bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and validity of the Korean‐language version of the Communication Function Classification System in children with cerebral palsy
Authors: Choi J. Y. , Hwang E. H. , Rha D. , Park E. S. 
Published: September 2017

AbstractPurposeThe Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) are useful systems for describing the broad communication function and speech intelligibility, respectively, of children with cerebral palsy (CP). The aims of this study were to determine the reliability and validity of the Korean version of the CFCS and also to investigate the association between the CFCS and the VSS and other functional classifications for children with CP.Materials and methodsParticipants were 50 children with CP (33 males, 17 females; mean age 7.2 years, range 4–16 years) recruited from a rehabilitation hospital. We analysed the interrater and intrarater reliabilities of the Korean version of the CFCS and VSS between parents, a physiatrist, and a speech–language pathologist (SLP). The social function domain of the Paediatric Evaluation of Disability Inventory was assessed to examine the concurrent validity of the CFCS and VSS.ResultsThe intrarater reliabilities of the CFCS and VSS were excellent in a physiatrist (ƙ = 0.92, ƙ = 0.94, respectively) and an SLP (ƙ = 0.98, ƙ = 0.98) and very good in parents (ƙ = 0.87, ƙ = 0.89). The interrater reliability of the CFCS and VSS was very good between the physiatrist and SLP (ƙ = 0.87, ƙ = 0.89) and good between parents and the SLP (ƙ = 0.63, ƙ = 0.78) and between parents and the physiatrist (ƙ = 0.61, ƙ = 0.76). The CFCS and VSS were strongly related with the social function domain of Paediatric Evaluation of Disability Inventory. In addition, we found very strong associations between the VSS and CFCS.ConclusionsThe Korean version of the CFCS is a valid and reliable tool to classify communication ability and is strongly associated with the VSS, a reliable tool to classify speech intelligibility.
Long‐term success of oral health intervention among care‐dependent institutionalized seniors: Findings from a controlled clinical trial
Authors: Schwindling Franz Sebastian , Krisam Johannes , Hassel Alexander J. , Rammelsberg Peter , Zenthöfer Andreas 
Published: September 2017

AbstractObjectivesThe purpose of this work was to investigate the long‐term effectiveness of oral health education of caregivers in nursing homes with care‐dependent and cognitively impaired residents.MethodsFourteen nursing homes with a total of 269 residents were allocated to a control group, with continued normal care, or to an intervention group. Allocation was performed at nursing home level. In the intervention group, caregivers were given oral health education, and ultrasonic cleaning devices were provided to clean removable prostheses. Oral health was assessed at baseline and after 6 and 12 months by use of the Plaque Control Record (PCR), Gingival Bleeding Index (GBI), Community Periodontal Index of Treatment Needs (CPITN) and Denture Hygiene Index (DHI). Mixed models for repeated measures were performed for each target variable, with possible confounding factors (intervention/control group, age, sex, residence location and care‐dependence).ResultsIn the control group, no changes of target variables were observed between baseline and the 6‐ and 12‐month follow‐ups. After 6 and 12 months, PCR and DHI were significantly improved in the intervention group. For PCR, the intergroup difference of improvements was −14.4 (95% CI: −21.8; −6.9) after 6 months. After 12 months, the difference was −16.2 (95% CI: −27.7; −4.7). For DHI, the intergroup difference compared to baseline was −15 (95% CI: −23.6; −6.5) after 6 months and −13.3 (95% CI: −24.9; −1.8) after 12 months. There was neither a statistically significant effect on GBI nor on CPITN. Care‐dependency showed a substantial trend to smaller improvements in PCR (P = .074), while an inverse effect was apparent for DHI (P < .001).ConclusionsEducation of caregivers improves and maintains the oral health of care‐dependent nursing home residents over longer periods. Use of ultrasonic devices is a promising means of improving denture hygiene among the severely care‐dependent. Such interventions can be easily and cheaply implemented in routine daily care.
Circumferential margin involvement after total mesorectal excision for mid or low rectal cancer: are all R1 resections equal?
Authors: Beaufrère A. , Guedj N. , Maggiori L. , Patroni A. , Bedossa P. , Panis Y. 
Published: September 2017

