bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public, Private and Voluntary Residential Mental Health Care: Is There a Cost Difference?
Authors: Knapp Martin , Chisholm Daniel , Astin Jack , Lelliott Paul , Audini Bernard 
Published: January 2017

Objectives: To determine how public (NHS or local government), private (for-profit) and voluntary (non-profit) providers of residential mental health care compare. Do they support different clienteles? And do their services cost different amounts? Methods: Based on a cross-sectional survey of residential care facilities and their residents in eight English and Welsh localities, the characteristics and costs of care in the different sectors (NHS, local government, private, voluntary) were compared. Variations in cost were examined in relation to residents' characteristics using multiple regression analyses, which also allowed standardisation of results before making inter-sectoral comparisons. Results: Private and voluntary providers of residential care support different clienteles from the public sector. The patterns of inter-sectoral cost differences vary between London and non-London localities. In London, voluntary sector facilities may be more cost-efficient than the other sectors, but local government/private sector comparisons show no consistent difference. Outside London, the results suggest clear cost advantages for the private and voluntary sectors over the local government sector. Conclusions: Private and voluntary providers may have some economic advantages over their public counterparts. However, outcomes for residents were not studied, leaving unanswered the question of comparative cost-effectiveness.
Can We Trust the Quality of Routine Hospital Outpatient Information in the UK?
Authors: Shaw Alison , Somerset Maggie , Dunn Liz , Peters Tim , Faulkner Alex , Sharp Deborah 
Published: January 2017

Background: A validation study of routine hospital outpatient data was carried out as part of a broader project focusing on outpatient re-attendance. The aim was to compare two patient administration system (PAS) data items with the same information collected directly from hospital clinicians. Methods: A total of 140 cases from four specialties at four National Health Service hospitals was randomly selected for comparison. The specific data items compared were the grade of doctor seen and the management decision taken following an outpatient appointment. The proportion of cases in which there was agreement was calculated, together with kappa values and relevant statistics indicating the accuracy of the PAS data when compared with information compiled immediately after the consultation by the relevant clinician. Results: There was agreement between the clinician's data and the PAS data in 118/140 (84.3%) cases for grade of doctor seen and in 105/139 (76.7%) cases for the management decision. There was complete agreement for both items in 88/139 (62.6%) cases. Kappa values indicated good agreement between the two data sources. However, ‘sensitivity’ statistics suggested that the likely accuracy of each data item varied. Conclusion: Although there was good agreement within individual categories between the two sources, 37% of patient computerised records held at least one inconsistency in this small study focusing on only two data items. Further systematic evaluation is needed to test the extent to which other items are similarly discrepant.
The use of teledermoscopy in the accurate identification of cancerous skin lesions in the adult population: A systematic review
Authors: Bruce Amy F , Mallow Jennifer A , Theeke Laurie A 
Published: January 2017

Background The use of teledermoscopy in the diagnostic management of pre-cancerous and cancerous skin lesions involves digital dermoscopic images transmitted over telecommunication networks via email or web applications. Teledermoscopy may improve the accuracy in clinical diagnoses of melanoma skin cancer if integrated into electronic medical records and made available to rural communities, potentially leading to decreased morbidity and mortality. Objective and method The purpose of this paper is to present a systematic review of evidence on the use of teledermoscopy to improve the accuracy of skin lesion identification in adult populations. The PRISMA method guided the development of this systematic review. A total of seven scholarly databases were searched for articles published between the years of 2000 and 2015. All studies were critically appraised using the Rosswurm and Larrabee critique worksheet, placed in a matrix for comparison evaluating internal and external validity and inspected for homogeneity of findings. Results Sixteen articles met inclusion criteria for this review. A majority of the studies were cross-sectional and non-experimental. Ten of the 16 focused on interobserver concordance and diagnostic agreement between teledermoscopy and another comparator. Instrumentation in conducting the studies showed inconsistency with reported results. Discussion Higher level evidence is needed to support clinical application of teledermoscopy for accuracy of diagnostic measurement in the treatment of pre-cancerous and cancerous skin lesions in adults. Future research is needed to develop a standardized, reliable and valid measurement tool for implementation in clinical practice.
Is Preoperative Evaluation of the Biliary Tree Necessary in Uncomplicated Gallstone Disease?
Authors: Järhult J. 
Published: January 2017

