bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale
Authors: Roux Paul , Urbach Mathieu , Fonteneau Sandrine , Berna Fabrice , Brunel Lore , Capdevielle Delphine , Chereau Isabelle , Dubreucq Julien , Faget-Agius Catherine , Fond Guillaume , Leignier Sylvain , Perier Claire-Cécile , Richieri Raphaëlle , Schneider Priscille , Schürhoff Franck , Tronche Anne Marie , Yazbek Hanan , Zinetti-Bertschy Anna ,   FondaMental Advanced Centers of Expertise in Schizophrenia (FACE-SCZ) Collaborators, Passerieux Christine , Brunet-Gouet Eric 
Published: July 2018

Objective: This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. Design: This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. Settings: The study was undertaken in a French network of seven outward referral centres. Subjects: We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. Main measures: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. Results: Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. Conclusion: The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.
Assessing the validity of proxy caregiver reporting for potential palliative care outcome measures in Parkinson’s disease
Authors: Sebring Kelly , Shattuck Jo , Berk Julie , Boersma Isabel , Sillau Stefan , Kluger Benzi M 
Published: July 2018

Background: There is increasing interest in applying palliative care approaches for patients with Parkinson’s disease. Methodological studies are needed to validate palliative care outcome measures for Parkinson’s disease to build this evidence base. As many patients with Parkinson’s disease have cognitive and/or communication issues, proxy outcome measures may improve the inclusivity and relevance of research. Aim: To assess the validity of proxy caregiver reports for several potential palliative care outcome measures. Design: A cross-sectional study of Parkinson’s disease patients and caregivers completed a battery of outcome measures relevant to palliative care including the Memorial Symptom Assessment Scale, Hospital Anxiety and Depression Scale, Prolonged Grief Questionnaire 12, Parkinson Disease Questionnaire 39, Functional Assessment of Chronic Illness Therapy–Spiritual Wellbeing, and Schwab and England. Intraclass correlation coefficients were used to assess agreement. Setting/participants: A total of 50 Parkinson’s disease patient and caregiver dyads recruited at an academic medical center, Veterans Affairs Medical Center, and community support groups. Results: There was moderate to good agreement for Schwab and England, Parkinson Disease Questionnaire 39 total, and majority of Parkinson Disease Questionnaire 39 subscales; moderate to good agreement for the Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy–Spiritual Wellbeing, Prolonged Grief Questionnaire 12, and Memorial Symptom Assessment Scale; and poor to moderate agreement for the Parkinson Disease Questionnaire 39 stigma, social support, and bodily pain subscales. Caregivers tended to attribute higher symptom severity than patients. We did not detect differences in intraclass correlation coefficient based on cognitive status but patients with advanced illness had significantly lower intraclass correlation coefficients for several outcomes. Conclusions: Caution is indicated when considering caregiver proxy reporting for most outcomes assessed, particularly in Parkinson’s disease patients with advanced disease.
The Presence and Degree of Bone Marrow Edema Influence Midterm Clinical Outcomes After Microfracture for Osteochondral Lesions of the Talus
Authors: Shimozono Yoshiharu , Hurley Eoghan T. , Yasui Youichi , Deyer Timothy W. , Kennedy John G. 
Published: July 2018

Background: Subchondral bone marrow edema (BME) has been associated with articular cartilage loss, with the potential to be a negative prognostic indicator for clinical outcomes after microfracture. However, no single study has investigated the association between BME and clinical outcomes after microfracture for osteochondral lesions of the talus (OLTs) at midterm follow-up. Purpose: To clarify the association between postoperative subchondral BME and clinical outcomes in patients treated with microfracture for OLTs at both short-term and midterm follow-up using a grading system that classified the extent of BME of the talus. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent microfracture between 2008 and 2013 were assessed at 2- and 4-year postoperative follow-up. BME was evaluated using magnetic resonance imaging, and the presence of subchondral BME was determined with fat-suppressed T2-weighted sequences. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS). P < .05 was considered to be statistically significant. Results: Forty-three (83%) of 52 eligible patients were included. No significant differences were found in the FAOS between the BME and no BME groups at 2-year follow-up (83.1 ± 6.5 vs 88.6 ± 8.0, respectively; P = .109), but there was a significant difference at 4-year follow-up (77.5 ± 11.1 vs 84.7 ± 8.4, respectively; P = .041). A significant difference was found among BME grades at 4-year follow-up (grade 0: 84.7 ± 7.4, grade 1: 80.1 ± 10.5, grade 2: 74.0 ± 10.3, and grade 3: 67.5 ± 7.1; P = .035). A post hoc analysis showed significant differences between grades 0 and 2, 0 and 3, and 1 and 3 ( P = .041, .037, and .048, respectively). In addition, at 4-year follow-up, a significant correlation was noted between the FAOS and BME grade ( r = −0.453, P = .003) but not at 2-year follow-up ( r = −0.212, P = .178). Seventy-four percent of patients still had subchondral BME at 4-year follow-up after microfracture for OLTs. Conclusion: Patients with subchondral BME at midterm follow-up after microfracture for OLTs had worse clinical outcomes than those without subchondral BME. In addition, the degree of subchondral BME at midterm follow-up was correlated with clinical outcomes. However, at short-term follow-up, there were no significant differences in clinical outcomes based on both the presence and degree of BME, and no correlation was found between clinical outcomes and the degree of BME. The current study suggests that BME at short-term follow-up is a normal physiological reaction. However, BME at midterm follow-up after microfracture for OLTs may be pathological and is associated with poorer clinical outcomes.
A Prospective Analysis of the Contralateral Hip Among Patients With Femoroacetabular Impingement: What Are the Risk Factors for Disease Progression?
Authors: Louer Craig R. , Pashos Gail , Clohisy John C. , Nepple Jeffrey J. 
Published: July 2018

