bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Common Thalamocortical Dysconnectivity in Four Major Psychiatric Disorders
Authors: Tu Pei-Chi , Bai Ya Mei , Li Cheng-Ta , Chen Mu-Hong , Lin Wei-Chen , Chang Wan-Chen , Su Tung-Ping 
Published: November 2018

Abstract

Background
Recent genetic and imaging analyses of large datasets suggested that common biological substrates exist across psychiatric diagnoses. Functional connectivity (FC) abnormalities of thalamocortical circuits were consistently found in patients with schizophrenia but have been less studied in other major psychiatric disorders. This study aimed to examine thalamocortical FC in 4 major psychiatric disorders to identify the common connectivity abnormalities across major psychiatric disorders.

Methods
This study recruited 100 patients with schizophrenia, 100 patients with bipolar I disorder, 88 patients with bipolar II disorder, 100 patients with major depressive disorder, and 160 healthy controls (HCs). Each participant underwent resting functional magnetic resonance imaging. The thalamus was used to derive FC maps, and group comparisons were made between each patient group and HCs using an independent-sample t test. Conjunction analysis was used to identify the common thalamocortical abnormalities among these 4 psychiatric disorders.

Results
The 4 groups of patients shared a similar pattern of thalamocortical dysconnectivity characterized by a decrease in thalamocortical FC with the dorsal anterior cingulate, anterior prefrontal cortex and inferior parietal cortex. The groups also showed an increase in FC with the postcentral gyrus, precentral gyrus, superior temporal cortex, and lateral occipital areas. Further network analysis demonstrated that the frontoparietal regions showing hypoconnectivity belonged to the salience network.

Conclusion
Our findings provide FC evidence that supports the common network hypothesis by identifying common thalamocortical dysconnectivities across 4 major psychiatric disorders. The network analysis also supports the cardinal role of salience network abnormalities in major psychiatric disorders.
Auditory and Visual Oddball Stimulus Processing Deficits in Schizophrenia and the Psychosis Risk Syndrome: Forecasting Psychosis Risk With P300
Authors: Hamilton Holly K , Woods Scott W , Roach Brian J , Llerena Katiah , McGlashan Thomas H , Srihari Vinod H , Ford Judith M , Mathalon Daniel H 
Published: November 2018

AbstractIdentification of neurophysiological abnormalities associated with schizophrenia that predate and predict psychosis onset may improve clinical prediction in the psychosis risk syndrome (PRS) and help elucidate the pathogenesis of schizophrenia. Amplitude reduction of the P300 event-related potential component reflects attention-mediated processing deficits and is among the most replicated biological findings in schizophrenia, making it a candidate biomarker of psychosis risk. The relative extent to which deficits in P300 amplitudes elicited by auditory and visual oddball stimuli precede psychosis onset during the PRS and predict transition to psychosis, however, remains unclear. Forty-three individuals meeting PRS criteria, 19 schizophrenia patients, and 43 healthy control (HC) participants completed baseline electroencephalography recording during separate auditory and visual oddball tasks. Two subcomponents of P300 were measured: P3b, elicited by infrequent target stimuli, and P3a, elicited by infrequent nontarget novel stimuli. Auditory and visual target P3b and novel P3a amplitudes were reduced in PRS and schizophrenia participants relative to HC participants. In addition, baseline auditory and visual target P3b, but not novel P3a, amplitudes were reduced in 15 PRS participants who later converted to psychosis, relative to 18 PRS non-converters who were followed for at least 22 months. Furthermore, target P3b amplitudes predicted time to psychosis onset among PRS participants. These results suggest that P300 amplitude deficits across auditory and visual modalities emerge early in the schizophrenia illness course and precede onset of full psychosis. Moreover, target P3b may represent an important neurophysiological vulnerability marker of the imminence of risk for psychosis.
Ventriculoperitoneal shunts
Authors: Vacca Vincent M. 
Published: November 2018

Abstract:
A ventriculoperitoneal shunt (VPS) is the most common type of implanted cerebrospinal fluid shunt system. Nurses may care for patients who have undergone shunt placement or revision. This article discusses the indications for VPS placement in adults, possible complications, and nursing care for patients following a shunt placement procedure.
Leadership Development in Postgraduate Medical Education: A Systematic Review of the Literature
Authors: Sultan Nabil , Torti Jacqueline , Haddara Wael , Inayat Ali , Inayat Hamza , Lingard Lorelei 
Published: November 2018

Purpose
To evaluate and interpret evidence relevant to leadership curricula in postgraduate medical education (PGME) to better understand leadership development in residency training.

