bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treating body, treating mind: The experiences of people with psychotic disorders and their general practitioners – Findings from the Australian National Survey of High Impact Psychosis
Authors: Waterreus Anna , Morgan Vera A 
Published: September 2017

Objectives: To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population. Methods: A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed. Results: Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services. Conclusion: People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.
Borderline personality disorder and polycystic ovary syndrome: A review of the literature
Authors: Tan Raelene YM , Grigg Jasmin , Kulkarni Jayashri 
Published: September 2017

Objective: This review examines the existing evidence for the relationship between borderline personality disorder and polycystic ovary syndrome, and to identify commonalities in etiological mechanisms of borderline personality disorder and polycystic ovary syndrome that might explain the relationship between these seemingly disparate disorders. Methods: A search of Medline, EMBASE and Cochrane Central was undertaken on 5 December 2016 to identify studies investigating women with borderline personality disorder and polycystic ovary syndrome (or symptoms and markers specific to polycystic ovary syndrome). Results: Nine studies were identified, including three cross-sectional studies investigating symptoms of polycystic ovary syndrome in women with borderline personality disorder, two cross-sectional and one cohort study examining the prevalence of psychiatric diagnoses in women with polycystic ovary syndrome and three case reports of comorbid borderline personality disorder and polycystic ovary syndrome. Conclusion: Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries, which can be key features of polycystic ovary syndrome. However, this research is still in its infancy, which limits our understanding of this potential comorbid phenomenon. Given the emerging anecdotal and empirical evidence to date, a theoretical discussion of the potential psychoneuroendocrinological mechanism underlying the borderline personality disorder and polycystic ovary syndrome comorbidity is provided. Further rigorous studies using standardized diagnostic criteria for polycystic ovary syndrome are warranted. Specifically, the use of prospective controlled cohort studies may be able to determine the causality and temporality of observed comorbid borderline personality disorder and polycystic ovary syndrome.
Development and Pilot Testing of an Objective Structured Clinical Examination for Obstructive Sleep Apnea
Authors: Bhatti Nasir I. , Abid Muhammad Abbas , Stewart C. Matthew , Fleishman Carol , Jefferson Niall , Ishman Stacey L. 
Published: September 2017

ObjectiveOur aim was (1) to develop an objective structured clinical examination (OSCE) for obstructive sleep apnea (OSA) and (2) to test the reliability and evaluate the feasibility of this OSCE while assessing residents’ clinical skills in multiple core competencies via the standardized patient methodology.Study DesignDevelopment of assessment tool.SettingJohns Hopkins Medicine Simulation Center.Subjects and MethodsResidents of the Department of Otolaryngology–Head and Neck Surgery at The Johns Hopkins University School of Medicine were invited to participate. A 2‐station OSCE was developed. The first station used a standardized patient, and the encounter was videotaped for later evaluation by medical faculty not familiar with the participants being tested. The second was a computer‐based station developed per a modified Delphi technique, based on feedback from otolaryngology and sleep medicine faculty involved in the care of patients with OSA. Checklists were developed for each station to standardize the evaluation of each trainee’s performance.ResultsThe OSCE that we developed is a feasible tool for assessing residents’ performance and skills to diagnose and manage a patient with OSA. Internal consistency, as assessed by Krippendorff’s alpha, was 0.699 for station 1 and 0.95 for station 2.ConclusionThis OSCE was found to be feasible for assessment of clinical competency in OSA. Our model provides targeted assessment of multiple competencies and opportunity to improve clinical knowledge and skills.
Cochlear Nerve Aplasia and Hypoplasia: Predictors of Cochlear Implant Success
Authors: Peng Kevin A. , Kuan Edward C. , Hagan Suzannah , Wilkinson Eric P. , Miller Mia E. 
Published: September 2017

