bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of untreated psychosis in an Egyptian sample: Sociodemographic and clinical variables
Authors: Okasha Tarek , Zaki Nivert , Meguid Marwa Abd El , El-Missiry Marwa , Sabry Walaa , Ismaeil Mostafa Kamel , Fouad Samar M 
Published: September 2016

Background: Duration of untreated psychosis (DUP) has been considered as a poor prognostic factor for psychotic disorder. Several studies have been investigating different predictors of DUP in Western countries, while in Egypt only a few studies have examined various predictors of DUP. Aims: To study DUP in Egyptian patients with psychotic disorders and to investigate how certain illnesses, patient, socio-cultural risk factors and help-seeking behaviour are correlated with prolonged DUP. Method: The sample included 100 patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) diagnosis of psychotic disorder were selected and interviewed to assess DUP. They were interviewed using the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scale. Results: Mean (±standard deviation ( SD)) of DUP was found to be 36.93(±45.27) months. DUP was correlated with various sociodemographic and clinical variables. Following log transformation of DUP, correlation with PANSS scores was done and revealed highly significant statistical relation of DUP to PANSS negative and PANSS positive scores. In linear regression analysis, it was found that age of patients, the age of onset, residence, being illiterate, the insidious mode of onset, negative family history of psychiatric disorder and the severity of illness as indicated by PANSS are among DUP predictors. Conclusion: Longer DUP results from multiple patient- and illness-related factors. This has many implications in targeting early intervention with specific consideration to cultural factors.
Performance analysis of a liquid desiccant system with an adjustable reflux ratio of regeneration solution
Authors: Niu Xiaofeng , Zhang Yue , Li Xing , Tong Yan , Zhang Guangli 
Published: September 2016

In the liquid desiccant system, the amount of the diluted solution sent to the regenerator has a great influence on the system performance. The liquid desiccant system with an adjustable reflux ratio of regeneration solution was proposed in the paper, and the effect of the solution regeneration reflux ratio on the system performance was analysed by simulation. The energy consumption, the electric coefficient of performance and the thermal coefficient of performance under different water condensation rates and varied solution regeneration reflux ratio were obtained. The results show that, the overall performance of the liquid desiccant system can be improved by reducing the solution regeneration reflux ratio; a 1% decrease in the reflux ratio leads to a 0.56–1.02% average growth rate of electric coefficient of performance and a 0.51–0.95% average growth rate of thermal coefficient of performance. Moreover, when the regeneration temperature is high and the water condensation rate of the process air is low, the improvement from decreasing the solution regeneration reflux ratio is more significant. However, the reflux ratio cannot be reduced to an unlimited extent. There is a rational optimum range of the reflux ratio to achieve high thermal coefficient of performance, the optimum range under low dehumidifying load is different from that under high load. Practical application: The performance of a liquid desiccant system can be improved by the proposed system configuration with an adjustable reflux ratio of regeneration solution, such novel system configuration could be applied for the design of air conditioning system, which is beneficial for the energy saving in building. Moreover, the rational optimum ranges of the reflux ratio to achieve high coefficient of performance under different dehumidifying loads are obtained, which could provide guidelines for the design and operation management of the liquid desiccant based building air conditioning system.
Working parameter selection and analysis of radiant floor cooling combined with desk-based task/ambient conditioning (TAC) system
Authors: Liying Sun , Shuang Tan , Lujie Zhen 
Published: September 2016

As a form of task/ambient conditioning (TAC) system, task ventilation is an effective way to control the micro environment of workplace. In response, we have proposed and investigated a radiant floor cooling combined with desk-based TAC system in order to accomplish complementary advantages of radiant floor system and TAC system. Up to now, very few studies on this system have been found in existing literatures. In this paper, appropriate working parameters of the system are examined by numerical simulation method. To improve simulation accuracy, experiments were simulated in reference by applying three turbulence models and two radiation models. It turned out that the standard k–ɛ model combined with Discrete Ordinates (DO) model boasts the best accuracy as is revealed by the comparison between simulated results with the experimental. On this basis, a simulation of an office adopting the system was performed. According to analysis of the influence of different radiant panel temperatures and air supply parameters of TAC system on the thermal environment based on calculated results, the appropriate working parameters that meet the thermal comfort requirements are obtained, which can be used as a reference for the design of the system. The TRNSYS software was employed to simulate the operation energy consumption of the composite system in the office building, and the design parameters of the comprehensive consideration of comfort and energy saving are put forward in the present study. Practical application: For the conference room applied a radiant floor cooling combined with TAC system, this paper analyzed the impact of floor surface temperatures, task air supply temperature and task air supply temperature to the occupants workplace’s thermal environment and energy consumption of the system, and obtained the design parameters which comprehensive considered comfort and energy consumption. The research results of this paper can provide guideline for the design and selection of the working parameters for the conference room applied a radiant floor cooling combined with TAC system.
Genetic Determinants of Clozapine-Induced Metabolic Side Effects
Authors: Vasudev Kamini , Choi Yun-Hee , Norman Ross , Kim Richard B. , Schwarz Ute I. 
Published: September 2016

