bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting rehospitalization in patients treated with antipsychotics: a prospective observational study
Authors: Abdullah-Koolmees Heshu , Gardarsdottir Helga , Minnema Lotte A. , Elmi Kamjar , Stoker Lennart J. , Vuyk Judith , Goedhard Laurette E. , Egberts Toine C. G. , Heerdink Eibert R. 
Published: March 2018

Background: Prediction of rehospitalization in patients treated with antipsychotics is important for identifying patients in need of additional support to prevent hospitalization. Our aim was to identify factors that predict rehospitalization in patients treated with antipsychotics at discharge from a psychiatric hospital. Methods: Adult patients suffering from schizophrenia, psychotic or bipolar I disorders who had been hospitalized in a psychiatric hospital for ⩾7 days and were treated with oral antipsychotics at discharge were included. The main outcome was rehospitalization within 6 months after discharge. A prediction model for rehospitalization was constructed including: patient/disease and medication characteristics, patients’ beliefs about medicines, and healthcare-professional-rated assessment for all patients. The patients were stratified by diagnosis (schizophrenia and nonschizophrenia). Area under the receiver operating characteristic curve (AUCROC) was also assessed. Results: A total of 87 patients were included and 33.3% of them were rehospitalized within 6 months after discharge. The variables that predicted rehospitalization were duration of hospitalization, patients’ attitude towards medicine use, and healthcare-professional-rated assessment with an AUCROC of 0.82. Rehospitalization for patients with schizophrenia could be predicted (AUCROC = 0.71) by the Global Assessment of Functioning score, age, and harm score. Rehospitalization was predicted (AUCROC = 0.73) for nonschizophrenia patients with, for example rehospitalization predicted by the nurse. Conclusions: Rehospitalization was predicted by a combination of variables from the patient/disease and medication characteristics, patients’ attitude towards medicine use, and healthcare-professional-rated assessment. These variables can be assessed relatively easily at discharge to predict rehospitalization within 6 months.
Surgical Correction of Supravalvar Aortic Stenosis: 52 Years’ Experience
Authors: Roemers Rosa , Kluin Jolanda , de Heer Frederiek , Arrigoni Sara , Bökenkamp Regina , van Melle Joost , Ebels Tjark , Hazekamp Mark 
Published: March 2018

Objectives: Supravalvar aortic stenosis (SVAS) is a rare congenital anomaly. The “single-patch technique,” “‘two sinus augmentation with an inverted Y-patch” (both nonsymmetrical corrections), “three-patch technique,” and the “slide aortoplasty” (both symmetrical corrections) are the techniques implemented by the majority of surgeons for the correction of SVAS. In the few studies that compared these techniques, no technique was shown to be superior over another. The aim of the present study is to review the 52-year experience with the surgical correction of SVAS in two of four congenital cardiothoracic surgical centers in the Netherlands. Methods: We retrospectively reviewed all patient files of those who underwent an operation to correct their SVAS, between 1962 and 2014 in our centers. Patients were divided according to their operating technique. These groups were compared using the end points freedom from reoperation and mortality. Results: A total of 49 patients were included, 23 (46.9%) patients in the nonsymmetrical group and 26 (53.1%) patients in the symmetrical group. Survival after 20 years in the nonsymmetrical group was 80% (standard error [SE]: 0.091) and in the symmetrical group was 85% (SE: 0.085; P = .163). Freedom from reoperation after 20 years in the nonsymmetrical group was 88% (SE: 0.079) and in the symmetrical group was 71% (SE: 0.107; P = 0.313). Conclusion: In this patient group, there is no significant difference in survival and freedom from reoperation between the different surgical techniques for SVAS repair. Compared to the survival in the general population, the survival of SVAS patients is remarkably low. Apparently, SVAS is not a benign disease and probably patients should be followed more closely for the rest of their lives.
Brom Aortoplasty for Supravalvular Aortic Stenosis
Authors: Mongé Michael C. , Eltayeb Osama M. , Costello John M. , Johnson Joyce T. , Popescu Andrada R. , Rigsby Cynthia K. , Backer Carl L. 
Published: March 2018

