.

Conclusions
Using current literature estimates, for every 100 patients discharged alive from the ICU, between 4 and 6 patients on average will be readmitted to the ICU and between 3 and 7 patients on average will die prior to hospital discharge. These estimates can inform the selection of benchmarks for quality metrics of transitions of patient care between the ICU and the hospital ward.
Role of bone-anabolic agents in the treatment of breast cancer bone metastases
Authors: Suvannasankha Attaya , Chirgwin John M 
Published: December 2014

AbstractSkeletal metastases are an incurable complication afflicting the majority of patients who die from advanced breast cancer. They are most often osteolytic, characterized by net bone destruction and suppressed new bone formation. Life expectancy from first diagnosis of breast cancer bone metastases is several years, during which time skeletal-related events - including pain, fracture, hypercalcemia, and spinal cord compression - significantly degrade quality of life. The bone marrow niche can also confer hormonal and chemo-resistance. Most treatments for skeletal metastases target bone-destroying osteoclasts and are palliative. Recent results from the Breast cancer trials of Oral Everolimus-2 trial suggest that agents such as the mammalian target of rapamycin inhibitor everolimus may have efficacy against breast cancer bone metastases in part via stimulating osteoblasts as well as by inhibiting tumor growth. Selective estrogen receptor modulators similarly inhibit growth of estrogen receptor-positive breast cancers while having positive effects on the skeleton. This review discusses the future role of bone-anabolic agents for the specific treatment of osteolytic breast cancer metastases. Agents with both anti-tumor and bone-anabolic actions have been tested in the setting of multiple myeloma, a hematological malignancy that causes severe osteolytic bone loss and suppression of osteoblastic new bone formation. Stimulation of osteoblast activity inhibits multiple myeloma growth - a strategy that might decrease breast cancer burden in osteolytic bone metastases. Proteasome inhibitors (bortezomib and carfilzomib) inhibit the growth of myeloma directly and are anabolic for bone. Drugs with limited anti-tumor activity but which are anabolic for bone include intermittent parathyroid hormone and antibodies that neutralize the WNT inhibitors DKK1 and sclerostin, as well as the activin A blocker sotatercept and the osteoporosis drug strontium ranelate. Transforming growth factor-beta inhibitors have little tumor anti-proliferative activity but block breast cancer production of osteolytic factors and are also anabolic for bone. Some of these treatments are already in clinical trials. This review provides an overview of agents with bone-anabolic properties, which may have utility in the treatment of breast cancer metastatic to the skeleton.
Mandatory costs by firm size thresholds: firm location, growth and death in Sri Lanka
Authors: Abidoye Babatunde O , Orazem Peter F , Vodopivec Milan 
Published: December 2014

AbstractSri Lanka’s Termination of Employment of Workmen Act (TEWA) requires that firms with 15 or more workers justify layoffs and provide generous severance pay to displaced workers, with smaller firms being exempted. Although formally subject to TEWA, firms in Export Promotion Zones (EPZs) do not face the same constraints as nonEPZ firms due to size incentives and lax labor law enforcement in that sector. In EPZ, 77% of firms have more than 15 employees while 76% of nonEPZ firms are smaller than 15 employees. Panel data on all formal sector firms between 1995 and 2003 shows that 80% of the size gap is from sorting of large firms into the EPZ. In addition, EPZ firms grow faster and are less likely to die than comparably sized nonEPZ firms. Despite its intent, TEWA lowered employment.JEL code:J30
Enzyme promiscuity: using the dark side of enzyme specificity in white biotechnology
Authors: Arora Benu , Mukherjee Joyeeta , Gupta Munishwar Nath 
Published: December 2014

AbstractEnzyme promiscuity can be classified into substrate promiscuity, condition promiscuity and catalytic promiscuity. Enzyme promiscuity results in far larger ranges of organic compounds which can be obtained by biocatalysis. While early examples mostly involved use of lipases, more recent literature shows that catalytic promiscuity occurs more widely and many other classes of enzymes can be used to obtain diverse kinds of molecules. This is of immense relevance in the context of white biotechnology as enzyme catalysed reactions use greener conditions.
Exploring the Burden of Inpatient Readmissions After Major Cancer Surgery
Authors: Stitzenberg Karyn B. , Chang YunKyung , Smith Angela B. , Nielsen Matthew E. 
Published: December 2014

