bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrospinal fluid GAP-43 in early multiple sclerosis
Authors: Rot U , Sandelius Å , Emeršič A , Zetterberg H , Blennow K 
Published: August 2018

Background/Objective Novel biomarkers identifying and predicting disease activity in multiple sclerosis (MS) would be valuable for primary diagnosis and as outcome measures for monitoring therapeutic effects in clinical trials. Axonal loss is present from the earliest stages of MS and correlates with disability measures. Growth-associated protein 43 (GAP-43) is a presynaptic protein with induced expression during axonal growth. We hypothesized this protein could serve as a biomarker of axonal regeneration capacity in MS. Methods We developed a novel GAP-43 enzyme-linked immunosorbent assay for quantification in cerebrospinal fluid (CSF) and measured GAP-43 levels in 71 patients with clinically isolated syndrome, 139 MS patients and 51 controls. Results GAP-43 concentrations were similar in patients and controls. Nevertheless, GAP-43 levels were higher in patients with >10 T2-magnetic resonance imaging (MRI) lesions ( p = 0.005). CSF GAP-43 concentrations correlated with CSF mononuclear cell counts ( p = 0.031) and were inversely correlated with patient age ( p = 0.038) with a trend for higher CSF GAP-43 concentrations in patients with gadolinium-enhancing MRI lesions and positive CSF oligoclonal immunoglobulin G status. Conclusion Our results suggest that axonal regeneration capacity is relatively preserved in early MS. CSF GAP-43 concentration is positively associated with markers of inflammation, suggesting possible inflammatory-driven expression of this growth-associated protein in early MS.
Contemporary Opinions on Intraoperative Facial Nerve Monitoring
Authors: Gidley Paul W. , Maw Jennifer , Gantz Bruce , Kaylie David , Lambert Paul , Malekzadeh Sonya , Chandrasekhar Sujana S. 
Published: August 2018

ObjectiveTo examine the current trend in intraoperative facial nerve monitoring (IOFNM) training, performance, and reimbursement by subspecialists.Study DesignCross‐sectional survey of the American Neurotology Society, American Otological Society, American Society of Pediatric Otolaryngology, and program directors of otolaryngology–head and neck surgery programs accredited by the Accreditation Council on Graduate Medical Education.SettingAmerican Academy of Otolaryngology–Head and Neck Surgery Intraoperative Nerve Monitoring Task Force.Subjects and MethodsThe task force developed 2 surveys, which were implemented through Surveymonkey.com: (1) a 10‐question survey sent to 1506 members of the societies listed to determine IOFNM practice and reimbursement patterns and (2) a 10‐question survey sent to the 107 accredited US otolaryngology residency program directors to examine the state of resident training on facial nerve monitoring.ResultsResponse rates were 18% for practicing physicians and 15% for residency program directors. The majority agreed that IOFNM was indicated for most otologic and neurotologic procedures. In addition to facial nerve monitoring, facial nerve stimulation was used in complex skull base and temporal bone procedures. When queried about reimbursement by Medicare, only 4.4% of surgeons responded that they received reimbursement. Program directors indicated universal exposure of residents to IOFNM, with 61% of programs giving residents formal training.ConclusionsIOFNM is widely used among otologists and neurotologists in the United States. The majority of residents receive formal training, and all residents are exposed to the setup, use, monitoring, and troubleshooting of the device. Reimbursement for IOFNM is reported by a paucity of those surveyed.
The Economic Burden of Affective Disorders
Authors: Rice Dorothy P. , Miller Leonard S. 
Published: August 2018

Background. This paper summarises the methods and sources of data used to estimate costs of affective disorders and presents the results.Method. A timing model employing regression analysis was developed to estimate morbidity costs. This model measures the lifetime effect on current income of individuals with affective disorders, taking into account the timing of onset and the duration of these disorders.Results. Affective disorders imposed an estimated US$20.8 billion burden in 1985 and US$30.4 billion in 1990 in the US. Affective disorders represent 21 % of the costs of all mental illnesses. Direct treatment costs comprised 58.4% of the total in 1985; morbidity costs, 8.1%; mortality costs, the present value of future earnings lost due to premature mortality, 28.9%, based on a 6% discount rate; and other related costs, including the cost of crime, lost productivity due to incarceration, and caregiver services, 4.6%. Private sources account for 49% of the total direct expenditures for treatment of persons with affective disorders; state and local funds, 26%; and federal funds, 25%.Conclusion. In light of the high burden of affective disorders on societal resources, more attention should be directed at comprehensive, research-based strategies to reduce the prevalence of these disorders in the United States.
The Person with Delusions
Authors: Strauss John S. 
Published: August 2018