Background: Controversy remains regarding the optimal surgical approach for children with supravalvular aortic stenosis (SVAS). Methods: Since 1997 we have used Brom three-patch aortoplasty for patients with SVAS. We prefer computed tomography (CT) imaging for preoperative evaluation rather than cardiac catheterization as it avoids the well-known morbidity of general anesthesia. The purpose of this study was to present our intermediate-term results of this strategy. Results: Twenty consecutive patients with SVAS were treated with Brom aortoplasty. Mean age was 3.7 ± 5.9 years (median, 1.5 years). Twelve patients had Williams syndrome. Ten patients had preoperative advanced medical imaging (seven CT, three magnetic resonance imaging) and did not have cardiac catheterization. Mean times for cardiopulmonary bypass and cross-clamp were 172 ± 29 minutes and 110 ± 21 minutes, respectively. Ten patients had simultaneous pulmonary artery stenosis patching. Median length of stay was seven days. There was no operative or late mortality. Mean follow-up was 6 ± 5 years. There were no reoperations on the aortic root. Fifteen patients had mild or less aortic insufficiency (AI) and two had moderate AI. One patient who had infant balloon dilation of the aortic valve and postoperative subacute bacterial endocarditis had moderate-to-severe AI and aortic stenosis (AS). One patient had moderate residual SVAS; all others had no AS. No patients had late coronary insufficiency. Conclusion: Brom aortoplasty promotes restoration of normal aortic root geometry and relief of coronary ostial stenosis, which is important in preventing myocardial ischemia. Computed tomography imaging is our preferred diagnostic modality. Intermediate-term outcomes are excellent with no recurrent SVAS, coronary events, or reoperations on the aortic valve.
Yoga for Young Adults With Noncurative Cancer: A Brief Report
Authors: Woodside Hillary , Culos-Reed S Nicole , Grégoire Marie-Claude , Rutledge Robert , Keats Melanie R 
Published: March 2018

Background The practice of yoga has been shown to improve disease- and treatment-related side effects in the noncurative cancer patient. Objective This user experience study aimed to examine the feasibility and usefulness of a DVD-based yoga program for young adult cancer patients with a noncurative diagnosis. Methods Participants were asked to partake in a 7-week DVD-based yoga program and complete measures of program use and usefulness. Results Nine patients expressed study interest and 5 consented to participate. Four completed the full study protocol. Participants reported being satisfied with the program and described that it provided an opportunity for self-care. Improvements in functional, physical, and spiritual well-being and overall quality of life were found. Barriers included competing time demands and feeling unwell. No adverse events were reported. Conclusion The program was viewed as an accessible and useful activity option; however, a desire for greater social support from relatable others was highlighted.
Ending Cervical Cancer Screening in Low-Risk Women After Age 65
Authors: Boone Emily , Karp Michael , Lewis LaVonna 
Published: March 2018

Background: Current evidence-based cervical cancer testing guidelines recommend that screening of low-risk women ceases after age 65. Despite this, research suggests that continued testing by primary care providers remains common and represents unnecessary patient discomfort, cost, and consumption of valuable primary care resources. Objective: To understand why primary care providers might knowingly ignore consensus evidence-based screening guidelines for cervical cancer in low-risk women of this age-group and to identify barriers to adherence with best practice recommendations. Methods: A survey tool to identify barriers to adherence with current guidelines for cervical cancer screening in low-risk women older than age 65 was mailed to 4929 randomly selected primary care providers throughout California. Providers were asked to indicate the predominant reason(s) they might knowingly continue cervical cancer screening in women older than 65 years, despite evidence-based recommendations to the contrary. Results: Qualified surveys were received from 1259 (25.5%) of those surveyed, representing primary care providers of all types, practicing in areas of vastly different demographics. Despite published reassurance to the contrary, many providers retain fear that discontinuation of testing in low-risk women after age 65 may result in missed invasive cervical cancer. Even among health-care providers who agree that cessation of screening is safe, other circumstances prompt their recommendation to continue cervical screening. Conclusion: Although the data from this study suggest areas of policy intervention to lessen unnecessary cervical cancer screening, the broader implication is that advancement of evidence-based medicine will be of little value in improving the quality and cost of health care if barriers to guideline adherence are poorly understood and addressed.
Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study
Authors: Walsh Mary E , Galvin Rose , Williams David JP , Harbison Joseph A , Murphy Sean , Collins Ronan , McCabe Dominick JH , Crowe Morgan , Horgan N Frances 
Published: March 2018

