bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early results of supervised versus unsupervised rehabilitation of patients with cervical pain
Authors: Huber Juliusz , Lisiński Przemysław 
Published: June 2019

Purpose: Comparison of early effects of supervised (led by physiotherapist) and unsupervised rehabilitation protocols in patients with myofascial pain syndrome, disk-root conflict and degenerative spine disease at cervical level. Methods: Three groups of patients (n = 60 each) with clinically and neurophysiologically confirmed myofascial pain syndrome, disk-root conflict and degenerative spine disease were randomly subdivided to supervised and unsupervised treatment subgroups (n = 30 each). Thirty healthy subjects with similar demographic and anthropometric properties as patients were enrolled to control group. Patients were examined before and after rehabilitation with visual analog scale of pain, Spurling’s test, painful passive elongation and active trigger points detection in trapezius muscle, sensory perception studies and surface electromyography (at rest, during maximal contraction) and electroneurography. Results: Supervised treatment resulted in decrease of pain intensity (P = .001) and Spurling’s symptoms incidence (P = .008) in patients from disk-root conflict group. Painful elongation and incidence of trigger points in trapezius muscle were the least observed at P = .009 after supervised therapy of myofascial pain syndrome. Supervised therapy resulted in decrease of resting electromyography amplitude and increase of maximal contraction electromyography amplitude from trapezius muscle (P = .02) in myofascial pain syndrome patients and from biceps and abductor pollicis brevis muscles of patients from other groups (P from .05 to .001). Median nerve electroneurography and sensory perception results improved at P = .05 after supervised treatment in disk-root conflict group. Conclusions: Twenty-day supervised rehabilitation provides better therapeutic effects than unsupervised one in treatment of muscle dysfunctions in patients with myofascial pain syndrome, degenerative changes and disk-root conflict at cervical spine.
Neurodevelopmental Treatment (Bobath) for Children With Cerebral Palsy: A Systematic Review
Authors: Zanon Márcia Andréa , Pacheco Rafael Leite , Latorraca Carolina de Oliveira Cruz , Martimbianco Ana Luiza Cabrera , Pachito Daniela Vianna , Riera Rachel 
Published: June 2019

Aim: To assess the effects of neurodevelopmental treatment for children with cerebral palsy. Methods: We conducted a systematic review following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance to PRISMA Statement. Through a comprehensive literature search we considered all randomized clinical trials that compared neurodevelopmental treatment with conventional physical therapy for children with cerebral palsy. We used the Cochrane Risk of Bias Table to assess the risk of bias of the included randomized clinical trial, and the GRADE approach to evaluate the certainty of the body of the evidence. Results: We found 3 randomized clinical trials (2 published and 1 ongoing) comprising 66 children. Published randomized clinical trials presented methodological and reporting limitations and only 1 provided data for outcomes of interest. No difference between neurodevelopmental treatment and conventional physical therapy was found for gross motor function (mean difference 1.40; 95% confidence interval –5.47 to 8.27, low certainty evidence). Conclusion: This review found that the effects of neurodevelopmental treatment for children with cerebral palsy are still uncertain. Further studies are required to assess the efficacy and safety of neurodevelopmental treatment for this purpose and until there, current evidence do not support its routinely use in practice. Number of protocol registration in PROSPERO database: CRD42017082817 (available from https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82817 ).
Structural Breaks in Volatility Transmission from Developed Markets to Major Asian Emerging Markets
Authors: Kumar Dilip 
Published: June 2019

The study investigates the volatility transmission from developed markets (the United States [US], the United Kingdom [UK] and Japan) to the major Asian emerging markets (India, China, Malaysia, Thailand and Indonesia) during a period from 1996 to 2015. We make use of the opening, high, low and closing prices to estimate unbiased extreme value volatility estimator and implement heterogeneous autoregressive distributed lag (HAR-DL) framework to study the spillover effects. Based on time-varying spillover analysis, we observe sudden changes in the spillover effect during the periods of major crises. Initially, we find evidence of contagion during the period of global financial crisis of 2007–2009. However, after accounting for conditional heteroscedasticity, we observe a decline in the strength of volatility transmission from developed markets to the Asian emerging markets. Moreover, the initial evidence of contagion is not detectable anymore. We also test the economic significance of the findings by implementing three trading strategies based on risk averse and risk-taking investors that make use of the forecasted variance based on HAR-DL specification. Our findings indicate that substantial average annualised gains in returns can be earned based on the lagged volatility components of the USA and the UK. JEL Classification: C32, C58, G01, G15
Forensic patients, treating psychiatrist and the Mental Health Review Tribunal – An ethical question?
Authors: Maheshwari Rajesh , Skinner Yvonne 
Published: June 2019