Aim: To analyse if preoperative radiology is of value in patients with uncomplicated gallstone disease. Material: 312 patients intended for laparoscopic cholecystectomy were randomly allocated to undergo preoperative radiology (intravenous cholangiography or magnetic resonance cholangiography) or to a control group. Intraoperative cholangiography was not used routinely in either group. Results: There was no bile duct injury and no difference in complication frequency between the two groups. The incidence of common bile duct stones was 3,8 % within the first postoperative year with no statistical difference between the two groups. Conclusions: Routine preoperative evaluation of the bile tree seems unnecessary before laparoscopic cholecystectomy in patients with uncomplicated gallstone disease.
Cement Augmentation in Fracture Treatment
Authors: Larsson S. 
Published: January 2017

Surgical treatment of fractures close to joints, especially in osteoporotic patients, is often associated with problems to obtain adequate strength of the bone-implant construct as well as sufficient purchase for screws in the weak bone. One way to address this increasing problem is through the development of new metal implants specifically designed for fixation of fractures in osteopenic bone. An alternative strategy is to develop methods for augmentation of the weak bone that surrounds the metal implant. In most instances augmentation is achieved by using injectable cement to reinforce the bone. Conventional PMMA provides good strength but due to several drawbacks it has never gained general acceptance for fracture augmentation. More recently several injectable cements based on calcium-phosphate, calcium-sulphate or bioglass has been developed for augmentation of fractures in the extremities as well as for vertebral compressive fractures in the spine. On the basis of biomechanical studies and the clinical experience so far, cement augmentation will enable faster rehabilitation, as the strength of the cement makes it possible to allow full weight-bearing earlier than conventional metal implants alone. More clinical studies are needed in order to refine the surgical technique, develop cement types aimed for fracture treatment and define the most appropriate indications and limitations of augmentation for fracture repair. The purpose of this article is to review the possible use of augmentation as a technique in the treatment of fractures in the extremities as well as in the spine.
Early Surgeryfor Treatment of Spontaneous Hemopneumothorax
Authors: Homma T. , Sugiyama S. , Kotoh K. , Doki Y. , Tsuda M. , Misaki T. 
Published: January 2017

Purpose: Spontaneous hemopneumothorax (SHP) is a rare life threatening disorder. We retrospectively investigated patients with SHP who were treated with video- assisted thoracic surgery (VATS), and report our results. Methods: From January 1993 to July 2006, 239 patients with spontaneous pneumothorax were treated, among whom 11 (4.6%) were diagnosed with SHP. Results: All 11 patients had a collapsed lung condition worse than moderate and a chest tube inserted, of whom 10 underwent an emergency operation. The points of hemorrhaging, each of which were in the apical portion of the lung, were easily revealed during VATS, and we were able to distinguish between brisk flow and seepage. Hemostasis was acquired using VATS in all surgery cases, while the other was treated with tube drainage. The single patient who did not undergo surgical treatment had recurrent spontaneous pneumothorax 3 months later. Conclusion: It is important to perform surgery for SHP at the appropriate time. VATS was found to be an easily performed and safe procedure for initial treatment in patients with active hemorrhaging and massive blood clotting in the thorax. The long-term outcome of our patients with early surgical indication was excellent and we recommend early surgical treatment for SHP.
The Early Effects of Intramedullary Reaming of the Femur on Bone Mineral Density; an Experimental Study in Pigs
Authors: Husebye E. Ellingsen , Lyberg T. , Madsen J. E. , Nordsletten L. , Røise O. 
Published: January 2017