AbstractAimOur aim was to assess the prognostic influence of the circumferential resection margin (CRM) exact value after total mesorectal excision for mid or low rectal cancer.MethodsAll patients (n = 321) who underwent total mesorectal excision from 2005 to 2013 were identified from a prospective database, including 49 (15%) who presented with a CRM ≤ 1 mm. Four groups were defined: group 1, CRM = 0 mm (n = 21); group 2, 0 < CRM ≤ 0.4 mm (n = 13); group 3, 0.4 < CRM ≤ 1 mm (n = 15); group 4, CRM > 1 mm (n = 272).ResultsAfter a mean follow‐up of 42 ± 26 months, locoregional recurrence rates were 8/21 (38%) in group 1, 3/13 (23%) in group 2, 0/12 (0%) in group 3 and 26/272 (10%) in group 4 (P < 0.001), leading to significantly impaired 3‐year locoregional recurrence‐free survival in group 1 (57% ± 13%) and group 2 (56% ± 15%) compared to group 3 (85% ± 10%, vs group 1, P = 0.021, vs group 2, P = 0.049) and to group 4 (89% ± 2%, vs group 1, P < 0.001, vs group 2, P < 0.001). In multivariate Cox analysis, a CRM ≤ 0.4 mm was identified as an independent factor impairing both locoregional recurrence‐free survival (OR 3.14, 95% CI 1.53–6.46; P = 0.002) and disease‐free survival (OR 2.15, 95% CI 1.28–3.63; P = 0.004).ConclusionOur study suggests that the prognosis after mid or low rectal cancer surgery was worse with a CRM ≤ 0.4 mm. The prognosis was similar in patients with a CRM > 0.4 mm or ≤ 1 mm and patients with an R0 resection.
A naturalistic longitudinal analysis of post‐detoxification outcomes in opioid‐dependent patients
Authors: Ivers Jo‐Hanna , Zgaga Lina , Sweeney Brion , Keenan Eamon , Darker Catherine , Smyth Bobby P. , Barry Joe 
Published: September 2017

AbstractIntroduction and AimsTo provide an assessment of outcomes in a cohort of opioid‐dependent patients post‐detoxification.Design and MethodsThis study employed an observational longitudinal cohort design. Patients who completed detoxification in the three major Drug Dependency Units in Ireland during a 14‐month period were included in the study (n = 143). Patients opting for one of the three pathways post‐detoxification (inpatient aftercare, outpatient aftercare or no formal aftercare) were assessed in the final week of detoxification and followed up after 3, 6 and 9 months. The primary outcome was abstinence following detoxification.ResultsA Cox (adjusted) model indicated participants who opted for outpatient aftercare treatment lapsed/relapsed at a rate of 52% higher than the inpatient aftercare group (hazard ratio = 1.52, 95% confidence interval 0.75–3.08, P = 0.24). Moreover, time to lapse/relapse was considerably shorter for the no formal aftercare group (hazard ratio = 7.68, 95% confidence interval 4.30–13.73, P = 5.75 × 10−12). Abstinence rates for outpatient aftercare and inpatient aftercare are about equal after 9 months.Discussion and ConclusionPatients who opt for aftercare post‐detoxification have significantly better outcomes at follow up when compared to no formal aftercare. In addition, patients’ intention to attend aftercare affected their outcomes regardless of eventual treatment path.
New integrated approach to percutaneous mitral valvuloplasty combining Wilkins score with commissural calcium score and commissural area ratio
Authors: Gajjala Obul Reddy , Durgaprasad Rajasekhar , Velam Vanajakshamma , Kayala Sridhar Babu , Kasala Latheef 
Published: September 2017