ObjectiveTo identify factors predicting performance outcomes following cochlear implantation in patients with cochlear nerve aplasia or hypoplasia.Data SourcesIndividual patient data extracted from published case series and reports.Review MethodsThe MEDLINE database, Cochrane Library, Embase, Web of Science, and Google Scholar were queried for “cochlear implant” in conjunction with “aplasia” or “hypoplasia” between 1985 and 2015. Eighteen studies were included describing 97 subjects with individual postimplant auditory data. Postimplant performance was categorized as follows: level 1, nonstimulation/minimal detection; level 2, improved detection; level 3, closed‐set speech perception; or level 4, open‐set speech perception. The subjects achieving speech perception (levels 3 and 4) were descriptively compared with those who did not.ResultsSubjects with a hypoplastic cochlear nerve on magnetic resonance imaging had higher reported rates of achieving speech perception than those with an aplastic nerve. Subjects with syndromic medical comorbidities had higher reported rates of nonstimulation than nonsyndromic subjects. The data showed that some children with an aplastic cochlear nerve or those with partial electrode insertion could obtain levels of speech discrimination. Reporting of patient characteristics and auditory outcomes was extremely variable across studies.ConclusionAs previously shown, cochlear implant in patients with cochlear nerve aplasia or hypoplasia can provide meaningful hearing for select patients. The current study suggests that presence of a cochlear nerve on magnetic resonance imaging and lack of comorbid medical syndrome are associated with better auditory outcomes in such patients. Future efforts to report individual data in a consistent manner may allow better determination of predictive factors.
Canadian Treatment Guidelines on Psychosocial Treatment of Schizophrenia in Children and Youth
Authors: Lecomte Tania , Abidi Sabina , Garcia-Ortega Iliana , Mian Irfan , Jackson Kevin , Jackson Kim , Norman Ross 
Published: September 2017

Objective: A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. Method: The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth. New treatments were also considered when recent meta-analyses suggested their usefulness. Results: The children and youth psychosocial guidelines include many cross-sectional recommendations in terms of clinical and interpersonal skills needed to work with this clientele, setting and collaboration issues and needed adaptations for specific subpopulations. In terms of specific treatments, the treatments most strongly recommended are family intervention and cognitive behavior therapy. Also recommended, although with different degrees of support, are supported employment/supported education programs, patient education, cognitive remediation, and social skills training. Novel and upcoming psychosocial treatments are also briefly discussed. Conclusion: These novel Canadian guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.
Correlation Between Recovery of Triceps Surae Muscle Strength and Level of Activity After Open Repair of Acute Achilles Tendon Rupture
Authors: Toyooka Seikai , Takeda Hideki , Nakajima Kohei , Masujima Atsushi , Miyamoto Wataru , Pagliazzi Gherardo , Nakagawa Takumi , Kawano Hirotaka 
Published: September 2017

Background: This study aimed to determine whether physical findings reflecting triceps surae strength recovery could predict return to activities such as jogging and sports and whether patients’ age and sex would influence recovery of triceps surae strength postoperatively. Methods: Between 2009 and 2013, 96 consecutive cases of postoperative acute Achilles tendon rupture were reviewed. The postoperative triceps surae strength recovery rate was investigated in all patients by using half body weight 1-time heel rise, full body weight (FBW) 1-time heel rise, FBW 20-time heel rise, jogging, and full return to sports activities. Influence of age and sex on triceps surae strength recovery was also investigated. Results: FBW 1-time heel rise and jogging were achieved at an average of 14 weeks (range, 6-24 weeks) and 15 weeks (range, 8-25 weeks) postoperatively, respectively. FBW 20-time heel rise and full return to sports activities were achieved at a mean of 21 weeks (range, 12-29 weeks) and 22 weeks (range, 13-29 weeks) postoperatively, respectively. Ability to perform FBW 1-time heel rise was directly related to resilience of jogging capability ( R2 = 0.317, P < 0.001), and ability to perform FBW 20-time heel rise was related to full return to sports activities ( R2 = 0.508, P < 0.001). Time to heel rise was not correlated with patient age or sex. Conclusion: Postoperative ability to perform FBW 1-time heel rise in patients postoperatively was directly related to resilience of jogging, and ability to perform FBW 20-time heel rise was directly related to full return to sports activities. Level of Evidence: Level IV, case series.
Functional Outcome of Acute Achilles Tendon Rupture With and Without Operative Treatment Using Identical Functional Bracing Protocol
Authors: Lim Che Siu , Lees David , Gwynne-Jones David P. 
Published: September 2017

