bluuebunny/crossref_metadata_2025_split huggingface dataset:
The clinical presentation, diagnosis and pathogenesis of symptomatic sports-related femoroacetabular impingement (SRFAI) in a consecutive series of 1021 athletic hips
Authors: Carton Patrick F , Filan David J 
Published: February 2019

Aim: To examine the pathogenesis and clinical presentation of sports-related femoroacetabular impingement (SRFAI) in a large consecutive series of symptomatic athletes. Methods: Between January 2009 and February 2017 prospectively collected data from competitive athletes within the Gaelic Athletic Association (GAA), and who subsequently underwent arthroscopic treatment for symptomatic FAI, were analysed. Data was collected using internationally validated health questionnaires (Harris Hip Score, UCLA, SF-36, WOMAC) and recognised clinical (ROM, symptom presentation, provocation tests) and radiological (AP pelvis, Dunn, False profile) indicators/measures of FAI. Results: A total of 1021 consecutive cases (mean 26.6 ± 6.2 years) were included. In every case, conservative treatment failed to resolve symptoms with athletes attending an average of 2.4 ± 1.1 health care professionals prior to referral. Symptoms developed gradually (78%) and consisted primarily of groin pain (76.1%) and hip stiffness (76.5%) following activity. An acetabular rim deformity (pincer) was present in all cases; a cam deformity in 72.1%. The prevalence and degree of cam deformity increased with progressing age groups ( p < 0.001); mean lateral centre-edge angle remained static ( p = 0.456). Increasing CEA, alpha angle and presence of rim fracture was associated with a reduction in all ranges of hip movement ( p < 0.001). Conclusion: Symptomatic SRFAI presented in this large series of GAA athletes failed to resolve with non-operative treatment. Increasing hip deformity resulted in poorer ROM. Abnormal acetabular morphology remains static with increasing athletic age while cam deformity is progressive and most likely a secondary pathology.
Effect of dislocation timing following primary total hip arthroplasty on the risk of redislocation and revision
Authors: Norambuena German A , Wyles Cody C , Van Demark Robert E , Trousdale Robert T 
Published: February 2019

Introduction: There is little data regarding timing of index dislocation in patients who undergo primary total hip arthroplasty (THA) and subsequent risk of redislocation and revision. Methods: Between 1992 and 2013, 21,490 primary THAs were performed at a single institution. 189 patients (190 hips) had a first episode of dislocation within one year of index surgery (0.9 %). 32 patients (32 hips) were excluded for the following reasons: complex THA secondary to fracture malunion, Crowe III/IV developmental hip dysplasia, periprosthetic fracture, prior hip surgery, incomplete information, and hip abductor avulsion. The final cohort consisted of 157 patients (158 hips) who experienced dislocation within 1 year of primary non-complex THA. 88 patients were female (56%), mean age was 61 years (SD = 14), and mean follow-up was 76 months (range 0–229). Multivariable Cox proportional-hazards regression models with fractional polynomial models were used to estimate the association between timing of index dislocation and subsequent redislocation and revision surgery. Results: 69 patients (44%) redislocated at final follow-up. Revision for any cause occurred in 26 out of 157 hips (17%). Time lapse from index THA to first dislocation was significantly associated with the risk of redislocation ( p = 0.004) and with the risk of revision ( p = 0.04). For every additional 7 days from surgery, risk of redislocation increased by a factor of 1.1 and risk of revision was increased by a factor of 1.13. Conclusion: This study demonstrates there is a lower risk of redislocation and revision in patients who have a first episode of dislocation closer to primary THA.
Treating to Target(s) With Interleukin-17 Inhibitors
Authors: Lynde Charles W. , Beecker Jennifer , Dutz Jan , Flanagan Cathy , Guenther Lyn C. , Gulliver Wayne , Papp Kim , Rahman Proton , Sholter Dalton , Searles Gordon E. 
Published: February 2019

