bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: Trauma and early psychotic mania
Authors: Daglas Rothanthi , Conus Philippe , Cotton Sue M , Macneil Craig A , Hasty Melissa K , Kader Linda , Berk Michael , Hallam Karen T 
Published: August 2014

Objective: Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania. Methods: Traumatic events were retrospectively evaluated from patient files in a sample of 65 participants who had experienced first episode psychotic mania. Participants were aged between 15 and 28 years and were treated at a specialised early psychosis service. Clinical outcomes were measured by a variety of symptomatic and functioning scales at the 12-month time-point. Results: Direct-personal traumatic experiences prior to the onset of psychotic mania were reported by 48% of the sample. Participants with past direct-personal trauma had significantly higher symptoms of mania ( p=0.02), depression ( p=0.03) and psychopathology ( p=0.01) 12 months following their first episode compared to participants without past direct-personal trauma, with medium to large effects observed. After adjusting for baseline scores, differences in global functioning (as measured by the Global Assessment of Functioning scale) were non-significant ( p=0.05); however, participants with past direct-personal trauma had significantly poorer social and occupational functioning ( p=0.04) at the 12-month assessment with medium effect. Conclusions: Past direct-personal trauma may predict poorer symptomatic and functional outcomes after first episode psychotic mania. Limitations include that the findings represent individuals treated at a specialist early intervention centre for youth and the retrospective assessment of traumatic events may have been underestimated.
Theory of Mind and attachment styles in people with psychotic disorders, their siblings, and controls
Authors: Pos Karin , Bartels-Velthuis Agna A , Simons Claudia JP , Korver-Nieberg Nikie , Meijer Carin J , de Haan Lieuwe ,   for GROUP, Bruggeman Richard , Cahn Wiepke , de Haan Lieuwe , Kahn René S , Meijer Carin J , Myin-Germeys Inez , van Os Jim , Wiersma Durk 
Published: August 2014

Objective: Impaired Theory of Mind (ToM) and insecure (adult) attachment styles have been found in persons with schizophrenia as well as in their healthy siblings. ToM refers to the ability to infer mental states of self and others including beliefs and emotions. Insecure attachment is proposed to underlie impaired ToM, and comprises avoidant (discomfort with close relationships, high value of autonomy) and anxious (separation anxiety, dependency on others) attachment. Insight into the association between attachment style and ToM is clinically relevant, as it enhances our understanding and clinical approach to social dysfunction in schizophrenia. Therefore, we studied the association between insecure attachment styles and ToM in patients with schizophrenia, their siblings, and healthy controls. Methods: A total of 111 patients with a diagnosis in the schizophrenia spectrum, 106 non-affected siblings and 63 controls completed the Psychosis Attachment Measure, the Conflicting Beliefs and Emotions, a subsection of the Wechsler Adult Intelligence Scale, and the Childhood Trauma Questionnaire-Short Form. Severity of symptoms was assessed with the Community Assessment of Psychic Experiences and the Positive and Negative Syndrome Scale. Results: After controlling for sex, intelligence, history of trauma and symptom severity, avoidant attachment was significantly associated with cognitive as well as with affective ToM, showing U-shaped associations, indicating better ToM performance for patients with lower or higher levels of avoidant attachment compared to medium levels. Anxious attachment in patients was associated with more problems in cognitive ToM. Conclusion: The results from this study support the idea that an anxious attachment style is associated with worse ToM performance in patients. Results also suggested a potential protective role of higher levels of avoidant attachment on ToM. These findings bear clinical relevance, as activation of (insecure) attachment mechanisms may affect interpersonal relations, as well as therapeutic working alliance. Further clarification is needed, especially on associations between ToM and avoidant attachment.
Effects of Carrying a Backpack in an Asymmetrical Manner on the Asymmetries of the Trunk and Parameters Defining Lateral Flexion of the Spine
Authors: Drzał-Grabiec Justyna , Snela Sławomir , Rachwał Maciej , Podgórska Justyna , Rykała Justyna 
Published: August 2014