Background: The purpose of this study was to compare the functional results of operative and nonoperative treatment of acute Achilles tendon rupture using an identical rehabilitation program of functional bracing. Methods: Over a 10-year period, 200 patients (99 operative, 101 nonoperative) aged between 18 and 65 years were treated at our institution’s physiotherapy department after acute Achilles tendon rupture. There were 132 patients (62 operative, 70 nonoperative) available for a minimum 2-year follow-up (average 6.5 years; range, 2-13 years). Functional outcome was assessed using the Achilles tendon total rupture score (ATRS). Results: With the numbers available, no significant difference could be detected in ATRS between operative (mean 84.8, median 90) and nonoperative groups (mean 85.3, median 91; P = 0.55). No significant difference could be detected in ATRS between male and female patients however treated ( P = 0.30) or between patients younger and older than 40 years at time of injury ( P = 0.68). There was no correlation between ATRS score and age at injury in all patients (ρ = −0.0168, P = 0.85). In male patients, there was a weak trend with older patients at follow-up having better scores (ρ = 0.21, P = 0.069). However, among female patients, there was a significant negative correlation between ATRS scores and increasing age (ρ = −0.29, P = 0.03). Logistic regression analysis failed to show any significant effect of age at rupture, gender, or mode of treatment on ATRS. Conclusions: This study showed no significant difference detectable in ATRS between operative and nonoperative patients in the treatment of acute Achilles tendon ruptures using an identical rehabilitation program with functional bracing. Level of Evidence: Level II, prospective comparative study.
Unplanned return to operating room after endovascular repair of abdominal aortic aneurysm (EVAR) is associated with increased risk of hospital readmission
Authors: Aziz Faisal , Ferranti Katelynn , Lehman Erik B 
Published: September 2017

Objectives Hospital readmissions after surgical operations are considered serious events. Centers for Medicare and Medicaid (CMS) consider surgical readmissions as preventable and hold hospitals responsible for them. Endovascular abdominal aortic aneurysm (EVAR) has become the first line modality of treatment for suitable patients with abdominal aortic aneurysm (AAA). The purpose of this study is to retrospectively review the factors associated with hospital readmission after EVAR. Methods The 2013 EVAR targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP participant use files were used for this study. Patient, diagnosis, and procedure characteristics of patients undergoing EVAR surgery were assessed. Multivariate logistic regression analysis was used to determine independent risk factors for hospital readmission within 30 days after surgery. Results A total of 2277 patients (81% males, 19% females) underwent EVAR operations in the year 2013. Indications for operations included: asymptomatic large diameter (79%), symptomatic (5.7%), rupture without hypotension (4.3%), and rupture with hypotension (2.8%). Among these patients, 178 (7.8%) were readmitted to the hospital within 30 days after surgery. About 53% of all readmissions were within two weeks after the discharge. Risk factors, associated with readmission included: body mass index (per 5-units, OR 1.23, CI 1.06–1.42, p < 0.05), days from admission to operation (per 1 day, OR 1.26, CI 1.12–1.41, p < 0.05), prior abdominal aortic surgery (OR 1.60, CI 1.10–2.31, p < 0.05), urinary tract infection (OR 5.93, CI 2.09–16.88, p < 0.05), superficial surgical site infection (OR 6.57, CI 2.53–17.09, p < 0.05), unplanned return to the operating room (OR 11.29, CI 6.29–20.28, p < 0.05), myocardial infarction (OR 11.30, CI 4.42–28.89, p < 0.05), deep venous thrombosis (OR 11.52, CI 2.89–45.86, p < 0.05 and deep incisional surgical site infection (OR 38.0, CI 2.87–373.56, p < 0.05). Risk of readmission for patients with presence of all these seven factors was 99.9%. Conclusions Readmission after EVAR is a serious occurrence. Various factors predispose a patient at a high risk for readmission. Unplanned return to operating room after EVAR is associated with a 11-fold increase in hospital readmission.
First crystal-structure determination of natural lansfordite, MgCO3·5H2O
Authors: Nestola Fabrizio , Kasatkin Anatoly V. , Potapov Sergey S. , Chervyatsova Olga YA. , Lanza Arianna 
Published: September 2017