Background and Aims: Both fracture and fracture treatment affect bone mineral density (BMD). BMD after standard intramedullary reaming of the femoral cavity and after reaming with a reamer-irrigator-aspirator (RIA) system were studied with the hypothesis that the RIA technique would lead to lower BMD levels. Material and Methods: Dual-energy X-ray absorptiometry (DXA) was performed on the third day after operation with standard intramedullary nailing technique (n = 6)or RIA technique (n = 7) in intact femora of young Norwegian landrace pigs. Results and conclusion: Significantly lower BMD were found in the mid-shaft and total femur after reaming with the RIA technique compared to the non-operated femur. Traditional reaming technique resulted in significantly higher BMD in the distal femur. Interpretation: The results of this study indicate that standard reaming increased BMD in the distal femur, suggesting compressive effects on trabecular bone. The RIA technique decreased BMD in the femoral diaphysis and total femur, suggesting removal of trabecular bone. A possible clinical impact of the findings remains to be investigated.
Adenocarcinomas on the Rise — Does it Influence Survival from Oesophageal Cancer?
Authors: Goscinski M. A. , Larsen S. G. , Warloe T. , Stoldt S. , Nesland J. M. , Suo Z. H. , Giercksky K.-E. 
Published: January 2017

Background and Aims: A significant change in the occurrence of oesophageal squamous cell carcinomas (SCCs) in relation to adenocarcinomas (ACs) has been observed in the Norwegian population during the last 20 years (1988–2007). The AC incidence has increased from 5–10% to more than 50% nowadays, while the incidence of SCCs has decreased. Our goal was to evaluate if the change from SCC to AC and the increased effort to control reflux could be reflected in tumour stage, patient demographics and treatment results. Material and Methods: We analysed clinical and pathological data from 347 patients with oesophageal AC (n = 189) and SCC (n = 158) treated at The Norwegian Radium Hospital during said period for patient- and tumour characteristics, treatment modalities and survival. Results: An oesophageal resection was performed in 169 of 347 patients. The median survival rate for all patients was 15 months, with a 5-year survival rate of 10%. The median survival time for operated and non-operated patients was 25 and 12 months respectively, with the corresponding 5-year survival rate of 13% and 2%. Patients with N0M0 disease operated with free resection margins presented a 5-year survival rate of 28%. Conclusions: The change from SCC to AC and the ensuing considerable efforts made in surveillance and treatment of AC did not lead to improved long time survival for our patients.
Can Elevated Serum Tracp-5B Levels Predict Stress Fractures? A Cohort Study
Authors: Ruohola J.-P. S. , Mulari M. , Haataja R. I. , Väänänen H. K. , Pihlajamäki H. K. 
Published: January 2017

Background and Aims: Stress fracture is a common overuse injury in athletes and military conscripts. The reliable diagnosis of stress fractures is often difficult, however, because it is usually based solely on radiographic findings. Biochemical markers of bone resorption reflect bone degradation and may also reflect the rate of bone loss. The aim of the study was to examine whether elevated serum tartrate-resistant acid phosphatase isoform 5b (TRACP-5b) levels reflect enhanced bone remodeling and predict the occurrence of stress fractures in military conscripts. Material and Methods: Randomly selected military conscripts [mean age, 19.8 (range 18–28) years; n = 820] were followed for 3 months. Baseline blood samples were drawn upon arrival to the service. Four subsequent samples were obtained from subjects that developed stress fractures and one sample each was obtained from two asymptomatic control subjects for each fracture case. Results: Plain radiography was used to diagnose stress fractures in 20 of the 820 conscripts (2.4%). Follow-up data were available for 14 subjects with 21 stress fractures and 28 control subjects. Subjects with proportionally increasing serum TRACP-5b levels had an 8-fold greater probability of stress fracture than controls. No statistically significant difference was detected. Conclusions: Although assessing serum TRACP-5b levels appears to be a promising method to predict bone stress injuries, the present study failed to give a conclusive statement of its usefulness as a diagnostic tool.
Differences in Quality of Life before Transplantation among Transplant Recipients with Respect to Selected Socioeconomic Variables
Authors: Cetingok Muammer , Hathaway Donna K. , Winsett Rebecca R. 
Published: January 2017

