bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of Tumor Stage in Sinonasal Undifferentiated Carcinoma Survival
Authors: Kuan Edward C. , Arshi Armin , Mallen‐St Clair Jon , Tajudeen Bobby A. , Abemayor Elliot , St John Maie A. 
Published: February 2016

ObjectiveTo describe the incidence and determinants of survival of patients with sinonasal undifferentiated carcinoma (SNUC) from 1973 to 2011 using the SEER database (Surveillance, Epidemiology, and End Results), with consideration of tumor stage based on the Kadish system.Study DesignRetrospective database analysis.SettingAcademic medical center.Subjects and MethodsThe SEER registry was utilized to calculate survival trends for 328 patients with SNUC between 1973 and 2011. Patient data were then analyzed with respect to histopathology, age, sex, race, subsite, modified Kadish stage, tumor size, and treatments rendered.ResultsThe cohort was composed of 61.9% males with median age of 60 years. The median overall survival (OS) was 1.9 years. Most tumors presented in the nasal cavity, maxillary sinus, and ethmoid sinus (29.3%, 27.4%, 21%, respectively); 43.7% of patients received both surgical and radiation therapy. OS at 2, 5, and 10 years was 43%, 30%, and 25%, respectively. On univariate analysis, age, Kadish stage, and tumor size were associated with worse OS and disease‐specific survival (DSS), while surgery and radiation therapy were associated with improved OS and DSS (all P <. 05). On multivariate analysis, radiation therapy and lower Kadish stage were associated with improved OS and DSS, while younger age was additionally associated with improved OS (all P <. 05).ConclusionSNUC is a rare but aggressive sinonasal malignancy. Tumor stage as determined by the Kadish system is associated with worse survival, with radiation therapy appearing to play a key role in therapeutic management.
Lateral Skull Base Attenuation in Patients with Anterior Cranial Fossa Spontaneous Cerebrospinal Fluid Leaks
Authors: O’Connell Brendan P. , Stevens Shawn M. , Xiao Christopher C. , Meyer Ted A. , Schlosser Rodney J. 
Published: February 2016

Objective(1) Determine if patients with anterior fossa spontaneous cerebrospinal fluid (SCSF) leaks demonstrate lateral skull base bone attenuation. (2) Examine the relation between body mass index (BMI; kg/m2) and skull base thickness.Study DesignRetrospective cohort study.SettingTertiary care hospital.Subjects and MethodsRetrospective review from 2004 to 2013 identified 96 patients with anterior cranial fossa SCSF leaks. A control group was identified from a consecutive series of clinic patients. Controls had no history of chronic sinonasal or temporal bone pathology and were divided according to BMI into nonobese (<30 kg/m2) and obese (≥30 kg/m2) groups. Composite skull base thickness was calculated for lateral and anterior subsites through predefined points according to previously published protocols.ResultsThirty‐two patients were included in each group. Composite lateral skull base thickness was less in patients with SCSF leaks(0.7 ± 0.1 mm) when compared with nonobese controls (0.8 ± 0.1 mm, P =. 004); no differences were apparent when SCSF leaks were compared with obese controls (0.7 ± 0.1 mm, P =. 99). A direct relation was observed between anterior skull base and lateral skull base thickness (r = 0.48, P <. 0001). An inverse correlation was noted between BMI and lateral skull base (r =−0.40, P <. 0001).ConclusionsPatients with anterior fossa SCSF leaks demonstrate attenuation of the lateral skull base. A significant correlation between anterior skull base thickness and lateral skull base thickness was observed. BMI was inversely related to lateral skull base thickness. Taken together, SCSF leaks are associated with obesity, which appears to be partly responsible for diffuse skull base erosion observed in patients with this condition.
Atomoxetine could improve intra-individual variability in drug-naïve adults with attention-deficit/hyperactivity disorder comparably with methylphenidate: A head-to-head randomized clinical trial
Authors: Ni Hsing-Chang , Hwang Gu Shoou-Lian , Lin Hsiang-Yuan , Lin Yu-Ju , Yang Li-Kuang , Huang Hui-Chun , Gau Susan Shur-Fen 
Published: February 2016