Method
The authors conducted a systematic review of peer-reviewed, English-language articles from four databases published between 1980 and May 2, 2017 that describe specific interventions aimed at leadership development. They characterized the educational setting, curricular format, learner level, instructor type, pedagogical methods, conceptual leadership framework (including intervention domain), and evaluation outcomes. They used Kirkpatrick effectiveness scores and Best Evidence in Medical Education (BEME) Quality of Evidence scores to assess the quality of the interventions.

Results
Twenty-one articles met inclusion criteria. The classroom setting was the most common educational setting (described in 17 articles). Most curricula (described in 13 articles) were isolated, with all curricula ranging from three hours to five years. The most common instructor type was clinical faculty (13 articles). The most commonly used pedagogical method was small group/discussion, followed by didactic teaching (described in, respectively, 15 and 14 articles). Study authors evaluated both pre/post surveys of participant perceptions (n = 7) and just postintervention surveys (n = 10). The average Kirkpatrick Effectiveness score was 1.0. The average BEME Quality of Evidence score was 2.

Conclusions
The results revealed that interventions for developing leadership during PGME lack grounding conceptual leadership frameworks, provide poor evaluation outcomes, and focus primarily on cognitive leadership domains. Medical educators should design future leadership interventions grounded in established conceptual frameworks and pursue a comprehensive approach that includes character development and emotional intelligence.
Centro SOL: A Community–Academic Partnership to Care for Undocumented Immigrants in an Emerging Latino Area
Authors: Polk Sarah , DeCamp Lisa R. , Guerrero Vázquez Mónica , Kline Kathryn , Andrade Adriana , Cook Barbara , Cheng Tina , Page Kathleen R. 
Published: November 2018

Problem
From 2000 to 2014, the Latino population in Baltimore city, an emerging Latino settlement area, experienced rapid growth. Many of these individuals are undocumented and not eligible for coverage. Academic medical centers often lead the way in addressing the health needs of undocumented immigrants; however, examples from emerging immigrant areas are limited.

Approach
In October 2013, Johns Hopkins Medicine clinicians established the Center for Salud/Health and Opportunities for Latinos (Centro SOL) to better address the health needs of Baltimore’s growing Latino community. Centro SOL’s mission focuses on four core activities: clinical services; advocacy and community engagement efforts; pipeline/education opportunities; and research consultations. Progress is measured through a scorecard reviewed annually by Centro SOL leadership.

Outcomes
Centro SOL’s program has expanded health care access for undocumented immigrants, patient safety and quality of service/care programs for patients with limited English proficiency, and pipeline opportunities for Latino youth. In 2017, 2,763 uninsured patients received primary or specialty care and 290 people received group therapy to address stress-related conditions. In addition, 49 Latino students (ranging from high school to postgraduate students) received mentorship at Centro SOL.

Next Steps
In the next five years, Centro SOL plans to expand the pipeline for Latinos interested in health professions fields and to further improve access to health services for Latino families through both advocacy efforts and enhanced clinical services.
Is It Time to Be More Explicit About the Purpose of a Hospital Admission?
Authors: Goldszmidt Mark , Faden Lisa , Baranova Katherina 
Published: November 2018

Purpose
Patient care suffers when teaching teams fail to achieve a shared understanding of problems to be addressed during a hospital admission. In academic contexts where attending physicians take turns supervising, practice variability may contribute to undermining this shared understanding. Exploring variability around what constitutes the purpose of the hospital admission was the focus of this study.

Method
Constructivist grounded theory was used to inform data collection and analysis of this two-phase study, conducted in London and Hamilton, Ontario, Canada, in 2012. In phase 1, interviews with 24 attending physicians from 2 academic health centers were conducted. Phase 2 involved analyzing 18 audio-recorded admission case review discussions in relation to the emergent theory from phase 1. Participants for phase 2 were 7 different attendings, 7 medical students, and 5 junior residents.