Purpose Travel distances to care have increased substantially with centralization of complex cancer procedures at high-volume centers. We hypothesize that longer travel distances are associated with higher rates of postoperative readmission and poorer outcomes. Methods SEER-Medicare patients with bladder, lung, pancreas, or esophagus cancer who were diagnosed in 2001 to 2007 and underwent extirpative surgery were included. Readmission rates and survival were calculated using Kaplan-Meier functions. Multivariable negative binomial models were used to examine factors associated with readmission. Results Four thousand nine hundred forty cystectomies, 1,573 esophagectomies, 20,362 lung resections, and 2,844 pancreatectomies were included. Thirty- and 90-day readmission rates ranged from 13% to 29% and 23% to 43%, respectively, based on tumor type. Predictors of readmission were discharge to somewhere other than home, longer length of stay, comorbidities, higher stage at diagnosis, and longer travel distance (P < .001 for each). Patients who lived farther from the index hospital also had increased emergency room visits and were more likely to be readmitted to a hospital other than the index hospital (P < .001). Of readmitted patients, 31.9% were readmitted more than once. Long-term survival was worse and costs of care higher for patients who were readmitted (P < .001 for all). Conclusion The burden of readmissions after major cancer surgery is high, resulting in substantially poorer patient outcomes and higher costs. Risk of readmission was most strongly associated with length of stay and discharge destination. Travel distance also has an impact on patterns of readmission. Interventions targeted at higher risk individuals could potentially decrease the population burden of readmissions after major cancer surgery.
Phase II Study of Paclitaxel Given Once per Week Along With Trastuzumab and Pertuzumab in Patients With Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer
Authors: Dang Chau , Iyengar Neil , Datko Farrah , D'Andrea Gabriella , Theodoulou Maria , Dickler Maura , Goldfarb Shari , Lake Diana , Fasano Julie , Fornier Monica , Gilewski Theresa , Modi Shanu , Gajria Devika , Moynahan Mary Ellen , Hamilton Nicola , Patil Sujata , Jochelson Maxine , Norton Larry , Baselga José , Hudis Clifford 
Published: December 2014

Purpose The CLEOPATRA (Clinical Evaluation of Trastuzumab and Pertuzumab) study demonstrated superior progression-free survival (PFS) and overall survival when pertuzumab was added to trastuzumab and docetaxel. Paclitaxel given once per week is effective and less toxic than docetaxel. We performed a phase II study to evaluate the efficacy and safety of pertuzumab and trastuzumab with paclitaxel given once per week. Patients and Methods Patients with metastatic human epidermal growth factor receptor 2–positive breast cancer with zero to one prior therapy were enrolled. Treatment consisted of paclitaxel 80 mg/m2 once per week plus trastuzumab (8 mg/kg loading dose → 6 mg/kg) once every 3 weeks plus pertuzumab (840 mg loading dose → 420 mg) once every 3 weeks, all given intravenously. The primary end point was 6-month PFS assessed by Kaplan-Meier methods. Results From January 2011 to December 2013, we enrolled 69 patients: 51 (74%) and 18 (26%) treated in first- and second-line metastatic settings, respectively. At a median follow-up of 21 months (range, 3 to 38 months), 6-month PFS was 86% (95% CI, 75% to 92%). The median PFS was 19.5 months (95% CI, 14 to 26 months) overall. PFS was 24.2 months (95% CI, 14 months to not reached [NR]) and 16.4 months (95% CI, 8.5 months to NR) for those without and with prior treatment, respectively. At 1 year, Kaplan-Meier PFS was 70% (95% CI, 56% to 79%) overall, 71% (95% CI, 55% to 82%) for those without prior therapy, and 66% (95% CI, 40% to 83%) for those with prior therapy. Treatment was well-tolerated; there was no febrile neutropenia or symptomatic left ventricular systolic dysfunction. Conclusion Paclitaxel given once per week with trastuzumab and pertuzumab is highly active and well tolerated and seems to be an effective alternative to docetaxel-based combination therapy.
Psychiatric Morbidity and Survival After Surgery for Esophageal Cancer: A Population-Based Cohort Study
Authors: Wikman Anna , Ljung Rickard , Johar Asif , Hellstadius Ylva , Lagergren Jesper , Lagergren Pernilla 
Published: December 2014

