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Lushefski KN, Wolf M, Dove J, Fluck M, Oxenberg JC. The Correlation of Thyroid Hormone Levels and Anti-Thyroidal Drugs on Thyroid Size, Weight, and Ease of Surgical Dissection for Thyroidectomy for Graves' Disease. Am Surg 2024; 90:15-22. [PMID: 37507121 DOI: 10.1177/00031348231192016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND Patients with Graves' Disease often have a larger thyroid size than patients without thyroid disease. These patients also have elevated T3 and T4 with decreased TSH. PURPOSE We evaluate whether these thyroid labs, the use of antithyroid agents, or the size of a thyroid on ultrasound, correlate with the pathological size of a thyroid in patients who undergo total thyroidectomy for Graves' Disease. We further determine whether these parameters affect perioperative complications. RESEARCH DESIGN A retrospective review of patients undergoing total thyroidectomy for Graves' Disease was performed from January 2004 to December 2016 in a single institution. STUDY SAMPLE 392 patients were included in the study. DATA COLLECTION AND/OR ANALYSIS Univariate analyses were performed to compare thyroid size on US and pathology as well as weight to preoperative thyroid hormone values and medical comorbidities. Spearman rank correlation and ANOVA were used to identify factors associated with thyroid weight, total pathology size, and differences in size. Multivariate analysis was also performed to evaluate for correlation between thyroid function and perioperative complications. RESULTS We found that elevated pre-operative T3 levels were associated with larger pathologic size (P = .027) and a greater difference in pathology vs. US thyroid volumes (P = .005), but not increased thyroid weight (P = .286). No significant differences were found for thyroid weight, pathology size, or difference in size for TSH, T4, or any specific preoperative ATD given. Only postoperative calcium levels were found to be statistically significant for TSH < 0.27 (P = .024) for peri-operative complications. CONCLUSIONS These findings may allow for more accurate preoperative planning and intraoperative expectations in patients with Graves' Disease.
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Affiliation(s)
- Kelcie N Lushefski
- Department of Surgical Oncology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, USA
| | - Mary Wolf
- Department of Surgery, Geisinger Medical Center, Danville, PA, USA
| | - James Dove
- Department of Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Marcus Fluck
- Department of Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Jacqueline C Oxenberg
- Department of Surgical Oncology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, USA
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Saylors S, Schaeffer HD, Dove J, Haley J, Smelser D, Carey D, Hoffman RL. Utilization of Genetically Inferred Pedigrees in a Large Clinical Population to Study Diverticulitis. J Gastrointest Surg 2023; 27:2223-2225. [PMID: 37277677 DOI: 10.1007/s11605-023-05716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/01/2023] [Indexed: 06/07/2023]
Affiliation(s)
- Seth Saylors
- Division of Colorectal Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA.
| | - H David Schaeffer
- Division of Colorectal Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - James Dove
- Division of Molecular and Functional Genomics, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - Jeremy Haley
- Division of Molecular and Functional Genomics, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - Diane Smelser
- Division of Molecular and Functional Genomics, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - David Carey
- Division of Molecular and Functional Genomics, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - Rebecca L Hoffman
- Division of Colorectal Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, 17822, USA
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Benotti PN, Wood GC, Dove J, Kaberi-Otarod J, Still CD, Gerhard GS, Bistrian BR. Clinical significance of iron deficiency among candidates for metabolic surgery. Surg Obes Relat Dis 2023; 19:981-989. [PMID: 37253650 DOI: 10.1016/j.soard.2023.04.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/20/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Iron deficiency (ID), a known complication after metabolic surgery, is common among preoperative patients in the presence of inflammation. Evidence is now accumulating that preoperative ID may adversely affect perioperative outcomes. OBJECTIVES To investigate the relationship between preoperative iron status and the risk of postoperative severe anemia. In addition, this study investigates the relationship between preoperative iron status and length of surgical stay SETTING: A large regional tertiary health system. METHODS Among patients who underwent metabolic surgery between 2004 and 2020, 5171 patients had a full iron nutritional assessment prior to surgery. Study patients were divided into multiple smaller groups (10 female groups and 7 male groups) on the basis of levels of serum ferritin and Transferrin Saturation (T Sat) < or ≥20%. Study patients were followed after surgery and the time to the development of severe anemia (hemoglobin < 8 gm/dL) was recorded. Hospital length of stay (LOS) was analyzed in relation to preoperative iron status. RESULTS Lower ferritin levels were associated with older age in males (P = .0001) and younger age in females (P < .0001). For males, after adjustment for age, body mass index (BMI), and year of surgery, surgical LOS was prolonged in those with T Sat <20% (P = .0041). For females the time until the development of severe anemia was associated with baseline iron status (P < .0001). CONCLUSIONS Male preoperative patients for metabolic surgery with T Sat <20% are at risk for increased surgical LOS. Females with low ferritin levels consistent with ID are at increased risk for the development of postoperative severe anemia.
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Affiliation(s)
- Peter N Benotti
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, Pennsylvania.
| | - G Craig Wood
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, Pennsylvania
| | - James Dove
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, Pennsylvania
| | - Jila Kaberi-Otarod
- Department of Nutrition and Weight Management, Geisinger Health System Northeast, Wilkes Barre, Pennsylvania
| | - Christopher D Still
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, Pennsylvania
| | - Glenn S Gerhard
- Department of Medical Genetics and Molecular Biology, Lewis, Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Bruce R Bistrian
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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4
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An FP, Bai WD, Balantekin AB, Bishai M, Blyth S, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen HY, Chen SM, Chen Y, Chen YX, Cheng J, Cheng J, Cheng YC, Cheng ZK, Cherwinka JJ, Chu MC, Cummings JP, Dalager O, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolzhikov D, Dove J, Dugas KV, Duyang HY, Dwyer DA, Gallo JP, Gonchar M, Gong GH, Gong H, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Han Y, Hans S, He M, Heeger KM, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Kohn S, Kramer M, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Marshall C, McDonald KT, McKeown RD, Meng Y, Napolitano J, Naumov D, Naumova E, Nguyen TMT, Ochoa-Ricoux JP, Olshevskiy A, Park J, Patton S, Peng JC, Pun CSJ, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Russell B, Steiner H, Sun JL, Tmej T, Treskov K, Tse WH, Tull CE, Tung YC, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Wei HY, Wei LH, Wen LJ, Whisnant K, White CG, Wong HLH, Worcester E, Wu DR, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JL, Zhang JW, Zhang QM, Zhang SQ, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. Improved Measurement of the Evolution of the Reactor Antineutrino Flux and Spectrum at Daya Bay. Phys Rev Lett 2023; 130:211801. [PMID: 37295075 DOI: 10.1103/physrevlett.130.211801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/10/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023]
Abstract
Reactor neutrino experiments play a crucial role in advancing our knowledge of neutrinos. In this Letter, the evolution of the flux and spectrum as a function of the reactor isotopic content is reported in terms of the inverse-beta-decay yield at Daya Bay with 1958 days of data and improved systematic uncertainties. These measurements are compared with two signature model predictions: the Huber-Mueller model based on the conversion method and the SM2018 model based on the summation method. The measured average flux and spectrum, as well as the flux evolution with the ^{239}Pu isotopic fraction, are inconsistent with the predictions of the Huber-Mueller model. In contrast, the SM2018 model is shown to agree with the average flux and its evolution but fails to describe the energy spectrum. Altering the predicted inverse-beta-decay spectrum from ^{239}Pu fission does not improve the agreement with the measurement for either model. The models can be brought into better agreement with the measurements if either the predicted spectrum due to ^{235}U fission is changed or the predicted ^{235}U, ^{238}U, ^{239}Pu, and ^{241}Pu spectra are changed in equal measure.
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Affiliation(s)
- F P An
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - W D Bai
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M Bishai
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - H Y Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- Shenzhen University, Shenzhen
| | - Y X Chen
- North China Electric Power University, Beijing
| | - J Cheng
- North China Electric Power University, Beijing
| | - J Cheng
- North China Electric Power University, Beijing
| | - Y-C Cheng
- Department of Physics, National Taiwan University, Taipei
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | | | - O Dalager
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | - M V Diwan
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague
| | - D Dolzhikov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - K V Dugas
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | | | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J P Gallo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York 11973
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | | | - Y Han
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - S Hans
- Brookhaven National Laboratory, Upton, New York 11973
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | - J H Huang
- Institute of High Energy Physics, Beijing
| | | | - Y B Huang
- Guangxi University, No. 100 Daxue East Road, Nanning
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York 11973
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York 11973
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221
| | - D Jones
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - T J Langford
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - J J Li
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - R H Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - L Littenberg
- Brookhaven National Laboratory, Upton, New York 11973
| | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J X Liu
- Institute of High Energy Physics, Beijing
| | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
- The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - B Z Ma
- Shandong University, Jinan
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - R C Mandujano
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - R D McKeown
- California Institute of Technology, Pasadena, California 91125
- College of William and Mary, Williamsburg, Virginia 23187
| | - Y Meng
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J Napolitano
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - T M T Nguyen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - J P Ochoa-Ricoux
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York 11973
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - C Morales Reveco
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York 11973
| | - B Roskovec
- Charles University, Faculty of Mathematics and Physics, Prague
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - B Russell
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - T Tmej
- Charles University, Faculty of Mathematics and Physics, Prague
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - Y C Tung
- Department of Physics, National Taiwan University, Taipei
| | - B Viren
- Brookhaven National Laboratory, Upton, New York 11973
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- College of William and Mary, Williamsburg, Virginia 23187
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York 11973
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | | | - C G White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York 11973
| | - D R Wu
- Institute of High Energy Physics, Beijing
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Q Xie
- Institute of High Energy Physics, Beijing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - H K Xu
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xu
- Department of Engineering Physics, Tsinghua University, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H F Yao
- Institute of High Energy Physics, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York 11973
| | - B L Young
- Iowa State University, Ames, Iowa 50011
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - V Zavadskyi
- Brookhaven National Laboratory, Upton, New York 11973
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York 11973
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - S Q Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - R Z Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
| | - J H Zou
- Institute of High Energy Physics, Beijing
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An FP, Bai WD, Balantekin AB, Bishai M, Blyth S, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen HY, Chen SM, Chen Y, Chen YX, Chen ZY, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Cummings JP, Dalager O, Deng FS, Ding YY, Ding XY, Diwan MV, Dohnal T, Dolzhikov D, Dove J, Duyang HY, Dwyer DA, Gallo JP, Gonchar M, Gong GH, Gong H, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Han Y, Hans S, He M, Heeger KM, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Kohn S, Kramer M, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Marshall C, McDonald KT, McKeown RD, Meng Y, Napolitano J, Naumov D, Naumova E, Nguyen TMT, Ochoa-Ricoux JP, Olshevskiy A, Pan HR, Park J, Patton S, Peng JC, Pun CSJ, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Russell B, Steiner H, Sun JL, Tmej T, Treskov K, Tse WH, Tull CE, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Wei HY, Wei LH, Wei W, Wen LJ, Whisnant K, White CG, Wong HLH, Worcester E, Wu DR, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JL, Zhang JW, Zhang QM, Zhang SQ, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. Precision Measurement of Reactor Antineutrino Oscillation at Kilometer-Scale Baselines by Daya Bay. Phys Rev Lett 2023; 130:161802. [PMID: 37154643 DOI: 10.1103/physrevlett.130.161802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/24/2023] [Indexed: 05/10/2023]
Abstract
We present a new determination of the smallest neutrino mixing angle θ_{13} and the mass-squared difference Δm_{32}^{2} using a final sample of 5.55×10^{6} inverse beta-decay (IBD) candidates with the final-state neutron captured on gadolinium. This sample is selected from the complete dataset obtained by the Daya Bay reactor neutrino experiment in 3158 days of operation. Compared to the previous Daya Bay results, selection of IBD candidates has been optimized, energy calibration refined, and treatment of backgrounds further improved. The resulting oscillation parameters are sin^{2}2θ_{13}=0.0851±0.0024, Δm_{32}^{2}=(2.466±0.060)×10^{-3} eV^{2} for the normal mass ordering or Δm_{32}^{2}=-(2.571±0.060)×10^{-3} eV^{2} for the inverted mass ordering.