“And the end of our exploring Will be to arrive where we started And know the place for the first time.” (Eliot, 1952, p. 145)In preparing this report I made the mistake of looking back in the literature, the literature not only of delusions, but also including some more general works of the earlier clinical writers, such as Birnbaum (1923), Conrad (1958), Jaspers (1963) and Kretschmer (1927). It was a humbling experience; these were obviously people who knew something about patients and about the realities of symptoms. For these writers, notions such as delusions were not just abstractions, not even just abstractions with operational definitions. These authors described real experiences of people, and their descriptions reflect the importance of studying patients from close clinical contact.
Fluoxetine vs Amitriptyline in the Treatment of Depressed Out-patients
Authors: Laakmann G. , Blaschke D. , Engel R. , Schwarz A. 
Published: August 2018

As a result of research in recent years, therapeutic possibilities for the treatment of depressive illnesses have been significantly expanded. Monoamine oxidase inhibitors and selective noradrenaline (e.g. oxaprotiline) or serotonin-reuptake inhibiting (e.g. fluoxetine, fluvoxamine) substances have been added to the classical tricyclic antidepressants, whose mode of action is primarily based upon combined noradrenaline and serotonin reuptake inhibition. Furthermore, the extent to which benzodiazepine derivatives or neuroleptics can be successfully used at low dosages for the treatment of depressive illness is currently being investigated.For these compounds to be used in an individualised manner, however, agreed diagnostic criteria must be taken into consideration, as well as other factors such as the severity and type of depressive syndrome (mild, marked, or severe, retarded or agitated). For example, the benzodiazepine derivative alprazolam has a therapeutic efficacy comparable to amitriptyline for the treatment of milder depressive syndromes, but is significantly less effective for a severe depressive disorder.We undertook a study of fluoxetine, a selective serotonin-reuptake inhibitor (Wong et al, 1974, 1975), in a double-blind comparison with amitriptyline. We particularly wanted to know if the efficacy of fluoxetine was comparable to that of amitriptyline, and whether fluoxetine caused less adverse effects as a result of its selectivity, which remains unchanged even after its metabolisation to desmethyl fluoxetine (Fuller et al, 1978).
Analysis of the initial treatment phase in first-episode psychosis
Authors: Power Paddy , Elkins Kathryn , Adlard Steven , Curry Christina , McGorry Patrick , Harrigan Susan 
Published: August 2018

Background The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.Method Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n=231) accepted in the programme in 1995–1996. A subsample of patients (n=120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication.Results Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic sub-scale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months.Conclusion This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.
Individual cognitive–behavioural interventions in early psychosis
Authors: Haddock Gillian , Morrison Anthony P. , Hopkins Richard , Lewis Shôn , Tarrier Nicholas 
Published: August 2018

BackgroundCognitive-behavioural treatments have previously been explored in the treatment of chronic psychotic problems, but recently, the effectiveness of these treatments has been investigated with regard to recent onset and acute psychosis.MethodThe literature relating to cognitive-behavioural treatments in psychosis is explored and the application of the approach to recent onset psychosis is described in detail.ResultsThere appears to be a growing body of evidence that the advances made in the treatment of people with chronic treatment resistant psychosis can be similarly applied to people with recent onset and acute psychosis.ConclusionsCognitive-behavioural treatments are feasible with recent onset psychotic patients although further evaluation of their effectiveness is necessary.
Stress and coping in early psychosis
Authors: MacDonald Elspeth M. , Pica Simone , McDonald Shelley , Hayes Robyn L. , Baglioni Anthony J. 
Published: August 2018

BackgroundAlthough coping with stress is important in early psychosis, little is known about how this population copes with the range of stressors they encounter in their daily life. This study aims to identify how people with early psychosis cope with a range of stressful situations and to identify what factors might influence their use of coping strategies.MethodParticipants included a clinical group of 50 people with early psychosis and a non-clinical group of 22 people matched on age and gender. Data were obtained on symptomatology and social support for the clinical group, and stress and coping, and self-efficacy for all participants.ResultsThe clinical group reported coping less well than the non-clinical group and they most commonly used emotion-focused coping. For the clinical group, effective coping correlated with less severe negative symptoms, greater perceived self-efficacy social support and greater use of problem-focused coping. Self-efficacy and social support predicted increased frequency of the use of problem-focused coping.ConclusionPeople with early psychosis who have greater feelings of self-efficacy and perceived social support, and the flexible use of problem-focused coping strategies, appear to be more likely to cope with day-to-day stressors.
Emotional management therapy in early psychosis
Authors: Hodel Bettina , Brenner Hans D. , Merlo Marco C. G. , Teuber Jeffrey F. 
Published: August 2018