Objective: The aim of this study was to examine changes in the body posture parameters defining asymmetry of the trunk and lateral flexion of the spine in children while carrying a backpack weighing 10% of a child’s weight. Background: Carrying a backpack may negatively affect the posture of schoolchildren and contribute to spinal pain. Method: The study involved 162 primary school students ages 11 to 13 years. The parameters describing body posture were assessed with a backpack carried on the right or left shoulder as well as without a load. To assess the predefined parameters, we used the CQ Elektronik System, employing the photogrammetric method. Results: Trunk inclination shifted significantly in the opposite direction to the shoulder the backpack was carried on, and an increase in shoulder asymmetry was also found. We also observed a more pronounced right-side lateral flexion of the spine when the backpack was carried on the right shoulder and an analogous relationship for the left side. Conclusion: The results of this study show that carrying a backpack in an asymmetrical manner negatively affects spine, even if the backpack weight constitutes 10% of the child’s weight, which has been previously recommended as a safe load for a child’s shoulders. Application: We suggest that the issue of safe backpack weight be reassessed and that students be taught basic ergonomic principles on how to carry loads. Changes to the management pattern of carrying textbooks to and from school also should be considered.
Metastatic index of non-small-cell lung cancer and long-term survival
Authors: Poullis Michael , Shackcloth Michael , Page Richard , Asanti-Siaw Julius , Woolley Steven , Mediratta Neeraj 
Published: August 2014

Aim We aimed to determine whether metastatic index is a factor determining long-term survival in patients undergoing curative resection for non-small-cell lung cancer. Methods There were 2695 consecutive pulmonary resections performed between October 2001 and September 2011 in our institution; 1795 were potentially curative resections for non-small-cell lung cancer with bronchial margin length data available. Benchmarking against the International Association for the Study of Lung Cancer data set was performed. Cox multivariate analysis was undertaken. Metastatic index was defined as N stage× bronchial resection margin length. Results Benchmarking failed to reveal any significant differences between our data and the International Association for the Study of Lung Cancer data set. Univariate analysis identified metastatic index as a significant factor determining long-term survival ( p = 0.04). Cox regression demonstrated that metastatic index (hazard ratio 1.29, p = 0.0002), age (hazard ratio 1.02, p < 0.0001), body mass index (hazard ratio 0.98, p = 0.006), female sex (hazard ratio 0.65, p < 0.0001), T1 stage (hazard ratio 0.67, p < 0.0001), T2 stage (hazard ratio 2.13, p < 0.0001), T3 stage (hazard ratio 1.59, p = 0.03), forced expiratory volume in 1 s (hazard ratio 0.70, p < 0.0001), pneumonectomy (hazard ratio 1.43, p = 0.001), histology subtype adenosquamous (hazard ratio 3.77, p = 0.01) and squamous (hazard ratio 0.83, p = 0.03) were all significant determinants of long-term survival. Conclusion Metastatic index is a significant factor determining long-term survival in patents with adenocarcinoma undergoing potentially curative surgery with a lobectomy.
Clinical outcome and blood transfusion after infant cardiac surgery with a routine use of conventional ultrafiltration
Authors: Golab HD , Kissler J , de Jong PL , van de Woestijne PC , Takkenberg JJM , Bogers AJJC 
Published: August 2014

Objective Priming-related hemodilution is the culprit behind excessive body water accumulation, postoperative coagulopathy and enhanced blood transfusion in infant cardiac surgery patients. In this retrospective, observational study, clinical data were analyzed to assess the effect of conventional ultrafiltration on allogenic blood transfusion and patient clinical outcome. Methods All infants with a bodyweight up to 10 kg who underwent consequent cardiac surgery in 2011 and 2012 were eligible for the audit. Seventy patients, operated in accordance with existing pediatric protocol, enrolled in the control group. The study group consisted of 55 patients who were operated employing conventional ultrafiltration during bypass and recently adjusted hematocrit targets. The following variables were primarily investigated: hematocrit and colloid osmotic pressure value, total volume of blood products transfused and duration of postoperative mechanical ventilation. Secondary outcome measures were: postoperative urine production, postoperative blood loss, length of stay at the intensive care unit and hospital stay. Results There were no significant differences between the groups in relation to demographics or hematological and cardiopulmonary bypass data. The ultrafiltration volume removed from circulation during bypass in the study group was 171 ± 99 ml. No significant difference between the groups was found with regard to the total allogenic blood transfusion (study group 216 ± 92 ml versus control group 191 ±93 ml; p = 0.136). All recorded clinical end points, duration of mechanical ventilation, duration of chest tube in situ, stay in ICU and stay in hospital, were similar between the groups. Conclusions Routine use of conventional ultrafiltration during the cardiac surgery for patients with a bodyweight less than 10 kg was a safe technique that allowed us to achieve higher hematocrit levels at the end of the operation without additional transfusions of allogenic blood. On the other hand, ultrafiltration did not improve the clinical end points.
The role of transapical cannulation in the operative management of acute aortic dissection
Authors: Djukanovic BP , Micovic S , Peric MS , Milojevic PS , Cirkovic MV , Boricic M , Vukovic PM 
Published: August 2014