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Affiliation(s)
- F P An
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - W D Bai
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M Bishai
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - H Y Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- Shenzhen University, Shenzhen
| | - Y X Chen
- North China Electric Power University, Beijing
| | - Z Y Chen
- Institute of High Energy Physics, Beijing
| | - J Cheng
- North China Electric Power University, Beijing
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | | | - O Dalager
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | | | - M V Diwan
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague
| | - D Dolzhikov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | | | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J P Gallo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York 11973
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | | | - Y Han
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - S Hans
- Brookhaven National Laboratory, Upton, New York 11973
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | - J H Huang
- Institute of High Energy Physics, Beijing
| | | | - Y B Huang
- Guangxi University, No.100 Daxue East Road, Nanning
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York 11973
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York 11973
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221
| | - D Jones
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - T J Langford
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - J J Li
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - R H Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - L Littenberg
- Brookhaven National Laboratory, Upton, New York 11973
| | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J X Liu
- Institute of High Energy Physics, Beijing
| | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
- The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - B Z Ma
- Shandong University, Jinan
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - R C Mandujano
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - R D McKeown
- California Institute of Technology, Pasadena, California 91125
- College of William and Mary, Williamsburg, Virginia 23187
| | - Y Meng
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J Napolitano
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - T M T Nguyen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - J P Ochoa-Ricoux
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - H-R Pan
- Department of Physics, National Taiwan University, Taipei
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York 11973
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - C Morales Reveco
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York 11973
| | - B Roskovec
- Charles University, Faculty of Mathematics and Physics, Prague
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - B Russell
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - T Tmej
- Charles University, Faculty of Mathematics and Physics, Prague
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - B Viren
- Brookhaven National Laboratory, Upton, New York 11973
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- College of William and Mary, Williamsburg, Virginia 23187
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York 11973
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - W Wei
- Shandong University, Jinan
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | | | - C G White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York 11973
| | - D R Wu
- Institute of High Energy Physics, Beijing
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Q Xie
- Institute of High Energy Physics, Beijing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - H K Xu
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xu
- Department of Engineering Physics, Tsinghua University, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H F Yao
- Institute of High Energy Physics, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York 11973
| | - B L Young
- Iowa State University, Ames, Iowa 50011
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - V Zavadskyi
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York 11973
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - S Q Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - R Z Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
| | - J H Zou
- Institute of High Energy Physics, Beijing
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Berglund DD, Parker DM, Fluck M, Dove J, Falvo A, Horsley RD, Gabrielsen J, Petrick AT, Daouadi M. Impact of Urinary Catheterization on Postoperative Outcomes After Roux-En-Y Gastric Bypass Surgery in Propensity-Matched Cohorts. Am Surg 2023; 89:280-285. [PMID: 34060921 DOI: 10.1177/00031348211023444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The impact of urinary catheter avoidance in bariatric enhanced recovery after surgery (ERAS) protocols is yet to be established. The purpose of the current study is to determine whether urinary catheter use in patients undergoing Roux-en-Y gastric bypass (RYGB) procedures has an effect on postoperative outcomes. METHODS An institutional database was utilized to identify adult patients undergoing primary minimally invasive RYGB surgery. Outcomes included incidence of urinary tract infection (UTI) within 30 days postoperatively, 30-day readmission rates, proportion of patients discharged after postoperative day 1 (delayed discharge), length of stay (LOS), and operating room time. These were compared between propensity-matched groups with and without urinary catheter placement. RESULTS There were no significant differences in postoperative UTI's (2.2% for both cohorts, P = .593) or 30-day readmission rates for patients with and without urinary catheters (6.6% and 4.4%, respectively, P = .260). Mean LOS (1.7 vs. 1.5 days, P = .001) and the proportion of patients having a delayed discharge (47.3% vs. 33.7%, P = .001) was greater in patients with a catheter. Operating room time was longer in the urinary catheter group (221.8 vs. 207.9 minutes, P = .002). DISCUSSION Avoidance of indwelling urinary catheters in RYGB surgical patients decreased delayed discharges and LOS without affecting readmission or reoperation rates. Therefore, we recommend that avoidance of urinary catheters in routine RYGB surgery be considered for inclusion into standardized ERAS protocols. Urinary catheters should continue to be utilized in select cases, however, as these were not shown to affect rate of UTIs.
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Affiliation(s)
| | | | | | - James Dove
- 2780Geisinger Health System, Danville, PA, USA
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Seton T, Mahan M, Dove J, Villanueva H, Obradovic V, Falvo A, Horsley R, Petrick A, Parker DM. Is Robotic Revisional Bariatric Surgery Justified? An MBSAQIP Analysis. Obes Surg 2022; 32:3863-3868. [PMID: 36264443 DOI: 10.1007/s11695-022-06293-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND The laparoscopic approach is utilized in greater than 90% of bariatric surgeries. With the growing prevalence of robotic-assisted surgery in bariatrics, there has been limited consensus on the superiority of either laparoscopic or robotic approaches, especially in revisional procedures (conversion from sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB)). METHODS A retrospective analysis was performed of the MBSAQIP PUF database of patients who underwent conversion from SG to RYGB procedures in either laparoscopic or robotic-assisted approaches. The groups underwent 2:1 propensity matching and primary outcomes included post-conversion days until discharge (POD), conversion operation length, total and major morbidity, 30-day readmission, 30-day reoperation, 30-day reintervention, and 30-day mortality after conversion. RESULTS After 2:1 propensity score matching, 3411 patients (2274 laparoscopic vs 1137 robotic) were included in the study. Intraoperatively, no significant difference was found in total morbidity (6.5% lap vs 5.9% robotic) or major morbidity (1.9% lap vs 1.7% robotic); however, the operative times were significantly longer robotically (126 min vs 164 min). Post-operatively, no significant differences were found in discharge day (1.8 lap vs 1.8 robotic), 30-day readmission (7.6% lap vs 8.6% robotic), reoperation rate (2.9% lap vs 3.7% robotic), additional intervention rate (2.5% lap vs 3.3% robotic), or 30-day mortality (0.1% vs 0.1%). CONCLUSION There is no significant difference in perioperative or intraoperative outcomes between laparoscopic and robotic-assisted SG to RYGB conversion procedures other than a longer operative time in the robotic approach, suggesting increased efficiency with the laparoscopic approach.
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Affiliation(s)
- Tristan Seton
- Geisinger Community Medical Center, 1800 Mulberry St, Scranton, PA, 18510, USA
| | - Mark Mahan
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA
| | - James Dove
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA
| | - Hugo Villanueva
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA
| | - Vladan Obradovic
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA
| | - Alexandra Falvo
- Geisinger Community Medical Center, 1800 Mulberry St, Scranton, PA, 18510, USA
| | - Ryan Horsley
- Geisinger Community Medical Center, 1800 Mulberry St, Scranton, PA, 18510, USA
| | - Anthony Petrick
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA
| | - David M Parker
- Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17821, USA.
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8
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Pina L, Dove J, Wood GC, Parker DM, Still C, Petrick A, Daouadi M. Stratified Preoperative A1c is not Significantly Associated With Clavien-Dindo Major Complications Following Bariatric Surgery in the MBSAQIP Database. Am Surg 2022; 88:2760-2767. [PMID: 36069148 DOI: 10.1177/00031348221121551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is highly prevalent comorbidity in patients with morbid obesity. It is still unclear whether a cutoff value of preoperative A1c represents an increased risk for major postoperative complications following Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG). METHODS Retrospective MBSAQIP Participant Use File cohort for both years 2017 and 2018 were analyzed to evaluate the relationship between HbA1c in patients with morbid obesity and T2DM undergoing bariatric surgery, and the 30 days postoperative major complications by Clavien-Dindo classification (III/IV). We used an HbA1c cutoff of <7, > =7, and stratified by 1% increment for a total of 11 groups. We used univariate and multivariate logistic regression to analyze the outcome of the complications. Predicted probabilities were calculated for major complications. All statistical tests were two-sided with a P-value of less than .05 considered as a cut-off for statistical significance. RESULTS Of 42,181 patients that met inclusion criteria, there were 20,955 identified with HbA1c <7%, and 21,226 patients with HbA1c >7%. Utilizing HbA1c <7% as a cutoff, we found no consistent statistical significance in the major postoperative complication in patients with HbA1c >7%, and when stratified with 1% increment between groups. We also found no significance between groups with risk adjustment. CONCLUSIONS Extensive analysis of the large MBSAQIP cohort didn't result in a clinically significant association between stratified HbA1c and 30-day Clavien-Dindo major complications (III/IV) following Roux-en-Y Gastric Bypass (RYGB) and (SG).
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Affiliation(s)
- Luis Pina
- Division of Bariatric and Foregut Surgery at 2780Geisinger Health System, Danville, PA, USA
| | - James Dove
- 21599The Obesity Institute at Geisinger Health System, Danville, PA, USA
| | - G Craig Wood
- 21599The Obesity Institute at Geisinger Health System, Danville, PA, USA
| | - David M Parker
- Division of Bariatric and Foregut Surgery at 2780Geisinger Health System, Danville, PA, USA
| | - Christopher Still
- 21599The Obesity Institute at Geisinger Health System, Danville, PA, USA
| | - Anthony Petrick
- Division of Bariatric and Foregut Surgery at 2780Geisinger Health System, Danville, PA, USA
| | - Mustapha Daouadi
- Center of Metabolic and Bariatric Surgery, 21599Geisinger Medical Center, Henry Ford Allegiance, Jackson, MI, USA
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An FP, Bai WD, Balantekin AB, Bishai M, Blyth S, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen HY, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Cummings JP, Dalager O, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolzhikov D, Dove J, Dwyer DA, Gallo JP, Gonchar M, Gong GH, Gong H, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Hans S, He M, Heeger KM, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Kohn S, Kramer M, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Marshall C, McDonald KT, McKeown RD, Meng Y, Napolitano J, Naumov D, Naumova E, Nguyen TMT, Ochoa-Ricoux JP, Olshevskiy A, Pan HR, Park J, Patton S, Peng JC, Pun CSJ, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Steiner H, Sun JL, Tmej T, Treskov K, Tse WH, Tull CE, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Wei HY, Wei LH, Wen LJ, Whisnant K, White CG, Wong HLH, Worcester E, Wu DR, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JL, Zhang JW, Zhang QM, Zhang SQ, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. First Measurement of High-Energy Reactor Antineutrinos at Daya Bay. Phys Rev Lett 2022; 129:041801. [PMID: 35939015 DOI: 10.1103/physrevlett.129.041801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/05/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
This Letter reports the first measurement of high-energy reactor antineutrinos at Daya Bay, with nearly 9000 inverse beta decay candidates in the prompt energy region of 8-12 MeV observed over 1958 days of data collection. A multivariate analysis is used to separate 2500 signal events from background statistically. The hypothesis of no reactor antineutrinos with neutrino energy above 10 MeV is rejected with a significance of 6.2 standard deviations. A 29% antineutrino flux deficit in the prompt energy region of 8-11 MeV is observed compared to a recent model prediction. We provide the unfolded antineutrino spectrum above 7 MeV as a data-based reference for other experiments. This result provides the first direct observation of the production of antineutrinos from several high-Q_{β} isotopes in commercial reactors.
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Affiliation(s)
- F P An
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - W D Bai
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M Bishai
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - H Y Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- Shenzhen University, Shenzhen
| | - Y X Chen
- North China Electric Power University, Beijing
| | - J Cheng
- North China Electric Power University, Beijing
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | | | - O Dalager
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | - M V Diwan
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague
| | - D Dolzhikov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J P Gallo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York 11973
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | | | - S Hans
- Brookhaven National Laboratory, Upton, New York 11973
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | - J H Huang
- Institute of High Energy Physics, Beijing
| | | | - Y B Huang
- Guangxi University, No. 100 Daxue East Road, Nanning
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York 11973
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York 11973
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221
| | - D Jones
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - T J Langford
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - J J Li
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - R H Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - L Littenberg
- Brookhaven National Laboratory, Upton, New York 11973
| | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J X Liu
- Institute of High Energy Physics, Beijing
| | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - B Z Ma
- Shandong University, Jinan
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - R C Mandujano
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - R D McKeown
- California Institute of Technology, Pasadena, California 91125
- College of William and Mary, Williamsburg, Virginia 23187
| | - Y Meng
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J Napolitano
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - T M T Nguyen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - J P Ochoa-Ricoux
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - H-R Pan
- Department of Physics, National Taiwan University, Taipei
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York 11973
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - C Morales Reveco
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York 11973
| | - B Roskovec
- Charles University, Faculty of Mathematics and Physics, Prague
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - T Tmej
- Charles University, Faculty of Mathematics and Physics, Prague
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - B Viren
- Brookhaven National Laboratory, Upton, New York 11973
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- College of William and Mary, Williamsburg, Virginia 23187
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York 11973
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | | | - C G White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York 11973
| | - D R Wu
- Institute of High Energy Physics, Beijing
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Q Xie
- Institute of High Energy Physics, Beijing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - H K Xu
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xu
- Department of Engineering Physics, Tsinghua University, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H F Yao
- Institute of High Energy Physics, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York 11973
| | - B L Young
- Iowa State University, Ames, Iowa 50011
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - V Zavadskyi
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York 11973
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - S Q Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - R Z Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
| | - J H Zou
- Institute of High Energy Physics, Beijing
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Dove J, Leveson S. Alternatives to emergency departments for mental health crisis - a system wide approach can lead to better patient outcomes. Eur Psychiatry 2022. [PMCID: PMC9566844 DOI: 10.1192/j.eurpsy.2022.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction In Camden and Islington (North Central London) we have restructured our emergency mental health services significantly. Prior to January 2020 all emergency mental health presentations, including those detained in public by the police (S136) were supported through our three emergency departments and their respective liaison mental health teams. In January 2020 a new ‘Health Based Place of Safety’ (for those detained by police) was opened to avoid people spending time in emergency departments unnecessarily. When the COVID-19 pandemic first took hold in the UK in March 2020 a second unit, a ‘Mental Health Crisis Assessment Service’ (MHCAS) was set up again away from the acute sites, encouraging people in MH crisis to attend a designated MH ED away from the acute sites. This study aims to review the system and patient outcomes since the development of the pathway. Objectives Relieving pressures on ED by reduction in patient numbers that could be better supported elsewhere and free up resource for alternative assessments and patient needs. Methods A retrospective cohort study to review the outcomes of the new system in relation to emergency mental health crisis presentations. Comparison to be made with ED data for 2 years prior to new system. Results Pending final results but initial data suggests 25% reduction in ED presentation for MH cause with new system. Reduction in psychiatric inpatient admissions of between 3-5%. Conclusions Creative system wide initiatives to provide alternatives to emergency departments for people in emergency mental health crisis can lead to significantly improved patient outcomes and experience. Disclosure No significant relationships.
