Concomitant Vascular Reconstruction During Pancreatectomy for Malignant Disease: A Propensity Score-Adjusted, Population-Based Trend Analysis Involving 10 206 Patients

OBJECTIVE To assess trends in the frequency of concomitant vascular reconstructions (VRs) from 2000 through 2009 among patients who underwent pancreatectomy, as well as to compare the short-term outcomes between patients who underwent pancreatic resection with and without VR. DESIGN Single-center series have been conducted to evaluate the short-term and long-term outcomes of VR during pancreatic resection. However, its effectiveness from a population-based perspective is still unknown. Unadjusted, multivariable, and propensity score-adjusted generalized linear models were performed. SETTING Nationwide Inpatient Sample from 2000 through 2009. PATIENTS A total of 10 206 patients were involved. MAIN OUTCOME MEASURES Incidence of VR during pancreatic resection, perioperative in-hospital complications, and length of hospital stay. RESULTS Overall, 10 206 patients were included in this analysis. Of these, 412 patients (4.0%) underwent VR, with the rate increasing from 0.7% in 2000 to 6.0% in 2009 (P < .001). Patients who underwent pancreatic resection with VR were at a higher risk for intraoperative (propensity score-adjusted odds ratio, 1.94; P = .001) and postoperative (propensity score-adjusted odds ratio, 1.36; P = .008) complications, while the mortality and median length of hospital stay were similar to those of patients without VR. Among the 25% of hospitals with the highest surgical volume, patients who underwent pancreatic surgery with VR had significantly higher rates of postoperative complications and mortality than patients without VR. CONCLUSIONS The frequency of VR during pancreatic surgery is increasing in the United States. In contrast with most single-center analyses, this population-based study demonstrated that patients who underwent VR during pancreatic surgery had higher rates of adverse postoperative outcomes than their counterparts who underwent pancreatic resection only. Prospective studies incorporating long-term outcomes are warranted to further define which patients benefit from VR.

The High School Transition: A Step Ahead or a Downward Trend

This research was recorded to discourage the placement of 7th and 8th graders into the Anaconda High School, because it was thought that the earlier transition to the high school environment causes poor and illegal decisions to be made as well causing a decrease in the responsibility of students. The research was conducted using the survey research method, and the surveys that were dispersed to the 7th grade through sophomore classes took all possible ethical concerns into consideration. The data collected showed significant increases in the consumption of both alcohol and marijuana after students had made the transition into high school, as well as decreases in student’s levels of responsibility if a substance was being abused.

Application and Development Trend of Integrated Supply Chain in China

Importing integrated supply chains have changed Chinese logistic from simplex freight to the process of product of production、circulation and consumption of logistic system. Different modal of integrated supply chain apply in the different companies, bring activity and efficiency integrated supply chain in China. The trend of Chinese integrated supply chain in the future will stress on e-commerce and customer service, and combined Chinese own logistic system to enlarge Chinese logistic, which will more international and world wild.

Explaining the Long-Term Trend in Violent Crime: A Heuristic Scheme and Some Methodological Considerations

There has been a discontinuous but fairly persistent long-term decline in homicide rates in core European countries since about 1500. Since the 1950s, however, we observe an upward trend in violent crime not only in Europe but in almost all of the economically advanced nations that combine democratic political structures with free-market economies. The paper presents an explanatory scheme designed to account for both, the long decline and its apparent reversal. The theoretical model draws heavily upon ideas taken from the sociological work of Emile Durkheim and Norbert Elias—with some modifications and extensions. It seeks to integrate sociological and historical perspectives and to give due weight to both, structural and developmental forces. A key hypothesis is that the pacifying effects of the erosion of traditional collectivism can only be maintained to the extent by which “cooperative individualism” dominates over against the forces of “disintegrative individualism.” Some suggestions are made concerning the selection of appropriate indicators and the handling of methodological problems related to causal attribution.

On trend estimation under monotone Gaussian subordination with long-memory: application to fossil pollen series

Fossil pollen data from stratigraphic cores are irregularly spaced in time due to non-linear age-depth relations. Moreover, their marginal distributions may vary over time. We address these features in a nonparametric regression model with errors that are monotone transformations of a latent continuous-time Gaussian process Z(T). Although Z(T) is unobserved, due to monotonicity, under suitable regularity conditions, it can be recovered facilitating further computations such as estimation of the long-memory parameter and the Hermite coefficients. The estimation of Z(T) itself involves estimation of the marginal distribution function of the regression errors. These issues are considered in proposing a plug-in algorithm for optimal bandwidth selection and construction of confidence bands for the trend function. Some high-resolution time series of pollen records from Lago di Origlio in Switzerland, which go back ca. 20,000 years are used to illustrate the methods.