Objectives: The aim of the study was to investigate the usefulness of transapical cannulation as the routine cannulation site in patients with acute aortic dissection and to compare it with other cannulation methods. Methods: Between January 2010 and December 2013, emergency surgery was performed in 111 consecutive patients with acute type A aortic dissection. Patients were divided into two groups: transapical cannulation group and other cannulation sites group (including femoral and axillary artery cannulation). Pre-, intra- and postoperative data were compared between these two groups of patients. Results: Transapical cannulation was the most frequent cannulation site (78 patients, 70.3%), the femoral artery was selected in 24 patients (21.6%) and the axillary artery in 9 patients (8.1%). The mortality rate in the transapical group was 16.7% and 18.2% when other cannulation sites were chosen (p=0.85). No difference in postoperative stroke rate (6.4% vs 9.1%, p=0.62, transapical vs other cannulation sites group, respectively), myocardial infarction (6.4% vs 6.1%, p=0.94) and postoperative acute renal insufficiency incidence (9% vs 6.1%, p=0.61) was found. Conclusions: Routine transapical cannulation in patients with acute type A aortic dissection is a fast and safe way to establish cardiopulmonary bypass. There is no difference in major operative outcomes after transapical cannulation when compared to the other cannulation sites.
Effects of ecstasy on cooperative behaviour and perception of trustworthiness: A naturalistic study
Authors: Stewart LH , Ferguson B , Morgan CJA , Swaboda N , Jones L , Fenton R , Wall MB , Curran HV 
Published: August 2014

Background: Acute recreational use of 3,4-methylenedioxymethamphetamine (MDMA; ‘ecstasy’) can promote pro-social effects which may alter interpersonal perceptions. Aims: To explore such effects, this study investigated whether acute recreational use of ecstasy was associated with changes in individual perception of trustworthiness of people’s faces and co-operative behaviours. Method: An independent group, repeated measures design was used in which 17 ecstasy users were tested on the night of drug use (day 0) and again three days later (day 3); 22 controls were tested on parallel days. On each day, participants rated the trustworthiness of 66 faces, carried out three co-operative behaviour tasks (public good; dictator; ultimatum game) and completed mood self-ratings. Results: Acute ecstasy use was associated with increased face trustworthiness ratings and increased cooperative behaviour on the dictator and ultimatum games; on day 3 there were no group differences on any task. Self-ratings showed the standard acute ecstasy effects (euphoria, energy, jaw clenching) with negative effects (less empathy, compassion, more distrust, hostility) emerging on day 3. Conclusions: Our findings of increased perceived trustworthiness and co-operative behaviours following use of ecstasy suggest that a single dose of the drug enhances aspects of empathy. This may in turn contribute to its popularity as a recreational drug and potentially to its enhancement of the therapeutic alliance in psychotherapy.
Randomized controlled trial of the orexin receptor antagonist filorexant for migraine prophylaxis
Authors: Chabi Almira , Zhang Ying , Jackson Saheeda , Cady Roger , Lines Christopher , Herring W Joseph , Connor Kathryn M , Michelson David 
Published: August 2014