Objective: In inpatient forensic settings, a psychiatrist is expected to wear ‘Two Hats’, as a treating physician and as an expert to provide risk assessments and expert advice to the judicial authorities for leave and release decisions. Although dual roles have long been accepted as an inevitable part of independent forensic practice, there are additional ethical challenges for the treating psychiatrist to provide an expert opinion. This paper examines the specific ethical ambiguities for a treating psychiatrist at the interface of legal process related to leave and release decisions in the treatment of forensic patients. Conclusions: While respect for justice is the prevailing ethical paradigm for court-related forensic work, the medical paradigm should remain the key ethical framework for psychiatrists in treatment settings. Thus, psychiatrist should be aware of possible adverse consequences in acting as forensic experts for their patients. A conscientious adherence to clinical facts and awareness of the ‘Two Hats’ ethical pitfall can serve as important reference points in framing the psychiatric evidence in the decision-making process and safeguard treating psychiatrist’s role.
Cauterized suture for complete tube occlusion of Ahmed glaucoma valve in hypotony maculopathy
Authors: Canut María Isabel , Alonso-Agesta Maddi , Botella Jessica , Julio Gemma 
Published: June 2019

Purpose: To present our experience treating hypotony maculopathy with a simple, minimally invasive, and removable ab interno tube Ahmed glaucoma valve occlusion. Methods: Under topical anesthesia a 5–0 polypropylene suture (Prolene; Ethicon) was inserted into the Ahmed glaucoma valve tube. The length of the tube was measured, and an external suture cauterization was performed to allow an easier and safer fixation in the tube. The suture was introduced into the tube itself with the viscoelastic 27-gauge cannula. Results: This technique was performed in three cases of hypotony maculopathy with a complex history of medical treatments: a 4-year-old boy with Donnai-Barrow syndrome and previous pars plana vitrectomy that developed hypotony maculopathy the day after Ahmed glaucoma valve insertion and two male patients (69 and 49 years old) that underwent hypotony maculopathy after cyclophotocoagulation as a last option to reduce intraocular pressure. One of the men had three filtering surgeries, two 5-fluorouracil needlings and Ahmed glaucoma valve insertion. The other male patient had keratoplasty and posterior Ahmed glaucoma valve insertion. In the three cases, both hypotony and maculopathy were reversed within a week and a month, respectively, after Ahmed glaucoma valve occlusion with no complications. When hypotony maculopathy develops it seems suitable to occlude completely the Ahmed glaucoma valve tube to swiftly reverse clinical and anatomic changes. Conclusion: Intraluminal Ahmed glaucoma valve occlusion with cauterized suture is a simple, quick, reversible, and effective technique that may offer a minimally invasive way to resolve hypotony maculopathy in complex cases and avoid severe loss of vision.
Segmental scleral buckling without sling sutures around the muscles
Authors: Gao Lei , Cui Lei , Yim Cindi Kao , Lou Huadong , Wu Peng 
Published: June 2019

Purpose: To introduce a modified technique for segmental buckling through a small in situ conjunctival opening without rectus muscle traction for minimally invasive repair of uncomplicated rhegmatogenous retinal detachment. Methods: This technique was performed in 15 eyes of 15 selected patients with primary retinal detachment. Conventional traction sutures placed beneath rectus muscles were replaced by an absorbable translimbal traction suture at lesion quadrant. The conjunctival incision was made 8–9 mm posterior and parallel to the limbus. After cryopexy, a minimal explant was fixed with one to two sutures through the conjunctival opening, expanded by a pediatric speculum. Results: Retinal reattachments were achieved with correct buckle positions in all patients, with rapid cosmetic recovery. Conclusion: This modified buckling technique simplifies the buckling procedure, minimizes surgical invasiveness, preserves intact limbal conjunctiva, and relieves discomfort.
Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand
Authors: Kosuma Pattamawan , Jedsadayanmata Arom 
Published: June 2019

Background: Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients. Methods: We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins. Results: A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, P = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, P < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, P < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, P < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, P = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, P < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, P < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, P = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, P = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, P < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, P = .002). Conclusions: Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.
Improvement of Chemotherapy Solutions Production Procedure in a Hospital Central Chemotherapy Preparation Unit: A Systematic Risk Assessment to Prevent Avoidable Harm in Cancer Patients
Authors: Bourika Klio , Koutras Angelos , Kalofonos Haralambos , Vicha Anna , Tsiata Ekaterini , Papadimitriou Evangelia , Avgoustakis Konstantinos , Panagi Zoi 
Published: June 2019