Results
Three dominant perspectives around the purpose of an admission were identified. The most focused perspective characterized the purpose as making patients ready for discharge. By contrast, the most comprehensive perspective characterized admission as an opportunity to identify ways to improve overall patient health status. The third perspective was in-between—treating acute issues while monitoring pertinent chronic conditions. All attendings expressed a sense of discharge pressure but responded with different strategies. Attendings rarely explicitly discussed their perspectives as part of case review.

Conclusions
These extremes of practice and lack of overt dialogue are concerning. Potential effects include mixed messages to trainees and missed opportunities for dialogue and debate around what can and should be achieved during a hospital admission.
A Multicountry Updated Assessment of the Economic Impact of Fetal Alcohol Spectrum Disorder: Costs for Children and Adults
Authors: Greenmyer Jacob R. , Klug Marilyn G. , Kambeitz Cassondra , Popova Svetlana , Burd Larry 
Published: November 2018

Aim:To conduct a systematic review and quantitative analysis of the world literature on the economic impact of fetal alcohol spectrum disorder (FASD).Methods:A comprehensive literature review was conducted using multiple electronic databases and reference materials.Results:Thirty-two studies from 4 countries met the inclusion criteria (United States [n = 20], Canada [n = 9], Sweden [n = 2], and New Zealand [n = 1]). The studies reported the economic impact of FASD on health care, special education, residential care, criminal justice system, productivity losses due to morbidity and premature mortality, productivity losses of caregivers of children with FASD, and intangible costs. The economic estimates vary considerably due to the different methodologies used by different studies. The mean annual cost for children with FASD was estimated to be $22,810 and for adults $24,308. Residential costs for children with FASD were 4-fold greater than for adults with FASD. The costs of lost productivity for adults were 6.3-fold greater than for children.Conclusions:The data on the economic burden of FASD are scarce, and the existing estimates likely underestimate the full economic impact of this disorder on the affected individuals, their caregivers, and society. However, the current research is sufficient to demonstrate that FASD is a serious public health problem associated with tremendous economic burden.
The Best Interests of Infants and Families During Palliative Care at the End of Life
Authors: Sieg Susan E. , Bradshaw Wanda T. , Blake Stephanie 
Published: November 2018

Background:
Palliative care is an integral element of care provision in neonatal intensive care units (NICUs). Healthcare providers working in NICUs are likely to provide palliative care at some point in their career.

Purpose:
This article examines what neonatal palliative care entails, how parents perceive healthcare providers' actions, what they potentially need at the end of their infant's life, and what bereavement interventions are most supportive for parents.

Search Strategy:
We conducted a search of full-text articles published in English in PubMed and CINAHL using the following key words: “NICU bereavement care,” “end-of-life care,” “infant loss,” and “palliative care.”

Findings:
Healthcare providers should consider alleviation of the infant's pain and suffering when discussing whether to provide or continue aggressive medical interventions. The timing of these discussions is important. Parents appear to be most comforted by compassionate, caring healthcare providers who show competence and knowledge in the provision of medical/nursing and palliative care.

Implications for Practice:
Healthcare providers working in NICUs require specific training in bereavement/palliative care for infants. Families facing the death of their infant must receive support from qualified providers both during and after that death. Furthermore, the infant's quality of life must be considered when discussing withholding or withdrawing care.

Implications for Research:
There is a need for further research investigating the specific types of training required by healthcare providers in NICU settings who are providing bereavement/palliative care to neonates, in order to best support the families' needs in these situations.
Discrepancies Between Patient and Surgeon Expectations of Surgery for Sciatica
Authors: Rehman Yasir , Syed Muzammil , Wiercioch Wojtek , Rehman Nadia , Drew Brian , Cenic Aleksa , Reddy Kesava , Murty Naresh , Kucher Edward , Dunlop Brett , Guyatt Gordon H. , Busse Jason W. , Schwartz Lisa , Vanstone Meredith 
Published: November 2018

Study Design.
Qualitative study.

Objective.
The objective of this study was to compare the perceptions of patients and surgeons regarding the risks and benefits of lumbar decompressive surgery for sciatica following a consultation meeting.