Objective: Atypical antipychotics are linked to a higher incidence of metabolic side effects, including weight gain, dyslipidemia, and diabetes. In this study, we examined the prevalence and potential genetic predictors of metabolic side effects in 60 adult patients on clozapine. Method: Genetic variants of relevance to clozapine metabolism, clearance, and response were assessed through targeted genotyping of cytochrome P450 enzymes CYP1A2 and CYP2C19, the efflux transporter ABCB1, the serotonin receptor (HTR2C), leptin (LEP), and leptin receptor (LEPR). Clozapine levels and other potential confounders, including concurrent medications, were also included in the analysis. Results: More than half of the patients were obese (51%), had metabolic syndrome (52.5%), and 30.5% were overweight. There was a high prevalence of antipsychotic polypharmacy (61.9%). With multivariable linear regression analysis, LEP –2548G>A, LEPR c.668A>G, and HTR2C c.551-3008 C>G were identified as genetic predictors of body mass index (BMI) after considering effects of clozapine dose, blood level, and concurrent medications (adjusted R2 = 0.305). Metabolic syndrome was found to be significantly associated with clozapine level and CYP2C19*2 and LEPR c.668 G alleles. Clozapine levels in patients with metabolic syndrome were significantly higher compared to those without metabolic syndrome (1886 ± 895 vs. 1283 ± 985 ng/mL, P < 0.01) and were associated with the CYP2C19*2 genotype. No association was found between the genetic variants studied and lipid or glucose levels. Conclusion: This study confirms a high prevalence of metabolic side effects with clozapine and suggests higher clozapine level and pharmacogenetic markers in CYP2C19, LEP, LEPR, and HTR2C receptors as important predictors of BMI and metabolic syndrome.
Things I wish I’d known: desiderata for early career psychiatrists
Authors: Ng Lillian , Steane Richard , Chacko Emme , Scollay Natalie 
Published: September 2016

Objective: The objective of this study was to disseminate advice imparted to early career psychiatrists by a panel of senior colleagues at a Royal Australian and New Zealand College of Psychiatrists symposium, reflecting on things they wished they had known at the earlier stage in their careers. Methods: Key themes were extracted from notes taken at the symposium, where opinions were expressed by three senior psychiatrists. Results: There are components in building a sustainable career as a psychiatrist, which include considering one’s work environment and relationships with colleagues; self-care, mentorship and reflective practice; and seeking opportunities to teach and research for career progression. Conclusions: The mentorship and advice from senior colleagues can be highly influential. In order to sustain a career that has reward, meaning and longevity, psychiatrists would do well to pay attention to aspects of self-care, stay connected to their loved ones, seek an optimal work–life balance and take an interest in their long term career plans.
Factors Affecting the Quality of Anticoagulation With Vitamin K Antagonists in Venous Thromboembolism Patients
Authors: Rivera-Caravaca José Miguel , Viedma-Viedma Inmaculada , Roldán Vanessa 
Published: September 2016

Introduction: Treatment of venous thromboembolism (VTE) is classically based on oral vitamin K antagonists (VKAs). Due to the disadvantages and side effects of these drugs, monitoring the quality of anticoagulation by assessing time within therapeutic range (TTR) is recommended. Variables altering the TTR in patients with VTE are yet to be determined. The aim of this study was to analyze the quality of anticoagulation in patients with VTE treated with VKAs and to identify factors associated with poor-quality anticoagulation. Methods: A retrospective observational study was performed in a cohort of 94 patients diagnosed with VTE undergoing treatment with VKAs. The TTR at 6 months was analyzed by the Rosendaal method. Univariate and a multivariate logistic regression analyses were performed to unravel factors that increase risk of poor-quality anticoagulation. Results: The TTR at 6 months in this cohort was 60.5%; 54 patients had a TTR < 65%. In the univariate analysis, female sex, age ≥ 65 years, and renal impairment were significantly associated with poor-quality anticoagulation. However, in the multivariate logistic regression model, only renal impairment was independently associated with poor-quality anticoagulation (odds ratio = 3.31, 95% confidence interval [1.049, 10.486], p = .041). Discussion: The average quality of anticoagulation was 60.5%, and a high percentage of patients had a quality of anticoagulation below recommended levels. Study findings indicate that renal impairment is an independent risk factor for poor-quality anticoagulation in patients with VTE treated with VKAs.
Ongoing increase in incidence and prevalence of multiple sclerosis in Newcastle, Australia: A 50-year study
Authors: Ribbons Karen , Lea Rodney , Tiedeman Clare , Mackenzie Laura , Lechner-Scott Jeannette 
Published: September 2016