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11
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An FP, Andriamirado M, Balantekin AB, Band HR, Bass CD, Bergeron DE, Berish D, Bishai M, Blyth S, Bowden NS, Bryan CD, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Classen T, Conant AJ, Cummings JP, Dalager O, Deichert G, Delgado A, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolinski MJ, Dolzhikov D, Dove J, Dvořák M, Dwyer DA, Erickson A, Foust BT, Gaison JK, Galindo-Uribarri A, Gallo JP, Gilbert CE, Gonchar M, Gong GH, Gong H, Grassi M, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Hans S, Hansell AB, He M, Heeger KM, Heffron B, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Koblanski J, Jaffe DE, Jayakumar S, Jen KL, Ji XL, Ji XP, Johnson RA, Jones DC, Kang L, Kettell SH, Kohn S, Kramer M, Kyzylova O, Lane CE, Langford TJ, LaRosa J, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Lu X, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Maricic J, Marshall C, McDonald KT, McKeown RD, Mendenhall MP, Meng Y, Meyer AM, Milincic R, Mueller PE, Mumm HP, Napolitano J, Naumov D, Naumova E, Neilson R, Nguyen TMT, Nikkel JA, Nour S, Ochoa-Ricoux JP, Olshevskiy A, Palomino JL, Pan HR, Park J, Patton S, Peng JC, Pun CSJ, Pushin DA, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Searles M, Steiner H, Sun JL, Surukuchi PT, Tmej T, Treskov K, Tse WH, Tull CE, Tyra MA, Varner RL, Venegas-Vargas D, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Weatherly PB, Wei HY, Wei LH, Wen LJ, Whisnant K, White C, Wilhelmi J, Wong HLH, Woolverton A, Worcester E, Wu DR, Wu FL, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JW, Zhang QM, Zhang SQ, Zhang X, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. Joint Determination of Reactor Antineutrino Spectra from ^{235}U and ^{239}Pu Fission by Daya Bay and PROSPECT. Phys Rev Lett 2022; 128:081801. [PMID: 35275656 DOI: 10.1103/physrevlett.128.081801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
A joint determination of the reactor antineutrino spectra resulting from the fission of ^{235}U and ^{239}Pu has been carried out by the Daya Bay and PROSPECT Collaborations. This Letter reports the level of consistency of ^{235}U spectrum measurements from the two experiments and presents new results from a joint analysis of both data sets. The measurements are found to be consistent. The combined analysis reduces the degeneracy between the dominant ^{235}U and ^{239}Pu isotopes and improves the uncertainty of the ^{235}U spectral shape to about 3%. The ^{235}U and ^{239}Pu antineutrino energy spectra are unfolded from the jointly deconvolved reactor spectra using the Wiener-SVD unfolding method, providing a data-based reference for other reactor antineutrino experiments and other applications. This is the first measurement of the ^{235}U and ^{239}Pu spectra based on the combination of experiments at low- and highly enriched uranium reactors.
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Affiliation(s)
- F P An
- Institute of Modern Physics, East China University of Science and Technology, Shanghai
| | - M Andriamirado
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois
| | - A B Balantekin
- Department of Physics, University of Wisconsin, Madison, Madison, Wisconsin
| | - H R Band
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - C D Bass
- Department of Physics, Le Moyne College, Syracuse, New York
| | - D E Bergeron
- National Institute of Standards and Technology, Gaithersburg, Maryland
| | - D Berish
- Department of Physics, Temple University, Philadelphia, Pennsylvania
| | - M Bishai
- Brookhaven National Laboratory, Upton, New York
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - N S Bowden
- Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, California
| | - C D Bryan
- High Flux Isotope Reactor, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Shenzhen University, Shenzhen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Chen
- North China Electric Power University, Beijing
| | - J Cheng
- Institute of High Energy Physics, Beijing
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J J Cherwinka
- Department of Physics, University of Wisconsin, Madison, Madison, Wisconsin
| | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | - T Classen
- Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, California
| | - A J Conant
- High Flux Isotope Reactor, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | | | - O Dalager
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - G Deichert
- High Flux Isotope Reactor, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - A Delgado
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | - M V Diwan
- Brookhaven National Laboratory, Upton, New York
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - M J Dolinski
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - D Dolzhikov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - M Dvořák
- Institute of High Energy Physics, Beijing
| | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - A Erickson
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - B T Foust
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - J K Gaison
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - A Galindo-Uribarri
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - J P Gallo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois
| | - C E Gilbert
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - M Grassi
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | | | - S Hans
- Brookhaven National Laboratory, Upton, New York
| | - A B Hansell
- Department of Physics, Temple University, Philadelphia, Pennsylvania
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - B Heffron
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | - J H Huang
- Institute of High Energy Physics, Beijing
| | | | - Y B Huang
- Guangxi University, No.100 Daxue East Road, Nanning
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - J Koblanski
- Department of Physics & Astronomy, University of Hawaii, Honolulu, Hawaii
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York
| | - S Jayakumar
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221
| | - D C Jones
- Department of Physics, Temple University, Philadelphia, Pennsylvania
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - O Kyzylova
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - C E Lane
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - T J Langford
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - J LaRosa
- National Institute of Standards and Technology, Gaithersburg, Maryland
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - J J Li
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - R H Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | | | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - J X Liu
- Institute of High Energy Physics, Beijing
| | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - X Lu
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - B Z Ma
- Shandong University, Jinan
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - R C Mandujano
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - J Maricic
- Department of Physics & Astronomy, University of Hawaii, Honolulu, Hawaii
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - R D McKeown
- California Institute of Technology, Pasadena, California 91125
- College of William and Mary, Williamsburg, Virginia 23187
| | - M P Mendenhall
- Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, California
| | - Y Meng
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - A M Meyer
- Department of Physics & Astronomy, University of Hawaii, Honolulu, Hawaii
| | - R Milincic
- Department of Physics & Astronomy, University of Hawaii, Honolulu, Hawaii
| | - P E Mueller
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - H P Mumm
- National Institute of Standards and Technology, Gaithersburg, Maryland
| | - J Napolitano
- Department of Physics, Temple University, Philadelphia, Pennsylvania
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - R Neilson
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - T M T Nguyen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - J A Nikkel
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - S Nour
- National Institute of Standards and Technology, Gaithersburg, Maryland
| | - J P Ochoa-Ricoux
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - J L Palomino
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois
| | - H-R Pan
- Department of Physics, National Taiwan University, Taipei
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - D A Pushin
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - C Morales Reveco
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York
| | - B Roskovec
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - M Searles
- High Flux Isotope Reactor, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - P T Surukuchi
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - T Tmej
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - M A Tyra
- National Institute of Standards and Technology, Gaithersburg, Maryland
| | - R L Varner
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - D Venegas-Vargas
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee
| | - B Viren
- Brookhaven National Laboratory, Upton, New York
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- College of William and Mary, Williamsburg, Virginia 23187
| | - W Wang
- Nanjing University, Nanjing
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - P B Weatherly
- Department of Physics, Drexel University, Philadelphia, Pennsylvania
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | | | - C White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois
| | - J Wilhelmi
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - A Woolverton
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York
| | - D R Wu
- Institute of High Energy Physics, Beijing
| | - F L Wu
- Nanjing University, Nanjing
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Q Xie
- Institute of High Energy Physics, Beijing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - H K Xu
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xu
- Department of Engineering Physics, Tsinghua University, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H F Yao
- Institute of High Energy Physics, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York
| | - B L Young
- Iowa State University, Ames, Iowa 50011
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - V Zavadskyi
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - S Q Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - X Zhang
- Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, California
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - R Z Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
| | - J H Zou
- Institute of High Energy Physics, Beijing
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Bailey-Davis L, Wood GC, Benotti P, Cook A, Dove J, Mowery J, Ramasamy A, Iyer NN, Smolarz BG, Kumar N, Still CD. Impact of Sustained Weight Loss on Cardiometabolic Outcomes. Am J Cardiol 2022; 162:66-72. [PMID: 34702552 DOI: 10.1016/j.amjcard.2021.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/01/2022]
Abstract
Obesity increases the risk of developing type 2 diabetes, hypertension, and hyperlipidemia. We sought to determine the impact of obesity maintenance, weight regain, weight loss maintenance, and magnitudes of weight loss on future risk and time to developing these cardiometabolic conditions. This was a retrospective cohort study of adults receiving primary care at Geisinger Health System between 2001 and 2017. Using electronic health records, patients with ≥3-weight measurements over a 2-year index period were identified and categorized. Obesity maintainers (OM) had obesity (body mass index ≥30 kg/m²) and maintained their weight within ±3% from baseline (reference group). Both weight loss rebounders (WLR) and weight loss maintainers (WLM) had obesity at baseline and lost >5% body weight in year 1; WLR regained ≥20% of weight loss by end of year 2 and WLM maintained ≥80% of weight loss. Incident type 2 diabetes, hypertension, and hyperlipidemia, and time-to-outcome were determined for each study group and by weight loss category for WLM. Of the 63,567 patients included, 67% were OM, 19% were WLR, and 14% were WLM. The mean duration of follow-up was 6.6 years (SD, 3.9). Time until the development of electronic health record-documented type 2 diabetes, hypertension, and hyperlipidemia was longest for WLM and shortest for OM (log-rank test p <0.0001). WLM had the lowest incident type 2 diabetes (adjusted hazard ratio [HR] 0.676 [95% confidence interval [CI] 0.617 to 0.740]; p <0.0001), hypertension (adjusted HR 0.723 [95% CI 0.655 to 0.799]; p <0.0001), and hyperlipidemia (adjusted HR 0.864 [95% CI 0.803 to 0.929]; p <0.0001). WLM with the greatest weight loss (>15%) had a longer time to develop any of the outcomes compared with those with the least amount of weight loss (<7%) (p <0.0001). In an integrated delivery network population, sustained weight loss was associated with a delayed onset of cardiometabolic diseases, particularly with a greater magnitude of weight loss.
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Sampson EL, Wright J, Dove J, Mukadam N. Psychiatric liaison service referral patterns during the UK COVID-19 pandemic: An observational study. Eur J Psychiatry 2022; 36:35-42. [PMID: 35068641 PMCID: PMC8762608 DOI: 10.1016/j.ejpsy.2021.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES COVID-19 has had a profound effect on mental health. Liaison psychiatry teams assess and treat people in mental health crises in emergency departments (EDs) and on hospital wards. During the first pandemic wave, new Mental Health Crisis Assessment Services (MHCAS) were created to divert people away from EDs. Our objective was to describe patterns in referrals to psychiatric liaison services across the North Central London care sector (NCL) and explore the impact of a new MHCAS. METHODS Retrospective study using routinely collected data (ED and ward referrals) from five liaison psychiatry services across NCL (total population 1.5 million people). We described referrals (per week and month) by individual liaison services and cross-sector, and patterns of activity (January 1st 2020 -September 31st 2020, weeks 1-39) compared with the same period in 2019. We calculated changes in the proportion of ED attendees (all-cause) referred to liaison psychiatry. RESULTS From 2019-2020, total referrals decreased by 16.5% (12,265 to 10,247), a 16.4% decrease in ED referrals (9528 to 7965) and 16.6% decrease in ward referrals (2737 to 2282). There was a marked decrease in referrals during the first pandemic wave (March/April 2020), which increased after lockdown ended. The proportion of ED attendees referred to liaison psychiatry services increased compared to 2019. CONCLUSIONS People in mental health crisis continued to seek help via ED/MHCAS and a higher proportion of people attending ED were referred to liaison psychiatry services just after the first pandemic wave. MHCAS absorbed some sector ED activity during the pandemic.
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Affiliation(s)
- E L Sampson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Rd, London W1T 7NF, United Kingdom
- Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, Sterling Way, London, United Kingdom
| | - J Wright
- Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, Sterling Way, London, United Kingdom
| | - J Dove
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London NW1 0PE, United Kingdom
| | - N Mukadam
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Rd, London W1T 7NF, United Kingdom
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London NW1 0PE, United Kingdom
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Wood GC, Bailey-Davis L, Benotti P, Cook A, Dove J, Mowery J, Ramasamy A, Iyer N, Smolarz BG, Kumar N, Still CD. Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization. PLoS One 2021; 16:e0258545. [PMID: 34731171 PMCID: PMC8565747 DOI: 10.1371/journal.pone.0258545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/29/2021] [Indexed: 01/01/2023] Open
Abstract
Objective Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization. Methods A cohort of adults receiving primary care within Geisinger Health System between 2001–2017 was retrospectively studied. Patients with ≥3 weight measurements in the two-year index period and obesity at baseline (BMI ≥30 kg/m2) were categorized: Obesity Maintainers (reference group) maintained weight within +/-3%; Weight Loss Rebounders lost ≥5% body weight in year one, regaining ≥20% of weight loss in year two; Weight Loss Maintainers lost ≥5% body weight in year one, maintaining ≥80% of weight loss. Association with development of osteoarthritis, cancer, opioid use, and depression/anxiety, was assessed; healthcare resource utilization was quantified. Magnitude of weight loss among maintainers was evaluated for impact on health outcomes. Results In total, 63,567 patients were analyzed including 67% Obesity Maintainers, 19% Weight Loss Rebounders, and 14% Weight Loss Maintainers; median follow-up was 9.7 years. Time until osteoarthritis onset was delayed for Weight Loss Maintainers compared to Obesity Maintainers (Logrank test p <0.0001). Female Weight Loss Maintainers had a 19% and 24% lower risk of developing any cancer (p = 0.0022) or obesity-related cancer (p = 0.0021), respectively. No significant trends were observed for opioid use. Weight loss Rebounders and Maintainers had increased risk (14% and 25%) of future treatment for anxiety/depression (both <0.0001). Weight loss maintenance of >15% weight loss was associated with the greatest decrease in incident osteoarthritis. Healthcare resource utilization was significantly higher for Weight Loss Rebounders and Maintainers compared to Obesity Maintainers. Increased weight loss among Weight Loss Maintainers trended with lower overall healthcare resource utilization, except for hospitalizations. Conclusions In people with obesity, sustained weight loss was associated with greater clinical benefits than regained short-term weight loss and obesity maintenance. Higher weight loss magnitudes were associated with delayed onset of osteoarthritis and led to decreased healthcare utilization.
