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Nasseri YY, La KHT, Oka K, Solis-Pazmino P, Smiley A, Langenfeld S, Cohen J, Barnajian M. Racial disparities in access to minimally invasive proctectomy for rectal cancer-a National Surgical Quality Improvement Program study. Colorectal Dis 2024. [PMID: 38702908 DOI: 10.1111/codi.16994] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/24/2023] [Accepted: 03/25/2024] [Indexed: 05/06/2024]
Abstract
AIM The aim of this work was to determine racial disparities in access to minimally invasive proctectomy using a national database. METHOD A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program evaluated for surgical approach (robotic, laparoscopic or open), demographics and comorbidity, and then compared by race. RESULTS A total of 3511 patients (325 Asian, 2925 White, 261 African American/Black) with cancer who underwent a proctectomy between 2016 and 2020 were included. Both Asians and Whites had significantly higher rates of laparoscopic proctectomy relative to African Americans (38.5%, 33.8% and 28.7%, respectively; p = 0.0001). Asians had the highest rate of robotic proctectomy (38.2%, p = 0.0001). Conversely, Black patients had significantly higher rates of open proctectomy followed by Whites and then Asians (42.1%, 35.4% and 23.4%, respectively; p = 0.0001). In multivariable logistic regression with backward elimination, African Americans were 0.7 times as likely to undergo laparoscopic proctectomy and 1.4 times more likely to undergo open proctectomy than Whites (p = 0.043). Compared with Whites, Asians were 1.8, 1.7 and 1.9 times more likely to undergo minimally invasive, laparoscopic proctectomy and robotic proctectomy, respectively (p = 0.0001, p = 0.001, p = 0.0001). CONCLUSION Asians had the highest rate of laparoscopic and robotic proctectomy, while Blacks had the highest rate of open proctectomy. African Americans were least likely to undergo laparoscopic proctectomy compared with all races. Race is an independent risk factor for access to minimally invasive proctectomy.
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Affiliation(s)
- Yosef Y Nasseri
- Cedars-Sinai Medical Center, Los Angeles, California, USA
- Surgery Group of LA, Los Angeles, California, USA
| | | | - Kimberly Oka
- Surgery Group of LA, Los Angeles, California, USA
| | | | - Abbas Smiley
- Westchester Medical Center Health Network, Valhalla, New York, USA
| | | | - Jason Cohen
- Cedars-Sinai Medical Center, Los Angeles, California, USA
- Surgery Group of LA, Los Angeles, California, USA
| | - Moshe Barnajian
- Cedars-Sinai Medical Center, Los Angeles, California, USA
- Surgery Group of LA, Los Angeles, California, USA
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Mandolfo NR, Berger AM, Struwe L, Hanna KM, Goldner W, Klute K, Langenfeld S, Hammer M. Glycemic Variability Within 1 Year Following Surgery for Stage II-III Colon Cancer. Biol Res Nurs 2022; 24:64-74. [PMID: 34610762 PMCID: PMC9248290 DOI: 10.1177/10998004211035184] [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: 01/03/2023]
Abstract
OBJECTIVE To examine glycemic variability within 1 month and 1 year following surgery among adult patients, with and without Type 2 Diabetes (T2D), treated for stage II-III colon cancer. METHOD A retrospective analysis of electronic health record data was conducted. Glycemic variability (i.e., standard deviation [SD] and coefficient of variation [CV] of > 2 blood glucose measures) was assessed within 1 month and within 1 year following colon surgery. Chi-square (χ2), Fisher's exact, and Mann-Whitney U tests were used for the analyses. RESULTS Among the sample of 165 patients with stage II-III colon cancer, those with T2D had higher glycemic variability compared to patients without T2D (p < .001), with values within 1 month following surgery (SD = 44.69 mg/dL, CV = 27.4%) vs (SD = 20.55 mg/dL, CV = 17.53%); and within 1 year following surgery (SD = 45.04 mg/dL, CV = 29.04%) vs (SD = 21.36 mg/dL, CV = 18.6%). Associations were found between lower body mass index and higher glycemic variability (i.e., SD [r = -.413, p < .05] and CV [r = -.481, p < .01]) within 1 month following surgery in patients with T2D. Higher preoperative glucose was associated with higher glycemic variability (i.e., SD r = .448, p < .01) within 1 year in patients with T2D. Demographic and clinical characteristics were weakly associated with glycemic variability in patients without T2D. CONCLUSIONS Patients with stage II-III colon cancer with T2D experienced higher glycemic variability within 1 month and within 1 year following surgery compared to those without T2D. Associations between glycemic variability and demographic and clinical characteristics differed by T2D status. Further research in prospective studies is warranted.