Background This study explored whether antagonism of orexin receptors might be an effective mechanism for migraine prevention. Methods We conducted a randomized, double-blind, placebo-controlled, pilot trial. Patients experiencing four to 14 days with migraine during a one-month baseline period were randomized to the orexin receptor antagonist filorexant 10 mg nightly or placebo for three months. Efficacy was assessed by mean monthly migraine days (headache plus at least one associated migraine symptom) and headache days. Safety and tolerability were assessed by adverse event reports and laboratory tests. Results Of 120 patients treated with filorexant and 115 treated with placebo, 97 (81%) and 101 (88%), respectively, completed the trial. There was no statistically significant difference between treatments for change from baseline in mean monthly migraine days (filorexant = −1.7, placebo = −1.3, difference = −0.4 (95% CI: −1.3, 0.4)) or headache days (filorexant = −1.7, placebo = −1.2, difference = −0.5 (95% CI: −1.4, 0.4)). Filorexant was generally well tolerated but was associated with a higher proportion of patients who reported adverse events than placebo (47% vs 37%), particularly somnolence (13% vs 4%). Conclusions These data fail to provide evidence that antagonism of orexin receptors with filorexant, when administered at night, is effective for migraine prophylaxis.
Does an Injection of a Stromal Vascular Fraction Containing Adipose-Derived Mesenchymal Stem Cells Influence the Outcomes of Marrow Stimulation in Osteochondral Lesions of the Talus?
Authors: Kim Yong Sang , Lee Ho Jin , Choi Yun Jin , Kim Yong Il , Koh Yong Gon 
Published: August 2014

Background: Marrow stimulation for the treatment of osteochondral lesions of the talus (OLTs) is controversial in patients with poor prognostic factors of OLTs. Currently, mesenchymal stem cells (MSCs) are expected to biologically augment the treatment of OLTs. Purpose: To compare the clinical and magnetic resonance imaging (MRI) outcomes between an injection of MSCs with marrow stimulation and marrow stimulation alone in patients with OLTs. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 49 patients (50 ankles) with OLTs underwent follow-up MRI after arthroscopic treatment. Among these 50 ankles, 26 underwent marrow stimulation alone (conventional group), and 24 underwent marrow stimulation with an injection of a stromal vascular fraction (SVF) containing MSCs (MSC group). Clinical outcomes were evaluated according to the visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and Tegner activity scale. The magnetic resonance observation of cartilage repair tissue (MOCART) score was used for the MRI evaluation of repaired lesions. Results: The mean VAS score, AOFAS score, and Tegner score improved from 7.1 ± 1.2, 68.5 ± 5.6, and 3.4 ± 0.6 to 3.9 ± 0.8, 78.3 ± 4.9, and 3.5 ± 0.8, respectively, in the conventional group and from 7.1 ± 0.8, 67.7 ± 4.7, and 3.4 ± 0.5 to 3.2 ± 0.8, 83.3 ± 7.0, and 3.9 ± 0.7, respectively, in the MSC group. All clinical outcomes, including the VAS, AOFAS, and Tegner scores, improved significantly in the MSC group compared with the conventional group ( P = .003, .009, and .041, respectively). There was a significant difference ( P = .037) in the mean MOCART score between the conventional and MSC groups (49.4 ± 16.6 vs 62.1 ± 21.8, respectively), and significant correlations of the MOCART score with clinical outcomes were found in both groups ( P < .05). Patient age (≥46.1 years), large lesion size (≥151.2 mm2), and the presence of subchondral cysts were associated with a worse MOCART score in the conventional group ( P = .015, .004, and .013, respectively) but not in the MSC group. Conclusion: Clinical and MRI outcomes of an injection of an SVF containing MSCs with marrow stimulation were encouraging, compared with marrow stimulation alone, for the treatment of OLTs. Therefore, an injection of an SVF containing MSCs with marrow stimulation should be considered as a treatment for OLTs, even when poor prognostic factors, including older age, large-sized lesion, or the presence of subchondral cysts, exist.
38th S.H. Foulkes Annual Lecture: Intimacy and Social Suffering in a Globalized World
Authors: Rohr Elisabeth 
Published: August 2014