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Affiliation(s)
- G. Craig Wood
- Geisinger Health, Danville, Pennsylvania, United States of America
- * E-mail:
| | | | - Peter Benotti
- Geisinger Health, Danville, Pennsylvania, United States of America
| | - Adam Cook
- Geisinger Health, Danville, Pennsylvania, United States of America
| | - James Dove
- Geisinger Health, Danville, Pennsylvania, United States of America
| | - Jacob Mowery
- Geisinger Health, Danville, Pennsylvania, United States of America
| | | | - Neeraj Iyer
- Novo Nordisk Inc, Plainsboro, New Jersey, United States of America
| | | | - Neela Kumar
- Novo Nordisk Inc, Plainsboro, New Jersey, United States of America
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Martinez M, Medeiros S, Dove J, Shabahang M. Post-Discharge Outcomes After Pancreatic Necrosectomy: A Single Institution Experience Following Endoscopic vs Open Debridement. Am Surg 2021:31348211038565. [PMID: 34404265 DOI: 10.1177/00031348211038565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pancreatic necrosectomy outcomes have been studied extensively; however, long-term results of these procedures have not been well characterized. Our study aimed to assess the outcomes at and after discharge for patients following necrosectomy. METHODS Data from patients undergoing pancreatic necrosectomy at a single tertiary referral hospital from January 1, 2007, to June 1, 2019 were retrospectively analyzed. Patients were stratified into an open pancreatic necrosectomy (OPN) and an endoscopic pancreatic necrosectomy (EPN) group. RESULTS Cohorts were composed of an OPN (n = 30) and EPN (n = 31) groups with a mean follow-up of 22 and 13.5 months, respectively. There was no statistically significant difference in the demographics or etiology of disease; however, the presence of severe sepsis and elevated BISAP scores was significantly higher in the OPN group (40% vs 13% p = .016, 37% vs 10% p = .012, respectively). There was no significant difference in discharge parameters or disposition other than a higher need for wound care in the OPN group (14% vs 0% p =< .0001). No significant difference in the number of patients who returned to baseline, 12-month ED visits, 12-month readmissions, medical comorbidities, or long-term survival was noted. CONCLUSIONS Previous studies have demonstrated that OPN patients have a higher severity of disease and higher inpatient mortality; however, this does not hold true once the acute phase of the illness has passed. Long-term medical comorbidities and survival of patients with necrotizing pancreatitis who endure the primary insult do not differ in long term, regardless of the debridement modality performed for source control.
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Affiliation(s)
- Manuel Martinez
- Department of General Surgery, 21599Geisinger Medical Center, Danville, PA, USA
| | - Steven Medeiros
- Department of General Surgery, 21599Geisinger Medical Center, Danville, PA, USA
| | - James Dove
- Department of General Surgery, 21599Geisinger Medical Center, Danville, PA, USA
| | - Mohsen Shabahang
- Department of General Surgery, 21599Geisinger Medical Center, Danville, PA, USA
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Abstract
CASE We present a case of a 41-year-old male bodybuilder with a partial delaminated quadriceps tendon rupture after a traumatic injury. Partial quadriceps tendon tears are rare overall and usually are treated nonoperatively with conservative management depending on the patient's limitations. He was found to have an intact superficial quadriceps tendon with a partial thickness tear of the vastus intermedius and delamination of the undersurface quadriceps tendon precluding active knee extension. CONCLUSION To our knowledge, there has never been a reported partial quadriceps tendon tear with delamination of the undersurface, causing a complete extensor mechanism failure necessitating operative repair.
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Affiliation(s)
- Ryan O'Donnell
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island
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Hayek S, Woo B, Darelli-Anderson A, Dove J, Fluck M, Stefanidis D, Shabahang MM, Smith BK. Disparate opinions on the value of Vice Chairs of education in Departments of Surgery: A national survey of Department Chairs and other surgical education stakeholders. Am J Surg 2020; 221:381-387. [PMID: 33288225 DOI: 10.1016/j.amjsurg.2020.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/28/2020] [Accepted: 11/15/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The position of Vice Chair of Education (VCE) is increasingly common in Surgery Departments. The role remains ill-defined. The purpose of this study was to explore perceptions of Department Chairs (DCs) and Other Education Stakeholders (OESs) regarding the VCE role. METHODS DCs and OESs at institutions with a VCE were surveyed. Descriptive statistics and cross-tabulations were calculated (SAS V9.4). RESULTS The overall response rate was 25% (166/666). There were significant differences in whether DCs and OESs agree that the VCE supports others in fulfilling educational roles (95.2% vs 49.5%, p = 0.0002), is critical in achieving education missions (90.5% vs 56.6%, p = 0.0032), enhances the quality of education (95.3% vs 65.7%, p = 0.0174), and is important to education teams (95.0% vs 68.7%, p = 0.0464). CONCLUSIONS DCs value the VCE role more so than OESs, whom VCEs support. In order for VCEs to be effective educational leaders in Departments of Surgery, the needs of key stakeholders deserve further clarification.
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Affiliation(s)
- Sarah Hayek
- Geisinger Medical Center, Department of Surgery, USA.
| | - Brandi Woo
- Geisinger Commonwealth School of Medicine, USA
| | | | | | | | | | - Mohsen M Shabahang
- Geisinger Medical Center, Department of Surgery, Chair of the Geisinger Surgical Institute, USA
| | - Brigitte K Smith
- University of Utah, Department of Surger, Division of Vascular Surgery, USA.
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18
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Martinez M, Dove J, Blansfield J, Widom K, Semian J, Alaparthi M, Factor M. Outcomes of Open Retro-Rectus Hernia Repair With Mesh in Obesity Class III. Am Surg 2020; 86:1163-1168. [PMID: 32972209 DOI: 10.1177/0003134820945246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Abdominal wall hernias continue to be one of the most common general surgery pathologies. Patients with an elevated body mass index (BMI) are routinely counseled about weight loss before elective repair. However, a definitive BMI "cutoff" has not been established. Here, we report our experience with open retro-rectus hernia repair (ORRHR) with mesh in patients with a BMI over 40 kg/m2, and we attempt to determine if a BMI "cutoff" can be established. METHODS Data from patients undergoing ORRHR with mesh at Geisinger Medical Center from January 1, 2014, to December 31, 2018, were collected and retrospectively analyzed. RESULTS Cohorts were composed of 2 groups, BMI ≥ 40 kg/m2 (n = 117) and BMI < 40 kg/m2 (n = 90). All patients underwent an elective ORRHR with mesh. Operative time increased significantly as the patient's BMI increased (P ≤ .01). Patients in the higher BMI group had a significantly higher rate of surgical site infections (SSIs) (8.55% vs. 1.1%, P = .018). Higher BMI did not translate to a higher recurrence rate. CONCLUSIONS Patients undergoing ORRHR with mesh who had a BMI over 40 kg/m2 had an increased risk of SSI and longer operative time, possibly suggesting a potential association other than SSI and BMI. More studies are needed to determine if BMI is indeed correlated with hernia recurrence and if BMI should influence the decision to undergo repair.
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Affiliation(s)
- Manuel Martinez
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - James Dove
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Joseph Blansfield
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Kenneth Widom
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - John Semian
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Mohanbabu Alaparthi
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Matthew Factor
- 195466 Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
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19
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Falvo AM, Vacharathit V, Dove J, Fluck M, Daouadi M, Gabrielsen J, Horsley R, Petrick A, Parker DM. A 3-Year MBSAQIP propensity-matched analysis of Roux-en-Y gastric bypass with concomitant cholecystectomy: Is the robotic or laparoscopic approach preferred? Surg Endosc 2020; 35:4712-4718. [PMID: 32959181 DOI: 10.1007/s00464-020-07939-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The primary objective of this study was to compare outcomes of patients undergoing minimally invasive RYGB (MIS/RYGB) versus MIS/RYGB with concomitant Cholecystectomy (CCY). A secondary objective was to compare the outcomes for laparoscopic RYGB (LRYGB) and robotic RYGB (RRYGB) with concomitant CCY. METHODS Outcomes of 117,939 MIS/RYGB with and without CCY were propensity-matched (Age, Gender, BMI, Comorbidities), 10:1, using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2015-2017. The MIS/RYGB with CCY were then separated into LRYGB and RRYGB cases for comparison. Exclusion criteria included emergency cases, conversions to open, and age less than 18. RESULTS The operative time and length of stay (LOS) was significantly increased with addition of concomitant CCY. There was no significant difference in readmission, reoperation, intervention, morbidity, or mortality. The RRYGB with CCY approach was associated with a significantly longer operative times compared to the LRYGB with CCY (177 vs. 135 min, p < 0.0001). The laparoscopic and robotic groups demonstrated no significant difference LOS, readmission, reoperation, intervention, morbidity, or mortality rates. CONCLUSIONS Our study demonstrates that concomitant cholecystectomy increased the operative time and length of stay. However, concomitant CCY was not associated with any increased morbidity. The study demonstrated no significant difference in morbidity between robotic and laparoscopic approach. The robotic approach, however, was associated with a significantly longer operative time compared to the laparoscopic approach. While the indications for CCY remain controversial, concomitant CCY does not convey additional risk regardless of operative approach.
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Affiliation(s)
- Alexandra M Falvo
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | | | - James Dove
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | - Marcus Fluck
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | - Mustapha Daouadi
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | - Jon Gabrielsen
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | - Ryan Horsley
- Geisinger Commonwealth Medical Center, Scranton, USA
| | - Anthony Petrick
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA
| | - David M Parker
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA.
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20
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Dove J, Gage A, Kriz P, Tabaddor RR, Owens BD. COVID-19 and Review of Current Recommendations for Return to Athletic Play. R I Med J (2013) 2020; 103:15-20. [PMID: 32872685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In December 2019 a respiratory illness known as Coronavirus 2 (SARS-CoV-2, COVID-19) broke out in a region in China and rapidly spread to become a pandemic affecting all sporting events worldwide. The Summer Olympics scheduled to be held in Tokyo were postponed until 2021, and all professional leagues in the United States postponed or canceled events. As the United States has begun to open up, there remains uncertainty of when sporting events can safely be held. Many professional leagues and the National Collegiate Athletic Association have established guidelines and recommendations for their athletes to compete safely. In this article, we review the protocols that have been established to allow athletes to return to play, and we review briefly the effects COVID-19 infection may have on athletes.
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Affiliation(s)
- James Dove
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI
| | - Andrew Gage
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI
| | - Peter Kriz
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI
| | - Ramin R Tabaddor
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI
| | - Brett D Owens
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI
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21
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Suraci C, Young K, Dove J, Shabahang M, Blansfield J. Predicting Positive Margins in Pancreatic Head Adenocarcinoma After Neoadjuvant Therapy: Investigating Disparities in Quality Care Using the National Cancer Database. Ann Surg Oncol 2020; 28:1595-1601. [PMID: 32856228 DOI: 10.1245/s10434-020-08766-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND In pancreatic cancer, surgical resection with neoadjuvant therapy improves survival, but survival relies significantly on the margin status of the resected tissue. This study aimed to develop a model that predicts margin positivity, and then to identify facility-specific factors that influence the observed-to-expected (O/E) ratio for positive margins among facilities. METHODS This retrospective review analyzed patients in the National Cancer Database (2004-2016) with pancreatic head adenocarcinoma [tumor-node-metastasis (TNM) stage 1 or 2] who received neoadjuvant therapy for a pancreaticoduodenectomy. Logistic regression was used to develop a model that predicts margin positivity. This model then was used to identify outlier facilities with regard to the O/E ratio. Hospital volume was defined as the total number of pancreaticoduodenectomies per year. RESULTS The study enrolled 4085 patients, and 16.8% of these patients had positive margins. Most of the patients (64%) had a tumor size of 2 to 4 cm, and approximately 51% of the patients did not have positive lymph nodes at resection. A logistic regression model showed that the predictors of positive margins after resection with neoadjuvant therapy were male sex, larger tumor size, and positive lymph nodes. This model was validated to yield a bootstrap-corrected concordance index of 0.632. The study calculated O/E ratios with the model, identifying 12 low- and 17 high O/E-ratio outlier facilities among 401 studied hospitals. The outlier hospitals did not differ in facility type (i.e., academic vs integrated network), but did differ significantly in terms of yearly hospital volume (low outlier of 20.6 vs high outlier of 10.7; p = 0.008). CONCLUSIONS An association of lower-volume facilities with higher than expected rates of positive margins was found to indicate a disparity in care. This disparity was identified via an O/E ratio as a quality indicator for facilities. Facilities can gauge the efficiency of their own practices by referencing their O/E ratios, and they also can improve their practices by analyzing the framework of low O/E-ratio facilities.
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Affiliation(s)
- Corey Suraci
- Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Katelyn Young
- Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - James Dove
- Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Mohsen Shabahang
- Department of General Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Joseph Blansfield
- Department of General Surgery, Geisinger Medical Center, Danville, PA, USA.