Background: The pathophysiology of femoroacetabular impingement (FAI) remains to be better understood, including factors affecting symptom development and disease progression. Purpose: (1) To determine rates of initial and subsequent symptom development in the contralateral hip of patients with symptomatic FAI and (2) to identify predictors of the development of symptomatic contralateral FAI. Study Design: Case-control study; Level of evidence, 3. Methods: This prospective study cohort included the contralateral hip of 179 consecutive patients undergoing primary surgical treatment of FAI. At presentation and follow-up time points, patients recorded the presence of symptoms in the contralateral hip. Patients with a minimum 1-year follow-up were included in the final cohort. Univariate analysis compared the patient characteristics and FAI imaging characteristics (cam and pincer) of initially asymptomatic patients who developed symptoms and those who remained asymptomatic. Kaplan-Meier survival curves were calculated to demonstrate symptom development over time. Results: A total of 148 patients (83%) were followed for at least 1 year (mean, 2.9 years). Thirty-four (23%) patients had symptoms in the contralateral hip at the time of the initial presentation. An additional 27 hips (24% of the initially asymptomatic) developed symptoms during the follow-up period at a mean 2.0 years from presentation. Head-neck offset ratio on the anteroposterior pelvis radiograph was significantly lower among hips that developed symptoms (0.153 vs 0.163 asymptomatic group, P = .027). Maximum alpha angle ( P = .503), lateral center edge angle ( P = .975), and crossover sign ( P = .865) were not predictive of the development of symptoms. Patients developing contralateral hip symptoms were less likely to have a UCLA (University of California, Los Angeles) activity score of 9 or 10 at presentation (18.2% vs 43.8%, P = .032). The total arc of rotation in flexion (internal rotation in 90° of flexion + external rotation in flexion) was significantly decreased in hips developing symptoms (39.4º vs 50.4º, P = .012). Kaplan-Meier survival analysis demonstrated that 72%, 67%, 56%, and 48% of all patients remained asymptomatic at 1, 2, 3, and 4 years, respectively. Conclusion: Approximately 1 in 4 patients with FAI presents with symptoms in the contralateral hip, and an additional 1 in 4 patients develops significant symptoms in the following 4 years. Several factors, including low activity level, less hip rotational motion, and decreased head-neck offset ratio, were significantly associated with the development of symptoms, while the alpha angle and crossover sign were not.
Challenges of Delivering HIV/AIDS Services to Migrant Patients in the Perspective of Hospital Management
Authors: Chungsivapornpong Warawan , Sooksriwong Chaoncin 
Published: July 2018

Background: There has been a big challenge facing hospital management in dealing with migrant patients with HIV/AIDS as a result of insufficient health care workers and increased hospital budget. This study aims to analyse the current situation and to propose a management model on service delivery among HIV/AIDS migrant patients in a hospital setting. Methods: A qualitative research method was conducted at Samut Sakhon province using in-depth interviews and focus group discussions (FGDs) with 32 key informants from hospitals, provincial health offices, non-government organizations (NGOs) and health policymakers. The context, input, process and product (CIPP) framework was applied to analyse the current situation and the findings from the strengths, weaknesses, opportunities and threats (SWOT) analysis helped design a management model of HIV/AIDS care. Results: A HIV/AIDS management model was developed, consisting of key components in three levels: national enforcement of migrant registration, provincial migrant data centre and HIV/AIDS service integrated in community. This model would help administrators reduce financial burden and improve clinical outcomes. Conclusions: To enhance HIV/AIDS service delivery for migrant workers, data management and follow-up system on treatment continuation along with participation of multiple stakeholders including government, provincial health offices, public and private health care setting and international institutions are required.
No Demand for Skill: The Bane of India’s Vocational Training
Authors: Chadha Nishant , Gangopadhyay Shubhashis , Yadav Bhupesh 
Published: July 2018