Background: The treat-to-target (T2T) strategy has become established in several medical specialties as a key guidance to optimal therapeutic decision making. T2T may be effective in the assessment of the biologic class of agents called interleukin (IL)-17 inhibitors, which are emerging as a safe and effective treatment option for autoimmune inflammatory conditions such as plaque psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Objective: The objective of this article is to use a T2T approach for the evaluation of the effectiveness and safety of IL-17 inhibitors in the management of patients with plaque psoriasis, PsA, and AS. Methods: Following a comprehensive literature search, a full-day meeting was convened to discuss and identify the T2T targets for psoriasis, PsA, and AS. Clinical trial evidence was presented for the approved IL-17 inhibitors—secukinumab, ixekizumab, and brodalumab—to assess whether these data meet T2T safety and efficacy targets. Results: All 3 approved agents were significantly superior to placebo and active controls in the achievement of T2T targets for psoriasis. Secukinumab and ixekizumab were likewise associated with significantly better outcomes than controls in the PsA targets, and secukinumab resulted in significant AS target improvements vs placebo. The IL-17 inhibitors were also associated with low rates of serious adverse events and exacerbations of common comorbid conditions. Conclusion: Phase III trial results support the T2T benefit and safety of IL-17 inhibitors according to their specific indications for the management of patients with plaque psoriasis, PsA, and AS.
Increased language co-activation leads to enhanced cross-linguistic phonetic convergence
Authors: Simonet Miquel , Amengual Mark 
Published: February 2019

Purpose: This study investigates the effects of bilingual language modes (or settings) on the speech production patterns of a group of early Catalan/Spanish bilinguals from Majorca, Spain. Our main research question was as follows: are bilingual speech patterns modulated by the level of (co-)activation of a bilingual’s two languages? Design: Bilingual participants were classified as a function of their linguistic experience (or dominance), from Catalan- to Spanish-dominant. Subsequently, we recorded their speech in two experimental settings: a unilingual setting in which only Catalan words were uttered, and a bilingual setting in which both Catalan and Spanish words (cognates) were produced in random order. Data and analysis: The study examined the acoustic realization of Spanish and Catalan unstressed /a/, which surfaces as [a] in Spanish but is reduced to schwa, [ə], in Catalan. The acoustic characteristics of unstressed /a/ were explored across the two languages and the two experimental settings. Findings: Catalan unstressed /a/, which was similarly reduced to schwa in the speech of all participants, became slightly more similar to Spanish unstressed /a/ (i.e., it had a higher first formant) when produced alongside Spanish words (bilingual setting) than when produced in a Catalan unilingual setting. There were no effects of linguistic experience, and the effects of setting did not interact with experience. Originality: Very few studies have reported the effects of dynamic cross-linguistic interference in phonetic production, and even fewer have reported them with a phonetic variable resulting from a language-specific phonological process (unstressed vowel reduction) rather than a phonemic contrast. Implications: These findings suggest that cross-linguistic interaction is dynamic and modulated by language activation, and that an absence of dominance effects does not necessarily entail an absence of online cross-linguistic phonetic influence.
Italian-German bilinguals: The effects of heritage language use on accent in early-acquired languages
Authors: Lloyd-Smith Anika , Einfeldt Marieke , Kupisch Tanja 
Published: February 2019

Aims and objectives/purpose/research questions: This study investigates perceived accent in the two early-acquired languages of 21 adult-aged bilinguals with Italian as the heritage language (HL) and German as the majority language (ML). We test the relative ability of ‘age of onset (AoO) in German’ (range = 0–6 years) and ‘Italian use’ to predict perceived nativeness in Italian and German. Design/methodology/approach: Two accent rating experiments were carried out (one in each language) comparing the bilingual speech samples to those of monolingual and second language (L2) control groups. The samples were rated by German and Italian-speaking judges for foreign accent (‘yes’ or ‘no’) and for degree of certainty (‘certain, ‘semi-certain’, ‘uncertain’). Data and analysis: The effects of ‘AoO in German’ and ‘Italian Use’ (operationalized as an Italian Use Score) were analysed using correlational analyses and logistic regression. Findings/conclusions: Our results show that almost all bilinguals were indistinguishable from monolingual controls in German, and that their perceived accent in Italian lay somewhere between that of the monolingual and L2 controls. Based on regression analyses, we conclude that a later introduction of the ML has neither a negative effect on the ML itself, nor does it show up advantages in the HL. Instead, how native-like the heritage speakers (HSs) sound in the HL largely depends on HL use. No negative effects of HL use are found for German. Originality: We test a new population of Italian HSs in South Germany and compare these results to findings from other HS populations in Germany. Significance/implications: This study shows that, although it may be the case for child-aged bilinguals that introducing the ML earlier causes more phonological pressure on the HL, this effect seems to have disappeared by adulthood – at least with regards to perceived global accent. Also, accent in the HL depends on HL use across the lifespan.
Safe Introduction of Minimally Invasive Esophagectomy at a Medium Volume Center
Authors: Linder G. , Jestin C. , Sundbom M. , Hedberg J. 
Published: February 2019