Purpose To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer. Patients and Methods A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival. Results In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs). Conclusion These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.
CXCR4 Promotes Renal Tubular Cell Survival in Male Diabetic Rats: Implications for Ligand Inactivation in the Human Kidney
Authors: Siddiqi Ferhan S. , Chen Li-Hao , Advani Suzanne L. , Thai Kerri , Batchu Sri N. , Alghamdi Tamadher A. , White Kathryn E. , Sood Manish M. , Gibson Ian W. , Connelly Kim A. , Marsden Philip A. , Advani Andrew 
Published: December 2014

AbstractBinding of the receptor CXCR4 to its ligand stromal cell–derived factor 1 (SDF-1) promotes cell survival and is under the influence of a number of regulatory processes including enzymatic ligand inactivation by endopeptidases such as matrix metalloproteinase 9 (MMP-9). In light of the pivotal role that the SDF-1/CXCR4 axis plays in renal development and in the pathological growth of renal cells, we explored the function of this pathway in diabetic rats and in biopsies from patients with diabetic nephropathy, hypothesizing that the pro-survival effects of CXCR4 in resident cells would attenuate renal injury. Renal CXCR4 expression was observed to be increased in diabetic rats, whereas antagonism of the receptor unmasked albuminuria and accelerated tubular epithelial cell death. In cultured cells, CXCR4 blockade promoted tubular cell apoptosis, up-regulated Bcl-2-associated death promoter, and prevented high glucose/SDF-1-augmented phosphorylation of the pro-survival kinase, Akt. Although CXCR4 expression was also increased in biopsy tissue from patients with diabetic nephropathy, serine 339 phosphorylation of the receptor, indicative of ligand engagement, was unaffected. Coincident with these changes in receptor expression but not activity, MMP-9 was also up-regulated in diabetic nephropathy biopsies. Supporting a ligand-inactivating effect of the endopeptidase, exposure of cultured cells to recombinant MMP-9 abrogated SDF-1 induced Akt phosphorylation. These observations demonstrate a potentially reno-protective role for CXCR4 in diabetes that is impeded in its actions in the human kidney by the coincident up-regulation of ligand-inactivating endopeptidases. Therapeutically intervening in this interplay may limit tubulointerstitial injury, the principal determinant of renal decline in diabetes.
Low Levels of Gαs and Ric8b in Testicular Sertoli Cells May Underlie Restricted FSH Action During Infancy in Primates
Authors: Bhattacharya Indrashis , Basu Sayon , Sarda Kanchan , Gautam Mukkesh , Nagarajan Perumal , Pradhan Bhola Shankar , Sarkar Hironmoy , Devi Yendrembam Sangeeta , Majumdar Subeer S. 
Published: December 2014

AbstractFSH acts via testicular Sertoli cells (Sc) bearing FSH receptor (FSH-R) for regulating male fertility. Despite an adult-like FSH milieu in infant boys and monkeys, spermatogenesis is not initiated until the onset of puberty. We used infant and pubertal monkey Sc to reveal the molecular basis underlying developmental differences of FSH-R signaling in them. Unlike pubertal Sc, increasing doses of FSH failed to augment cAMP production by infant Sc. The expression of Gαs subunit and Ric8b, which collectively activate adenylyl cyclase (AC) for augmenting cAMP production and gene transcription, were significantly low in infant Sc. However, forskolin, which acts directly on AC bypassing FSH-R, augmented cAMP production and gene transcription uniformly in both infant and pubertal Sc. FSH-induced Gαs mRNA expression was higher in pubertal Sc. However, Gαi-2 expression was down-regulated by FSH in pubertal Sc, unlike infant Sc. FSH failed, but forskolin or 8-Bromoadenosine 3',5'-cyclic monophosphate treatment to infant Sc significantly augmented the expression of transferrin, androgen binding protein, inhibin-β-B, stem cell factor, and glial-derived neurotropic factor, which are usually up-regulated by FSH in pubertal Sc during spermatogenic onset. This suggested that lack of FSH mediated down-regulation of Gαi-2 expression and limited expression of Gαs subunit as well as Ric8b may underlie limited FSH responsiveness of Sc during infancy. This study also divulged that intracellular signaling events downstream of FSH-R are in place and can be activated exogenously in infant Sc. Additionally, this information may help in the proper diagnosis and treatment of infertile individuals having abnormal G protein-coupled FSH-R.
Promoting self-management through adherence among heart failure patients discharged from rural hospitals: a study protocol
Authors: Young Lufei , Barnason Sue , Do Van 
Published: December 2014