Objective: This study was designed to reevaluate and improve the quality and safety of the chemotherapy preparation in a Central Chemotherapy Preparation Unit of a Public Hospital. Methods: A failure modes, effects, and criticality analysis (FMECA) was conducted by a multidisciplinary team. All potential failure modes at each stage of the chemotherapy preparation were recorded, and the associated risks were scored for their severity, occurrence, and detectability with a risk priority number (RPN). Corrective actions were suggested, and new RPNs were estimated for the modified process. Results: Failure modes, effects, and criticality analysis and priority matrix construction, revealed that the partial compliance of Unit’s premises with international standards (RPNstage: 307), the human errors throughout the compounding (RPNstage: 223)—labeling (RPNstage: 216)—prescribing (RPNstage: 198) steps, and the violation of working protocols by employees (RPNstage: 215), were the most important risks for which either urgent or immediate corrective actions had to be taken. Modifying the procedure through the proposed corrective actions is expected to lead to a significant (71.3%) risk containment, with a total RPNpreparation process reduction from 2102 to 604. Conclusions: Failure modes, effects, and criticality analysis and priority matrix development identified and prioritized effectively the risks associated with chemotherapy preparation allowing for the improvement of health services to cancer patients.
The Agency of the Principal–Agent Relationship: An Opportunity for HRD
Authors: Baker Rose M. 
Published: June 2019

The Problem Agency theory has been empirically studied in other fields of study such as economics, political science, sociology, and management. Although a proposal for inclusion of agency theory to test training and development outcomes was made in human resource development (HRD)-related publications, little research has been conducted and published in HRD-related literature. The Solution This review of agency theory offers a description of the elements and factors associated with the principal–agent relationship that have been theorized and empirically tested in other fields of study. Much of the theoretical implications are transferable to HRD. The principal–agent relationship should be empirically tested in HRD situations and interpreted through an HRD lens. The Stakeholders The review of the principal–agent relationship in other fields is expected to benefit HRD researchers, practitioners, principals, and agents in organizations by providing insight into the orientation, elements, and influence of principal–agent relationships.
The Life Cycle of Employee Engagement Theory in HRD Research
Authors: Kwon Kibum , Park Jiwon 
Published: June 2019

The Problem Although the current proliferation of employee engagement research in human resource development (HRD) has advanced our theoretical understanding of the nature of employee engagement and its importance, the scarcity of practical knowledge has circumscribed our understanding of how to assess, boost, and sustain employee engagement in workplaces. The Solution Examining the life cycle of employee engagement theory, we determined that employee engagement is in the initial stages of becoming a formal theory. A better understanding of the application of employee engagement theory would facilitate the development of more effective interventions for building employee engagement and would, in turn, strengthen the etiology of employee engagement, which represents a complex interplay of multiple variables involving individual and environmental factors. Key Stakeholders This study contributes to the HRD literature by elucidating the need for greater attention to the practical applications of employee engagement theory in HRD scholars and scholar-practitioners’ future research and practice.
Adaptive Imaging Versus Periodic Surveillance for Intrafraction Motion Management During Prostate Cancer Radiotherapy
Authors: Ma Xiangyu , Yan Huagang , Nath Ravinder , Chen Zhe , Li Haiyun , Liu Wu 
Published: June 2019

Objective: To evaluate the benefits of adaptive imaging with automatic correction compared to periodic surveillance strategies with either manual or automatic correction. Methods: Using Calypso trajectories from 54 patients with prostate cancer at 2 institutions, we simulated 5-field intensity-modulated radiation therapy and dual-arc volumetric-modulated arc therapy with periodic imaging at various frequencies and with continuous adaptive imaging, respectively. With manual/automatic correction, we assumed there was a 30/1 second delay after imaging to determine and apply couch shift. For adaptive imaging, real-time “dose-free” cine-MV images during beam delivery are used in conjunction with online-updated motion pattern information to estimate 3D displacement. Simultaneous MV-kV imaging is only used to confirm the estimated overthreshold motion and calculate couch shift, hence very low additional patient dose from kV imaging. Results: Without intrafraction intervention, the prostates could on average have moved out of a 3-mm margin for ∼20% of the beam-on time after setup imaging in current clinical situation. If the time interval from the setup imaging to beam-on can be reduced to only 30 seconds, the mean over-3 mm percentage can be reduced to ∼7%. For intensity-modulated radiation therapy simulation, with manual correction, 110 and 70 seconds imaging periods both reduced the mean over-3 mm time to ∼4%. Automatic correction could give another 1% to 2% improvement. However, with either manual or automatic correction, the maximum patient-specific over-3 mm time was still relatively high (from 6.4% to 12.6%) and those patients are actually clinically most important. In contrast, adaptive imaging with automatic intervention significantly reduced the mean percentage to 0.6% and the maximum to 2.7% and averagely only ∼1 kV image and ∼1 couch shift were needed per fraction. The results of volumetric-modulated arc therapy simulation show a similar trend to that of intensity-modulated radiation therapy. Conclusions: Adaptive continuous monitoring with automatic motion compensation is more beneficial than periodic imaging surveillance at similar or even less imaging dose.
Can the Student Outperform the Master? A Plan Comparison Between Pinnacle Auto-Planning and Eclipse knowledge-Based RapidPlan Following a Prostate-Bed Plan Competition
Authors: Smith April , Granatowicz Andrew , Stoltenberg Cole , Wang Shuo , Liang Xiaoying , Enke Charles A. , Wahl Andrew O. , Zhou Sumin , Zheng Dandan 
Published: June 2019