BackgroundPresent echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations, and no scoring system is significant determinant of procedural outcome. In this study, we assess the relationship between various echocardiographic parameters and scoring systems with immediate outcomes and test an integrated approach by combining Wilkins score with other parameters.MethodsOne hundred two patients who had undergone PMV were included in this prospective observational study. Preprocedural mitral valve morphology was assessed and categorized using Wilkins score, Sutaria scoring system, and Nunes quantitative scoring system.ResultsOptimal PMV results were obtained in 84 patients (82.35%), and suboptimal PMV results were obtained in 18 patients (17.65%). Using Nunes scoring system, suboptimal PMV results were obtained in 9 (37.5%) patients of high‐risk group (n=24), 8 (13.8%) of intermediate‐risk group (n=58), and one (5%) patient of low‐risk group (n=20). Using Wilkins scoring system, in patients having score>8 (n=16) suboptimal results were obtained in 5 (31.7%) and in patients having score<8 (n=86) suboptimal results were obtained in 13 (15.1%). Using Sutaria scoring system, in patients having score 3 to 4 (low risk, n=68) suboptimal results were obtained in 6 (8.8%), and in patients having score 0‐2 (high risk, n=34) suboptimal results were obtained in 12 (35.3%) patients.ConclusionAll echocardiographic scores have significant limitations, and an integrative approach is mandatory. Combining traditional Wilkins score with Sutaria score and commissural area ratio better predicts procedural outcomes.
Correlation between myocardial deformation on three‐dimensional speckle tracking echocardiography and cardiopulmonary exercise testing
Authors: Li Mei , Lu Yaran , Fang Cui , Zhang Xiaorong 
Published: September 2017

PurposeHeart failure (HF) is a multifactorial entity that combines derangements in both systolic and diastolic function. The relationship between systolic and diastolic function and exercise capacity is not fully understood. We sought to determine the mechanisms linking cardiac function and exercise tolerance in patients with HF.MethodsOne hundred fifty‐six subjects with different cardiac function levels were included in the study. Subjects’ 2D echocardiographic, 3D speckle tracking echocardiographic, and cardiopulmonary exercise testing (CPET) data were collected.ResultThe amount of untwisting at 25% of the untwist duration (25%Untwist) and global longitudinal peak systolic strain (GLS) showed the best positive correlations with peak oxygen uptake (peakVO2) (r = .41; P < .001 and r = .32; P < .001, respectively), while the left ventricular ejection fraction (EF) was weakly correlated with peakVO2. The 25%Untwist value was negatively correlated with the carbon dioxide equivalent slope (VE/VCO2) (r = −.49; P < .001). Both E/e and the left atrium volume index (LA index) exhibited good positive correlations with VE/VCO2 (r = .39; P < .01 and r = .32; P < .001). In the multiple regression analysis, the best predictive model for the peakVO2 included the 25%Untwist, GLS, and E/e, explained 64% of the variation in peakVO2, with 25%Untwist explaining 17.6% of the variation. Including EF in the model explained only 3.1% of the variation in peakVO2. In a multivariable model for VE/VCO2, 25%Untwist was the strongest independent predictor, explaining 23% of the variance in VE/VCO2.ConclusionLeft ventricular early diastolic function is a modest independent predictor of aerobic exercise capacity. The 25%Untwist value is a good indicator of cardiac diastolic function.
A quality control exercise in the echo laboratory: Reduction in inter‐observer variability in the interpretation of pulmonary hypertension
Authors: Patton Daniel M. , Enzevaie Atoosa , Day Andrew , Sanfilippo Anthony , Johri Amer M. 
Published: September 2017

BackgroundRight ventricular systolic pressure (RVSP) estimated by echocardiography is critical for the initial screening and follow‐up of pulmonary hypertension (PH). Inter‐observer variability (IOV) in RVSP can impact clinical decision making. This study assessed whether a simple guideline‐based teaching intervention could reduce the IOV in RVSP interpretation.Methods and ResultsEleven participants in a high‐volume tertiary level echocardiography laboratory underwent an assessment of the baseline IOV in the assessment of RVSP for a series of transthoracic echocardiograms (TTE), depicting various degrees of PH among 8 cases each before and after a teaching intervention. The inter‐observer variance (root‐mean‐square error) decreased from 26.0 mm Hg2 (5.1 mm Hg) at baseline to 5.8 mm Hg2 (2.4 mm Hg) post‐teaching intervention (P = .025). The corresponding inter‐class coefficient (ICC) increased from 0.89 to 0.98. Several factors relating to image acquisition and interpretation were identified as contributing to IOV in RVSP. The outcome was the development of a practical tool to mitigate these factors.ConclusionsA simple structured teaching intervention successfully reduced IOV in the measurement of RVSP in a high‐volume echo laboratory.
The association between specific types of childhood adversity and attenuated psychotic symptoms in a community sample
Authors: Mongan David , Shannon Ciaran , Hanna Donncha , Boyd Adrian , Mulholland Ciaran 
Published: September 2017