AbstractThis study presents the first crystal-structure determination of natural MgCO3·5H2O, mineral lansfordite, in comparison with previous structural works performed on synthetic analogues. A new prototype single-crystal X-ray diffractometer allowed us to measure an extremely small crystal (i.e. 0.020 mm × 0.010 mm × 0.005 mm) and refine anisotropically all non-hydrogen atoms in the structure and provide a robust hydrogen-bond arrangement. Our new data confirm that natural lansfordite can be stable for several months at room temperature, in contrast with previous works, which reported that such a mineral could be stable only below 10°C.
European Respiratory Society guidelines for the management of adult bronchiectasis
Authors: Polverino Eva , Goeminne Pieter C. , McDonnell Melissa J. , Aliberti Stefano , Marshall Sara E. , Loebinger Michael R. , Murris Marlene , Cantón Rafael , Torres Antoni , Dimakou Katerina , De Soyza Anthony , Hill Adam T. , Haworth Charles S. , Vendrell Montserrat , Ringshausen Felix C. , Subotic Dragan , Wilson Robert , Vilaró Jordi , Stallberg Bjorn , Welte Tobias , Rohde Gernot , Blasi Francesco , Elborn Stuart , Almagro Marta , Timothy Alan , Ruddy Thomas , Tonia Thomy , Rigau David , Chalmers James D. 
Published: September 2017

Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes.
The paradoxes of asthma management: time for a new approach?
Authors: O'Byrne Paul M. , Jenkins Christine , Bateman Eric D. 
Published: September 2017

Poor adherence to maintenance pharmacotherapy is a reality in asthma. Studies confirm that when symptoms worsen, most patients increase short-acting β2-agonist (SABA) use, instead of using controller medication. This behaviour might be attributable to several paradoxes in the current treatment approach. These paradoxes include the recommended use of a SABA bronchodilator alone at Global Initiative for Asthma (GINA) step 1, despite the fact that asthma is a chronic inflammatory disease. At step 1, the patient has autonomy and their perception of need and disease control is accepted, but at higher asthma treatment steps a fixed-dose approach is recommended, irrespective of symptom severity. The unintended consequence is the establishment of a pattern of early over-reliance on SABA. New approaches that avoid these paradoxes are needed, such as patient-adjusted therapy, in which patients adopt a symptom-driven approach using a combination reliever/controller. We propose that SABA reliever monotherapy should be replaced by a combination of inhaled corticosteroid (ICS) and formoterol, or similar rapid-onset bronchodilator, as reliever therapy for patients at GINA steps 1 or 2. This will ensure early and more regular administration of a controller medication. However, a significant body of clinical data will be needed before this approach can be approved by regulatory authorities.
Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement
Authors: Halvorsen Thomas , Walsted Emil Schwarz , Bucca Caterina , Bush Andrew , Cantarella Giovanna , Friedrich Gerhard , Herth Felix J.F. , Hull James H. , Jung Harald , Maat Robert , Nordang Leif , Remacle Marc , Rasmussen Niels , Wilson Janet A. , Heimdal John-Helge 
Published: September 2017

Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenclature and variable approaches to assessment and management. A task force of the European Respiratory Society (ERS) and European Laryngological Society (ELS) was thus set up to address this, and to identify research priorities.A literature search identified relevant articles published until June 2016, using all identifiable terms for ILO, although including only articles using laryngoscopy. In total, 172 out of 252 articles met the inclusion criteria, summarised in sections on diagnostic approach, aetiology, comorbidities, epidemiology and treatment. The consensus taxonomy published by ERS, ELS and the American College of Chest Physicians (ACCP) in 2015 is used throughout this statement.We highlight the high prevalence of ILO and the clinical impact for those affected. Despite recent advances, most aspects of this condition unfortunately remain incompletely understood, precluding firm guidance. Specifically, validated diagnostic and treatment algorithms are yet to be established, and no randomised control studies were identified in this search; hence we also make recommendations for future research.