Introduction Falls are common post-stroke adverse events. This study aimed to describe the first-year falls incidence, circumstances and consequences among persons discharged home after stroke in Ireland, and to examine the association between potential risk factors and recurrent falls. Patients and methods Patients with acute stroke and planned home-discharge were recruited consecutively from five hospitals. Variables recorded pre-discharge included: age, stroke severity, co-morbidities, fall history, prescribed medications, hemi-neglect, cognition and functional independence (Barthel index). Falls were recorded with monthly diaries, and 6 and 12-month interviews. The association of pre-discharge factors with recurrent falls (>1 fall) was examined using univariable logistic regression. Results A total of 128 participants (mean age = 68.6, SD = 13.3) were recruited; 110 completed the 12-month follow-up. The first-year falls incidence was 44.5% (95% CI = 35.1–53.6) with 25.6% falling repeatedly (95% CI = 18.5–34.4). Fallers experienced 1–18 falls (median = 2) and five reported fractures; 47% of fallers experienced at least one fall outdoors. Only 10% of recurrent fallers had bone health medication prescribed at discharge. Lower Barthel index scores (<75/100, RR = 4.38, 1.64–11.72) and psychotropic medication prescription (RR = 2.10, 1.13–3.91) were associated with recurrent falls. Discussion This study presents prospectively collected information about falls circumstances. It was not powered for multivariable analysis of risk factors. Conclusion One-quarter of stroke survivors discharged to the community fall repeatedly and mostly indoors in the first year. Specific attention may be required for individuals with poor functional independence or those on psychotropic medication. Future falls-management research in this population should explore falls in younger individuals, outdoor as well as indoor falls and post-stroke bone health status.
In-hospital dynamics of glucose, blood pressure and temperature predict outcome in patients with acute ischaemic stroke
Authors: Skafida Anastasia , Mitrakou Asimina , Georgiopoulos Georgios , Alevizaki Maria , Spengos Konstantinos , Takis Konstantinos , Ntaios George , Thomadakis Christos , Vemmos Konstantinos 
Published: March 2018

Introduction We aimed to assess alterations in glucose, blood pressure and temperature in acute ischaemic stroke and investigate their association with early all-cause mortality and functional outcome. Patients and methods We studied all consecutive acute ischaemic stroke patients admitted in 2001–2010 to the Acute Stroke Unit, at Alexandra University Hospital, in Athens. Serial measurements were performed in the first seven days post-stroke and different parameters have been estimated: mean daily values, variability, subject-specific baseline levels and rate of change in serial measurements. Cox-proportional-hazards-model analysis and logistic-regression analysis were applied to investigate the association between these parameters and all-cause mortality and functional outcome after adjustment for known confounders of stroke outcome. Results In 1271 patients (mean age 72.3 ± 11.2 years), after adjusting for confounders, baseline glucose levels (HR: 1.005, 95%CI: 1.001–1.01; p = 0.017), variability of systolic BP (SBP) as estimated by standard deviation (HR: 1.028, 95%CI: 1.01–1.048; p = 0.005), the baseline temperature (HR: 2.758, 95%CI: 2.067–3.68; p < 0.001) and the rate of temperature change (HR: 1.841, 95%CI: 1.616–2.908; p < 0.001) were independently associated with all-cause mortality within three months. Poor functional outcome was associated with subject-specific baseline values of temperature (OR: 1.743; 95%CI: 1.076–2.825; p = 0.024), the rate of SBP (OR: 1.159; 95% CI: 1.047–1.280; p = 0.004) and temperature change (OR: 1.402; 95% CI: 1.061–1.853; p = 0.018). Discussion The main strength of our study is that we analysed simultaneously three parameters and we used four different variables for each parameter of interest. Conclusion Baseline glucose levels, variability of SBP and baseline temperature and its rate of change are independent predictors of all-cause mortality. Baseline values of temperature and the rate of changes in SBP and temperature are independent predictors of poor functional outcome.
Human CTL-based functional analysis shows the reliability of a munc13-4 protein expression assay for FHL3 diagnosis
Authors: Shibata Hirofumi , Yasumi Takahiro , Shimodera Saeko , Hiejima Eitaro , Izawa Kazushi , Kawai Tomoki , Shirakawa Ryutaro , Wada Taizo , Nishikomori Ryuta , Horiuchi Hisanori , Ohara Osamu , Ishii Eiichi , Heike Toshio 
Published: March 2018