In this article, we document some empirical facts about vocational training in India. First, we show that the education levels and vocational training of the Indian labour force are low and have not changed between 2004–2005 and 2011–2012. Then, we show that in wage employment, regular wage and salary earners and casual labour, the returns to skilling are low while the returns to general education are significant, even within the same occupation and industry category. Using the enterprise surveys from the NSS, we also document that self-employment, which is the outside option for most unskilled, semi-skilled and even skilled people, is very unproductive. We, thus, argue that the Indian labour market is stuck in an equilibrium where both the number of persons getting skilled and the returns to skilling are low. JEL: J240, O150
Huntington’s disease: Neuropsychiatric manifestations of Huntington’s disease
Authors: Goh Anita MY , Wibawa Pierre , Loi Samantha M , Walterfang Mark , Velakoulis Dennis , Looi Jeffrey CL 
Published: July 2018

Objectives: Huntington’s disease (HD) is a profoundly incapacitating, and ultimately fatal, neurodegenerative disease. HD is presently incurable, so the current goal is to allow affected individuals to live as well as possible with the illness, to maximise functional independence and quality of life for the person with HD, their carers and family members. This clinical update review focuses on the common neuropsychiatric manifestations in HD, and outlines and evaluates the various neuropsychiatric facets of HD, including the aetiology, symptoms and diagnosis. Conclusions: Neuropsychiatric symptoms can precede the classic motor clinical symptoms of HD (prodromal HD) by decades, and cause significant functional impairment. HD provides key insights and understanding into the organic psychiatric disorders, including contemporary clinical insights into the process of neurodegeneration and manifestation of neuropsychiatric symptoms.
Comparative effectiveness of telemonitoring versus usual care for type 2 diabetes: A systematic review and meta-analysis
Authors: Kim Yunjung , Park Jeong-Eun , Lee Byung-Wan , Jung Chang-Hee , Park Dong-Ah 
Published: July 2018

Aims This study evaluated clinical effectiveness of telemonitoring on the management of patients with type 2 diabetes. Methods We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane Library to identify randomized controlled trials that compared telemonitoring and usual care in patients with type 2 diabetes. Results Thirty-eight studies (6855 patients) were included. Telemonitoring was associated with a significant decrease in glycated haemoglobin levels compared to usual care (weighted mean difference –0.42%, 95% confidence interval –0.56 to –0.27) but there was evidence of heterogeneity ( I2 = 96.9%). Telemonitoring was associated with a significant glycated haemoglobin reduction when biological data were transmitted through a web-based device weekly, when voice feedback was performed daily or immediately and when patients were provided with counselling. Telemonitoring also reduced glycated haemoglobin level in studies that monitored patients’ medication adherence, provided counselling, education and alarm message. The rate of achieving glycated haemoglobin levels of < 7% was 1.8 times higher in the telemonitoring group compared to the usual care group (risk ratio 1.83, 95% confidence interval 1.35 to 2.47, I2 = 0%). There was also significant reduction in systolic blood pressure (weighted mean difference –1.33 mm Hg) and body mass index (weighted mean difference –0.25 kg/m2), but the clinical relevance of these results can be questioned. The data available on patient satisfaction, quality of life, medication adherence, prescription changes, stress and depression were limited. Conclusions Telemonitoring interventions may be a better option than usual care in improving glycated haemoglobin control of patients with type 2 diabetes. Further studies should assess clinical benefit according to specific delivery modes of the intervention and patient-reported outcomes.
Redesigning Transplant Organ Labeling to Prevent Patient Harm and Organ Loss
Authors: Khorzad Rebeca , Montague Enid , Nannicelli Anna P. , Woods Donna M. , Ladner Daniela P. , Brown Alexandra , Holl Jane Louise 
Published: July 2018

Background: In 2012, the Health Resources and Services Administration and the United Network for Organ Sharing launched the “Electronic Tracking and Transportation” (ETT) project, in response to “labeling and packaging issues” being a frequently reported safety incident. This article describes an improvement project conducted as part of this United Network for Organ Sharing project. Methods: An interdisciplinary team conducted a Process Failure Modes and Effects Analysis, laboratory simulations of organ labeling during procurement, and a heuristic evaluation of a label software application to inform the design of TransNet, a system that uses barcode technology at the point of organ recovery. A total of 42 clinicians and staff from 10 organ procurement organizations and 2 transplant centers in the United States participated. Processes Addressed: Key features of the redesigned labeling system include independent, double entry of label information into the software application, a machine-readable barcode on each organ’s label, and a handheld printer for at “point of use” label printing. Outcomes: The new labeling system, TransNet, has become mandatory since June 2017. A survey conducted on early adopters (N = 11), after 1 year of use, indicates the process is safer and more efficient. Implications for Practice: The findings from this study suggest that the application of quality planning methods, common in other industries, when redesigning a health-care process, are valuable and revelatory and should be adopted more extensively. Future evaluation of TransNet effectiveness to reduce safety incidents is critical.
How do integrated care programmes work for patients with cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes and multi-morbidity? A rapid realist review
Authors: Mewes JC , Ahmed SA , Vrijhoef HJM 
Published: July 2018