Objective: Intra-individual variability in reaction time (IIV-RT) is common in individuals with attention-deficit/hyperactivity disorder (ADHD). It can be improved by stimulants. However, the effects of atomoxetine on IIV-RT are inconclusive. We aimed to investigate the effects of atomoxetine on IIV-RT, and directly compared its efficacy with methylphenidate in adults with ADHD. Methods: An 8–10 week, open-label, head-to-head, randomized clinical trial was conducted in 52 drug-naïve adults with ADHD, who were randomly assigned to two treatment groups: immediate-release methylphenidate ( n=26) thrice daily (10–20 mg per dose) and atomoxetine once daily ( n=26) (0.5–1.2 mg/kg/day). IIV-RT, derived from the Conners’ continuous performance test (CCPT), was represented by the Gaussian (reaction time standard error, RTSE) and ex-Gaussian models (sigma and tau). Other neuropsychological functions, including response errors and mean of reaction time, were also measured. Participants received CCPT assessments at baseline and week 8-10 (60.4±6.3 days). Results: We found comparable improvements in performances of CCPT between the immediate-release methylphenidate- and atomoxetine-treated groups. Both medications significantly improved IIV-RT in terms of reducing tau values with comparable efficacy. In addition, both medications significantly improved inhibitory control by reducing commission errors. Conclusion: Our results provide evidence to support that atomoxetine could improve IIV-RT and inhibitory control, of comparable efficacy with immediate-release methylphenidate, in drug-naïve adults with ADHD. Shared and unique mechanisms underpinning these medication effects on IIV-RT awaits further investigation.
Concussion Characteristics in High School Football by Helmet Age/Recondition Status, Manufacturer, and Model
Authors: Collins Christy L. , McKenzie Lara B. , Ferketich Amy K. , Andridge Rebecca , Xiang Huiyun , Comstock R. Dawn 
Published: February 2016

Background: Football helmets used by high school athletes in the United States should meet the National Operating Committee on Standards for Athletic Equipment performance standards. Despite differences in interior padding and exterior shells, all football helmets should provide comparable protection against concussions. Yet, debate continues on whether differences in the rates or severity of concussions exist based on helmet age/recondition status, manufacturer, or model. Purpose: To investigate whether high school football concussion characteristics varied by helmet age/recondition status, manufacturer, and model. Study Design: Descriptive epidemiological study. Methods: High school football concussion and helmet data were collected from academic years 2008-2009 through 2012-2013 as part of the National High School Sports-Related Injury Surveillance Study. The certified athletic trainers of participating schools submitted athlete-exposure (AE) and injury information weekly. Results: Participating schools reported 2900 football concussions during 3,528,790 AEs for an overall rate of 8.2 concussions per 10,000 AEs. Concussion rates significantly increased from 2008-2009 through 2012-2013 overall ( P = .006) as well as in competition ( P = .027) and practice ( P = .023). Characteristics of concussed football players (ie, mean number of symptoms, specific concussion symptoms, symptom resolution time, and time until return to play) were similar among players wearing new helmets when compared with reconditioned helmets. Fewer players wearing an old/not reconditioned helmet had concussion symptoms resolve within 1 day compared with players wearing a new helmet. Despite differences in the manufacturers and models of helmets worn by all high school football players compared with players who sustained a concussion, the mean number of concussion symptoms, specific concussion symptoms, symptom resolution time, and time until return to play were similar for concussions sustained by football players wearing the most common helmet manufacturers and models. Conclusion: Overall, for new and reconditioned football helmets, the most common helmet manufacturers and models on the market today appear to provide high school football players with similar protection against concussions. Clinical Relevance: Concussions can have serious acute and long-term effects. An understanding of concussion patterns in high school athletes can drive targeted preventive measures, including improvements to and/or better use of protective equipment, to reduce the incidence and/or severity of sports-related concussions.
Apgar Scores Are Associated with Attention-Deficit/Hyperactivity Disorder Symptom Severity
Authors: Grizenko Natalie , Eberle Maria Loren , Fortier Marie-Eve , Côté-Corriveau Gabriel , Jolicoeur Claude , Joober Ridha 
Published: February 2016

Objective: Adverse events during pregnancy and delivery have been linked to attention-deficit/hyperactivity disorder (ADHD). Previous studies have investigated Apgar scores, which assess the physical condition of newborns, in relation to the risk of developing ADHD. We propose to go one step further and examine if Apgar scores are associated with ADHD symptom severity in children already diagnosed with ADHD. Method: ADHD symptoms severity, while off medication, was compared in 2 groups of children with ADHD: those with low (≤6, n = 52) and those with higher (≥7, n = 400) Apgar scores sequentially recruited from the ADHD clinic. Results: Children with low Apgar at 1 minute after birth had more severe symptoms as assessed by the externalizing scale of the Child Behaviour Checklist, the Conners’ Global Index for Parents, and the DSM-IV hyperactivity symptoms count ( P = 0.02, <0.01, <0.01, respectively). Conclusion: Low 1-minute Apgar scores are associated with a significant increase in ADHD symptom severity. These findings underline the importance of appropriate pregnancy and perinatal care.
A retrospective chart audit of electroconvulsive therapy at a regional Australian hospital
Authors: Stormont Barry , Diedricks Angelo A , Kidd Garry 
Published: February 2016