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Affiliation(s)
- Natalie Rasmussen Mandolfo
- College of Nursing, Nebraska Medical
Center, University of Nebraska Medical Center, Omaha, NE, USA,Natalie Rasmussen Mandolfo, PhD, APRN-NP,
AOCN, University of Nebraska Medical Center, 985330 Nebraska Medical Center,
Omaha, NE 68198, USA. Emails: ;
| | - Ann M. Berger
- College of Nursing, Nebraska Medical
Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Leeza Struwe
- College of Nursing, Nebraska Medical
Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kathleen M. Hanna
- College of Nursing, Nebraska Medical
Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Whitney Goldner
- Department of Internal Medicine,
Section of Diabetes, Nebraska Medical Center, University of Nebraska Medical Center,
Omaha, NE, USA
| | - Kelsey Klute
- Department of Internal Medicine,
Division of Oncology & Hematology, Nebraska Medical Center, University of
Nebraska Medical Center, Omaha, NE, USA
| | - Sean Langenfeld
- Department of Surgery, Nebraska Medical
Center, University of Nebraska Medical Center, Omaha, NE, USA
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Langenfeld S, Thomas P, Morin O, Rempe G. Quantum Repeater Node Demonstrating Unconditionally Secure Key Distribution. Phys Rev Lett 2021; 126:230506. [PMID: 34170169 DOI: 10.1103/physrevlett.126.230506] [Citation(s) in RCA: 3] [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: 12/23/2020] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
Long-distance quantum communication requires quantum repeaters to overcome photon loss in optical fibers. Here we demonstrate a repeater node with two memory atoms in an optical cavity. Both atoms are individually and repeatedly entangled with photons that are distributed until each communication partner has independently received one of them. An atomic Bell-state measurement followed by classical communication serves to establish a key. We demonstrate scaling advantage of the key rate, increase the effective attenuation length by a factor of 2, and beat the error-rate threshold of 11% for unconditionally secure communication, the corner stones for repeater-based quantum networks.
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Affiliation(s)
- S Langenfeld
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - P Thomas
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - O Morin
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - G Rempe
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
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Morin O, Körber M, Langenfeld S, Rempe G. Deterministic Shaping and Reshaping of Single-Photon Temporal Wave Functions. Phys Rev Lett 2019; 123:133602. [PMID: 31697544 DOI: 10.1103/physrevlett.123.133602] [Citation(s) in RCA: 5] [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: 05/29/2019] [Indexed: 06/10/2023]
Abstract
Thorough control of the optical mode of a single photon is essential for quantum information applications. We present a comprehensive experimental and theoretical study of a light-matter interface based on cavity quantum electrodynamics. We identify key parameters like the phases of the involved light fields and demonstrate absolute, flexible, and accurate control of the time-dependent complex-valued wave function of a single photon over several orders of magnitude. This capability will be an important tool for the development of distributed quantum systems with multiple components that interact via photons.
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Affiliation(s)
- O Morin
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - M Körber
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - S Langenfeld
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
| | - G Rempe
- Max-Planck-Institut für Quantenoptik, Hans-Kopfermann-Strasse 1, 85748 Garching, Germany
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Schlesinger A, Schulz R, Scholtyssek S, Langenfeld S. Pneumologisch-Geriatrisches Co-Management – Ein gemeinsamer Behandlungspfad bei Lungenerkrankungen bei multimorbiden Patienten. Pneumologie 2017. [DOI: 10.1055/s-0037-1598579] [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: 10/20/2022]
Affiliation(s)
- A Schlesinger
- Abtl. Innere Medizin, Pneumologie, Lungenklinik Köln-Nord, St. Marien Hospital Köln
| | - R Schulz
- Klinik für Geriatrie, St. Marien Hospital Köln
| | - S Scholtyssek
- Abtl. Innere Medizin, Pneumologie, Lungenklinik Köln-Nord, St. Marien Hospital Köln
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Abstract
Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.
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Affiliation(s)
- Paul J. Schenarts
- Department of Surgery, University of Nebraska, College of Medicine, Omaha, Nebraska
| | - Sean Langenfeld
- Department of Surgery, University of Nebraska, College of Medicine, Omaha, Nebraska
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Schenarts PJ, Langenfeld S. The Fundamentals of Resident Dismissal. Am Surg 2017; 83:119-126. [PMID: 28228197] [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: 06/06/2023]
Abstract
Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.
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Schulz RJ, Langenfeld S, Wendel J. P-319: Risk management for patients with Clostridium difficile in geriatric departments. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30416-2] [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: 10/23/2022]
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Gleason H, Hobart M, Bradley L, Landers J, Langenfeld S, Tonelli M, Kolodziej M. Gender differences of mental health consumers accessing integrated primary and behavioral care. PSYCHOL HEALTH MED 2013; 19:146-52. [DOI: 10.1080/13548506.2013.793371] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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