bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Strengths and Challenges of Palliative Day-Care Centers
Authors: Vandaele Bieke , Chambaere Kenneth , Devisch Ignaas 
Published: October 2017

Background: Palliative day-care centers are a marginal service within the palliative care landscape. Relevant research on the potential and added value of this service model is lacking, and it may therefore be underappreciated. Aim: To examine how representatives of Belgian palliative day-care centers perceive their strengths and added value, as well as the biggest challenges to their survival. Design: Qualitative study of individual interviews and an overarching focus group. Data collection was performed from December 2014 to April 2015. Inductive coding was used to extract relevant themes from the verbatim transcripts. Setting/Participants: Participants were professional representatives of all 5 Flemish palliative day-care centers: 7 participants for the individual interviews and 6 participants for the focus group. Results: Five strengths were identified: (1) unique care model, (2) contact with peers in a nonclinical environment, (3) a reliable and competent multiprofessional team, (4) care tailored to the individual, and (5) respite for family caregivers. The most significant challenges were (1) optimizing government funding and (2) achieving sufficiently high occupancy and referral. According to interviewees, this latter challenge was due to the low visibility of the service to professionals and the public, unclear referral criteria, and the psychological threshold for referral among patients and professionals. Conclusions: Palliative day-care centers strive to provide unique services for patients with advanced illness. However, negotiating adequate funding and raising referral by changing current perceptions are paramount to unlocking their potential. Scientific analysis of cost utility and patient outcomes associated with their use is necessary.
Lord Nelson’s (1758–1805) left eye
Authors: Pryse-Phillips William 
Published: October 2017

Summary Following the loss of his right eye at Calvi in 1794, Lord Nelson suffered increasing left-sided visual loss, here considered most likely to have been due to the ocular inflammatory condition ‘sympathetic ophthalmia’. It is also argued that his succeeding episodes of violent headaches with nausea and prostration, and possible depigmentation of hair, reflected the development of an uveomeningoencephalitic syndrome akin to that of Vogt–Koyanagi–Harada disease, which is best regarded as the same condition with a different aetiology.
Coping planning: a patient-centred and strengths-focused approach to suicide prevention training
Authors: Stallman Helen M 
Published: October 2017

Objectives: Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of ‘safety planning’ as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to ‘coping planning’ to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality. Conclusions: Coping planning is a strategy used to support people with acute distress. Its components of ‘caring’, ‘collaborating’ and ‘connecting’ reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide.
An audit of the management of nicotine withdrawal in an Australian inpatient unit: are we there yet?
Authors: Iyer Reena , Smith David , Lawn Sharon 
Published: October 2017

Objectives: This paper reports outcomes of a clinical audit of smoke-free policy implementation within an Australian inpatient psychiatric setting. It aimed to evaluate assessment of smoking status and subsequent management of nicotine withdrawal, and investigate any patient factors influencing these processes. Methods: A total of 67 medical case notes were retrospectively analysed for inpatients admitted to psychiatric units of a general hospital in South Australia, from July to September 2015. Patient demographic variables and information from the hospital’s Smoking Assessment and Management Form (SAMF) were recorded. Data analysis involved descriptive statistics and Chi-square tests of association between dependent variables (how the SAMF was completed) and independent variables (sex, voluntary status, diagnosis). Results: The SAMF was implemented for most patients (76.1%), with 64.71% completed within 24 hours of admission; though, many were incomplete. Nicotine dependence was not properly assessed for 42.3% of smokers; 69.23% were prescribed nicotine replacement therapy (NRT), despite most scoring moderate to high nicotine dependence. No statistically significant relationships were found between patient factors and form completion. Conclusions: SAMF completion was timely for most patients; however, sections important for determining support actions remained largely incomplete, suggesting patients’ nicotine withdrawal is not being adequately addressed. More work is needed to improve inpatient staff’s assessment to ensure optimal care.
Prospective Evaluation of Structural Allograft Transplantation for Osteochondral Lesions of the Talar Shoulder
Authors: Adams Samuel B. , Dekker Travis J. , Schiff Adam P. , Gross Christopher P. , Nunley James A. , Easley Mark E. 
Published: October 2017