Purpose To examine differences in quality of life before transplantation among transplant recipients with respect to a selected set of socioeconomic variables related to household/housing, family social and health history, and availability and use of community resources. Methods An exploratory-descriptive study in a US university's transplant clinic. Sample included 249 kidney, liver, and pancreas transplant recipients aged 18 years or older. Instruments were a socioeconomic data questionnaire, the Sickness Impact Profile, the Adult Self-Image Scale, the Quality of Life Index, and a general quality of life scale. Descriptive statistics and analysis of variance with Bonferroni adjustment were used with a significance level of .05. Effect sizes were estimated. Results Quality of life did not differ significantly for any variable except for the use of private insurance combined with public health insurance. Such coverage was associated with significantly better scores on the psychosocial and total dimensions of the Sickness Impact Profile, indicating better health before transplantation. Conclusion Researchers must first explore why a mix of private and public health insurance is associated with a higher quality of life and second reexamine whether these results occur at other transplant centers. These results also provide direction for social work professionals as they counsel patients in an attempt to help patients achieve a better psychosocial and physical quality of life before transplantation.
Do People Accept Brain Death as Death? A Study in Brazil
Authors: Tessmer Chiara Scaglioni , Silva André Rodrigues da , Barcellos Franklin Correa , Araujo Cora Luiza , Costa Juvenal Dias da , Böhlke Maristela 
Published: January 2017

Background Although the term brain death has been clinically and legally accepted as a death criterion, few data are published about public attitudes and beliefs concerning this topic. Objectives To examine public understanding of brain death and how the term brain death affects decisions about organ donation. Methods Population-based cross-sectional study, with individuals aged 20 years or older in the urban area of Pelotas, State of Rio Grande do Sul, Brazil. The instrument used was a structured questionnaire, completed in individual interviews. χ2 and t test were used in the univariate and logistic regression in multivariate analysis. Results Of 3159 participants, 80.1% would authorize organ donation from a relative who had previously declared a willingness to do so. However, when the words “brain death” were used as death, only 63% would authorize organ donation. When the subject had not been discussed, only a third of the participants would authorize the donation of a relative's organs. Conclusions When the term death was substituted with brain death, the willingness to donate decreased by 20%, suggesting that some individuals do not understand or accept the term brain death. Increasing comprehension about the concept of brain death and adopting educational strategies are essential to obtain higher rates of organ donation in developing countries.
Effect of Annual Influenza Immunization on Antibody Response in Lung Transplant Patients
Authors: Dopp John M. , Wiegert Nicholas A. , Moran John J. M. , Francois Mary L. , Radford Kelly L. , Thomas Holly , Love Robert B. , Hayney Mary S. 
Published: January 2017

Background Influenza viral infections cause significant morbidity and mortality each season. Lung transplant patients may be at higher risk because of their underlying pathophysiology. Although annual immunization is the standard of care, its efficacy remains largely unproven. Previous studies showed poor antibody response to influenza vaccine in lung transplant patients, but no data on the antibody response in consecutive seasons have been published. Methods We studied antibody responses to influenza vaccine in 122 subjects: 66 lung transplant recipients, 28 control subjects, and 28 patients awaiting lung transplantation. We compared antibody response rates to individual viruses contained in influenza vaccines in consecutive years within the 3 groups. Serum antibody concentrations were measured at baseline and 2 to 4 weeks after vaccination by using the hemagglutination inhibition assay. Log-transformed antibody concentrations and incidence of serconversion and seroprotection were calculated. Results Median log-transformed antibody responses were similar in consecutive seasons in lung transplant subjects. Incidences of seroprotection and seroconversion did not differ between consecutive seasons in lung transplant recipients. Conclusions Antibody responses were similar in consecutively measured years in lung transplant subjects. Annual influenza vaccination in lung transplant subjects produces similar immune responses in 2 consecutive years, indicating that these patients are not at significantly increased risk of vaccine failure.
Patterns and Predictors of Sleep Quality Within the First Year After Lung Transplantation
Authors: Fatigati Angela , Alrawashdeh Mohammad , Zaldonis Jenna , Dabbs Annette DeVito 
Published: January 2017