Background Heart failure is one of the most prevalent chronic conditions in adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients’ health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure patients discharged from rural hospitals.Objective This article describes the study design and research methods used to implement and evaluate the intervention.Method Our intervention is a 12-week patient activation (Patient AcTivated Care at Home [PATCH]) to improve self-management adherence. Patients were randomized into two parallel groups (12-week PATCH intervention + usual care vs. usual care only) to evaluate the effectiveness of this intervention. Outcomes were measured at baseline, 3 and 6 months.DiscussionThis study aimed to examine the effectiveness of a rural theory based, advance practice nurse led, activation enhancing intervention on the self-management adherence in heart failure patients residing in rural areas. Our expectation is to facilitate adherence to self-management behaviors in heart failure patients following discharge from rural hospitals and decrease complications and hospital readmissions, leading to the reduction of economic burden. Clinical Trial Registration Information: ClinicalTrials.gov; https://register.clinicaltrials.gov/ NCT01964053
Human Capital and Labor Productivity in the North-West Federal District of Russia
Authors: Комарова  , Komarova Anna 
Published: December 2014

A technique based on implementing of labor productivity’s econometric models
in regions of the North-West Federal District of Russia has been realized. It has
been shown that such a factor as employed population’s education level is
significant in labor productivity determining in the regions of the North-West
Federal District of Russia.
Registry-Linked Electronic Influenza Vaccine Provider Reminders: A Cluster-Crossover Trial
Authors: Stockwell Melissa S. , Catallozzi Marina , Camargo Stewin , Ramakrishnan Rajasekhar , Holleran Stephen , Findley Sally E. , Kukafka Rita , Hofstetter Annika M. , Fernandez Nadira , Vawdrey David K. 
Published: December 2014

OBJECTIVE:
To determine the impact of a vaccination reminder in an electronic health record supplemented with data from an immunization information system (IIS).

METHODS:
A noninterruptive influenza vaccination reminder, based on a real-time query of hospital and city IIS, was used at 4 urban, academically affiliated clinics serving a low-income population. Using a randomized cluster-crossover design, each study site had “on” and “off” period during the fall and winter of 2011–2012. Influenza vaccination during a clinic visit was assessed for 6-month to 17-year-old patients. To assess sustainability, the reminder was active at all sites during the 2012–2013 season.

RESULTS:
In the 2011–2012 season, 8481 unique non-up-to-date children had visits. Slightly more non–up-to-date children seen when the reminder was ‘on’ were vaccinated than when ‘off’ (76.2% vs 73.8%; P = .027). Effects were seen in the winter (67.9% vs 62.2%; P = .005), not fall (76.8% vs 76.5%). The reminder also increased documentation of the reason for vaccine non-administration (68.1% vs 41.5%; P &lt; .0001). During the 2011–2012 season, the reminder displayed for 8630 unique visits, and clinicians interacted with it in 83.1% of cases where patients required vaccination. During the 2012–2013 season, it displayed for 22 248 unique visits; clinicians interacted with it in 84.8% of cases.

CONCLUSIONS:
An IIS-linked influenza vaccination reminder increased vaccination later in the winter when fewer vaccine doses are usually given. Although the reminder did not require clinicians to interact with it, they frequently did; utilization did not wane over time.