Key PointsA novel human CTL-based platform for comprehensive functional analysis of UNC13D variants is introduced. Pathogenicity of a reported UNC13D variant was determined by measuring expression of the translated munc13-4 protein.
Choice of provider for out-patient treatment is not working
Authors: Veale David 
Published: March 2018

SummaryIn 2012, the coalition government introduced the legal right for National Health Service (NHS) patients in England to choose their mental healthcare provider for out-patient treatment. This was a significant step towards parity of care between mental and physical ill health, and NHS Improvement and NHS England have provided sensible guidance on its implementation. However, several factors prevent the system from working as it was intended: lack of awareness of the principle of patient choice for out-patient treatment; complacency from some trusts and commissioners; mental health trusts operating outside the e-referrals system; misuse of care pathways; lack of direct access by many general practitioners for out-of-area referrals; and delays in authorisation for funding. I describe how I have come to this conclusion and suggest some solutions.Declaration of interestThe author is employed by a trust that potentially benefits from ‘patient choice’.
Diet regulates membrane extension and survival of niche escort cells for germline homeostasis via insulin signaling
Authors: Su Yu-Han , Rastegri Elham , Kao Shih-Han , Lai Chun-Min , Lin Kun-Yang , Liao Hung-Yu , Wang Mu-Hsiang , Hsu Hwei-Jan 
Published: March 2018

ABSTRACT
Diet is an important regulator of stem cell homeostasis; however, the underlying mechanisms of this regulation are not fully known. Here, we report that insulin signaling mediates dietary maintenance of Drosophila ovarian germline stem cells (GSCs) by promoting the extension of niche escort cell (EC) membranes to wrap around GSCs. This wrapping may facilitate the delivery of bone morphogenetic protein stemness factors from ECs in the niche to GSCs. In addition to the effects on GSCs, insulin signaling-mediated regulation of EC number and protrusions controls the division and growth of GSC progeny. The effects of insulin signaling on EC membrane extension are, at least in part, driven by enhanced translation of Failed axon connections (Fax) via Ribosomal protein S6 kinase. Fax is a membrane protein that may participate in Abelson tyrosine kinase-regulated cytoskeletal dynamics and is known to be involved in axon bundle formation. Therefore, we conclude that dietary cues stimulate insulin signaling in the niche to regulate EC cellular structure, probably via Fax-dependent cytoskeleton remodeling. This mechanism enhances intercellular contact and facilitates homeostatic interactions between somatic and germline cells in response to diet.
Aplip1, the Drosophila homolog of JIP1, regulates myonuclear positioning and muscle stability
Authors: Auld Alexander L. , Roberts Sacha A. , Murphy Ciaran B. , Camuglia Jaclyn M. , Folker Eric S. 
Published: March 2018