Background In previous years, many multi-faceted initiatives have been set up to improve outcomes for people with chronic diseases. Evaluation studies about the (cost-)effectiveness of these integrated care programs showed heterogeneity in outcomes. Hence, it has been suggested to use realist evaluation for the evaluation of integrated care programmes. Thus, our aim was to gain insight into whether and how existing integrated care programmes work for people with cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes and multi-morbidity, and under what conditions within the Dutch healthcare setting. Methods A rapid realist review was conducted to identify the context and mechanisms that are associated with the outcomes of integrated care programmes. From a selection of systematic reviews and meta-analyses and Dutch literature, data on the context, mechanisms and outcomes of integrated care programmes were extracted. The data were analysed by placing the extracted variables in context-mechanism-outcome configurations which showed their interrelatedness. A panel of executives from Dutch care groups assessed the face validity of the context-mechanism-outcome configurations. Results Based on the existing literature, context-mechanism-outcome configurations were compiled for all five diseases. Some configurations could be filled with more detail than others, with the configuration of integrated care for people with diabetes being the most complete. Context-mechanism-outcome configurations were completed and confirmed by executives from Dutch care groups. Conclusion The configurations together with the identified factors in them reveal the underlying preliminary program theories of integrated care programmes. These theories need to be tested in further research.
Cost-effectiveness of internet-based cognitive–behavioural therapy and physical exercise for depression
Authors: Kraepelien Martin , Mattsson Simon , Hedman-Lagerlöf Erik , Petersson Ingemar F. , Forsell Yvonne , Lindefors Nils , Kaldo Viktor 
Published: July 2018

BackgroundBoth internet-based cognitive–behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.AimsTo determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.MethodEconomic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.ResultsThe primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76%, compared with TAU.ConclusionsFrom a primary care perspective, both ICBT and physical exercise for depression are likely to be cost-effective compared with TAU.Declaration of interestNone.
Aldosterone Suppression by Dexamethasone in Patients With KCNJ5-Mutated Aldosterone-Producing Adenoma
Authors: Inoue Kosuke , Yamazaki Yuto , Kitamoto Takumi , Hirose Rei , Saito Jun , Omura Masao , Sasano Hironobu , Nishikawa Tetsuo 
Published: July 2018

Abstract

Context
Aldosterone biosynthesis is regulated principally by ACTH and gene mutations as well as by angiotensin II and serum potassium. In addition, previous studies have reported the potential effects of KCNJ5 mutations in aldosterone-producing adenoma (APA) on cardiovascular diseases. However, responsiveness to ACTH in APAs according to potassium inwardly rectifying channel, subfamily J, member 5 (KCNJ5) mutations remains unknown.

Objective
To investigate KCNJ5 genotype–specific differences in aldosterone biosynthesis in response to ACTH stimulation.

Design and Setting
A cross-sectional study through retrieval of clinical records.

Participants
One hundred forty-one patients aged ≥20 years with APA were examined.

Main Outcome Measures
Associations between KCNJ5 mutations and clinical parameters reflecting the renin-angiotensin system [saline infusion test (SIT)] and ACTH pathways [dexamethasone suppression test (DST)].

Results
KCNJ5 mutations were detected in 107 cases. In the crude comparison, patients with mutations in KCNJ5 had higher plasma aldosterone concentrations (PACs) both at baseline and after the SIT. PAC after the DST showed a significant inverse association with KCNJ5 genotypes after controlling for age, sex, tumor size, and PAC after the SIT. Immunohistochemical analysis of 101 cases revealed more abundant immunoreactivity of CYP11B1 and CYP17 in the KCNJ5-mutated group than in the KCNJ5 wild-type group.

Conclusion
This report of marked suppression of PAC by dexamethasone in patients with KCNJ5-mutated APAs indicates that such APAs respond to endogenous ACTH more readily than APAs in nonmutated cases. Further molecular and epidemiologic studies are required to validate our results and clarify the clinical effectiveness of the DST for predicting KCNJ5 mutations before adrenalectomy.