Background: Structural or bulk osteochondral allograft transplantation for shoulder talar osteochondral lesions as a salvage procedure has demonstrated efficacy in several retrospective reviews. The purpose of this study was to evaluate prospectively patients who received fresh structural allograft transplantation to the talus. Methods: Prospective evaluation of a consecutive series of patients who underwent fresh structural allograft transplantation for an osteochondral lesion of the talus (OLT) was performed. Preoperative magnetic resonance imaging (MRI) and/or computed tomography (CT) and plain radiographs were obtained on all patients. The following patient-reported outcomes questionnaires were administered preoperatively and yearly after surgery: 100-mm visual analog scale (VAS) pain scale, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale, Short Form 36 (SF-36), and the Short Musculoskeletal Functional Assessment (SMFA). Preoperative and postoperative radiographs were assessed for allograft incorporation and subsequent arthritis. Fourteen patients with an average age of 40 years (range, 18-69) and a mean follow-up of 55 months (range, 24-97) underwent structural fresh osteochondral allograft transplantation to the talar shoulder. Results: The average size of the OLT was 2269 mm3 (range, 813-8366) based on CT imaging and 5797 mm3 (range, 1136-12 489) based on MRI imaging. There was significant ( P < .05) improvement in the VAS pain, AOFAS scale, SF-36, and SMFA scores. Five (36%) of the patients required additional surgery for pain and stiffness. Two patients had cartilage delamination and were considered treatment failures. Therefore, the success rate was 86% (12/14). Conclusion: Significant improvement in pain and function was achieved with structural allograft transplantation for large OLTs at midterm follow-up. This was a safe and effective treatment option in this small series for large OLTs. Level of Evidence: Level IV, prospective case series.
Weightbearing CT Scan Assessment of Foot Alignment in Patients With Hallux Rigidus
Authors: Cheung Zoe B. , Myerson Mark S. , Tracey Joseph , Vulcano Ettore 
Published: October 2017

Background: An association between hallux rigidus and metatarsus primus elevatus (MPE) has been suggested, although there remains no general consensus about the nature of this relationship. Past studies were limited due to inaccuracies of assessing MPE on 2-dimensional radiographs. The aims of this study were to (1) assess and compare foot alignment in patients with and without hallux rigidus using 3-dimensional (3D) reconstructions from weightbearing computed tomography (CT) and (2) assess intraobserver and interobserver reliability of these measurements. Methods: A prospective study was performed in 50 consecutive patients with symptomatic hallux rigidus and 50 control patients who underwent a weightbearing CT. Two investigators measured first and second metatarsal declination angles, first and second metatarsal lengths, first to second intermetatarsal angle (IMA), hallux valgus angle (HVA), and foot width on 3D CT reconstructions. Measurements were repeated after 1 month. Student t tests were performed to compare hallux rigidus and control groups. Intraclass and interclass correlation coefficients were calculated to evaluate reliability. Results: The first to second metatarsal declination ratio was less in patients with hallux rigidus (mean, 0.81) than controls (mean, 0.92; P < .001). Patients with Coughlin and Shurnas grade 3 and 4 hallux rigidus had greater first metatarsal declination than patients with grade 1 and 2 hallux rigidus. Last, IMA was higher (mean, 13 degrees) but HVA was lower (mean, 11 degrees) in patients with hallux rigidus than controls (IMA mean, 12 degrees; HVA mean, 15 degrees; P = .04). Intraobserver (ICC1,1 ≥ 0.93) and interobserver (ICC3,1 ≥ 0.85) reliability were good to excellent for all measured parameters. Conclusions: Patients with hallux rigidus had MPE. Patients with grade 3 and 4 hallux rigidus had more MPE than patients with grade 1 and 2 hallux rigidus. There was no clear correlation between hallux rigidus and bunions. Finally, weightbearing CT proved to be a reliable method of assessing all measured parameters. Level of Evidence: II, prospective comparative series.
Comparison of the Schirmer tear test I values after placement in ventral and dorsal conjunctival fornices in healthy cats
Authors: Aftab Ghazal , Rajaei Seyed Mehdi , Faghihi Houman 
Published: October 2017