Background and Aims: Minimally invasive esophagectomy is a favored alternative in high-volume centers. We evaluated the introduction of, and transition to, minimally invasive esophagectomy at a medium volume tertiary referral center (10–20 esophagectomies annually) with focus on surgical results. Material and Methods: Patients who underwent minimally invasive esophagectomy or open transthoracic surgery for carcinoma of the esophagus or gastroesophageal junction (Siewert I and II) during 2007–2016 were retrospectively studied. Sorted on surgical approach, perioperative data, surgical outcomes, and postoperative complications were analyzed and multivariate regression models were used to adjust for possible confounders. Results: One hundred and sixteen patients were included, 51 minimally invasive esophagectomy (21 hybrid and 30 totally minimally invasive) and 65 open resections. The groups were well matched. However, higher body mass index, neoadjuvant chemoradiotherapy, and cervical anastomosis were more frequent in the minimally invasive esophagectomy group. Minimally invasive esophagectomy was associated with less peroperative bleeding (384 vs 607 mL, p = 0.036) and reduced length of stay (14 vs 15 days, p = 0.042). Duration of surgery, radical resection rate, and postoperative complications did not differ between groups. Lymph node yield was higher in the minimally invasive esophagectomy group, 18 (13–23) vs 12 (8–16), p < 0.001, confirmed in a multivariate regression model (adjusted odds ratio 3.15, 95% class interval 1.11–8.98, p = 0.032). Conclusion: The introduction of minimally invasive esophagectomy at a medium volume tertiary referral center resulted in superior lymph node yield, less peroperative blood loss and shorter length of stay, without compromising the rate of radical resection, or increasing the complication rate.
Perceptions and experiences of wrist surgeons on the management of triangular fibrocartilage complex tears: a qualitative study
Authors: Robba Vanessa I. , Karantana Alexia , Fowler Andrew P. G. , Diver Claire 
Published: February 2019

There is lack of consensus on the management of triangular fibrocartilage injuries. The aim of this study was to investigate wrist surgeons’ experiences and perceptions regarding treatment of triangular fibrocartilage complex injuries and to explore the rationale behind clinical decision-making. A purposive sample of consultant wrist surgeons ( n = 10) was recruited through ‘snow-balling’ until data saturation was reached. Semi-structured interviews were conducted, digitally recorded and transcribed verbatim. Two researchers independently analysed data using an iterative/thematic approach. Findings suggest that surgeons rely more on their own training and experience, and patient-related factors such as individual expectations, to inform their decision-making, rather than on published material. Current classification systems are largely considered to be unhelpful. Level of evidence: V
Nurses' Experiences of Establishing Meaningful and Effective Relationships With American Indian Patients in the Cancer Care Setting
Authors: M. Pool Natalie 
Published: February 2019

