bluuebunny/crossref_metadata_2025_split huggingface dataset:
ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for Brain Hemorrhage
Authors: Vespa Paul , Hanley Daniel , Betz Joshua , Hoffer Alan , Engh Johnathan , Carter Robert , Nakaji Peter , Ogilvy Chris , Jallo Jack , Selman Warren , Bistran-Hall Amanda , Lane Karen , McBee Nichol , Saver Jeffery , Thompson Richard E. , Martin Neil 
Published: October 2016

Background and Purpose—
Intracerebral hemorrhage (ICH) is a devastating disease without a proven therapy to improve long-term outcome. Considerable controversy about the role of surgery remains. Minimally invasive endoscopic surgery for ICH offers the potential of improved neurological outcome.

Methods—
We tested the hypothesis that intraoperative computerized tomographic image–guided endoscopic surgery is safe and effectively removes the majority of the hematoma rapidly. A prospective randomized controlled study was performed on 20 subjects (14 surgical and 4 medical) with primary ICH of >20 mL volume within 48 hours of ICH onset. We prospectively used a contemporaneous medical control cohort (n=36) from the MISTIE trial (Minimally Invasive Surgery and r-tPA for ICH Evacuation). We evaluated surgical safety and neurological outcomes at 6 months and 1 year.

Results—

The intraoperative computerized tomographic image–guided endoscopic surgery procedure resulted in immediate reduction of hemorrhagic volume by 68±21.6% (interquartile range 59–84.5) within 29 hours of hemorrhage onset. Surgery was successfully completed in all cases, with a mean operative time of 1.9 hours (interquartile range 1.5–2.2 hours). One surgically related bleed occurred peri-operatively, but no patient met surgical safety stopping threshold end points for intraoperative hemorrhage, infection, or death. The surgical intervention group had a greater percentage of patients with good neurological outcome (modified Rankin scale score 0–3) at 180 and 365 days as compared with medical control subjects (42.9% versus 23.7%;
P
=0.19).

Conclusions—
Early computerized tomographic image–guided endoscopic surgery is a safe and effective method to remove acute intracerebral hematomas, with a potential to enhance neurological recovery.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00224770.
Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China
Authors: Li Zixiao , Wang Chunjuan , Zhao Xingquan , Liu Liping , Wang Chunxue , Li Hao , Shen Haipeng , Liang Li , Bettger Janet , Yang Qing , Wang David , Wang Anxin , Pan Yuesong , Jiang Yong , Yang Xiaomeng , Zhang Changqing , Fonarow Gregg C. , Schwamm Lee H. , Hu Bo , Peterson Eric D. , Xian Ying , Wang Yilong , Wang Yongjun 
Published: October 2016

Background and Purpose—
Stroke is a leading cause of death in China. Yet the adherence to guideline-recommended ischemic stroke performance metrics in the past decade has been previously shown to be suboptimal. Since then, several nationwide stroke quality management initiatives have been conducted in China. We sought to determine whether adherence had improved since then.

Methods—
Data were obtained from the 2 phases of China National Stroke Registries, which included 131 hospitals (12 173 patients with acute ischemic stroke) in China National Stroke Registries phase 1 from 2007 to 2008 versus 219 hospitals (19 604 patients) in China National Stroke Registries phase 2 from 2012 to 2013. Multiple regression models were developed to evaluate the difference in adherence to performance measure between the 2 study periods.

Results—
The overall quality of care has improved over time, as reflected by the higher composite score of 0.76 in 2012 to 2013 versus 0.63 in 2007 to 2008. Nine of 13 individual performance metrics improved. However, there were no significant improvements in the rates of intravenous thrombolytic therapy and anticoagulation for atrial fibrillation. After multivariate analysis, there remained a significant 1.17-fold (95% confidence interval, 1.14–1.21) increase in the odds of delivering evidence-based performance metrics in the more recent time periods versus older data. The performance metrics with the most significantly increased odds included stroke education, dysphagia screening, smoking cessation, and antithrombotics at discharge.

Conclusions—
Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China.
Proclus on the Forms of Attributes
Authors: Kobec Alberto 
Published: October 2016

AbstractAtin Parmenidem3.826.19-827.18, within the context of a discussion concerning the extent of the world of Forms, Proclus addresses the problem of the Forms of attributes. He admits of Forms of substantial attributes, however denies the existence of Forms corresponding to mere accidental attributes. In the last lines of the passage, he contends that we should also posit Forms of figure and number. These opaque lines have been neglected in previous scholarship, with the sole exception of the recent Budé edition of the text, where it is argued that since figures and numbers cannot be conceived of as attributes, the paragraph is thus out of place as it stands. This article aims to show that such an interpretation is mistaken and that the paragraph indeed belongs to the discussion of the Forms of attributes insofar as figures and numbers are regarded here as attributes—more precisely, as substantial attributes.
Covariation of Finite-Amplitude Wave Activity and the Zonal-Mean Flow in the Midlatitude Troposphere. Part II: Eddy Forcing Spectra and the Periodic Behavior in the Southern Hemisphere Summer
Authors: Wang Lei , Nakamura Noboru 
Published: October 2016