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22
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Adamson P, An FP, Anghel I, Aurisano A, Balantekin AB, Band HR, Barr G, Bishai M, Blake A, Blyth S, Cao GF, Cao J, Cao SV, Carroll TJ, Castromonte CM, Chang JF, Chang Y, Chen HS, Chen R, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Childress S, Chu MC, Chukanov A, Coelho JAB, Cummings JP, Dash N, De Rijck S, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolzhikov D, Dove J, Dvořák M, Dwyer DA, Evans JJ, Feldman GJ, Flanagan W, Gabrielyan M, Gallo JP, Germani S, Gomes RA, Gonchar M, Gong GH, Gong H, Gouffon P, Graf N, Grzelak K, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Habig A, Hackenburg RW, Hahn SR, Hans S, Hartnell J, Hatcher R, He M, Heeger KM, Heng YK, Higuera A, Holin A, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang J, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Koerner LW, Kohn S, Kordosky M, Kramer M, Kreymer A, Lang K, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li S, Li SC, Li SJ, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu Y, Liu YH, Lu C, Lu HQ, Lu JS, Lucas P, Luk KB, Ma XB, Ma XY, Ma YQ, Mann WA, Marshak ML, Marshall C, Martinez Caicedo DA, Mayer N, McDonald KT, McKeown RD, Mehdiyev R, Meier JR, Meng Y, Miller WH, Mills G, Mora Lepin L, Naples D, Napolitano J, Naumov D, Naumova E, Nelson JK, Nichol RJ, O'Connor J, Ochoa-Ricoux JP, Olshevskiy A, Pahlka RB, Pan HR, Park J, Patton S, Pavlović Ž, Pawloski G, Peng JC, Perch A, Pfützner MM, Phan DD, Plunkett RK, Poonthottathil N, Pun CSJ, Qi FZ, Qi M, Qian X, Qiu X, Radovic A, Raper N, Ren J, Reveco CM, Rosero R, Roskovec B, Ruan XC, Sail P, Sanchez MC, Schneps J, Schreckenberger A, Shaheed N, Sharma R, Sousa A, Steiner H, Sun JL, Tagg N, Thomas J, Thomson MA, Timmons A, Tmej T, Todd J, Tognini SC, Toner R, Torretta D, Treskov K, Tse WH, Tull CE, Vahle P, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Weber A, Wei HY, Wei LH, Wen LJ, Whisnant K, White C, Whitehead LH, Wojcicki SG, Wong HLH, Wong SCF, Worcester E, Wu DR, Wu FL, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JW, Zhang QM, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhou L, Zhuang HL. Improved Constraints on Sterile Neutrino Mixing from Disappearance Searches in the MINOS, MINOS+, Daya Bay, and Bugey-3 Experiments. Phys Rev Lett 2020; 125:071801. [PMID: 32857527 DOI: 10.1103/physrevlett.125.071801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Searches for electron antineutrino, muon neutrino, and muon antineutrino disappearance driven by sterile neutrino mixing have been carried out by the Daya Bay and MINOS+ collaborations. This Letter presents the combined results of these searches, along with exclusion results from the Bugey-3 reactor experiment, framed in a minimally extended four-neutrino scenario. Significantly improved constraints on the θ_{μe} mixing angle are derived that constitute the most constraining limits to date over five orders of magnitude in the mass-squared splitting Δm_{41}^{2}, excluding the 90% C.L. sterile-neutrino parameter space allowed by the LSND and MiniBooNE observations at 90% CL_{s} for Δm_{41}^{2}<13 eV^{2}. Furthermore, the LSND and MiniBooNE 99% C.L. allowed regions are excluded at 99% CL_{s} for Δm_{41}^{2}<1.6 eV^{2}.
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Affiliation(s)
- P Adamson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F P An
- Institute of Modern Physics, East China University of Science and Technology, Shanghai
| | - I Anghel
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011 USA
| | - A Aurisano
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - A B Balantekin
- Physics Department, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - H R Band
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - G Barr
- Subdepartment of Particle Physics, University of Oxford, Oxford OX1 3RH, United Kingdom
| | - M Bishai
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Blake
- Cavendish Laboratory, University of Cambridge, Cambridge CB3 0HE, United Kingdom
- Lancaster University, Lancaster, LA1 4YB, United Kingdom
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - S V Cao
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - T J Carroll
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - C M Castromonte
- Instituto de Física, Universidade Federal de Goiás, 74690-900, Goiánia, Goias, Brazil
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - R Chen
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Shenzhen University, Shenzhen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Chen
- North China Electric Power University, Beijing
| | - J Cheng
- Institute of High Energy Physics, Beijing
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J J Cherwinka
- Physics Department, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - S Childress
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | - A Chukanov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - J A B Coelho
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | | | - N Dash
- Institute of High Energy Physics, Beijing
| | - S De Rijck
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | - M V Diwan
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - D Dolzhikov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - M Dvořák
- Institute of High Energy Physics, Beijing
| | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - J J Evans
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - G J Feldman
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - W Flanagan
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
- Department of Physics, University of Dallas, Irving, Texas 75062, USA
| | - M Gabrielyan
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - J P Gallo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - S Germani
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - R A Gomes
- Instituto de Física, Universidade Federal de Goiás, 74690-900, Goiánia, Goias, Brazil
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - P Gouffon
- Instituto de Física, Universidade de São Paulo, CP 66318, 05315-970, São Paulo, Sao Paulo, Brazil
| | - N Graf
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - K Grzelak
- Department of Physics, University of Warsaw, PL-02-093 Warsaw, Poland
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - A Habig
- Department of Physics, University of Minnesota Duluth, Duluth, Minnesota 55812, USA
| | - R W Hackenburg
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S R Hahn
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Hans
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Hartnell
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Hatcher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - A Higuera
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - A Holin
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | - J Huang
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | | | - Y B Huang
- Institute of High Energy Physics, Beijing
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - D Jones
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L W Koerner
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Kordosky
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - A Kreymer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Lang
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - T J Langford
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - J J Li
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S J Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - L Littenberg
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Y Liu
- Shandong University, Jinan
| | | | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544, USA
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - J S Lu
- Institute of High Energy Physics, Beijing
| | - P Lucas
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - W A Mann
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - M L Marshak
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - D A Martinez Caicedo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - N Mayer
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544, USA
| | - R D McKeown
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
- Lauritsen Laboratory, California Institute of Technology, Pasadena, California 91125, USA
| | - R Mehdiyev
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - J R Meier
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Y Meng
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - W H Miller
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Mills
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L Mora Lepin
- Instituto de Física, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - D Naples
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - J Napolitano
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - J K Nelson
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - R J Nichol
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - J O'Connor
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - J P Ochoa-Ricoux
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - R B Pahlka
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H-R Pan
- Department of Physics, National Taiwan University, Taipei
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - Ž Pavlović
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - G Pawloski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Perch
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - M M Pfützner
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - D D Phan
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - R K Plunkett
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - N Poonthottathil
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - X Qiu
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - A Radovic
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - C Morales Reveco
- Instituto de Física, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B Roskovec
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - P Sail
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | - M C Sanchez
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011 USA
| | - J Schneps
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - A Schreckenberger
- Department of Physics, University of Texas at Austin, Austin, Texas 78712, USA
| | | | - R Sharma
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Sousa
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - N Tagg
- Otterbein University, Westerville, Ohio 43081, USA
| | - J Thomas
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - M A Thomson
- Cavendish Laboratory, University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Timmons
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - T Tmej
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - J Todd
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - S C Tognini
- Instituto de Física, Universidade Federal de Goiás, 74690-900, Goiánia, Goias, Brazil
| | - R Toner
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Torretta
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region, Russia
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
| | - P Vahle
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - B Viren
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague, Czech Republic
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - W Wang
- Nanjing University, Nanjing
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - A Weber
- Subdepartment of Particle Physics, University of Oxford, Oxford OX1 3RH, United Kingdom
- Rutherford Appleton Laboratory, Science and Technology Facilities Council, Didcot, OX11 0QX, United Kingdom
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | - K Whisnant
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011 USA
| | - C White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - L H Whitehead
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - S G Wojcicki
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California, 94720 USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S C F Wong
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D R Wu
- Institute of High Energy Physics, Beijing
| | - F L Wu
- Nanjing University, Nanjing
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Q Xie
- Institute of High Energy Physics, Beijing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xu
- Department of Engineering Physics, Tsinghua University, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H F Yao
- Institute of High Energy Physics, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B L Young
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011 USA
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
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Martinez M, Cole J, Dove J, Blansfield J, Shabahang M, Wild J, Widom K, Torres D, Factor M. Outcomes of Endoscopic and Surgical Pancreatic Necrosectomy: A Single Institution Experience. Am Surg 2020. [DOI: 10.1177/000313481908500946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pancreatic necrosis can be managed conservatively; however, infection of pancreatic necrosis usually dictates more aggressive management. Our study aimed to assess the outcomes of open pancreatic necrosectomy (OPN) and endoscopic pancreatic necrosectomy (EPN) in a single center. Data from patients undergoing pancreatic necrosectomy at the Geisinger Medical Center from January 1, 2007, to April 25, 2016, were collected and retrospectively analyzed. Cohorts were composed of EPN (n = 22) and OPN (n = 34) groups. The prevalence of preoperative respiratory failure, septic shock, and multiorgan dysfunction syndrome was higher in the OPN group. The OPN group presented with a higher Bedside Index Severity in Acute Pancreatitis score. Postoperative abscess, persistent kidney dysfunction, and death were more frequent in the OPN group. The EPN group had a higher read-mission rate. The results of the univariate analysis for complication and mortality demonstrated that higher mortality and persistent kidney dysfunction were associated with the procedure type, specifically OPN and with a higher Bedside Index Severity in Acute Pancreatitis score. Patients who presented with higher severity of disease underwent an OPN, whereas EPN often was performed successfully in a more benign clinical setting. However, patients with infected necrosis are served best in a tertiary medical facility where multiple treatment modalities are available.
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Affiliation(s)
- Manuel Martinez
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joshua Cole
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joseph Blansfield
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Mohsen Shabahang
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Matthew Factor
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
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24
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Gretschel A, Carman K, Medin C, Dove J, Chu K, Oxenberg J. The Impact of Education on LN Harvesting for Gastric and Esophageal Cancer Specimens. Am Surg 2020. [DOI: 10.1177/000313482008600201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alanna Gretschel
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
| | - Kelly Carman
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
| | - Caroline Medin
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
| | - James Dove
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
| | - Kyo Chu
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
| | - Jacqueline Oxenberg
- Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania Geisinger Medical Center Danville, Pennsylvania Geisinger Commonwealth School of Medicine Scranton, Pennsylvania
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25
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Gretschel A, Carman K, Medin C, Dove J, Chu K, Oxenberg J. The Impact of Education on LN Harvesting for Gastric and Esophageal Cancer Specimens. Am Surg 2020; 86:e51-e53. [PMID: 32106912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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26
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Horsley RD, Vogels ED, McField DAP, Parker DM, Medico C, Dove J, Fluck M, Gabrielsen JD, Gionfriddo MR, Petrick AT. Multimodal Postoperative Pain Control Is Effective and Reduces Opioid Use After Laparoscopic Roux-en-Y Gastric Bypass. Obes Surg 2019; 29:394-400. [PMID: 30317488 DOI: 10.1007/s11695-018-3526-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Opioids have been the mainstay for postoperative pain relief for many decades. Recently, opioid-related adverse events and death have been linked to postoperative dependency. Multimodal approaches to postoperative pain control may be part of the solution to this health care crisis. The safety and effectiveness of multimodal pain control regimens after laparoscopic Roux-en-Y gastric bypass (LRYGB) has not been well studied. The primary aim of our study was to determine if an evidence-based, multimodal pain regimen during hospitalization could decrease the total oral morphine equivalent (TME) use after LRYGB. STUDY DESIGN We conducted a retrospective cohort study comparing outcomes prior to the implementation of a multimodal pain protocol (December 2010-December 2012) to those after implementation (April 2013-July 2015). The protocol utilized oral celecoxib and scheduled oral acetaminophen for pain control, with opioids used only as needed for breakthrough pain. Data was extracted from an electronic medical record and an institutionally maintained database of all patients undergoing bariatric surgery at a single center. RESULTS Compared to controls, the multimodal pain regimen significantly reduced TME used and maximum pain scores with no change in mean pain scores. Multimodal pain protocol patients had a shorter length of stay with no increase in bleeding complications or marginal ulcer rates. CONCLUSIONS An opioid-sparing multimodal pain regimen adequately controls pain while reducing TME use. The regimen appears to be safe and was associated with a reduced length of stay in patients undergoing LRYGB.
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Affiliation(s)
- Ryan D Horsley
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA.
| | - Ellen D Vogels
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - Daaron A P McField
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - David M Parker
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - Charles Medico
- Enterprise Pharmacy, Geisinger, 100 North Academy Ave, Danville, PA, 17822, USA
| | - James Dove
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - Marcus Fluck
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - Jon D Gabrielsen
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
| | - Michael R Gionfriddo
- Center for Pharmacy Innovation and Outcomes, Geisinger, 190 Welles Street, Suite 128, Forty Fort, PA, USA
| | - Anthony T Petrick
- Division of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Ave, Danville, PA, 17822, USA
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27
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Lauer CI, Shabahang MM, Restivo B, Lane S, Hayek S, Dove J, Ellison HB, Pica E, Ryer EJ. The Value of Surgical Graduate Medical Education (GME) Programs Within An Integrated Health Care System. J Surg Educ 2019; 76:e173-e181. [PMID: 31466894 DOI: 10.1016/j.jsurg.2019.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/06/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Surgical graduate medical education (GME) programs add both significant cost and complexity to the mission of teaching hospitals. While expenses tied directly to surgical training programs are well tracked, overall cost-benefit accounting has not been performed. In this study, we attempt to better define the costs and benefits of maintaining surgical GME programs within a large integrated health system. DESIGN We examined the costs, in 2018 US dollars, associated with the surgical training programs within a single health system. Total health system expenses were calculated using actual and estimated direct GME expenses (salary, benefits, supplies, overhead, and teaching expenses) as well as indirect medical education (IME) expenses. IME expenses for each training program were estimated by using both Medicare percentages and the Medicare Payment Advisor Commission study. The projected cost to replace surgical trainees with advanced practitioners or hospitalists was obtained through interviews with program directors and administrators and was validated by our system's business office. SETTING A physician lead, integrated, rural health system consisting of 8 hospitals, a medical school and a health insurance company. PARTICIPANTS GME surgical training programs within a single health system's department of surgery. RESULTS Our health system's department of surgery supports 8 surgical GME programs (2 general surgery residencies along with residencies in otolaryngology, ophthalmology, oral-maxillofacial surgery, urology, pediatric dentistry, and vascular surgery), encompassing 89 trainees. Trainees work an average of 64.4 hours per week. Total health system cost per resident ranged from $249,657 to $516,783 based on specialty as well as method of calculating IME expenses. After averaging program costs and excluding IME and overhead expenses, we estimated the average annual cost per trainee to be $84,171. We projected that replacing our surgical trainees would require hiring 145 additional advanced practitioners at a cost of $166,500 each per year, or 97 hospitalists at a cost of $346,500 each per year. Excluding overhead, teaching and IME expenses, these replacements would cost the health system an estimated additional $16,651,281 or $26,119,281 per year, respectively. CONCLUSIONS Surgical education is an integral part of our health system and ending surgical GME programs would require large expansion of human resources and significant additional fiscal capital.