Background: Since 1959, multiple sclerosis (MS) prevalence has been estimated for the east coast Australian city of Newcastle. Previous surveys, conducted in 1988 and 2003, have described an increase in the prevalence and incidence of MS. Objectives: In this study, we evaluated whether these trends continue and provide 50 years of MS epidemiological follow-up for this southern hemisphere city. Methods: Expressed per 100,000 people, prevalence of MS in Newcastle was calculated for those with a confirmed diagnosis of MS on 9 August 2011 and incidence based on the number of cases with MS diagnosis made during the preceding decade. Data were age-standardised to the total Australian population. Statistical comparisons were undertaken using Poisson regression analysis. Results: In 2011, the estimate of MS prevalence was 124.2, with female-to-male ratio reaching 3.1, a 53% increase in female predominance since 1996. MS incidence increased to 6.7, with a significantly higher proportion of new female cases since the previous survey. Conclusion: Prevalence of MS in Newcastle has risen linearly and is contributed to by a substantial increase in new cases over the preceding decade. Female predominance of MS cases continues to increase with a new diagnosis three times more likely in women.
Risk Factors for Graft Loss in Pediatric Renal Transplant Recipients After Transfer of Care
Authors: Coyne Bethany , Hollen Patricia J. , Yan Guofen , Brayman Kenneth 
Published: September 2016

Background: Improvements in transplantation have increased the survival of children after kidney transplantation. These patients have complex needs, and the current medical system is not prepared to effectively transfer the care of these individuals from pediatric to adult health-care systems. Too often, transfer occurs during moments of crisis and is associated with poor outcomes. Objective: The aim of this study was to use a national database, the Scientific Registry of Transplant Recipients, to test the hypothesis that the increased risk of graft loss after transfer of care (from pediatric to adult services) for young adult kidney transplant recipients over a 2- to 3-year posttransfer follow-up period was related to these posttransfer risk factors (medication noncompliance, acute rejection, insurance status). Design: A retrospective, longitudinal, correlational design using secondary data was used to evaluate the transfer of care of 250 kidney transplant recipients (ages 16-25). Results: Seventy-seven (30.8%) individuals lost their graft within 3 years after transfer of care. Medication noncompliance, acute rejection, and serum creatinine >2.0 mg/dL at transfer were significant predictors of graft loss after accounting for multiple other factors. Conclusion: These individuals are at risk for graft loss after transfer of care and may benefit from increased personalized care during this risky period.
Clinical Application of a Hybrid RapidArc Radiotherapy Technique for Locally Advanced Lung Cancer
Authors: Silva Scott R. , Surucu Murat , Steber Jennifer , Harkenrider Matthew M. , Choi Mehee 
Published: September 2016

Objective: Radiation treatment planning for locally advanced lung cancer can be technically challenging, as delivery of ≥60 Gy to large volumes with concurrent chemotherapy is often associated with significant risk of normal tissue toxicity. We clinically implemented a novel hybrid RapidArc technique in patients with lung cancer and compared these plans with 3-dimensional conformal radiotherapy and RapidArc-only plans. Materials/Methods: Hybrid RapidArc was used to treat 11 patients with locally advanced lung cancer having bulky mediastinal adenopathy. All 11 patients received concurrent chemotherapy. All underwent a 4-dimensional computed tomography planning scan. Hybrid RapidArc plans concurrently combined static (60%) and RapidArc (40%) beams. All cases were replanned using 3- to 5-field 3-dimensional conformal radiotherapy and RapidArc technique as controls. Results: Significant reductions in dose were observed in hybrid RapidArc plans compared to 3-dimensional conformal radiotherapy plans for total lung V20 and mean (−2% and −0.6 Gy); contralateral lung mean (−2.92 Gy); and esophagus V60 and mean (−16.0% and −2.2 Gy; all P < .05). Contralateral lung doses were significantly lower for hybrid RapidArc plans compared to RapidArc-only plans (all P < .05). Compared to 3-dimensional conformal radiotherapy, heart V60 and mean dose were significantly improved with hybrid RapidArc (3% vs 5%, P = .04 and 16.32 Gy vs 16.65 Gy, P = .03). However, heart V40 and V45 and maximum spinal cord dose were significantly lower with RapidArc plans compared to hybrid RapidArc plans. Conformity and homogeneity were significantly better with hybrid RapidArc plans compared to 3-dimensional conformal radiotherapy plans ( P < .05). Treatment was well tolerated, with no grade 3+ toxicities. Conclusion: To our knowledge, this is the first report on the clinical application of hybrid RapidArc in patients with locally advanced lung cancer. Hybrid RapidArc permitted safe delivery of 60 to 66 Gy to large lung tumors with concurrent chemotherapy and demonstrated advantages for reduction in low-dose lung volumes, esophageal dose, and mean heart dose.
Cardiac monitoring for detection of atrial fibrillation after TIA: A systematic review and meta-analysis
Authors: Korompoki Eleni , Del Giudice Angela , Hillmann Steffi , Malzahn Uwe , Gladstone David J , Heuschmann Peter , Veltkamp Roland 
Published: September 2016