Background Emotional management therapy (EMT) aims to improve handling of emotional stress in schizophrenia. It consists of two sub-programmes: the first includes relaxation techniques, the second stress coping skills.Method A pilot study of EMT in 19 patients with early psychosis produced positive results and a post-hoc study of 16 patients was commenced.Results EMT showed positive results, with chronic patients improving more than patients with early psychosis.Conclusion EMT can be effective in early psychosis, especially for cognitive functioning.
Different roles for serotonin in anti-obsessional drug action and the pathophysiology of obsessive-compulsive disorder
Authors: Delgado Pedro L. , Moreno Fransisco A. 
Published: August 2018

Background There is a major role for serotonin in the mechanism of anti-obsessional drug action. Drugs that block uptake of noradrenaline are not effective in the treatment of obsessive-compulsive disorder (OCD), while drugs that potently bock serotonin reuptake are effective. While enhancement of serotonin neurotransmission is clearly involved in the treatment of OCD, the role of serotonin in the pathophysiology of OCD is less clear.Method This paper provides a brief, focused review ofthe literature regarding treatment of OCD, the effects of drugs with selective action at various serotonin receptors and results of neurotransmitter depletion studies in patients with OCD.Results Some patients with OCD may experience remission of OCD symptoms during intoxication with psychedelic drugs that have potent 5-HT2A/2c agonist activity. These findings, coupled with results from serotonin depletion studies in depressed and OCD patients, suggest that enhancement of serotonin neurotransmission may underlie both antidepressant and anti-obsessional drug action, although the targeted brain areas may differ.Conclusions OCD may not involve a dysfunction ofthe serotonin system. Rather, it is more likely to involve a dysfunction of specific brain circuits, particularly in the frontal cortex. Modulation of these circuits by serotonin neurons may underlie the specific action of anti-obsessional drugs.
Supraspinal Fatigue and Neural-evoked Responses in Lowlanders and Sherpa at 5050 m
Authors: RUGGIERO LUCA , MCNEIL CHRIS J. 
Published: August 2018

ABSTRACT

Purpose
At high altitude, Lowlanders exhibit exacerbated fatigue and impaired performance. Conversely, Sherpa (native Highlanders) are known for their outstanding performance at altitude. Presently, there are no reports comparing neuromuscular fatigue and its etiology between Lowlanders and Sherpa at altitude.

Methods
At 5050 m, nine age-matched Lowlanders and Sherpa (31 ± 10 vs 30 ± 12 yr, respectively) completed a 4-min sustained isometric elbow flexion at 25% maximal voluntary contraction (MVC) torque. Mid-minute, stimuli were applied to the motor cortex and brachial plexus to elicit a motor-evoked potential and maximal compound muscle action potential (M
max), respectively. Supraspinal fatigue was assessed as the reduction in cortical voluntary activation (cVA) from prefatigue to postfatigue. Cerebral hemoglobin concentrations and tissue oxygenation index (TOI) were measured over the prefrontal cortex by near-infrared spectroscopy.

Results
Prefatigue, MVC torque, and cVA were significantly greater for Lowlanders than Sherpa (79.5 ± 3.6 vs 50.1 ± 11.3 N·m, and 95.4% ± 2.7% vs 88.2% ± 6.6%, respectively). With fatigue, MVC torque and cVA declined similarly for both groups (~24%–26% and ~5%–7%, respectively). During the task, motor-evoked potential area increased more and sooner for Lowlanders (1.5 min) than Sherpa (3.5 min). The M
max area was lower than baseline throughout fatigue for Lowlanders but unchanged for Sherpa. TOI increased earlier for Lowlanders (2 min) than Sherpa (4 min). Total hemoglobin increased only for Lowlanders (2 min). M
max was lower, whereas TOI and total hemoglobin were higher for Lowlanders than Sherpa during the second half of the protocol.

Conclusions
Although neither MVC torque loss nor development of supraspinal fatigue was different between groups, neural-evoked responses and cerebral oxygenation indices were less perturbed in Sherpa. This represents an advantage for maintenance of homeostasis, presumably due to bequeathed genotype and long-term altitude adaptations.
Daytime variation in hepatitis C virus replication kinetics following liver transplant
Authors: Zhuang Xiaodong , Lai Alvina G. , McKeating Jane A. , Rowe Ian , Balfe Peter 
Published: August 2018

Background: There is a growing interest in the role of circadian regulated pathways in disease pathogenesis. Methods: In a cohort of hepatitis C virus (HCV) infected patients undergoing liver transplantation, we observed differences in early viral infection kinetics of the allograft that associated with the time of liver transplant. Results: A higher frequency of subjects transplanted in the morning showed a rebound in viral RNA levels (n=4/6) during the first week post-surgery. In contrast, no viral rebound was observed in seven subjects transplanted in the afternoon. None of the other parameters previously reported to influence viral replication in the post-transplant setting, such as donor age, cold-ischemia time and length of surgery associated with viral rebound. Conclusions: These observation highlights a role for circadian processes to regulate HCV infection of the liver and warrants further investigation.
Perioperative factors and pressure ulcer development in postoperative ICU patients: a retrospective review
Authors: Kumta Neha , Coyer Fiona , David Michael 
Published: August 2018