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Affiliation(s)
- Claire I Lauer
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | | | - Brian Restivo
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Samantha Lane
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Sarah Hayek
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Halle B Ellison
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Erin Pica
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Evan J Ryer
- Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania.
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28
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Cunningham R, Kuhn J, Falvo A, Vacharathit V, Williams V, Fluck M, Dove J, Still C, Parker D, Gabrielsen J, Petrick A. A192 Destination Care for Bariatric Surgery Can Be Feasible, Safe and Cost Effective: Proceed with Caution. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Cunningham R, Kuhn J, Fluck M, Dove J, Falvo A, Horsley R, Daouadi M, Gabrielsen J, Parker D, Petrick A, Vacharathit V. A451 A Step Closer to the Elimination of Opioids After Bariatric Surgery. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Cole J, Shajari A, Dudash M, Young K, Dove J, Buzas CJ, Long KC, Shabahang M, Blansfield JA. Using a NSQIP-Based Frailty Index to Identify Risk for Postoperative Complications in Patients Undergoing Surgery for Rectal Malignancy. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Berglund D, Fluck M, Dove J, Kuhn J, Cunningham R, Falvo A, Gabrielsen J, Parker D, Horsley R, Petrick A, Daouadi M. A118 Impact of Urinary Catheter on Post-operative Urinary Complications After Roux en Y Gastric Bypass Surgery. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Kuhn J, Dudash M, Petrick A, Cunningham R, Dove J, Falvo A, Daouadi M, Horsley R, Gabrielsen J, Parker D. A586 Propensity Matched Comparison of Robotic and Laparoscopic Bariatric Surgery: Are we still in a learning curve or can we agree Robotic bariatric surgery is associated with longer operative times? Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adey D, An FP, Balantekin AB, Band HR, Bishai M, Blyth S, Cao D, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Chukanov A, Cummings JP, Dash N, Deng FS, Ding YY, Diwan MV, Dohnal T, Dove J, Dvořák M, Dwyer DA, Gonchar M, Gong GH, Gong H, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Hans S, He M, Heeger KM, Heng YK, Higuera A, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Koerner LW, Kohn S, Kramer M, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li C, Li F, Li HL, Li QJ, Li S, Li SC, Li SJ, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu Y, Liu YH, Lu C, Lu HQ, Lu JS, Luk KB, Ma XB, Ma XY, Ma YQ, Marshall C, Martinez Caicedo DA, McDonald KT, McKeown RD, Mitchell I, Mora Lepin L, Napolitano J, Naumov D, Naumova E, Ochoa-Ricoux JP, Olshevskiy A, Pan HR, Park J, Patton S, Pec V, Peng JC, Pinsky L, Pun CSJ, Qi FZ, Qi M, Qian X, Raper N, Ren J, Rosero R, Roskovec B, Ruan XC, Steiner H, Sun JL, Treskov K, Tse WH, Tull CE, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Wei HY, Wei LH, Wen LJ, Whisnant K, White CG, Wong HLH, Wong SCF, Worcester E, Wu Q, Wu WJ, Xia DM, Xing ZZ, Xu JL, Xue T, Yang CG, Yang L, Yang MS, Yang YZ, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang CC, Zhang FY, Zhang HH, Zhang JW, Zhang QM, Zhang R, Zhang XF, Zhang XT, Zhang YM, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhou L, Zhuang HL, Zou JH. Extraction of the ^{235}U and ^{239}Pu Antineutrino Spectra at Daya Bay. Phys Rev Lett 2019; 123:111801. [PMID: 31573238 DOI: 10.1103/physrevlett.123.111801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/04/2019] [Indexed: 06/10/2023]
Abstract
This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.
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Affiliation(s)
- D Adey
- Institute of High Energy Physics, Beijing
| | - F P An
- Institute of Modern Physics, East China University of Science and Technology, Shanghai
| | | | - H R Band
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - M Bishai
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Blyth
- Department of Physics, National Taiwan University, Taipei
| | - D Cao
- Nanjing University, Nanjing
| | - G F Cao
- Institute of High Energy Physics, Beijing
| | - J Cao
- Institute of High Energy Physics, Beijing
| | - J F Chang
- Institute of High Energy Physics, Beijing
| | - Y Chang
- National United University, Miao-Li
| | - H S Chen
- Institute of High Energy Physics, Beijing
| | - S M Chen
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y Chen
- Shenzhen University, Shenzhen
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y X Chen
- North China Electric Power University, Beijing
| | - J Cheng
- Institute of High Energy Physics, Beijing
| | - Z K Cheng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | | | - M C Chu
- Chinese University of Hong Kong, Hong Kong
| | - A Chukanov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | | | - N Dash
- Institute of High Energy Physics, Beijing
| | - F S Deng
- University of Science and Technology of China, Hefei
| | - Y Y Ding
- Institute of High Energy Physics, Beijing
| | - M V Diwan
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Dohnal
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J Dove
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - M Dvořák
- Charles University, Faculty of Mathematics and Physics, Prague
| | - D A Dwyer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - M Gonchar
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - G H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - H Gong
- Department of Engineering Physics, Tsinghua University, Beijing
| | - W Q Gu
- Brookhaven National Laboratory, Upton, New York 11973
| | - J Y Guo
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | - X H Guo
- Beijing Normal University, Beijing
| | - Y H Guo
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | - Z Guo
- Department of Engineering Physics, Tsinghua University, Beijing
| | | | - S Hans
- Brookhaven National Laboratory, Upton, New York 11973
| | - M He
- Institute of High Energy Physics, Beijing
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - Y K Heng
- Institute of High Energy Physics, Beijing
| | - A Higuera
- Department of Physics, University of Houston, Houston, Texas 77204
| | - Y K Hor
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei
| | - B Z Hu
- Department of Physics, National Taiwan University, Taipei
| | - J R Hu
- Institute of High Energy Physics, Beijing
| | - T Hu
- Institute of High Energy Physics, Beijing
| | - Z J Hu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H X Huang
- China Institute of Atomic Energy, Beijing
| | | | - Y B Huang
- Institute of High Energy Physics, Beijing
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - D E Jaffe
- Brookhaven National Laboratory, Upton, New York 11973
| | - K L Jen
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - X L Ji
- Institute of High Energy Physics, Beijing
| | - X P Ji
- Brookhaven National Laboratory, Upton, New York 11973
| | - R A Johnson
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221
| | - D Jones
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - L Kang
- Dongguan University of Technology, Dongguan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973
| | - L W Koerner
- Department of Physics, University of Houston, Houston, Texas 77204
| | - S Kohn
- Department of Physics, University of California, Berkeley, California 94720
| | - M Kramer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - T J Langford
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520
| | - J Lee
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - J H C Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - R T Lei
- Dongguan University of Technology, Dongguan
| | - R Leitner
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J K C Leung
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - C Li
- Shandong University, Jinan
| | - F Li
- Institute of High Energy Physics, Beijing
| | - H L Li
- Institute of High Energy Physics, Beijing
| | - Q J Li
- Institute of High Energy Physics, Beijing
| | - S Li
- Dongguan University of Technology, Dongguan
| | - S C Li
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S J Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - W D Li
- Institute of High Energy Physics, Beijing
| | - X N Li
- Institute of High Energy Physics, Beijing
| | - X Q Li
- School of Physics, Nankai University, Tianjin
| | - Y F Li
- Institute of High Energy Physics, Beijing
| | - Z B Li
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - H Liang
- University of Science and Technology of China, Hefei
| | - C J Lin
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - G L Lin
- Institute of Physics, National Chiao-Tung University, Hsinchu
| | - S Lin
- Dongguan University of Technology, Dongguan
| | - J J Ling
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - L Littenberg
- Brookhaven National Laboratory, Upton, New York 11973
| | - B R Littlejohn
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - J C Liu
- Institute of High Energy Physics, Beijing
| | - J L Liu
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Y Liu
- Shandong University, Jinan
| | | | - C Lu
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - H Q Lu
- Institute of High Energy Physics, Beijing
| | - J S Lu
- Institute of High Energy Physics, Beijing
| | - K B Luk
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - X B Ma
- North China Electric Power University, Beijing
| | - X Y Ma
- Institute of High Energy Physics, Beijing
| | - Y Q Ma
- Institute of High Energy Physics, Beijing
| | - C Marshall
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - D A Martinez Caicedo
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - K T McDonald
- Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544
| | - R D McKeown
- California Institute of Technology, Pasadena, California 91125
- College of William and Mary, Williamsburg, Virginia 23187
| | - I Mitchell
- Department of Physics, University of Houston, Houston, Texas 77204
| | - L Mora Lepin
- Instituto de Física, Pontificia Universidad Católica de Chile, Santiago
| | - J Napolitano
- Department of Physics, College of Science and Technology, Temple University, Philadelphia, Pennsylvania 19122
| | - D Naumov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - E Naumova
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - J P Ochoa-Ricoux
- Instituto de Física, Pontificia Universidad Católica de Chile, Santiago
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - A Olshevskiy
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - H-R Pan
- Department of Physics, National Taiwan University, Taipei
| | - J Park
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061
| | - S Patton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - V Pec
- Charles University, Faculty of Mathematics and Physics, Prague
| | - J C Peng
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801
| | - L Pinsky
- Department of Physics, University of Houston, Houston, Texas 77204
| | - C S J Pun
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Z Qi
- Institute of High Energy Physics, Beijing
| | - M Qi
- Nanjing University, Nanjing
| | - X Qian
- Brookhaven National Laboratory, Upton, New York 11973
| | - N Raper
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J Ren
- China Institute of Atomic Energy, Beijing
| | - R Rosero
- Brookhaven National Laboratory, Upton, New York 11973
| | - B Roskovec
- Department of Physics and Astronomy, University of California, Irvine, California 92697
| | - X C Ruan
- China Institute of Atomic Energy, Beijing
| | - H Steiner
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - J L Sun
- China General Nuclear Power Group, Shenzhen
| | - K Treskov
- Joint Institute for Nuclear Research, Dubna, Moscow Region
| | - W-H Tse
- Chinese University of Hong Kong, Hong Kong
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - B Viren
- Brookhaven National Laboratory, Upton, New York 11973
| | - V Vorobel
- Charles University, Faculty of Mathematics and Physics, Prague
| | - C H Wang
- National United University, Miao-Li
| | - J Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - M Wang
- Shandong University, Jinan
| | - N Y Wang
- Beijing Normal University, Beijing
| | - R G Wang
- Institute of High Energy Physics, Beijing
| | - W Wang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
- College of William and Mary, Williamsburg, Virginia 23187
| | - W Wang
- Nanjing University, Nanjing
| | - X Wang
- College of Electronic Science and Engineering, National University of Defense Technology, Changsha
| | - Y Wang
- Nanjing University, Nanjing
| | - Y F Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Institute of High Energy Physics, Beijing
| | - Z Wang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Z M Wang
- Institute of High Energy Physics, Beijing
| | - H Y Wei
- Brookhaven National Laboratory, Upton, New York 11973
| | - L H Wei
- Institute of High Energy Physics, Beijing
| | - L J Wen
- Institute of High Energy Physics, Beijing
| | | | - C G White
- Department of Physics, Illinois Institute of Technology, Chicago, Illinois 60616
| | - H L H Wong
- Lawrence Berkeley National Laboratory, Berkeley, California 94720
- Department of Physics, University of California, Berkeley, California 94720
| | - S C F Wong
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - E Worcester
- Brookhaven National Laboratory, Upton, New York 11973
| | - Q Wu
- Shandong University, Jinan
| | - W J Wu
- Institute of High Energy Physics, Beijing
| | - D M Xia
- Chongqing University, Chongqing
| | - Z Z Xing
- Institute of High Energy Physics, Beijing
| | - J L Xu
- Institute of High Energy Physics, Beijing
| | - T Xue
- Department of Engineering Physics, Tsinghua University, Beijing
| | - C G Yang
- Institute of High Energy Physics, Beijing
| | - L Yang
- Dongguan University of Technology, Dongguan
| | - M S Yang
- Institute of High Energy Physics, Beijing
| | - Y Z Yang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - M Ye
- Institute of High Energy Physics, Beijing
| | - M Yeh
- Brookhaven National Laboratory, Upton, New York 11973
| | - B L Young
- Iowa State University, Ames, Iowa 50011
| | - H Z Yu
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Z Y Yu
- Institute of High Energy Physics, Beijing
| | - B B Yue
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - S Zeng
- Institute of High Energy Physics, Beijing
| | - Y Zeng
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - L Zhan
- Institute of High Energy Physics, Beijing
| | - C Zhang
- Brookhaven National Laboratory, Upton, New York 11973
| | - C C Zhang
- Institute of High Energy Physics, Beijing
| | - F Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - H H Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - J W Zhang
- Institute of High Energy Physics, Beijing
| | - Q M Zhang
- Department of Nuclear Science and Technology, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an
| | | | - X F Zhang
- Institute of High Energy Physics, Beijing
| | - X T Zhang
- Institute of High Energy Physics, Beijing
| | - Y M Zhang
- Sun Yat-Sen (Zhongshan) University, Guangzhou
| | - Y M Zhang
- Department of Engineering Physics, Tsinghua University, Beijing
| | - Y X Zhang
- China General Nuclear Power Group, Shenzhen
| | - Y Y Zhang
- Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai Laboratory for Particle Physics and Cosmology, Shanghai
| | - Z J Zhang
- Dongguan University of Technology, Dongguan
| | - Z P Zhang
- University of Science and Technology of China, Hefei
| | - Z Y Zhang
- Institute of High Energy Physics, Beijing
| | - J Zhao
- Institute of High Energy Physics, Beijing
| | - L Zhou
- Institute of High Energy Physics, Beijing
| | - H L Zhuang
- Institute of High Energy Physics, Beijing
| | - J H Zou
- Institute of High Energy Physics, Beijing
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Martinez M, Cole J, Dove J, Blansfield J, Shabahang M, Wild J, Widom K, Torres D, Factor M. Outcomes of Endoscopic and Surgical Pancreatic Necrosectomy: A Single Institution Experience. Am Surg 2019; 85:1017-1024. [PMID: 31638517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pancreatic necrosis can be managed conservatively; however, infection of pancreatic necrosis usually dictates more aggressive management. Our study aimed to assess the outcomes of open pancreatic necrosectomy (OPN) and endoscopic pancreatic necrosectomy (EPN) in a single center. Data from patients undergoing pancreatic necrosectomy at the Geisinger Medical Center from January 1, 2007, to April 25, 2016, were collected and retrospectively analyzed. Cohorts were composed of EPN (n = 22) and OPN (n = 34) groups. The prevalence of preoperative respiratory failure, septic shock, and multiorgan dysfunction syndrome was higher in the OPN group. The OPN group presented with a higher Bedside Index Severity in Acute Pancreatitis score. Postoperative abscess, persistent kidney dysfunction, and death were more frequent in the OPN group. The EPN group had a higher readmission rate. The results of the univariate analysis for complication and mortality demonstrated that higher mortality and persistent kidney dysfunction were associated with the procedure type, specifically OPN and with a higher Bedside Index Severity in Acute Pancreatitis score. Patients who presented with higher severity of disease underwent an OPN, whereas EPN often was performed successfully in a more benign clinical setting. However, patients with infected necrosis are served best in a tertiary medical facility where multiple treatment modalities are available.