How is intimacy possible in a globalized world—and how does the loss of intimacy effect societies as well as individuals? This is the central question of the following article. It is argued that sociology alone cannot find any convincing answers, because we need to understand the unconscious dynamics of global developments that undermine the human capacity to bond and to experience intimacy. Group analysis offers quite a unique position ‘on the edge’, that allows us to observe and to connect, to analyse and to understand not only patients, but also people and situations outside of the clinical world. In this sense it is social group analysis that turns out to be a valid research method and an approach that is capable of deciphering the ‘social unconscious’. An extensive case study out of a research project about transnational children in Ecuador (South America) and the story of Daqui are offered to show what is unconsciously at stake in a modern and globalized world, how much intimacy has degenerated already and how this can be understood in terms of group analysis.
Effective thermal conductivity of lithium multipurpose grease filled with metal particles
Authors: Verma Kamalesh , Dabas Manju , Upadhyay Anupama , Singh Ramvir 
Published: August 2014

Two-phase samples were prepared by mixing Fe, Cu, and Al particles (<50 µm) in lithium multipurpose grease with different weight fractions of Fe, Cu, and Al powders. Effective thermal conductivity of these samples has been measured by a laboratory-made thermal conductivity probe as a function of weight fraction of filled metal particles. Grease-Fe, Grease-Cu, and Grease-Al systems showed maximum thermal conductivity enhancement of 35.28%, 72.28%, and 97.40% at weight fraction of 0.3, 0.4, and 0.4 of Fe, Cu, and Al particles, respectively. An artificial neural network approach is used to model the effective thermal conductivity of these samples with three input parameters, viz. thermal conductivity of grease, thermal conductivity of metal particles, and weight fraction of metal particles, respectively. A theoretical prediction was also done using a model developed by Verma et al. Results obtained were compared based on coefficient of determination and mean absolute error between experimental and predicted values of effective thermal conductivity by artificial neural network and theoretical formulation. It is found that artificial neural network approach showed better agreement with the experimental results.
Monitoring of Outpatient Parenteral Antimicrobial Therapy and Implementation of Clinical Pharmacy Services at a Community Hospital Infusion Unit
Authors: Shah Punit J. , Bergman Scott J. , Graham Donald R. , Glenn Stephanie 
Published: August 2014

Background: In 2004, the Infectious Diseases Society of America (IDSA) published monitoring guidelines for outpatient parenteral antimicrobial therapy (OPAT), but no assessment of their utilization has been reported. We evaluated adherence to these recommendations by physicians at infusion centers and then piloted a program of supervision of monitoring by pharmacists. Methods: Phase I: We performed a retrospective case–control study of patients who received OPAT over 1 year at 2 hospital infusion centers. Controls were patients treated by an infectious diseases (ID) physician, and cases were those without an ID physician. Patients were excluded if they received fewer than 3 days of OPAT. Clinical pharmacy monitoring services were then implemented for patients on OPAT prescribed by non-ID physicians at 1 hospital’s infusion unit. Two outcomes were measured: adherence to guidelines on monitoring and attainment of goal vancomycin and aminoglycoside serum concentrations when appropriate. The results for non-ID physicians were compared to both ID physicians and subsequently a pharmacist. Results: Ninety-nine patients were included in the retrospective study. Compared with patients who had ID physician supervision, the non-ID physicians who prescribed OPAT for 39 patients had lower adherence to monitoring recommendations (35.9% vs 68.3%, P = .003). No difference could be detected in achievement of goal vancomycin and aminoglycoside serum concentrations for the 14 cases and 19 controls requiring therapeutic drug monitoring (57.1% vs 68.4%, respectively, P = .765). Seven patients were enrolled in the study after pharmacy monitoring was implemented. Adherence to monitoring recommendations for these patients was significantly improved compared to the prior patients who lacked ID physician supervision (35.9% vs 100%, P = .0065). Conclusion: Non-ID physicians are less likely to monitor OPAT according to the IDSA guidelines than ID physicians; however, pharmacist oversight improves adherence to recommendations. Further studies of monitoring of OPAT by pharmacists should investigate the impact of pharmacist involvement on prevention of adverse events and hospital readmissions.