Context: Sleep quality affects health and self-management in chronic illness. Limited research has examined patterns and predictors of sleep quality and its impact on self-management and health-related quality of life (HRQOL) among lung transplant recipients (LTRs). Objective: The aims of this study were to identify the patterns, predictors, and impact of poor sleep quality on self-management behaviors and HRQOL the first year after lung transplantation. Methods: Secondary analysis of 75 LTRs who participated in a randomized controlled trial. Pittsburgh Sleep Quality Index (PSQI) was administered at baseline, 2, 6, and 12 months after transplant; 12-month PSQI was dichotomized categorizing good versus poor sleepers. Predictors were measured at the time of transplant; self-management and HRQOL were measured at 12 months. Logistic regression identified predictors of poor sleep. Correlations examined poor sleep quality, self-management behaviors, and HRQOL. Results: Sleep quality was relatively stable during the first year, and 24 of the 75 (32%) of the sample met criteria for poor sleep quality at 12 months. The only multivariate predictor of poor sleep was female gender (odds ratio = 3.421; P = .026); the mental component of HRQOL was the only outcome associated with poor sleep ( r = −.348; P < .01). Conclusion: Nearly one-third of LTRs reported persistent poor sleep through year 1. More females reported poor sleep quality, and sleep quality was inversely related to mental HRQOL by 12 months. Knowledge of these relationships may help identify LTRs at the greatest risk for poor sleep and guide strategies to promote sleep and optimize HRQOL.
Neuroradiological Analysis of 23 Cases of Basilar Artery Fenestration Based on 2280 Cases of MR Angiographies
Authors: Tanaka M. , Kikuchi Y. , Ouchi T. 
Published: January 2017

Basilar artery (BA) fenestrations are the most frequently observed variant of the cerebral arteries. We examined the magnetic resonance (MR) angiographic incidence, location, characteristic configuration of BA fenestration and associated vascular disease. From April 2004 to September 2004, a total of 2280 cranial MR angiographies were performed at our institution. Twenty-three BA fenestrations (1.0%) were detected on MRA. There were 13 males and ten females in this group and mean age was 57.6 years old. Three cases of these fenestration group are suffered with atherothrombic infarction in the territory of vertebro-basilar system. Seven of 23 cases (30%) were associated with intracranial aneurysm. Of those four cases, aneurysms were located at anterior circulation. Of those three cases, the aneurysms were associated with BA fenestration. Since saccular aneurysms are reported to arise frequently at BA fenestration, knowledge and recognition of fenestration are useful and important in the interpretation of cerebral MR angiography.
Endovascular Treatment of Experimental Cerebral Aneurysms Using Thermoreversible Liquid Embolic Agents
Authors: Takao H. , Murayama Y. , Saguchi T. , Ishibashi T. , Ebara M. , Irie K. , Yoshioka H. , Mori Y. , Ohtsubo S. , Viñuela F. , Abe T. 
Published: January 2017

We have developed a new embolic agent, thermoreversible gelation polymer (TGP). This polymer is unique in that solidification occurs at body temperature. The utility of this new liquid embolic agent for the treatment of large experimental aneurysms was evaluated angiographically. TGP remains liquid at temperatures below the sol-gel transition temperature (TT) and becomes gelatinous above the TT. TGP can also be used to slowly deliver biologically active substances such as growth factors or engineered cells. In this study, TGP was mixed with radiopaque material without solvent. Bilateral common carotid arteries of swine (n=5) were used for surgical creation of lateral aneurysms, then 1 aneurysm in each animal was embolized using TGP without any protection device. The remaining untreated aneurysm in each animal was used as a control. All aneurysms were successfully embolized using TGP. No distal migration of TGP was observed when aneurysms were embolized without using protection devices. TGP can be safely used to embolize experimental aneurysms. Embolization of aneurysms with a protection device needs to be evaluated. Further modifications such as mechanical stability and use as a drug delivery system will be necessary prior to the clinical application of TGP.