AimThis study aimed to examine the relationship between types of childhood adversity and attenuated psychotic symptoms in a general population sample, and to determine the predictive role of other psychosocial factors such as resilience, coping style and social support.MethodsAn online survey was conducted with a US‐based general population sample of 748 participants (aged 18 to 35 years) using Amazon's Mechanical Turk (an online crowd‐sourcing service). Participants completed the Adverse Childhood Experiences Questionnaire (ACE‐Q), the Prodromal Questionnaire (PQ‐16), the Brief COPE Scale, the Brief Resilience Scale (BRS), the Multidimensional Scale of Perceived Social Support and the Neighbourhood Cohesion Scale. A series of backwards stepwise hierarchical regression analyses was employed to determine the predictors of PQ‐16 score.ResultsParticipants reported an average of 2.99 attenuated psychotic symptoms (from a total of 16), and an average of 2.77 childhood adversities (from a total of 10). In the final model, the specific types of childhood adversity which significantly predicted PQ‐16 score were verbal abuse, sexual abuse and physical neglect. Resilience, as well as the coping styles of self‐distraction, denial, substance use, emotional support, venting, religion and self‐blame, were significant predictors; perceived social support and neighbourhood cohesion were not. This model predicted 33% of the variance in PQ‐16 score.ConclusionsThe results of this study support the association between childhood adversity and attenuated psychotic symptoms in the general population. Resilience and coping styles were also important predictive factors. These data suggest potential strategies on which to focus for early intervention and prevention.
Patient value: Perspectives from the advocacy community
Authors: Addario Bonnie J , Fadich Ana , Fox Jesme , Krebs Linda , Maskens Deborah , Oliver Kathy , Schwartz Erin , Spurrier‐Bernard Gilliosa , Turnham Timothy 
Published: September 2017

AbstractAll health‐care systems are under financial pressure and many have therefore developed value frameworks to assist decision making regarding access to treatment. Unfortunately, many frameworks simply reflect the clinically focused values held by health‐care professionals rather than outcomes that also matter to patients. It is difficult to define one single homogeneous set of patient values as these are shaped by social, religious and cultural factors, and health‐care environment, as well as many factors such as age, gender, education, family and friends and personal finances. Instead of focusing on an aggregated set of values, frameworks should attempt to incorporate the broader range of outcomes that patients may regard as more relevant. Patient advocates are well placed to advise assessment bodies on how particular therapies will impact the patient population under consideration and should be closely involved in developing value frameworks. In this paper, a group of patient advocates explore the varying definitions of patient value and make positive recommendations for working together to strengthen the patient voice in this area. The authors call on framework developers, the patient advocacy and research communities, the health‐care industry and decision‐makers to undertake specific actions to ensure patient value is included in current and future value frameworks. This is justified on compassionate and economic grounds: better health outcomes result when patients receive treatment tailored to individual needs. Paying attention to the patient perspective also results in better use of resources—a goal that should appeal to all stakeholders.
Molecular genotyping of the non‐invasive encapsulated follicular variant of papillary thyroid carcinoma
Authors: Kim Tae Hyuk , Lee Minju , Kwon Ah‐Young , Choe Jun‐Ho , Kim Jung‐Han , Kim Jee Soo , Hahn Soo Yeon , Shin Jung Hee , Chung Man Ki , Son Young Ik , Ki Chang‐Seok , Yim Hyun Sook , Kim Yoo‐Li , Chung Jae Hoon , Kim Sun Wook , Oh Young Lyun 
Published: September 2017