ABSTRACT
During muscle development, myonuclei undergo a complex set of movements that result in evenly spaced nuclei throughout the muscle cell. In Drosophila, two separate pools of Kinesin and Dynein work in synchrony to drive this process. However, how these two pools are specified is not known. Here, we investigate the role of Aplip1 (the Drosophila homolog of JIP1, JIP1 is also known as MAPK8IP1), a known regulator of both Kinesin and Dynein, in myonuclear positioning. Aplip1 localizes to the myotendinous junction and has genetically separable roles in myonuclear positioning and muscle stability. In Aplip1 mutant embryos, there was an increase in the percentage of embryos that had both missing and collapsed muscles. Via a separate mechanism, we demonstrate that Aplip1 regulates both the final position of and the dynamic movements of myonuclei. Aplip1 genetically interacts with both Raps (also known as Pins) and Kinesin to position myonuclei. Furthermore, Dynein and Kinesin localization are disrupted in Aplip1 mutants suggesting that Aplip1-dependent nuclear positioning requires Dynein and Kinesin. Taken together, these data are consistent with Aplip1 having a function in the regulation of Dynein- and Kinesin-mediated pulling of nuclei from the muscle end.
This article has an associated First Person interview with the first author of the paper.
Substitution with Satiation: A New Class of Utility Functions and a Complementary Pivot Algorithm
Authors: Garg Jugal , Mehta Ruta , Vazirani Vijay V. 
Published: March 2018

We introduce new classes of utility functions and production sets, called Leontief-free, which are applicable when goods are substitutes and utilities/production are subadditive (to model inter-good satiation). When goods are complements, the well studied Leontief utility functions do an adequate job; however, to the best of our knowledge, a similar concept for the case of goods that are substitutes was not known. For markets with these utility functions and production sets, we obtain the following results: Rational-valued equilibria, despite the fact that these utility functions and production sets are nonseparable. We prove that the problem of computing an equilibrium is PPAD-complete, where PPAD stands for Polynomial Parity Arguments on Directed Graphs. We obtain complementary pivot algorithms based on a suitable adaptation of Lemke’s classic algorithm. Our algorithms run in strongly polynomial time if the number of goods is a constant, despite the fact that the set of solutions is disconnected. Experimental verification confirms that our algorithms are practical.
Optimal interference of the tibial component of the cementless Oxford Unicompartmental Knee Replacement
Authors: Campi S. , Mellon S. J. , Ridley D. , Foulke B. , Dodd C. A. F. , Pandit H. G. , Murray D. W. 
Published: March 2018

Objectives The primary stability of the cementless Oxford Unicompartmental Knee Replacement (OUKR) relies on interference fit (or press fit). Insufficient interference may cause implant loosening, whilst excessive interference could cause bone damage and fracture. The aim of this study was to identify the optimal interference fit by measuring the force required to seat the tibial component of the cementless OUKR (push-in force) and the force required to remove the component (pull-out force). Materials and Methods Six cementless OUKR tibial components were implanted in 12 new slots prepared on blocks of solid polyurethane foam (20 pounds per cubic foot (PCF), Sawbones, Malmo, Sweden) with a range of interference of 0.1 mm to 1.9 mm using a Dartec materials testing machine HC10 (Zwick Ltd, Herefordshire, United Kingdom) . The experiment was repeated with cellular polyurethane foam (15 PCF), which is a more porous analogue for trabecular bone. Results The push-in force progressively increased with increasing interference. The pull-out force was related in a non-linear fashion to interference, decreasing with higher interference. Compared with the current nominal interference, a lower interference would reduce the push-in forces by up to 45% (p < 0.001 One way ANOVA) ensuring comparable (or improved) pull-out forces (p > 0.05 Bonferroni post hoc test). With the more porous bone analogue, although the forces were lower, the relationship between interference and push-in and pull-out force were similar. Conclusions This study suggests that decreasing the interference fit of the tibial component of the cementless OUKR reduces the push-in force and can increase the pull-out force. An optimal interference fit may both improve primary fixation and decrease the risk of fracture. Cite this article: S. Campi, S. J. Mellon, D. Ridley, B. Foulke, C. A. F. Dodd, H. G. Pandit, D. W. Murray. Optimal interference of the tibial component of the cementless Oxford Unicompartmental Knee Replacement. Bone Joint Res 2018;7:226–231. DOI: 10.1302/2046-3758.73.BJR-2017-0193.R1.