Abstract
Previously, in Part I of this study, the authors used latitude-by-latitude budgets of the vertically integrated finite-amplitude wave activity (FAWA) to describe the covariation of the zonal-mean state and eddy amplitude. In the austral summer within 40°–55°S, FAWA exhibits a marked 20–30-day periodicity driven mainly by the low-level meridional eddy heat flux, consistent with the recently identified baroclinic annular mode (BAM).
The present article examines the spectra of eddy heat flux that produce the periodic behavior in the Southern Hemisphere storm track. Analysis of the ERA-Interim product reveals that the 20–30-day periodicity in raw FAWA and eddy heat flux is particularly robust during the warm season. A dry GCM is shown to reproduce qualitatively BAM-like eddy heat flux spectra if the zonal-mean state resembles that of the austral summer and if the surface thermal damping is sufficiently strong. The observed eddy heat flux cospectra in summer contain a few dominant frequencies for each of the energy-containing zonal wavenumbers (4–6). The corresponding Fourier modes are heat transporting but neutral, with slightly different meridional structures. As these modes travel at different phase speeds they interfere with each other and produce an amplitude modulation to the eddy heat flux with a periodicity consistent with the BAM. The meridionally confined baroclinic zone in the mean state of the austral summer provides a waveguide that directs the mode propagation and interference along the latitude circle. However, the processes that give rise to the quasi-discrete Fourier modes remain to be identified.
Influence of urbanity on perception of mental illness stigma: a population based study in urban and rural Hanoi, Vietnam
Authors: Ta Thi Minh Tam , Zieger Aron , Schomerus Georg , Cao Tien Duc , Dettling Michael , Do Xuan Tinh , Mungee Aditya , Diefenbacher Albert , Angermeyer Matthias C , Hahn Eric 
Published: October 2016

Background and Aims: To examine, for the first time in Vietnam, whether urbanity of respondents among other socio-demographic factors affects the public perception of stigma attached to persons with mental illness in Hanoi. Methods: A general population-based survey was carried out in 2013 in the greater Hanoi area. The perception of stigma attached to people with mental illness was elicited using Link’s perceived discrimination and devaluation scale (PDDS) carried out in Vietnamese language. The survey sample ( n = 806) was stratified for gender, urban/rural location, age, household size and marital status, in accordance with the 2013 Vietnamese census. Results: Comparing the total score of the PDDS and its single items, we found less perceived stigma and discrimination among the rural population of Hanoi and in respondents who reported religious attainment to either Buddhism or Christianity. Logistic regression analyses found no significant influences of gender, age, household size or marital status regarding the perceived stigma toward persons with mental illness. Conclusion: Less negative perception of stigma attached to persons with mental illness that was observed among the rural population in the Hanoi area may be interpreted in the light of possibly more demanding living conditions in modern urban Vietnam with less opportunities for mentally ill patients and points toward a dynamic interaction with rapidly changing living conditions in Asian megacities.
Wide discrepancies in activated clotting times measured by two devices were detected for a patient with lupus anticoagulant in a cardiac surgery
Authors: Miyazawa Keika , Otsuka Yuji , Ishiguro Yoshiki 
Published: October 2016

Introduction: For a patient with lupus anticoagulant (LA), activated coagulation time (ACT) was measured with two different types of devices (HEMOCHRON® 801 and HEMOCHRON® Jr). Case Report: ACTs during heparinization measured with the HEMOCHRON® 801 were over the range of measurement, while those with the HEMOCHRON® Jr. reflected an almost normal response to heparin. Discussion: The phospholipid contained in an activating agent of the HEMOCHRON® Jr was suggested to have counteracted the effect of LA. Conclusion: It was indicated that the coagulation status for LA-positive patients might be better assessed by ACT measured with phospholipid in an activating agent, although careful interpretation is required.
Supervised Injectable Heroin: A Clinical Perspective
Authors: Bell James , Waal Rob van der , Strang John 
Published: October 2016