Objectives: The objective of the current study was to provide a contemporary review of electroconvulsive therapy (ECT) practice in Far North Queensland, Australia. Method: Demographic, diagnostic and treatment characteristics were extracted from the hospital files of people who received ECT between 2011 and 2013. Data were quantitatively analysed and described. Results: Depressive illnesses were the most common indicator for treatment. However, psychotic illnesses also made up a large proportion of treated cases. The technical aspects of treatment were commensurate with previous Australian findings except for the higher incidence of bifrontal ECT and maintenance treatment. Conclusions: Further research is needed across Australia to determine whether the findings of the current study represent changes in Australian ECT practice.
Psychiatrist-determined suitability of patients on long-acting injectable antipsychotics to be discharged from specialist to primary care
Authors: Castelino Alwyn M , Ramakrishnan Jairam K 
Published: February 2016

Objective: We aim to determine psychiatrists’ identified factors associated with suitability of discharging patients on long-acting injectable antipsychotics (LAI) from specialist to primary care. Method: We undertook a retrospective observational study utilising case file reviews. A questionnaire was developed specifically for this including sociodemographic information, clinical characteristics of the patients and clinical opinion on suitability of discharge to primary care. Results: In total, 72 case files (51 men, 21 women) were included in the study. The most common diagnosis was schizophrenia (71%) and Risperidone was the most often used LAI (71%). Fourteen (19%) of the patients were deemed suitable for discharge to primary care. A minimum period of 1 year of stability, having good cognitive function and insight, and absence of high-risk history were associated with suitability for discharge. Conclusions: Treating psychiatrists consider only a minority of patients on long-acting injection antipsychotics as suitable for discharge to primary care.
Later life transitions and changes in psychiatry
Authors: Randles Jennifer A 
Published: February 2016

Objective: The objective of this study was to discuss some concerns that today’s psychiatrists are likely to experience in the later stages of their careers. Conclusions: When changes associated with ageing begin to make their presence felt, there is a need to come to terms with them. For many psychiatrists this may generate a surprising creativity. Psychiatrists also need to come to terms with a paradigm change that has taken place in psychiatric practice. This paper, one of a series that captures a broad perspective on ageing, was solicited (by the Members Engagement Committee) to specifically capture the psychotherapist’s view of later life transitions.
Expert leadership of eating disorder services in South Australia
Authors: Long Randall , Allison Stephen 
Published: February 2016

Objectives: The objective of this study was to describe the history of South Australian Government eating disorder service from the perspective of changing leadership, health policies and politics. Conclusions: The history reveals a foundation of early expert academic clinical leadership changing into a centralised managerial bureaucracy correlating with a diminution of services. A threat to the survival of the service led to a solution involving reinvigoration of expert clinical and academic leadership. Expert leadership was shown to be an important part of an eating disorder service.
Self-management-support in dementia care: A mixed methods study among nursing staff
Authors: Verkaik Renate , van Antwerpen-Hoogenraad Paulien , de Veer Anke , Francke Anneke , Huis in het Veld Judith 
Published: February 2016

Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: ‘What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and ‘Do nursing staff feel sufficiently trained and skilled for self-management support?’. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider ‘helping people with dementia to maintain control over their lives by involving them in decisions in daily care’ the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN’s and CNA’s did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations Nursing staff need sufficient training to enable the proper provision of self-management support for people with dementia. More attention should also be given to the support of self-management for family caregivers.
Mechanical thrombectomy in acute basilar artery occlusion: A safety and efficacy single centre study
Authors: Werner Mariano , Lopez-Rueda Antonio , Zarco Federico , Román Luis San , Blasco Jordi , Amaro Sergio , Carrero Enrique , Fontanals Jaume , Oleaga Laura , Macho Juan , Bargallo Nuria 
Published: February 2016

