bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of ethnicity and diagnosis in rates of adolescent psychiatric admission and compulsory detention: a longitudinal case-note study
Authors: Corrigall Richard , Bhugra Dinesh 
Published: June 2013

Objectives To explore whether ethnic variations in psychiatric admission and detention reported for adults also apply to adolescents and to establish the influence of diagnosis. Design A longitudinal, case-note study over a 10-year period. Setting An adolescent inpatient psychiatric unit in London. Participants All adolescents admitted to the unit. Main outcome measures Rates of admission and detention under the Mental Health Act, according to catchment area population. Results Young Black people were nearly six times more likely than the White group to be admitted with psychosis but showed no increase in admission for non-psychotic conditions. Young people in the Other group were over three times more likely to be admitted with psychosis but showed only a modest increase in admission with non-psychotic conditions. Young Asians were over twice as likely to be admitted with psychosis but were only one-third as likely to be admitted with non-psychotic conditions. Young people with psychosis in the Black and Other groups were around three times more likely to have been detained, but there were no significant differences for non-psychotic conditions. Conclusions Significant ethnic variation was found in the rates of admission and detention for adolescents. However, diagnosis was also an important consideration and must be taken into account when examining for evidence of ethnic bias in the use of mental health services by young people. Further investigation is required to establish whether adolescent care pathways are providing a safe and appropriate level of inpatient care for all ethnic groups.
Application of patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery in England
Authors: Coronini-Cronberg Sophie , Appleby John , Thompson James 
Published: June 2013

Objectives To demonstrate potential uses of nationally collected patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery. Design Cost-utility model populated with national PROMs, National Reference Cost and Hospital Episodes Statistics data. Setting Hospitals in England that provided elective inguinal hernia repair surgery for NHS patients between 1 April 2009 and 31 March 2010. Participants Patients >18 years undergoing NHS-funded elective hernia surgery in English hospitals who completed PROMs questionnaires. Main outcome measures Change in quality-adjusted life year (QALY) following surgery; cost per QALY of surgery by acute provider hospital; health gain and cost per QALY by surgery type received (laparoscopic or open hernia repair). Results The casemix-adjusted, discounted (at 3.5%) and degraded (over 25 years) mean change in QALYs following elective hernia repair surgery is 0.826 (95% CI, 0.793–0.859) compared to a counterfactual of no treatment. Patients undergoing laparoscopic surgery show a significantly greater gain in health-related quality of life (EQ-5D index change, 0.0915; 95% CI, 0.0850–0.0979) with an estimated gain of 0.923 QALYS (95% CI, 0.859–0.988) compared to those having open repair (EQ-5D index change, 0.0806; 95% CI, 0.0771–0.0841) at 0.817 QALYS (95% CI, 0.782–0.852). The average cost of hernia surgery in England is £1554, representing a mean cost per QALY of £1881. The mean cost of laparoscopic and open hernia surgery is equivocal (£1421 vs. £1426 respectively) but laparoscopies appear to offer higher cost-utility at £1540 per QALY, compared to £1746 per QALY for open surgery. Conclusions Routine PROMs data derived from NHS patients could be usefully analyzed to estimate health outcomes and cost-effectiveness of interventions to inform decision-making. This analysis suggests elective hernia surgery offers value-for-money, and laparoscopic repair is more clinically effective and generates higher cost-utility than open surgery.
Day-case re-do varicose vein surgery
Authors: Nagpal Kamal , Glore RJ , Chong Peter Lee , Singh Sewa , Pillay Woolagasen , Tan Peter , Cuschieri RJ 
Published: June 2013

Objective: To assess whether re-do varicose vein surgery as a day case is feasible and safe. Methods: Data were collected retrospectively on 70 consecutive patients (77 legs) undergoing re-do sapheno-femoral or sapheno-popliteal ligation by consultant surgeons as day cases. Follow-up was by structured telephone interview. Results: The 70 patients comprised 53 females and 17 males. Median age and body mass index were 47.5 years and 27, respectively. All patients were ASA Grade I or II. Median operating time was 75 min (range 25–140). Of the 70 patients intended to be treated as day cases, four (5.7%) were admitted overnight. There were no were re-admissions nor did any patient develop deep vein thrombosis. Eleven per cent developed wound infection and 4% transient lymphatic leakage. Overall, 91% of patients were pleased with the initial surgical result but this decreased to 81% in the longer term. Eighty-nine per cent would have their surgery performed again as a day case. Conclusion: Re-do sapheno-femoral or sapheno-popliteal can be performed safely as a day case.
Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb
Authors: Li Fenghe , Wang Xuehu , Huang Wen , Ren Wei , Cheng Jun , Zhang Mao , Zhao Yu 
Published: June 2013

Objective The aim of our study is to investigate the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in the lower limbs and to evaluate the associated risk factors. Methods A total of 322 patients with acute deep venous thrombosis confirmed by CT venography or Doppler ultrasonography were studied. The diagnosis of silent pulmonary embolism was established by computed tomography pulmonary arteriography (CTPA). The association between covariates and the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs were assessed using chi-square test and multivariable regression. Results The incidence of silent pulmonary embolism was 33.5% (108 in 322 patients) in all patients with deep venous thrombosis in lower limbs. Chi-square test showed male gender, the right lower limb, proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases were related to a higher incidence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs. The multivariate regression analysis confirmed that the risk factors associated with silent pulmonary embolism in deep venous thrombosis patients included the right side and proximal location of the thrombus (odds ratio: 2.023, 95% CI: 1.215–3.368; odds ratio: 3.610, 95% CI: 1.772–7.354), unprovoked venous thrombosis (odds ratio: 2.037, 95% CI: 1.188–3.493), coexisting heart diseases (odds ratio: 4.507, 95% CI: 2.667–7.618). Conclusion Silent pulmonary embolism occurred frequently in patients with deep venous thrombosis in lower limbs. The right side, the proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases increased the risk for the occurrence of silent pulmonary embolism.
Reporting the impact of inferior vena cava perforation by filters
Authors: Wood Emily A , Malgor Rafael D , Gasparis Antonios P , Labropoulos Nicos 
Published: June 2013