Background: Six recent randomised control trials (RCTs) have suggested that supervised injectable heroin (SIH) can be effective in patients who persist in street heroin use during methadone treatment. However, short-term randomised control trials have limitations in assessing the effectiveness of treatments for addictive disorders, which are chronic and relapsing disorders of motivation. These RCTs particularly fail to capture the process of the SIH treatment and the diversity of influence and change over time. Method: This narrative review is based on the analysis of published data. Conclusions are drawn from a process of reflection informed by experience in delivering one of the published trials, subsequent experiences in varying the way SIH is delivered, and through consideration of possible mechanisms of action of SIH. Observations: Many long-term, socially marginalised and demoralised people who are addicted to heroin experience few rewards from the stability afforded by methadone treatment. Supervised injected heroin is sufficiently reinforcing for many of these individuals to attend daily and participate in highly structured treatment. With an adequate daily dose of supervised methadone to avoid withdrawal dysphoria, occasional diamorphine injections—not necessarily twice daily, or even every day—is enough to hold people in treatment. Participation was associated with reduced amounts of non-prescribed drug use, a gradual change in self-image and attitude, and for some subjects, a movement towards social reintegration and eventual withdrawal from SIH. Conclusions: Prescribed heroin is sufficiently motivating to hold a proportion of recidivist addicts in long-term treatment. Participation in structured treatment provides respite from compulsive drug use, and a proportion of subjects develop sufficient rewards from social reintegration to successfully withdraw from treatment. Such change, when it occurs, is slow and stuttering.
COMMUTER BRIDGE
Authors: Merlone Ugo , Romano Angelo 
Published: October 2016

Background. COMMUTER BRIDGE is a n-person social dilemma game that allows participants to experience situations in which individual rationality leads to collective disaster. Aim. Participants are asked to imagine they are commuters who must every day reach a place in the shortest possible time. Method. The game is divided in two phases: in the first phase, participants can choose between two routes whereas in the second phase they are given a third possibility by the construction of a bridge that, paradoxically, increases traffic. Results and conclusion. Participating in this activity will enhance understanding of social dilemmas, help discover the limitations of communications, and develop insights about personal fallacies in strategic reasoning.
The real cost of training health professionals in Australia: it costs as much to build a dietician workforce as a dental workforce
Authors: Segal Leonie , Marsh Claire , Heyes Rob 
Published: October 2016

Objectives We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. Methods The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out. Census data were used to identify the number of qualified professionals working in their profession over a working life and to model expected years of practice by discipline. Data were combined to estimate the mean cost of training a health professional per year of service in their occupation. Results General medical graduates were the most expensive to train at $451,000 per completing student and a mean cost of $18,400 per year of practice (expected 24.5 years in general practice), while dentistry also had a high training cost of $352,180 but an estimated costs of $11,140 per year of practice (based on an expected 31.6 years in practice). Training costs are similar for dieticians and podiatrists, but because of differential workforce retention (mean 14.9 vs 31.5 years), the cost of training per year of clinical practice is twice as high for dieticians ($10,300 vs. $5200), only 8% lower than that for dentistry. Conclusions Return on investment in training across professions is highly variable, with expected time in the profession as important as the direct training cost. These results can indicate where increased retention and/or attracting trained professionals to return to practice should be the focus of any supply expansion versus increasing the student cohort.
The Nursing Assessment of Medication Acceptance: the reliability and validity of a schizophrenia medication adherence scale
Authors: Hori Hikaru , Ueda Nobuhisa , Shiozuka Hideki , Igata Ryohei , Miki Tazuko , Atake Kiyokazu , Takeuchi Yuji , Shirozu Hiroaki , Ohara Naotoshi , Konishi Yuki , Nagai Hiroshi , Sakurai Noriaki , Kubota Takanori , Yoshimura Reiji 
Published: October 2016

Background: Many patients with schizophrenia have low medication adherence. There is, however, no objective assessment scale that can be used by nurses or caregiver specialists. The Nursing Assessment of Medication Acceptance (NAMA) was developed to assess patients’ medication adherence. The aim of this study was to examine the validity and reliability of the NAMA in patients with schizophrenia. Methods: A total of 121 Japanese patients with schizophrenia were enrolled. All patients underwent evaluation using the NAMA and the Drug Attitude Inventory (DAI-10). Reliability was investigated using a test-retest method and a parallel-test method. To determine the test-retest reliability of the NAMA, we tested 101 schizophrenia patients twice, with the second assessment 2–4 weeks after the date of the first assessment. For validity verification, standard-related validity and the degree of concordance with the DAI-10 scores were measured. Results: The Cronbach’s alpha value of the NAMA in schizophrenia was 0.88. The test-retest correlation coefficients were all between 0.53–0.74. The total scores and all subscores for the NAMA were significantly correlated, and the NAMA total scores were significantly correlated with the DAI-10 total scores. Conclusions: The NAMA shows good reliability and validity in measuring medication adherence in schizophrenia.
Pain may be an important factor to consider in inflammatory bowel disease patients troubled by fatigue
Authors: Jelsness‐Jørgensen Lars‐Petter , Frigstad Svein‐Oskar , Moum Bjørn , Grimstad Tore , Opheim Randi , Jahnsen Jørgen , Bernklev Tomm 
Published: October 2016