AimsThe non‐invasive encapsulated follicular variant of papillary thyroid carcinoma (FVPTC) has been managed as a low‐risk malignancy. Recently, a proposal was made to reclassify this tumour type as a premalignant lesion and rename it non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP). This study aims to provide the first comprehensive study on molecular genotype–phenotype correlations of encapsulated FVPTC.Methods and resultsThis study was performed on 177 consecutive FVPTCs from January 2014 to April 2016. These were classified as non‐invasive encapsulated FVPTC (n = 74) invasive encapsulated FVPTC (n = 51), and infiltrative FVPTC (n = 52), according to standard criteria, by two independent pathologists. Genetic alterations and other clinicopathological information were compared. BRAFV600E was found in 12.2% (non‐invasive) and 11.8% (invasive) of encapsulated FVPTCs, and in 34.6% of infiltrative FVPTCs (P = 0.001). Mutation in encapsulated FVPTCs was limited to cases with rare or abortive papillae. RET–PTC1 and RET–PTC3 rearrangements were present (11.5%) only in infiltrative FVPTCs. In contrast, NRAS, HRAS and KRAS mutations were observed more often in encapsulated FVPTCs (48.6% in non‐invasive and 66.7% in invasive) than in infiltrative FVPTCs (15.4%) (P < 0.001). Preoperative cytological examination did not distinguish between non‐invasive and invasive encapsulated FVPTCs, whereas infiltrative FVPTC was more likely to be Bethesda class V/VI than the encapsulated type (60.4% versus 38.1%; P = 0.01).ConclusionsThere were no differences in clinicopathological or molecular profiles between non‐invasive and invasive encapsulated FVPTCs, except in vascular and capsular invasion. Therefore, the diagnosis of NIFTP, like that of follicular adenoma, may require surgical resection and exclusion of those tumours with any papillae.
Prevalence of mental illness within families in a regional child‐focussed mental health service
Authors: Naughton Michael F. A. , Maybery Darryl J. , Goodyear Melinda 
Published: September 2017

AbstractNearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co‐occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross‐sectional study design was employed involving a case record review and clinician‐completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co‐occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family‐focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent.
Systolic orthostatic hypotension is related to lowered cognitive function: Findings from the Maine‐Syracuse Longitudinal Study
Authors: Torres Rachael V. , Elias Merrill F. , Crichton Georgina E. , Dore Gregory A. , Davey Adam 
Published: September 2017

The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross‐sectional analysis included 961 community‐dwelling participants of the Maine‐Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg). Orthostatic hypotension and hypertension defined using traditional criteria were unrelated to cognition with covariate adjustment. However, an examination of systolic and diastolic BP change independently revealed that participants with systolic orthostatic hypotension had poorer global cognition, verbal memory, and scanning and tracking scores than those with normal systolic BP change. The authors conclude that systolic orthostatic hypotension is significantly associated with reduced cognitive function.
Differential diversifications of South American and Eastern Asian disjunct genera Bocconia and Macleaya (Papaveraceae)
Authors: Li Jianhua , Murray K. Gregory , Li Pan , Brown Kenneth 
Published: September 2017

AbstractBocconia (10 species) and Macleaya (2 species) are two disjunct genera between South America and eastern Asia (EAS) in the Papaveraceae offering an opportunity to compare its biogeographic history with that of the well‐known disjunction between EAS and eastern North American (ENA). Our phylogenetic analyses of the chloroplast matK and rbcL gene sequences of Ranunculales including two species of Macleaya and six species of Bocconia supported the monophyly of Bocconia, Macleaya, and Chelidonioideae to which Bocconia and Macleaya belong. Nucleotide sequences of matK, rbcL, and nrDNA ITS supported the sister relationship of Bocconia and Macleaya. Biogeographic analyses of Chelidonioideae using S‐DIVA (statistical dispersal vicariance analysis) and DEC (dispersal extinction cladogenesis) methods inferred Eurasia as the most likely ancestral area of Bocconia and Macleaya and suggested no extinction events in either Bocconia or Macleaya. This agrees with the “Out‐of‐Asia” pattern of the EAS‐ENA disjunction. Molecular dating of Ranunculales with fossil‐based calibrations showed that Bocconia and Macleaya diverged in the late Eocene and early Oligocene, which is much earlier than most EAS‐ENA disjunct taxa. The disjunction may have formed via long distance dispersal or boreotropical connections via the North Atlantic and Bering land bridges. Both Bocconia and Macleaya diversified in the late mid‐Miocene, but Bocconia has apparently experienced a greater diversification probably aided by the evolution of the bird dispersal syndrome in fruit and seed after migration to South America. The greater diversification of Bocconia is also evidenced by the diverse leaf morphology and growth habit in response to colonization in various local habitats in South America.