Objectives The objective of this study was to compare the Schirmer tear test I values obtained from placement of Schirmer tear test (STT) strips in ventral and dorsal conjunctival fornices and to investigate any correlation between age, body weight and STT values in clinically normal cats. Methods Twenty-eight intact adult domestic shorthair and Persian cats were used in this study. The cats were gently physically restrained in a sternal position, and a Schirmer tear strip was placed on each eye in the ventral conjunctival fornix at one-third of the distance from the temporal to nasal canthus for 60 s. Then, the wetted portion of the strips was measured as mm/min (L-STT I). After 48 h, the same procedure was performed on each eye in the dorsal conjunctival fornix (U-STT I). Results Mean ± SD STT values of the ventral and dorsal conjunctival fornices were 20.80 ± 2.25 mm/min (range 14–25 mm/min; 95% confidence interval [CI] 19.92–21.67) and 18.28 ± 2.27 mm/min (range 15–22 mm/min; 95% CI 17.39–19.16) in all of the study population, respectively. A significant difference was found between STT values obtained from the ventral and dorsal conjunctival fornices ( P <0.001). There was no correlation between the age and body weight of the animals and STT I values. Conclusions and relevance This study compared the STT I values of the dorsal and ventral conjunctival fornices in cats. The difference was significant between the L-STT I and U-STT I values; however, the L-STT I and U-STT I values were within normal reference intervals. The U-STT I data have diagnostic value that might be of benefit in cases where there is a problem in the ventral conjunctival fornix.
Initial Outcomes of Cyanoacrylate Closure, VenaSeal System, for the Treatment of the Incompetent Great and Small Saphenous Veins
Authors: Park Insoo 
Published: October 2017

Purpose: Cyanoacrylate closure of the saphenous vein with the VenaSeal system is a new technique just approved on December 2016 in Korea. Therefore, there are seldom reports about postprocedural outcomes of VenaSeal system in Asian countries. We report the initial outcomes of VenaSeal system for the treatment of great saphenous veins (GSVs) and small saphenous veins (SSVs) as a first report in Korea. Methods: Thirty-four patients with incompetent saphenous veins (47 GSVs and 16 SSVs) were treated at a single session. Concomitant phlebectomy was performed in 15 (44.1%) of 34 patients. All procedures were started with local anesthesia with music therapy and switched to intravenous sedation if patient requested. Patients revisited the clinic on 10 days, 1 month, and 3 months after surgery. Postprocedural evaluations including numerical pain rating score, revised Venous Clinical Severity Scores (rVCSS), and Aberdeen Varicose Vein Questionnaires were checked. Duplex ultrasound was performed on 10 days, 1 month, and 3 months. Results: All treated veins (47 GSVs and 16 SSVs; 100%) had complete closure by duplex ultrasound during the follow-up period. Mean numerical pain rating scale of 6 hours after procedure was 2.7. The rVCSS was improved during the follow-up period. Phlebitis-like “abnormal skin reaction” in the treatment area was occurred in 8 (23.5%) of 34 patients and recovered fully in 2 weeks. Conclusions: Cyanoacrylate closure, VenaSeal system, is safe and effective for the treatment of incompetent saphenous veins.
Effect of Comt1 genetype on anxiety and nociceptive sensitivity: An ego network analysis approach
Authors: Li Wenzheng , Zhao Shoutao , Zhang Zhenhong 
Published: October 2017