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Abstract
Total thyroidectomy (TT) or near-TT (NTT) is often recommended over medical management for the treatment of Graves’ disease (GD). We assess the safety within surgical subspecialties at our institution for TT/NTT in GD patients. A retrospective review of patients undergoing TT/NTT for GD was performed from 2004 to 2016. Patient factors, thyroid size, surgeon subspecialty, and intraoperative/postoperative outcomes were all reviewed. Multivariate analyses were used to determine risk factors for complications. A total of 383 patients underwent TT/NTT. Two hundred thirty-three patients underwent TT/NTT by otolaryngology (n = 233, 60.8%), surgical oncology (n = 140, 36.6%), general surgery (n = 8, 2.1%), and unknown (n = 2, 0.5%). On multivariate analysis, surgical duration was longer for males ( P = 0.001) and increased thyroid weights ( P = 0.001). No association with hypocalcemia or recurrent laryngeal nerve paralysis was found with factors considered. No factors were found to be associated with the ability to identify the recurrent laryngeal nerve. Estimated blood loss (EBL) was increased in younger patients (0.010), males ( P = 0.001), increased BMI ( P = 0.012), and increased thyroid weight ( P < 0.001). EBL was also associated with the physician performing the operation, where EBL was greatest for TT/NTT performed by general surgeons, followed by surgical oncologists and then by otolaryngology ( P = 0.006). TT/NTT is safe and a reasonable option for the treatment of GD.
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Affiliation(s)
- Aaron Feaster
- From the Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
| | | | - Mary Wolf
- From the Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
| | - James Dove
- From the Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
| | - Marcus Fluck
- From the Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
| | - Jacqueline Oxenberg
- From the Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
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Feaster A, DeCapua-Guarino A, Wolf M, Dove J, Fluck M, Oxenberg J. Thyroidectomy Remains a Safe Option for Graves' Disease. Am Surg 2019; 85:851-854. [PMID: 32051065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Total thyroidectomy (TT) or near-TT (NTT) is often recommended over medical management for the treatment of Graves' disease (GD). We assess the safety within surgical subspecialties at our institution for TT/NTT in GD patients. A retrospective review of patients undergoing TT/NTT for GD was performed from 2004 to 2016. Patient factors, thyroid size, surgeon subspecialty, and intraoperative/postoperative outcomes were all reviewed. Multivariate analyses were used to determine risk factors for complications. A total of 383 patients underwent TT/NTT. Two hundred thirty-three patients underwent TT/NTT by otolaryngology (n = 233, 60.8%), surgical oncology (n = 140, 36.6%), general surgery (n = 8, 2.1%), and unknown (n = 2, 0.5%). On multivariate analysis, surgical duration was longer for males (P = 0.001) and increased thyroid weights (P = 0.001). No association with hypocalcemia or recurrent laryngeal nerve paralysis was found with factors considered. No factors were found to be associated with the ability to identify the recurrent laryngeal nerve. Estimated blood loss (EBL) was increased in younger patients (0.010), males (P = 0.001), increased BMI (P = 0.012), and increased thyroid weight (P < 0.001). EBL was also associated with the physician performing the operation, where EBL was greatest for TT/NTT performed by general surgeons, followed by surgical oncologists and then by otolaryngology (P = 0.006). TT/NTT is safe and a reasonable option for the treatment of GD.
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Mador B, Fuselli P, Choudhary D, Bokhari F, Tanenbaum B, Tze N, Wong TH, Grant I, Sahi S, Tanenbaum B, Figueira S, Knight H, Grant I, Beno S, Moore L, Macpherson A, Laverty C, Watson I, Watson I, Laverty C, Bérubé M, Cowan S, Homer K, Bouderba S, Soltana K, Fransblow L, Fransblow L, Bérubé M, Gonthier C, Bryson A, Bokhari F, Rados A, Courval V, Masales C, Trust MD, Hogan J, Warriner Z, Lalande A, Chung D, Tanenbaun B, Kuper T, Mckee J, Bratu I, Makish A, Versolatto A, Ramagnano S, Mehrnoush V, Kang D, Moore L, Schellenberg M, LeBreton M, Javidan AP, Schwartz G, Doucet J, Cunningham A, Clarke R, Paradis T, Beamish I, Hilsden R, Raizman I, Green R, Green R, Green R, Esmail R, Moon J(J, Cheng V, Brisson A, Beno S, Heck C, Koeck E, Schneider P, Bal C, Ko YM(D, Martinez M, Kim D, Tierney J, Emigh B, Lie J, Tierney J, MacLean A, Milton L, Bradley N, Kim M, White J, Harris I, Tekian A, Babul S, Cowle S, Turcotte K, Dhillon R, Chadha K, Fu CY, Bajan F, Welsh S, Kaminsky M, Dennis A, Starr F, Butler C, Messer T, Poulakidas S, Ramagnano S, Grushka J, Beckett A, Filteau C, Larocque J, Nadkarni N, Chua WC, Loo L, Ang ASH, Iau PTC, Goo JTT, Chan KC, Adam TN, Seow DCC, Ng YS, Malhotra R, Chan AWM, Matchar DB, Van Nguyen H, Ong MEH, Lampron J, Bougie A, Brown C, Patel A, Edwards L, Spitz K, Ramagnano S, Lampron J, Nucete M, Lindsey S, Lampron J, Figueira S, Matar M, Michael D, Rosenfield D, Harvey G, Jessa K, Tardif PA, Mercier E, Berthelot S, Lecky F, Cameron P, Archambault P, Tien H, Beckett A, Nathens A, Luz LTD, Benjamin S, Chisholm A, Benjamin S, Chisholm A, Tien H, Beckett A, Nathens A, Luz LTD, Pasquotti T, Klassen B, Brisson A, Tze N, Fawcett V, Tsang B, Kabaroff A, Verhoeff K, Turner S, Kim M, Widder S, Fung C, Widder S, Kim M, Moore L, Lecky F, Lawrence T, Soltana K, Mansour T, Moore L, Bouderba S, Turgeon A, Krouchev R, Mercier E, Friedman D, Souranis A, Slapcoff L, Friedman D, Fakir MB, Turcotte V, Valiquette MP, Bernard F, Giroux M, Côté MÈ, Gagné A, Dollé S, Gélinas C, Belcaïd A, Truchon C, Moore L, Clément J, Pelletier LP, Ivkov V, Gamble K, Constable L, Haegert J, Bajani F, Fu CY, Welsh S, Kaminsky M, Dennis A, Starr F, Messer T, Butler C, Tatebe L, Poulakidas S, Thauvette D, Engels P, Klassen B, Coates A, De Silva S, Schellenberg M, Biswas S, Inaba K, Cheng V, Warriner Z, Love B, Demetriades D, Schellenberg M, Inaba K, Trust MD, Love B, Cheng V, Strumwasser A, Demetriades D, Joos E, Dawe P, Hameed M, Evans D, Garraway N, Gawaziuk J, Cristall N, Logsetty S, Ramagnano S, Federman N, Murphy P, Parry N, Leeper R, McBeth P, Wachs J, Hamilton D, Ball C, Gillman L, Kirkpatrick A, Dulai S, Falconer C, McLachlin M, Armstrong A, Parry N, Vogt K, Shi Q, Coates A, Engels P, Rice T, Nathens A, Naidu D, Brubacher J, Chan H, Erdelyi S, Kubasiak J, Bokhari F, Kaminsky M, Lauzier F, Tardif PA, Lamontagne F, Chassé M, Stelfox HT, Kortbeek J, Lessard-Bonaventure P, Truchon C, Turgeon A, Cheng V, Inaba K, Foran C, Warriner Z, Trust MD, Clark D, Demetriades D, Levesque K, Lampron J, Nathens A, Tien H, Luz LTD, Jing R, McFarlan A, Liu M, Sander B, Fowler R, Rizoli S, Ferrada P, Murthi S, Nirula R, Edwards S, Cantrell E, Han J, Haase D, Singleton A, Birkas Y, Casola G, Coimbra R, Condron M, Schreiber M, Azarow K, Hamilton N, Long W, Maxwell B, Jafri M, Whitman L, Wilson H, Wong H, Grushka J, Razek T, Fata P, Deckelbaum D, Kawaja K, Beckett A, Razek T, Deckelbaum D, Grushka J, Fata P, Beckett A, Lund M, Leeper R, Conn LG, Strauss R, Haas B, Beckett A, Nathens A, Tien H, Callum J, Luz LTD, Higgins S, Coles J, Erdogan M, Coles J, Higgins S, Erdogan M, Erdogan M, Kureshi N, Fenerty L, Thibault-Halman G, Walling S, Clarke DB, Vis C, Nosworthy S, Razek T, Boulanger N, Deckelbaum D, Grushka J, Fata P, Beckett A, Khwaja K, Schellenberg M, Inaba K, Warriner Z, Trust MD, Matsushima K, Lam L, Demetriades D, Lakha N, Wong H, McLauchlin L, Ashe CS, Logie SA, Lenton-Brym T, Rosenfield D, McDowall D, Wales P, Principi T, Mis J, Kaminsky M, Bokhari F, Rahbar E, Cotton B, Bryan P, MacGillivray S, Thompson G, Wishart I, Hameed M, Joos E, Evans D, Garraway N, Dawe P, Wild J, Widom K, Torres D, Blansfield J, Shabahang M, Dove J, Fluck M, Hameed M, Roux L, Nicol A, Schulenberg L, Fredericks C, Messer T, Starr F, Dennis A, Bokhari F, Kaminsky M, Teixeira P, Coopwood B, Aydelotte J, Cardenas T, Ali S, Brown C, Dawe P, Fredericks C, Matta LD, Messer T, Starr F, Dennis A, Kaminsky M, Bokhari F, Jiang HY, Yoon J, Kim M, Widder S, Hameed M, Wray C, Agarwal A, Harvin J. 2019 Trauma Association of Canada Annual Scientific Meeting Abstracts. Can J Surg 2019; 62:S3-S35. [PMID: 31091053 DOI: 10.1503/cjs.008619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Makar M, Worple E, Dove J, Hunsinger M, Arora T, Oxenberg J, Blansfield JA. Disparities in Care: Impact of Socioeconomic Factors on Pancreatic Surgery: Exploring the National Cancer Database. Am Surg 2019; 85:327-334. [PMID: 31043190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Studies have shown high-volume institutions have decreased mortality and increased survival for pancreatectomy. However, not all patients can travel to high-volume centers. Socioeconomic factors may influence treatment decisions. The goal of this study is to examine socioeconomic factors that determine where a patient is treated and how that location affects outcome. This is a retrospective study of the National Cancer Database of patients diagnosed with pancreatic cancer from 2004 to 2014. The primary outcome was to examine socioeconomic factors that predicted where a patient underwent their pancreatectomy. Patients treated at academic programs (APs) had to travel a mean distance of 80.9 miles, whereas patients treated at community programs (CPs) had to travel 31.7 miles (P < 0.0001). Spanish and Hispanic patients were less likely to travel to an AP (69% had surgery at an AP versus 76% of non-Hispanic patients, P < 0.001). Patients with higher comorbidities were also more likely to have care at CPs. Patients who had pancreatic cancer surgery at CPs were more likely to be Hispanic or with higher medical comorbidities. Those who had surgery at AP traveled further distances but had better perioperative outcomes and had an improvement in overall survival.