Objectives The objective of this study was to add more evidence about the efficacy and safety of mechanical thrombectomy in patients with basilar artery occlusion and secondarily to identify prognostic factors. Methods Twenty-two consecutive patients (mean age 60.5 years, 15 men) with basilar artery occlusion treated with mechanical thrombectomy were included. Clinical, procedure and radiological data were collected. Primary outcomes were the modified Rankin scale score with a good outcome defined by a modified Rankin scale score of 0–2 and mortality rate at three months. Results The median National Institutes of Health stroke scale at admission was 24 (interquartile range 11.5–31.25). Twelve patients (54.5%) required tracheal intubation due to a decreased level of consciousness. Successful recanalisation (modified treatment in cerebral ischaemia scale 2b–3) was achieved in 20 patients (90.9%). A favourable clinical outcome (modified Rankin scale score 0–2) was observed in nine patients (40.9%) and the overall mortality rate was 40.9% (nine patients). Haemorrhagic events were observed in three patients (13.63%). A decreased level of consciousness requiring intubation in the acute setting was more frequent in patients with poor outcomes (84.6%) than in patients with favourable outcomes (11.1%), and in patients who died (100%) compared with those who survived (23.1%), with a statistically significant difference ( P = 0.002 and P = 0.001, respectively). Conclusion Mechanical thrombectomy is feasible and effective in patients with acute basilar artery occlusion. A decreased level of consciousness requiring tracheal intubation seems to be a prognostic factor and is associated with a poor clinical outcome and higher mortality rate. These initial results must be confirmed by further prospective studies with a larger number of patients.
ARTS (Aspiration–Retriever Technique for Stroke): Initial clinical experience
Authors: Massari Francesco , Henninger Nils , Lozano Juan Diego , Patel Anand , Kuhn Anna Luisa , Howk Mary , Perras Mary , Brooks Christopher , Gounis Matthew J , Kan Peter , Wakhloo Ajay K , Puri Ajit S 
Published: February 2016

Background A new generation of highly navigable large-bore aspiration catheters and retriever devices for intracranial mechanical thrombectomy has markedly improved recanalization rates, time and clinical outcomes. We report collected clinical data utilizing a new technique based on combined large lumen aspiration catheter and partially resheathed stent retriever (ARTS: Aspiration (catheter)–(stent) Retriever Technique for Stroke). This technique is applied, especially in presence of bulky/rubbery emboli, when resistance is felt while retracting the stent retriever; at that point the entire assembly is locked and removed in-toto under continuous aspiration with additional flow arrest. Methods A retrospective data analysis was performed to identify patients with large cerebral artery acute ischemic stroke treated with ARTS. The study was conducted between August 2013 and February 2015 at a single high volume stroke center. Procedural and clinical data were captured for analysis. Results Forty-two patients (median age 66 years) met inclusion criteria for this study. The ARTS was successful in achieving Thrombolysis in Cerebral Infarction (TICI) ≥2b revascularization in 97.6% of cases (TICI 2b = 18 patients, TICI 3 = 23 patients). Patients’ median National Institutes of Health Stroke Scale score at admission was 18 (6–40). A 3-month follow-up modified Rankin Scale value of 0–2 was achieved in 65.7% of the successfully treated patients (average 2.4). Two patients (4.8%) developed symptomatic intraparenchymal hemorrhages. Six procedure unrelated deaths were observed. Conclusions We found that ARTS is a fast, safe and effective method for endovascular recanalization of large vessel occlusions presenting within the context of acute ischemic stroke.
A behavior change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams: The Out-and-About trial
Authors: McCluskey Annie , Ada Louise , Kelly Patrick J , Middleton Sandy , Goodall Stephen , Grimshaw Jeremy M , Logan Pip , Longworth Mark , Karageorge Aspasia 
Published: February 2016

Background Australian guidelines recommend that outdoor mobility be addressed to increase participation after stroke. Aim To investigate the efficacy of the Out-and-About program at increasing outings delivered during therapy by community teams, and outings taken by stroke survivors in real life. Method Cluster-randomized trial involving 22 community teams providing stroke rehabilitation. Experimental teams received the Out-and-About program (a behavior change program comprising a training workshop with barrier identification and booster session, printed educational materials, audit, and feedback). Control teams received printed clinical guidelines only. The primary outcome was the percentage of stroke survivors receiving four or more outings during therapy. Secondary outcomes included the number of outings received by stroke survivors during therapy and undertaken in real life. Results At 12 months after implementation of the behavior change program, 9% of audited experimental group stroke survivors received four or more outings during therapy compared with 5% in the control group (adjusted risk difference 4%, 95% CI − 9 to 17, p = 0.54). They received 1.1 (SD 0.9) outings during therapy compared with 0.6 (SD 1.0) in the control group (adjusted mean difference 0.5, 95% CI − 0.4 to 1.4; p = 0.26). After six months of rehabilitation, observed experimental group stroke survivors took 9.0 (SD 3.0) outings per week in real life compared with 7.4 (SD 4.0) in the control group (adjusted mean difference 0.5, 95% CI − 1.8 to 2.8; p = 0.63). Conclusion The Out-and-About program did not change team or stroke survivor behavior.