Purpose The aim of this study was to predict key genes and their relationships for anxiety and nociceptive sensitivity related to Comt1 genetype. Methods The raw data of E-GEOD-20160 related to anxiety and nociceptive sensitivity were obtained. Pearson correlation coefficient of interaction in protein–protein interaction was calculated. Topological analysis was processed for protein–protein interaction network, and genes in this network were ranked based on their degrees. Ego genes were identified, and models were searched and refined. A total of 1000 randomized tests were processed for ego networks. The classification accuracy of each ego network was obtained in this process. Results The interactions with genes in gene expression profiles were extracted, and protein–protein interaction was constructed. The protein–protein interaction included 4639 genes and 43,837 relationships. Differential co-expression network was constructed, and 74 ego genes were obtained. Thereinto, top five ego genes were ADCY2, GRM8, S1PR3, ADCY6, and ANXA1. After module searching and refinement, a total of 11 candidate modules were obtained, including module 14, module 51, and module 9. In addition, these 11 modules were confirmed to be with significance. Module 14 contained 10 genes, such as HRH3, DRD2, and CXCR3. Similarly, module 51 included six genes, such as HELZ2, NCOA3, and MED30. Conclusions Ego network analysis was a useful and comprehensive method for biomarkers screening. Several modules such as module 3 and module 36 were important subnetworks. Potential genes in these modules including ADCYs, GNAI1, DRD2, PNOC, CCR2, DRD2, and LPAR1 might be important genes in the research of anxiety and nociceptive sensitivity.
Abnormal functional integration across core brain networks in migraine without aura
Authors: Yu Dahua , Yuan Kai , Luo Lin , Zhai Jinquan , Bi Yanzhi , Xue Ting , Ren Xiaoying , Zhang Ming , Ren Guoyin , Lu Xiaoqi 
Published: October 2017

Background As a complex subjective experience, pain processing may be related to functional integration among intrinsic connectivity networks of migraine patients without aura. However, few study focused on the pattern alterations in the intrinsic connectivity networks of migraine patients without aura. Results Thirty-one migraine patients without aura and 31 age- and education-matched healthy controls participated in this study. After identifying the default mode network, central executive network and salience network as core intrinsic connectivity networks by using independent component analysis, functional connectivity, and effective connectivity during the resting state were used to investigate the abnormalities in intrinsic connectivity network interactions. Migraine patients without aura showed decreased functional connectivity among intrinsic connectivity networks compared with healthy controls. The strength of causal influences from the right frontoinsular cortex to the right anterior cingulate cortex became weaker, and the right frontoinsular cortex to the right medial prefrontal cortex became stronger in migraine patients without aura. Conclusions These changes suggested that the salience network may play a major role in the pathophysiological features of migraine patients without aura and helped us to synthesize previous findings into an aberrant network dynamical framework.
Patients’ perceptions on the usability of the SurePal™ self-injection device for Omnitrope®: a questionnaire-based observational study conducted in paediatric patients in France
Authors: Coutant Régis , Dupuis Clémentine , Pigeon Patricia , Rebaud Phillipe 
Published: October 2017

Background: A questionnaire-based survey was conducted to evaluate attitudes towards a reusable self-injection system, SurePal™, among paediatric patients with growth disturbances who were prescribed treatment with somatropin (Omnitrope®) as part of routine clinical practice. Methods: This cross-sectional survey was incorporated into the multinational, multi-centre, noninterventional PAtients TReated with Omnitrope® (PATRO) Children study. Questions were mainly focused on five areas: the attractiveness of SurePal™; training received; use of the device; opinion of the low-drug wastage system; experience compared with previous devices used (among pretreated patients). Results: Final results from participants in France are reported. Completed questionnaires were returned by 409 participants. Most patients (55%) were male and 89% were recombinant human growth hormone (rhGH)-treatment naïve. Around 57% of children completed the questionnaire by themselves, while 43% had help from a family member/other person. The mean (standard deviation) age of all participants was 11.3 (3.6) years, and most patients were aged 10–12 years ( n = 126) or 13–15 years ( n = 117). Overall, 86% of patients reported that preparing SurePal™ for injection was easy/very easy. Similarly, 83% reported that performing injections with SurePal™ was easy/very easy. The attractiveness of SurePal™ was rated as good/excellent by the majority (85%) of patients; this proportion was similarly high (> 80%) across all age groups. The dose-memory function was rated as helpful/very helpful by 54% of patients. Of the 174 patients who reported using the low drug-waste feature, 90% found it to be helpful/very helpful. Among the 24 pretreated patients, 17 reported that SurePal™ was better/much better than their previous device. Conclusions: This questionnaire-based survey conducted in a large cohort of paediatric patients with growth disturbances from France confirms the ease of use of SurePal™ to support daily administration of Omnitrope® across all age groups. The demonstrated acceptability of the device may help to improve patient adherence to long-term daily treatment with rhGH.
Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series
Authors: Tírico Luís E.P. , Early Samuel A. , McCauley Julie C. , Bugbee William D. 
Published: October 2017