Purpose: Pinnacle Auto-Planning and Eclipse RapidPlan are 2 major commercial automated planning engines that are fundamentally different: Auto-Planning mimics real planners in the iterative optimization, while RapidPlan generates static dose objectives from estimations predicted based on a prior knowledge base. This study objectively compared their performances on intensity-modulated radiotherapy planning for prostate fossa and lymphatics adopting the plan quality metric used in the 2011 American Association of Medical Dosimetrists Plan Challenge. Methods: All plans used an identical intensity-modulated radiotherapy beam setup and a simultaneous integrated boost prescription (68 Gy/56 Gy to prostate fossa/lymphatics). Auto-Planning was used to retrospectively plan on 20 patients, which were subsequently employed as the library to build an RapidPlan model. To compare the 2 engines’ performances, a test set including 10 patients and the Plan Challenge patient was planned by both Auto-Planning (master) and RapidPlan (student) without manual intervention except for a common dose normalization and evaluated using the plan quality metric that included 14 quantitative submetrics ranging over target coverage, spillage, and organ at risk doses. Plan quality metric scores were compared between the Auto-Planning and RapidPlan plans using the Mann-Whitney U test. Results: There was no significant difference between the overall performance of the 2 engines on the 11 test cases ( P = .509). Among the 14 submetrics, Auto-Planning and RapidPlan showed no significant difference on most submetrics except for 2. On the Plan Challenge case, Auto-Planning scored 129.9 and RapidPlan scored 130.3 out of 150, as compared with the average score of 116.9 ± 16.4 (range: 58.2-142.5) among the 125 Plan Challenge participants. Conclusion: Using an innovative study design, an objective comparison has been conducted between 2 major commercial automated inverse planning engines. The 2 engines performed comparably with each other and both yielded plans at par with average human planners. Using a constant-performing planner (Auto-Planning) to train and to compare, RapidPlan was found to yield plans no better than but as good as its library plans.
The role of a critical care outreach service in the management of patients with haematological malignancy
Authors: Taheri Leila , Anandanadesan Rathai , de Lavallade Hugues , Pagkalidou Eirini , Pagliuca Antonio , Mufti Ghulam , Auzinger Georg , Metaxa Victoria 
Published: June 2019

Introduction Although improvement in survival from haematological malignancies has been reported, a substantial number of these patients develop life threatening complications. Critical care outreach services (CCOS) aim to avert inappropriate ICU admissions, while ensuring timely patient review. Methods We retrospectively analysed patients with haematological malignancy reviewed by an outreach service between January 2014 and December 2015 at a single institution. The aim of our study was to describe the patient population assessed by a well-established outreach team, identify predictors of ICU admission, as well as ICU and hospital mortality. Results Sixty of 126 patients reviewed (47.6%) were admitted to ICU. ICU and hospital mortality were 25.3% and 45.2%, respectively. The odds of being admitted to ICU was 13 times higher ( p = 0.013) if the patient was referred for hypoxia, 20 times higher ( p = 0.006) if they were referred for sepsis or 14 times higher ( p = 0.027) if they were referred to CCOS for hypotension, compared to when the team was automatically alerted. The odds of not surviving hospital admission increased 1.27 times for every extra day of CCOS review ( p = 0.02). When a patient was referred having a refractory or progressive haematological condition, the odds of not surviving to hospital discharge increased by four or 12 times, respectively, compared to when the referred patient was in remission. Receiving high flow nasal cannula oxygen (HFNCO) was associated with a reduction in ICU admission ( p = 0.03), irrespective of the underlying diagnosis, performance status or location of delivery. The CCOS participated in end-of-life discussions in 29% patients. Conclusions ICU and hospital mortality of patients with haemato-oncological malignancy continue to improve. CCOS are heavily involved in the recognition and management of these patients, as well as in the facilitation of end-of-life discussions. Sepsis was associated with increased risk of ICU admission and mortality. Initiation of HFNCO outside ICU appears to be feasible and safe and was not associated with increasing risk in this single centre study.