Summary of Background Data.
Evidence regarding pain improvement in patients following lumbar decompressive surgery for sciatica is inconsistent. Given this inconsistency, patients choosing to undergo lumbar decompressive surgery must accept the risks associated with the surgery despite uncertainty regarding benefits. This raises questions as to the nature of informed decision-making for patients choosing to undergo surgery for sciatica.

Methods.
We undertook a qualitative descriptive study with 12 adult lumbar decompressive surgery candidates and six of their spine surgeons and analyzed data using inductive content analysis.

Results.
Our analysis revealed that most patients were satisfied with the consultation despite limited understanding of lumbar decompressive surgery. We found discrepancies between patients’ preoperative expectations and understanding of information provided by surgeons and what surgeons believed they had conveyed. Surgeons and patients disagreed on how much information is needed about postsurgical activity modifications and long-term outcomes to make a decision about whether or not to undergo surgery, with patients desiring more information. As a result, for most patients, the decision-making process extended beyond the information provided by surgeons and incorporated information from family members, friends, family doctors, and the internet.

Conclusion.
Our results highlight misunderstandings between patients and surgeons, particularly in regard to prognosis and activity modifications. Since this information is important for patients choosing whether to undergo a surgical intervention, our study provides guidance to improve informed decisions about sciatica and, potentially, other elective surgeries.

Level of Evidence: 4
An Insight Into the Health-Related Quality of Life of Adolescent Idiopathic Scoliosis Patients Who Are Braced, Observed, and Previously Braced
Authors: Cheung Prudence Wing Hang , Wong Carlos King Ho , Cheung Jason Pui Yin 
Published: November 2018

Study Design.
Prospective cross-sectional study.

Objective.
To determine the health-related quality of life (HRQoL) of adolescent idiopathic scoliosis (AIS) patients undergoing bracing, previously braced and observation only.

Summary of Background Data.
HRQoL is an important treatment outcome measure for AIS. A poor HRQoL may also negatively influence the success of bracing by reducing the likelihood of good brace compliance. Yet, the HRQoL thresholds for patients undergoing observation only, brace treatment or previous brace treatment is not well understood.

Methods.
Chinese AIS patients with refined Scoliosis Research Society 22-item (SRS-22r) Questionnaire and 5-level EQ-5D (EQ-5D-5L) Questionnaire scores were consecutively recruited for this cross-sectional study. Patients were grouped based on their treatment modality (observation only, bracing, previously braced, and postoperatively). Coronal and sagittal Cobb angles, degree of apical vertebral rotation, and curve type were studied. Spearman correlation test, independent t test, and one-way analysis of variance (ANOVA) with Tukey Post-hoc test were performed for statistical analysis.

Results.
A total of 652 AIS patients with mean age of 14.8 ± 1.9 years and mean Cobb angle of 18.6° ± 10.0° was studied. The respective mean SRS-22r total scores for bracing, observation, and previously braced groups were 4.20, 4.54, and 4.42, and mean EQ-5D-5L scores were 0.87, 0.95, and 0.92. The total and domain scores were correlated with coronal Cobb angles (P < 0.001) while only EQ-5D-5L correlated with sagittal Cobb angles (P < 0.001). Curves greater than 40° had worse HRQoL (P < 0.001). Currently braced patients had significantly worse HRQoL than those under observation, as indicated by lower EQ-5D-5L (0.08) and SRS-22r (0.35) scores (P < 0.001 to P < 0.05). Previously braced patients had better HRQoL than currently braced patients, with 0.05 higher EQ-5D-5L score (P < 0.001), and 0.23 higher SRS-22r score (P < 0.001). However, currently braced patients were more satisfied with treatment (1.94 difference; P < 0.001) than previously braced. There were no gross differences between patients previously braced and undergoing observation only.

Conclusion.
The negative impact of bracing on HRQoL is only transient as previously braced patients have superior HRQoL. It appears as though the EQ-5D-5L scores are more sensitive to changes in the sagittal profile as compared with SRS-22r. Our study highlights the differences in HRQoL between patients only being observed, undergoing bracing or previous brace treatment and the importance of monitoring HRQoL throughout follow-up. Further longitudinal studies may help determine the timing and threshold of HRQoL changes during the entire duration of bracing as well as after brace weaning.