Background: Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions. Hypothesis: OCA transplantation is an effective treatment for SONK lesions on the medial femoral condyle. Study Design: Case series; Level of evidence, 4. Methods: A case series was analyzed of 7 patients treated with OCA for large SONK lesions of the medial femoral condyle with a minimum 4-year follow-up. All patients experienced failure of at least 6 months of conservative treatment and declined arthroplasty as the form of definitive treatment for medial femoral condyle lesion. All patients underwent OCA of the medial femoral condyle. Mean lesion size was 4.6 cm2 (range, 3.24-6.25 cm2), with a mean condylar width of 41.7 mm (range, 35.4-48.6 mm), resulting in a median proportion (lesion size/condylar width) of 56.8% (range, 32.7%-62.6%). The median surface allograft area was 5.1 cm2 (range, 3.2-6.3 cm2). Results: The median follow-up was 7.1 years (range, 4.5-14.1 years). No patient had additional surgery following OCA transplant; the allograft failure rate was 0%. Subjective outcome scores from the International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, and modified Merle d’Aubigné-Postel scale improved from preoperative assessment to the latest follow-up. All patients were extremely satisfied with the results of the OCA transplant. Conclusion: Fresh OCA transplantation demonstrated excellent efficacy, durability, and satisfaction in this group of patients with isolated stage 2 and 3 SONK lesions who had experienced failure of conservative treatment. Fresh osteochondral allografts are an attractive method for surgical management of selected patients with spontaneous osteonecrosis of the knee.
Choroidal Angioarchitecture According to Ultra-Widefield Indocyanine Green Angiography in Age-Related Macular Degeneration
Authors: Maruyama-Inoue Maiko , Yamane Shin , Satoh Hisayoshi , Sato Shimpei , Kadonosono Kazuaki 
Published: October 2017

Purpose: To examine choroidal blood flow using ultra-widefield indocyanine green angiography (ICGA) in patients with age-related macular degeneration (AMD) and to compare these characteristics with those in normal controls. Methods: We reviewed the findings of ultra-widefield ICGA in patients with AMD and age-matched normal controls for comparison between April 2016 and November 2016. The primary outcome measure was the comparison of the vascular patterns of the choroid in the venous phase. The secondary outcome was abnormalities of the arterioles or venules in the macula in each group. Results: The study included 113 eyes of 84 patients with AMD (26 eyes with nonneovascular AMD, 58 eyes with typical AMD, and 29 eyes with polypoidal choroidal vasculopathy), 50 fellow eyes without the clinical characteristics of AMD, and 27 eyes of 24 age-matched normal controls. Patients with AMD were more likely than normal controls to have the region of greater hyperfluorescence of the ICGA with asymmetry of choroidal vasculature or abnormality of the vessels in the macula. Abnormalities of the vessels in the macula could be classified into 3 types: a small vortex vein, anastomosis between the choroidal veins, and the large choroidal vessels. Conclusions: Using ultra-widefield ICGA, we found that having an asymmetry of choroidal venules or abnormality of the vessels in the macula may be a predictive risk factor for the development or progression of AMD. These findings also support the association of alterations in choroidal hemodynamics with the pathogenesis of AMD.