Background and purpose The detection rate of atrial fibrillation has not been studied specifically in transient ischemic attack (TIA) patients although extrapolation from ischemic stroke may be inadequate. We conducted a systematic review and meta-analysis to determine the rate of newly diagnosed atrial fibrillation using different methods of ECG monitoring in TIA. Methods A comprehensive literature search was performed following a pre-specified protocol the PRISMA statement. Prospective observational studies and randomized controlled trials were considered that included TIA patients who underwent cardiac monitoring for >12 h. Primary outcome was frequency of detection of atrial fibrillation ≥30 s. Analyses of subgroups and of duration and type of monitoring were performed. Results Seventeen studies enrolling 1163 patients were included. The pooled atrial fibrillation detection rate for all methods was 4% (95% CI: 2–7%). Yield of monitoring was higher in selected (higher age, more extensive testing for arrhythmias before enrolment, or presumed cardioembolic/cryptogenic cause) than in unselected cohorts (7% vs 3%). Pooled mean atrial fibrillation detection rates rose with duration of monitoring: 4% (24 h), 5% (24 h to 7 days) and 6% (>7 days), respectively. Yield of non-invasive was significantly lower than that of invasive monitoring (4% vs. 11%). Significant heterogeneity was observed among studies (I2=60.61%). Conclusion This first meta-analysis of atrial fibrillation detection in TIA patients finds a lower atrial fibrillation detection rate in TIA than reported for IS and TIA cohorts in previous meta-analyses. Prospective studies are needed to determine actual prevalence of atrial fibrillation and optimal diagnostic procedure for atrial fibrillation detection in TIA.
PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies
Authors: Laver Lior , Marom Niv , Dnyanesh Lad , Mei-Dan Omer , Espregueira-Mendes João , Gobbi Alberto 
Published: September 2016

Objective:To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects.Design:Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords “platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis.”Results:The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs—one for knee and one for hip—did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies.Conclusion:Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.
Interobserver Agreement in the Classification of Partial-Thickness Rotator Cuff Tears Using the Snyder Classification System
Authors: Lee Christopher S. , Davis Shane M. , Doremus Brittany , Kouk Shalen , Stetson William B. 
Published: September 2016

Background: At present, there is no widely accepted classification system for partial-thickness rotator cuff tears, and as a result, optimal treatment remains controversial. Purpose: To examine the interobserver reliability and accuracy of classifying partial rotator cuff tears using the Snyder classification system. We hypothesized that the Snyder classification would be reproducible with high reliability and accuracy. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Twenty-seven orthopaedic surgeons reviewed 10 video-recorded shoulder arthroscopies. Each surgeon was provided with a description of the Snyder classification system for partial-thickness rotator cuff tears and was then instructed to use this system to describe each tear. Interrater kappa statistics and percentage agreement between observers were calculated to measure the level of agreement. Surgeon experience as well as fellowship training was evaluated to determine possible correlations. Results: A kappa coefficient of 0.512 indicated moderate reliability between surgeons using the Snyder classification to describe partial-thickness rotator cuff tears. The mean correct score was 80%, which indicated “very good” agreement. There was no correlation between the number of shoulder arthroscopies performed per year and fellowship training and the number of correct scores. Conclusion: The Snyder classification system is reproducible and can be used in future research studies in analyzing the treatment options of partial rotator cuff tears.
Prolyl-4-hydroxylase 2 and 3 coregulate murine erythropoietin in brain pericytes
Authors: Urrutia Andres A. , Afzal Aqeela , Nelson Jacob , Davidoff Olena , Gross Kenneth W. , Haase Volker H. 
Published: September 2016

Key PointsPericytes function as oxygen sensors and are major sites of erythropoietin production in the hypoxic brain. The ability to synthesize erythropoietin is a functional feature of pericytes in the brain and kidney.