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Makar M, Worple E, Dove J, Hunsinger M, Arora T, Oxenberg J, Blansfield JA. Disparities in Care: Impact of Socioeconomic Factors on Pancreatic Surgery: Exploring the National Cancer Database. Am Surg 2019. [DOI: 10.1177/000313481908500420] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Studies have shown high-volume institutions have decreased mortality and increased survival for pancreatectomy. However, not all patients can travel to high-volume centers. Socioeconomic factors may influence treatment decisions. The goal of this study is to examine socioeconomic factors that determine where a patient is treated and how that location affects outcome. This is a retrospective study of the National Cancer Database of patients diagnosed with pancreatic cancer from 2004 to 2014. The primary outcome was to examine socioeconomic factors that predicted where a patient underwent their pancreatectomy. Patients treated at academic programs (APs) had to travel a mean distance of 80.9 miles, whereas patients treated at community programs (CPs) had to travel 31.7 miles ( P < 0.0001). Spanish and Hispanic patients were less likely to travel to an AP (69% had surgery at an AP versus 76% of non-Hispanic patients, P < 0.001). Patients with higher comorbidities were also more likely to have care at CPs. Patients who had pancreatic cancer surgery at CPs were more likely to be Hispanic or with higher medical comorbidities. Those who had surgery at AP traveled further distances but had better perioperative outcomes and had an improvement in overall survival.
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Affiliation(s)
- Michael Makar
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania and
| | - Ericha Worple
- Section of Surgical Oncology, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- Section of Surgical Oncology, Geisinger Medical Center, Danville, Pennsylvania
| | - Marie Hunsinger
- Section of Surgical Oncology, Geisinger Medical Center, Danville, Pennsylvania
| | - Tania Arora
- Section of Surgical Oncology, Geisinger Medical Center, Danville, Pennsylvania
| | - Jacqueline Oxenberg
- Section of Surgical Oncology, Geisinger Medical Center, Danville, Pennsylvania
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Dudash MJ, Slipak S, Dove J, Hunsinger M, Wild J, Shabahang M, Arora TK, Blansfield JA. Lymph Node Harvest as a Measure of Quality and Effect on Overall Survival in Esophageal Cancer: A National Cancer Database Assessment. Am Surg 2019; 85:201-205. [PMID: 30819299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Surgical therapy for esophageal cancer is the cornerstone of treatment, and the highest quality operation should lead to the highest cure rate. Evaluated lymph node (ELN) count is one quality measure that has been championed. The objective of this study was to explore ELN in esophagectomy, examine predictors of harvesting ≥12 nodes, and determine whether higher ELN improves overall survival (OS). ELN was examined in patients with resected esophageal cancer using the National Cancer Database from 2004 to 2013. In this study, 41,746 patients met the inclusion criteria. Fifty-two per cent of patients had 12 or more nodes harvested. Academic programs were most likely to harvest ≥12 nodes (58% of cases) compared with other programs (43-56% of cases). Seventy per cent of cases with ≥12 nodes harvested were performed at high-volume centers. Preoperative radiation or preoperative chemoradiation led to lower ELN (46% and 48%) versus preoperative chemotherapy alone (66%). Multivariate analysis showed that patients who had ≥12 nodes removed had better OS (Hazard Ratio 0.843 [95 confidence interval 0.820-0.867]). In addition, care at a high-volume facility, care at an academic facility, private insurance, and income ≥$63,000 were all associated with improved OS. Higher ELN count is associated with OS in patients with esophageal cancer. Patients who receive care at high-volume centers and academic centers are more likely to undergo more extensive lymphadenectomy. All centers should strive to examine at least 12 nodes to provide a quality esophagectomy.
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Dudash MJ, Slipak S, Dove J, Hunsinger M, Wild J, Shabahang M, Arora TK, Blansfield JA. Lymph Node Harvest as a Measure of Quality and Effect on Overall Survival in Esophageal Cancer: A National Cancer Database Assessment. Am Surg 2019. [DOI: 10.1177/000313481908500229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Surgical therapy for esophageal cancer is the cornerstone of treatment, and the highest quality operation should lead to the highest cure rate. Evaluated lymph node (ELN) count is one quality measure that has been championed. The objective of this study was to explore ELN in esophagectomy, examine predictors of harvesting ≥12 nodes, and determine whether higher ELN improves overall survival (OS). ELN was examined in patients with resected esophageal cancer using the National Cancer Database from 2004 to 2013. In this study, 41,746 patients met the inclusion criteria. Fifty-two per cent of patients had 12 or more nodes harvested. Academic programs were most likely to harvest ≥12 nodes (58% of cases) compared with other programs (43–56% of cases). Seventy per cent of cases with ≥12 nodes harvested were performed at high-volume centers. Preoperative radiation or preoperative chemoradiation led to lower ELN (46% and 48%) versus preoperative chemotherapy alone (66%). Multivariate analysis showed that patients who had ≥12 nodes removed had better OS (Hazard Ratio 0.843 [95 confidence interval 0.820–0.867]). In addition, care at a high-volume facility, care at an academic facility, private insurance, and income ≥$63,000 were all associated with improved OS. Higher ELN count is associated with OS in patients with esophageal cancer. Patients who receive care at high-volume centers and academic centers are more likely to undergo more extensive lymphadenectomy. All centers should strive to examine at least 12 nodes to provide a quality esophagectomy.
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Affiliation(s)
- Mark J. Dudash
- From the Geisinger Medical Center, Danville, Pennsylvania
| | - Sasha Slipak
- From the Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- From the Geisinger Medical Center, Danville, Pennsylvania
| | | | - Jeffrey Wild
- From the Geisinger Medical Center, Danville, Pennsylvania
| | | | - Tania K. Arora
- From the Geisinger Medical Center, Danville, Pennsylvania
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Malekpour M, Widom K, Dove J, Blansfield J, Shabahang M, Torres D, Wild JL. Management of computed tomography scan detected hemothorax in blunt chest trauma: What computed tomography scan measurements say? World J Radiol 2018; 10:184-189. [PMID: 30631406 PMCID: PMC6323492 DOI: 10.4329/wjr.v10.i12.184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/17/2018] [Accepted: 10/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the hemothorax size for which tube thoracostomy is necessary.
METHODS Over a 5-year period, we included all patients who were admitted with blunt chest trauma to our level 1 trauma center. Focus was placed on identifying the hemothorax size requiring tube thoracostomy.
RESULTS A total number of 274 hemothoraces were studied. All patients with hemothoraces measuring above 3 cm received a chest tube. The 50% predicted probability of tube thoracostomy was 2 cm. Pneumothorax was associated with odds of receiving tube thoracostomy for hemothoraces below 2 cm (Odds Ratio: 4.967, 95%CI: 2.225-11.097, P < 0.0001).
CONCLUSION All patients with a hemothorax size greater than 3% underwent tube thoracostomy. Prospective studies are warranted to elucidate the clinical outcome of patients with smaller hemothoraces.
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Affiliation(s)
- Mahdi Malekpour
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Kenneth Widom
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - James Dove
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Joseph Blansfield
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Mohsen Shabahang
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Denise Torres
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Jeffrey L Wild
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
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Francomacaro LM, Walker C, Jaap K, Dove J, Hunsinger M, Widom K, Torres D, Shabahang M, Blansfield J, Wild J. Sarcopenia predicts poor outcomes in urgent exploratory laparotomy. Am J Surg 2018; 216:1107-1113. [DOI: 10.1016/j.amjsurg.2018.10.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 10/08/2018] [Accepted: 10/24/2018] [Indexed: 01/06/2023]
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Prasad J, Petrosky JA, Kuhn J, Cunningham R, Wood C, Dove J, Fluck M, David PM, Gabrielsen J, Still CD, Petrick A. Why are Bariatric Medicare Patients Younger than 65 Disabled and Does Disability Impact Safety? Surg Obes Relat Dis 2018. [DOI: 10.1016/j.soard.2018.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McGraw TL, Horsley RD, Prasad J, Petrosky J, Dove J, Fluck M, Petrick A. Revisiting COI: A Comparison of Public Open Payments Data and Financial Disclosures for Obesity Week 2016. Surg Obes Relat Dis 2018. [DOI: 10.1016/j.soard.2018.09.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Carman K, Gretschel A, Frank R, Dove J, Bannon JP, Protyniak B, Erchinger T, Chu K, Oxenberg J. Improvement in Pathology Lymph Node Harvesting Guideline Adherence for Colorectal Cancer. Am Surg 2018. [DOI: 10.1177/000313481808400804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kelly Carman
- Geisinger Health System Wilkes Barre, Pennsylvania
| | | | - Renee Frank
- Geisinger Health System Wilkes Barre, Pennsylvania
| | - James Dove
- Geisinger Health System Wilkes Barre, Pennsylvania
| | | | | | | | - Kyo Chu
- Geisinger Health System Wilkes Barre, Pennsylvania
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Carman K, Gretschel A, Frank R, Dove J, Bannon JP, Protyniak B, Erchinger T, Chu K, Oxenberg J. Improvement in Pathology Lymph Node Harvesting Guideline Adherence for Colorectal Cancer. Am Surg 2018; 84:e279-e281. [PMID: 30841999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Petrick A, Brindle SA, Vogels E, Dove J, Parker D, Gabrielsen J. The readmission contradiction: toward clarifying common misconceptions about bariatric readmissions and quality improvement. Surg Obes Relat Dis 2018; 14:1026-1032. [PMID: 29730162 DOI: 10.1016/j.soard.2018.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/09/2018] [Accepted: 02/17/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Efforts to improve quality in U.S. medicine have included reimbursement penalties for readmissions. OBJECTIVES This study's first phase measured readmissions after initial bariatric surgery and analyzed surgical outcomes secondarily. The second phase aimed to identify nonclinical factors associated with bariatric readmissions. SETTING Rural U.S. academic hospital. METHODS This retrospective study analyzed a prospective database of patients undergoing initial Roux-en-Y gastric bypass or sleeve gastrectomy between May 1, 2007 and April 30, 2015. Phase I included readmission data as well as demographic and surgical outcomes data. Phase II focused on "nonclinical" data from readmitted patients including payor status (Medicare, Medicaid, Commercial, Geisinger Health Plan), distance from home to the index hospital, and utilization of a transfer center. RESULTS A total of 2275 patients were studied; 5.5% were readmitted. Of remissions, 48% were preventable and were most often associated with nausea, vomiting, and dehydration (gastrointestinal). Nonpreventable readmissions were significantly associated with major complications. No significant difference was found in overall or preventable readmission rates by payor. Distance from index hospital was not significantly associated with readmissions; however, 28% of readmitted patients were transferred from other healthcare facilities. CONCLUSIONS Payor status was not associated with increased risk for readmissions. Nearly half of all bariatric readmissions were preventable, identifying a quality improvement opportunity. However, 28% came through a transfer center, resulting in both better treatment and patient capture rates. Such quality improvement initiatives paradoxically risk increased reimbursement penalties.
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Affiliation(s)
- Anthony Petrick
- Surgical Institute, Division of Bariatric and Foregut Surgery, Geisinger Medical Center, Danville, Pennsylvania.
| | - Shannon A Brindle
- Surgical Institute, Division of Bariatric and Foregut Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | | | - James Dove
- Surgical Institute, Division of Bariatric and Foregut Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - David Parker
- Surgical Institute, Division of Bariatric and Foregut Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jon Gabrielsen
- Surgical Institute, Division of Bariatric and Foregut Surgery, Geisinger Medical Center, Danville, Pennsylvania
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An F, Balantekin A, Band H, Bishai M, Blyth S, Cao D, Cao G, Cao J, Chan Y, Chang J, Chang Y, Chen H, Chen S, Chen Y, Chen Y, Cheng J, Cheng Z, Cherwinka J, Chu M, Chukanov A, Cummings J, Ding Y, Diwan M, Dolgareva M, Dove J, Dwyer D, Edwards W, Gill R, Gonchar M, Gong G, Gong H, Grassi M, Gu W, Guo L, Guo X, Guo Y, Guo Z, Hackenburg R, Hans S, He M, Heeger K, Heng Y, Higuera A, Hsiung Y, Hu B, Hu T, Huang H, Huang X, Huang Y, Huber P, Huo W, Hussain G, Jaffe D, Jen K, Ji X, Ji X, Jiao J, Johnson R, Jones D, Kang L, Kettell S, Khan A, Koerner L, Kohn S, Kramer M, Kwok M, Langford T, Lau K, Lebanowski L, Lee J, Lee J, Lei R, Leitner R, Leung J, Li C, Li D, Li F, Li G, Li Q, Li S, Li S, Li W, Li X, Li X, Li Y, Li Z, Liang H, Lin C, Lin G, Lin S, Lin S, Lin YC, Ling J, Link J, Littenberg L, Littlejohn B, Liu J, Liu J, Loh C, Lu C, Lu H, Lu J, Luk K, Ma X, Ma X, Ma Y, Malyshkin Y, Martinez Caicedo D, McDonald K, McKeown R, Mitchell I, Nakajima Y, Napolitano J, Naumov D, Naumova E, Ochoa-Ricoux J, Olshevskiy A, Pan HR, Park J, Patton S, Pec V, Peng J, Pinsky L, Pun C, Qi F, Qi M, Qian X, Qiu R, Raper N, Ren J, Rosero R, Roskovec B, Ruan X, Steiner H, Sun J, Tang W, Taychenachev D, Treskov K, Tsang K, Tse WH, Tull C, Viaux N, Viren B, Vorobel V, Wang C, Wang M, Wang N, Wang R, Wang W, Wang X, Wang Y, Wang Z, Wang Z, Wang Z, Wei H, Wen L, Whisnant K, White C, Wise T, Wong H, Wong S, Worcester E, Wu CH, Wu Q, Wu W, Xia D, Xia J, Xing Z, Xu J, Xu Y, Xue T, Yang C, Yang H, Yang L, Yang M, Yang M, Yang Y, Ye M, Ye Z, Yeh M, Young B, Yu Z, Zeng S, Zhan L, Zhang C, Zhang C, Zhang H, Zhang J, Zhang Q, Zhang R, Zhang X, Zhang Y, Zhang Y, Zhang Y, Zhang Z, Zhang Z, Zhang Z, Zhao J, Zhou L, Zhuang H, Zou J. Cosmogenic neutron production at Daya Bay. Int J Clin Exp Med 2018. [DOI: 10.1103/physrevd.97.052009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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