Level of Evidence: 2
Predictors of Extended Length of Hospital Stay in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Segmental Instrumented Fusion
Authors: Sultan Assem A. , Berger Ryan J. , Cantrell William A. , Samuel Linsen T. , Ramanathan Deepak , Churchill Jessica , Minkara Anas A. , Golubovsky Joshua , Bachour Salam , Pasadyn Selena , Karnuta Jaret M. , Tamer Pierre , Kuivila Thomas E. , Gurd David P. , Goodwin Ryan C. 
Published: November 2018

Study Design.
Retrospective cohort study.

Objective.
The aims of this study were to (1) compare patient and procedure-specific characteristics among those who had short versus long hospital stays and (2) identify independent risk factors that may correlate with extended length of hospital stay (LOS) in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior segmental instrumented fusion (PSIF).

Summary of Background Data.
Reducing the LOS and identifying risk factors associated with extended admission have become increasingly relevant to healthcare policy makers. There is currently limited research identifying risk factors that correlate with extended stay in patients undergoing PSIF for AIS.

Methods.
A single-institution, longitudinally maintained database was queried to identify 407 patients who met specific inclusion and exclusion criteria. Based on the distribution and median LOS in the cohort (4 days), patients were divided into those who had long versus short LOS. In both groups, patient demographics, comorbidities, preoperative scoliosis curve measurements, surgery-related characteristics, and complications were analyzed. A univariate and multivariate regression analysis was then conducted to identify independent risk factors associated with extended LOS.

Results.
Patients who had extended LOS tended to be women (84.6% vs. 75%, P = 0.01), had more levels fused (9 ± 2 vs. 7 ± 2 levels, P < 0.001), had more major postoperative complications (0.8% vs. 7.4%, P = 0.002), had more blood loss during surgery (723 ± 548 vs. 488 ± 341 cm3, P < 0.001), and received less epidural analgesia for pain control (69% vs. 89%, P < 0.001). Except for higher thoracic kyphosis, long LOS patients did not have worse preoperative radiographic curve parameters. Multivariate logistic analysis identified female sex, having ≥9 ± 2 levels of fusion, operative blood loss, major postoperative complications, lack of epidural analgesia, and higher thoracic kyphosis as independent risk factors correlating for extended LOS.

Conclusion.
Independent risk factors identified by this study may be used to recognize patients with AIS at risk of prolonged hospital stay.

Level of Evidence: 3
A Morphometric Study on Subaxial Cervical Pedicles of Thai People
Authors: Mahiphot Jarupon , Iamsaard Sitthichai , Sawatpanich Tarinee , Sae-Jung Surachai , Khamanarong Kimaporn 
Published: November 2018

Study Design.
This study investigated the subaxial cervical pedicles from C3 to C7 to provide information for accurately transpedicular screw fixation in this region.

Objective.
This study was evaluated the morphology of the subaxial cervical pedicle to determine the size and trajectory of screw fixation.

Summary of Background Data.
Cervical vertebrae are an important structure to protect the neurovascular structure. The cervical spine surgery using screw fixation is an effective method to treat the cervical spine instability. There have been many research morphological data of subaxial cervical vertebrae. However, no studies have reports on dried cervical vertebrae of Thai's people.

Methods.
The measurement was conducted in 130 dried cervical vertebrae (C3–C7), including 61 males and 69 females. The measurement parameters were pedicle width (PW), pedicle length (PL), pedicle height (PH), pedicle axis length (PAL), pedicle transverse angle (PTA), and pedicle sagittal angle (PSA), which determined using ImageJ software.

Results.
The results of morphological data of C3 to C7 was found that the mean of PW, PL, PH, PAL, PTA, and PSA that obtained from male were significantly higher than female excepted for PL (C7) and PTA (C3, C5). Except for the C6 PW, C3 PL, C4 to C5 to C7 PTA, and C4 PSA, there were no significant differences of these parameters between male and female.

Conclusion.
The appropriate pedicle screw size is 4.0 mm for C3 and C4, and 4.5 mm for C5 to C7. The results of this study are the useful information for cervical spine fixation while prevent the vascular and neurological injuries from the large screw causing pedicle breakage.

Level of Evidence: 3