Introduction The establishment of caring relationships with racial and ethnic minority populations is challenging for many cancer care nurses. Nurses serving American Indian (AI) patients frequently encounter population-specific issues, yet their experiences are largely unknown. Objective The purpose of this study was to describe the meaning of the AI patient–cancer care nurse relationship from nurses' perspectives. The study included three objectives: (a) to describe the immediate experiences of nurses that have engaged in cancer care relationships with AI patients, (b) to identify the underlying structures of the AI patient–cancer care nurse relationship as described by nurses, and (c) to interpret the meaning of the patient–nurse relationship within the context of AI cancer care experiences. Methods This was an interpretive phenomenological study using a hermeneutical process for data collection and analysis of multiple, exploratory interviews. Thematic reduction was completed to explicate the fundamental structures of this particular relationship. Reduction of individually situated themes resulted in seven shared meta-themes including from task to connection; unnerving messaging; we are one; the freedom of unconditional acceptance; attuning and opening; atoning for the past, one moment at a time; and humanizing the inhumane. Results Nine cancer care nurses participated. Reconstitution of data and reflective writing suggested that the essential meaning of the AI patient–cancer care nurse relationship was expressed in contradictory yet simultaneous patterns for nurses. Nurses sought synchronicity with their AI patients despite their contextual differences and similarities, yet most lacked adequate cultural safety training. Being in relationship provided nurses great purpose within the universal human context of caring. Conclusions Results contribute to the development of interventions designed to improve both the AI cancer care experience and the support and training of nurses. The mutually dependent nature of the patient–nurse relationship implies that strengthening and improving support for one entity may in turn positively impact the other.
Clinicopathological features and impact of adjuvant chemotherapy on the long‐term survival of patients with multiple gastric cancers: a propensity score matching analysis
Authors: Lin Jian‐Xian , Wang Zu‐Kai , Xie Jian‐Wei , Wang Jia‐Bin , Lu Jun , Chen Qi‐Yue , Cao Long‐Long , Lin Mi , Tu Ru‐Hong , Huang Ze‐Ning , Lin Ju‐Li , Zheng Chao‐Hui , Huang Chang‐Ming , Li Ping 
Published: February 2019

AbstractBackgroundLittle is known about the correlation between the clinicopathological features, postoperative treatment, and prognosis of multiple gastric cancers (MGCs). In this study, we aimed to investigate the correlation between these features and the impact of postoperative adjuvant chemotherapy on the long‐term survival of patients with MGC.MethodsThe clinical and pathological data of patients diagnosed with gastric adenocarcinoma who had radical gastrectomy from January 2007 to December 2016 were analyzed. Using propensity score matching, the prognostic differences, and the impact of postoperative adjuvant chemotherapy between those with MGC and solitary gastric cancers (SGC) were compared.ResultsAmong the 4107 patients investigated, the incidence of MGC was 3.2% (133/4107). Before matching, patients with MGC and SGC had disparities in the type of gastrectomy, pathological tumor stage (pT), pathological node stage (pN), and pathological tumor‐node‐metastasis stage (pTNM). After a 1:4 ratio matching, the clinical data of 133 cases of MGC and 532 cases of SGC were found to be comparable. The 5‐year overall survival (OS) rate was 56.6% in the entire matched cohort, 48.1% in the MGC group, and 58.7% in the SGC group (P = 0.013). Multivariate analysis revealed that MGC, age, pT stage, pN stage, and adjuvant chemotherapy were independent predictors of OS (all P < 0.05). Stratified analyses demonstrated that for the cohort of advanced gastric cancer (AGC) patients who did not had adjuvant chemotherapy, the 5‐year OS rate of advanced cases of MGC was inferior than that of SGC patients (34.0% vs. 46.1%, respectively; P = 0.025) but there were no significant difference in the 5‐year OS rate between advanced MGC and SGC patients who had adjuvant chemotherapy (48.0% vs. 53.3%, respectively; P = 0.292). Further, we found that the 5‐year OS rate of advanced MGC who had adjuvant chemotherapy was significantly higher than those who did not had adjuvant chemotherapy (48.0% vs. 34.0%, P = 0.026).ConclusionsPatients with advanced MGC was identified as having a poorer survival as to SGC patients, but the implementation of postoperative adjuvant chemotherapy showed that it had the potential to significantly improve the long‐term prognoses of MGC patients.
Working with MAPPA: ethics and pragmatics
Authors: Taylor Richard , Yakeley Jessica 
Published: February 2019