Objective: To identify variables during surgery that may contribute to the development of pressure ulcers (PUs) in postoperative, intensive care unit (ICU) patients within 72 hours of admission, as well as over their entire ICU admission. Furthermore, to investigate how these variables may impact on the number of PUs acquired. Method: In a three-year retrospective audit, from 1 January 2014 to 31 December 2016, data from the electronic medical records of 3484 postoperative ICU patients in a major Australian metropolitan public hospital were retrieved and analysed to investigate associations between perioperative variables and PU occurrence. Results: A total of 69 ICU admissions (1.98%) out of 3484 resulted in at least one PU developing within the ICU. No specific variables were associated with the development of a PU within 72 hours of the patient's ICU admission. Multiple regression Cox analysis showed that length of time in the operating theatre (OT) (p=0.045), surgical specialty (p<0.001), 1–4 hypotensive episodes (p=0.017) and >5 hypotensive episodes (p<0.0005) were significantly associated with PU risk. Multivariable negative binomial regression demonstrated APACHE II score (p<0.01), OT time (p<0.01) and surgical specialty (p<0.01) were associated with PU number. Conclusion: There are many risks to skin integrity at the perioperative period, and these risks may exert their effect well into the ICU admission period. It is imperative to identify and mitigate these factors in order to reduce PU incidence, morbidity and mortality.
Simplifying wound dressing selection for residential aged care
Authors: Rando Tabatha , Kang Ai Choo , Guerin Michelle , Boylan Jo , Dyer Anthony 
Published: August 2018

Objective: To demonstrate the effectiveness of a simplified wound dressing regimen and develop a decision tree tool for wound management, for use by nurses in a residential aged care setting. Method: A three-phase process was used. Firstly, practice was audited, including a cost analysis of existing wound treatment. Secondly, staff were educated on wounds, wound care products and a simplified wound management protocol. In the final phase, the new wound care products and protocol used for skin tears and other wounds (as assessed by a nurse practitioner) were evaluated and ongoing education provided as required. Results: A total of 93 residents from two residential aged care facilities participated in the study. Overall, 178 wounds were identified, of which 121 were considered eligible for treatment under the new protocol. The majority of residents were aged >85 years and the major wound type was skin tears 72.7% (n=88). The mean healing time for skin tears was significantly shorter than for other wounds (19.7±14.2 days versus 30.9±25.2 days, p=0.0359). Most wounds were suitable for the simplified dressing selection regimen. Data collected from a survey of nursing staff demonstrated that the simplified protocol products were easy to apply, conformed well, were easy to remove and stayed in place. In addition, patient satisfaction was positive and removal of dressings was generally pain free. Conclusion: In summary, data collected from this project showed that the dressings were effective, performed well and simplified wound dressing selection for nursing staff.
Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking
Authors: Phan C-B. , Nguyen D-P. , Lee K. M. , Koo S. 
Published: August 2018

ObjectivesThe objective of this study was to quantify the relative movement between the articular surfaces in the tibiotalar and subtalar joints during normal walking in asymptomatic individuals.Methods3D movement data of the ankle joint complex were acquired from 18 subjects using a biplanar fluoroscopic system and 3D-to-2D registration of bone models obtained from CT images. Surface relative velocity vectors (SRVVs) of the articular surfaces of the tibiotalar and subtalar joints were calculated. The relative movement of the articulating surfaces was quantified as the mean relative speed (RS) and synchronization index (SIENT) of the SRVVs.ResultsSIENTand mean RS data showed that the tibiotalar joint exhibited translational movement throughout the stance, with a mean SIENTof 0.54 (sd 0.21). The mean RS of the tibiotalar joint during the 0% to 20% post heel-strike phase was 36.0 mm/s (sd 14.2), which was higher than for the rest of the stance period. The subtalar joint had a mean SIENTvalue of 0.43 (sd 0.21) during the stance phase and exhibited a greater degree of rotational movement than the tibiotalar joint. The mean relative speeds of the subtalar joint in early (0% to 10%) and late (80% to 90%) stance were 23.9 mm/s (sd 11.3) and 25.1 mm/s (sd 9.5), respectively, which were significantly higher than the mean RS during mid-stance (10% to 80%).ConclusionThe tibiotalar and subtalar joints exhibited significant translational and rotational movement in the initial stance, whereas only the subtalar joint exhibited significant rotational movement during the late stance. The relative movement on the articular surfaces provided deeper insight into the interactions between articular surfaces, which are unobtainable using the joint coordinate system. Cite this article: C-B. Phan, D-P. Nguyen, K. M. Lee, S. Koo. Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking. Bone Joint Res 2018;7:501–507. DOI: 10.1302/2046-3758.78.BJR-2018-0014.R1.