BackgroundPain has been associated with fatigue in many chronic diseases, but data are not available for inflammatory bowel disease (IBD). The aim of this study was to investigate whether fatigue is associated with pain in IBD after adjusting for the relevant covariates.MethodsParticipants were recruited from nine hospitals in the south‐eastern and western part of Norway. Socio‐demographic variables were self‐reported by patients. Disease activity was assessed by disease activity indices and faecal calprotectin. Patient‐reported outcomes (PROs) were collected using the Fatigue Questionnaire (FQ), Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and Basic Nordic Sleep Questionnaire.ResultsFrom a total of 452 invited patients, 414 (91.6%) provided written informed consent. After excluding any missing data, 408 total patients were included in the analyses (ulcerative colitis = 180 and Crohn’s disease = 228). In the crude analysis, substantial and chronic fatigue were associated with increased pain intensity regardless of the diagnosis. However, when controlling for relevant covariates in the ANCOVA, the differences in pain intensity among patients with and without substantial or chronic fatigue were insignificant. The Cohen’s d effect size was small to moderate (>0.20) in patients with chronic fatigue.ConclusionsDespite a tendency of elevated pain intensity scores among patients with fatigue, these differences were insignificant after controlling for the relevant covariates. However, based on Cohen’s effect size, these differences may be of clinical importance in a subset of patients.
Trainee logbook analysis reveals regional operative experience
Authors: Yamamoto Hidekazu , Datta Soumendra N , Maan Zafar , Junaid Islam , Webster Jeff , Greenwell Tamsin , Kavia Rajesh 
Published: October 2016

Objective: Indicative operative numbers have become a new benchmark for higher surgical training. The aim of the deanery-led audit was to assess our regional operative experience using trainee logbooks against indicative number standards and to develop a tool to help guide regional training. Subjects and methods: Annual logbook data were collected using a questionnaire from urology trainees in a single region. Logbook data were excluded for an incomplete entry or work at multiple trusts in the same year. Logbooks were assumed to be current and validated. Analysis of variance (ANOVA) was used for statistical analysis. Results: Altogether 24 trainees across 19 different training sites responded to the questionnaire. A total of 9777 indicative procedures were included in the analysis. Median annual operative numbers were lower than required for 10/13 procedures, but mean annual operative numbers were higher than required for only 1/13 procedures (andrology). Significant variation in annual operative numbers across training sites was observed for 6/13 procedures. Annual logbook data was used to rank training sites by procedure-specific volumes and likelihood of trainees to achieve the annual operative target. Conclusion: Trainee logbook data is useful for objective ranking of training sites. In our region, difficulty in surpassing indicative numbers would arise due to significant case number variation between training sites and not due to regional insufficiency in case numbers. Regular analysis of trainee logbooks would allow better management of regional training with respect to indicative numbers.
Tendon Resection and Functional Rehabilitation for Achilles Tendon Infection Following Tendon Repair
Authors: Ryu Chang Hyun , Bae Seung Hwan , Seo Sang Gyo , Lee Ho Seong 
Published: October 2016

Category: Other. Introduction/Purpose: An infected Achilles tendon after tendon repair is particularly difficult to treat because of the poor vascularity of the tendon, itself, as well as the thin surrounding soft tissue. For management of an infected Achilles tendon following tendon repair, we first focused on complete debridement with tenectomy and then promoted scar healing of the Achilles tendon using functional management. Methods: We retrospectively reviewed all of the medical records of 15 patients with post-operative infection of the Achilles tendon occurring between 2007 and 2012. The mean follow-up time was 33 months (range, twenty two to 97 months). Tenectomy with radical debridement was performed, and the ankle was placed in a short leg splint for two weeks. The splint was then replaced with an ankle brace for the next four weeks. Partial weight-bearing walking was allowed immediately, and full weight-bearing walking was allowed two weeks postoperatively. We assessed the physical parameters such as range of motion, the calf circumference, capability of single heel raising, satisfactions and the Arner Lindholm scale were recorded. Laboratory test, post- operative ultrasonography and isokinetic plantar flexion power was also checked. Results: At the final follow-up, any sign of infection had disappeared without recurrence in all of the patients. Achilles tendon continuity recovered in all by scar healing. Compared to the contralateral side, there was no difference in the range of motion in eight patients. According to the Arner Lindholm scale, nine of fifteen cases were excellent and the other six cases were good. Their ability regarding single-heel rising on involved leg was achieved in ten patients. Eleven of 15 patients could return to their pre-injury recreational activities. Diffuse homogeneous echotexture of the Achilles tendon with continuity within the tendon sheath was observed on the ultrasonographic examination or MRI. Conclusion: Tenectomy of infected Achilles tendon and radical debridement with vigorous rehabilitation is simple and successful management way for the postoperative infection following Achilles tendon repair.