SUMMARYMulti-agency public protection arrangements (MAPPA) have been in operation for around 18 years in England and Wales. The primary purpose is for the sharing of information between agencies regarding the risk management of offenders returning to the community from custodial and hospital settings. The legal framework regarding information by psychiatrists is not dealt with in one single policy or guidance document. Psychiatrists must use their clinical and professional judgement when engaging with the MAPPA process, mindful of guidance available from professional bodies such as the Royal College of Psychiatrists, General Medical Council and British Medical Association.LEARNING OBJECTIVESAfter reading this article you will be able to:
•Learn the legal and political background that led to the formation of MAPPA•Understand the structure and function of MAPPA•Understand the role of psychiatrists in the MAPPA processDECLARATION OF INTERESTR.T. is a member of the London Strategic Management Board for MAPPA.
The interpersonal dynamics consultation in physical health settings: a model for reflective practice
Authors: Li Ching , Hillen Thomas , Reiss David , Kirtchuk Gabriel , Scott Sandra , Maier Michael 
Published: February 2019

SUMMARYThe interpersonal dynamics between patient and doctor remain a daily challenge for clinicians, and reflective practice is a tool that allows them better understanding of how patients engage with treatment. The interpersonal dynamics consultation is a form of group-based reflective practice for patients with difficult relational (interpersonal) styles. It includes the whole multidisciplinary team in a systematic consultation in order to arrive at new understanding and management plans for these patients. Interpersonal dynamics consultations have been used successfully for many years in mental healthcare, and this article has arisen from a project exploring their application in physical healthcare settings. The project works to promote effective working at the interface of physical and mental healthcare and facilitates the important translational work of making psychiatry and psychotherapeutic ideas applicable in a broader context. This article outlines the interpersonal dynamics consultation model and illustrates its use in three fictitious cases from different medical specialties.LEARNING OBJECTIVESAfter reading this article you will be able to:•describe the ways in which reflective practice is beneficial to clinical work•describe the basic structure of the interpersonal dynamics consultation, including the four interpersonal perspectives•recognise the types of cases where interpersonal dynamics consultation might be most useful.DECLARATION OF INTERESTNone.
Questioning the efficacy of predatory journals' blacklists
Authors: Manca Andrea , Cugusi Lucia , Deriu Franca 
Published: February 2019

SUMMARYWe question whether blacklists are the best answer to the serious problem of predatory journals. In conjunction with the worrying recent rise in the number of predatory journals, a remarkable number of blacklists have been compiled for specific scientific fields. However, predatory journals are continuously changing names and publishers; they are set up to make easy money and buried shortly after. Predatory journals have such a rapidly evolving nature that it is hard to keep track of them and keep blacklists up to date. We therefore propose a focus on ‘whitelists’ and directories of virtuous journals rather than on blacklists of pseudo-journals. We suggest that a set of criteria be determined that journals have to meet to be qualify as legitimate. In addition, the scientific community should come up with strategies to close the established biomedical databases to predatory journals, thus preventing them from achieving global exposure.DECLARATION OF INTERESTNone.
ARFID: old wine in a new bottle?
Authors: Waller Glenn 
Published: February 2019

SUMMARYIn this commentary, some aspects of the context of this diagnosis are considered. It is suggested that avoidant/restrictive food intake disorder (ARFID) is principally a reconfiguration of existing problems. However, it is also stressed that we still need to develop treatments that help patients and their families, given the expectation that has been fuelled by the promotion of the new diagnostic scheme. In developing those therapies, we should not forget that we previously had a number of psychosocial treatment approaches that were helpful for such children when their problems were labelled differently.DECLARATION OF INTERESTNone.
Against the stream: intermittent nurse observations of in-patients at night serve no purpose and cause sleep deprivation
Authors: Veale David 
Published: February 2019

This paper argues that intermittent nursing observations of in-patients at night do not reduce the risk of suicide or severe self-harm. Suicides between 23.00 h and 07.00 h are rare, and these overwhelmingly occur under intermittent observations. Such observation is purely a defensive intervention to document that a patient is safe at a particular time, as there is no engagement. For the large majority of in-patients, it has the unintended consequence of causing sleep deprivation. The intervention may cause harm to in-patients by making their disorder worse and increase their risk during the day. If patients are judged to be at immediate risk, then they should be placed on constant observation. If they are not, then optimising sleep is important for treating a psychiatric disorder and they should be placed on general observations.Declaration of interestNone.