Background Perforation of the inferior vena cava by filters struts is a known complication. The goal of our review is to assess the impact of inferior vena cava perforation by filters based on an open, voluntary national database. Methods We reviewed 3311 adverse events of inferior vena cava filters reported in Manufacturer and User Facility Device Experience database from January 2000 to June 2011. Outcomes of interest were incidence of inferior vena cava perforation, type of filter, clinical presentation, and management of the perforation, including retrievability rates. Results Three hundred ninety-one (12%) cases of inferior vena cava perforation were reported. The annual distribution of inferior vena cava perforation was 35 cases (9%), varying from seven (2%) to 70 (18%). A three-fold increment in the number of adverse events related to inferior vena cava filters has been noted since 2004. Wall perforation as an incidental finding was the most common presentation ( N = 268, 69%). Surrounding organ involvement was found in 117 cases (30%), with the aorta being the most common in 43 cases (37%), followed by small bowel in 36 (31%). Filters were retrieved in 97 patients (83%) regardless of wall perforation. Twenty-five (26%) cases required an open procedure to remove the filter. Neither major bleeding requiring further intervention nor mortality was reported. Conclusions Inferior vena cava perforation by filters remains stable over the studied years despite increasing numbers of adverse events reported. The majority of filters involved in a perforation were retrievable. Filter retrieval, regardless of inferior vena cava wall perforation, is feasible and must be attempted whenever possible in order to avoid complications.
Iliac vein stenting as a durable option for residual stenosis after catheter-directed thrombolysis and angioplasty of iliofemoral deep vein thrombosis secondary to May–Thurner syndrome
Authors: Park Jae Young , Ahn Jong Hyuk , Jeon Yong Sun , Cho Soon Gu , Kim Jang Yong , Hong Kee Chun 
Published: June 2013

Introduction This study aims to evaluate the primary patency and clinical outcomes after stenting for residual iliac venous stenosis during catheter-directed thrombolysis treatment of acute iliofemoral deep vein thrombosis arising from May–Thurner syndome. Methods A retrospective study was done for the all patients who underwent iliac vein stenting after catheter-directed thrombolysis treatment of acute iliofemoral deep vein thrombosis due to May–Thurner syndrome from January 2005 to April 2011 in Inha University Hospital. Patient information was assembled from the electronic medical records, imaging and interview. The patency of iliac vein stent was evaluated with serial computed tomography. Results Fifty-one patients were enrolled. The median age was 70 years (range 44–86). There were 37 females (72.5%). The duration of symptoms of acute deep vein thrombosis before catheter-directed thrombolysis treatment was 6 days (median, range 1–33). Self-expanding stent was used for iliac vein stenting. Initial technical success rate was 94.1%. There were two complications (3.9%): an arteriovenous fistula formation in left popliteal area and a right inguinal hematoma. Mean follow-up was 15.6 months (range 6 days–80.8 months). Primary patency rate after iliac vein stenting was 95.8% at 6 months, 87.5% at 12 months and 84.3% at 24 months. Four patients had recurrent thrombotic occlusion (7.8%) during the follow-up. Conclusion Iliac vein stenting showed good primary patency rate with few complications. Iliac vein stenting is a durable option for residual stenosis after catheter-directed thrombolysis treatment of acute deep vein thrombosis in May–Thurner syndrome.
Place of death, and its relation with underlying cause of death, in Parkinson’s disease, motor neurone disease, and multiple sclerosis: A population-based study
Authors: Sleeman Katherine E , Ho Yuen K , Verne Julia , Glickman Myer , Silber Eli , Gao Wei , Higginson Irene J ,   on behalf of the GUIDE_Care Project
Published: June 2013

Background: Little is known about place of death in chronic neurological diseases. Mortality statistics are ideal for examining trends in place of death, but analyses are limited by coding rule changes. Aim: To examine the relationship between place of death and underlying cause of death in Parkinson’s disease, multiple sclerosis and motor neurone disease and the impact of coding rule changes on analysis of place of death. Design: Population-based study. Proportion ratios for death in hospice, home, care home and hospital were calculated according to underlying cause of death, using multivariable Poisson regression. Participants: Deaths in England (1993–2010) with any mention of Parkinson’s disease, multiple sclerosis or motor neurone disease as a cause of death, identified from national mortality data. Results: In this study, 125,242 patients with Parkinson’s disease, 23,501 with multiple sclerosis, and 27,030 with motor neurone disease were included. Home deaths ranged from 9.7% (Parkinson’s disease) to 27.1% (motor neurone disease), hospice deaths ranged from 0.6% (Parkinson’s disease) to 11.2% (motor neurone disease) and hospital deaths ranged from 43.4% (Parkinson’s disease) to 55.8% (multiple sclerosis). In Parkinson’s disease and multiple sclerosis, cancer as underlying cause of death increased likelihood of hospice death (proportion ratio (PR): 18.8, 95% confidence interval (CI) = 16.1–22.0; 8.88, 95% CI = 7.49–10.5) and home death (PR: 1.91, 95% CI = 1.80–2.04; 1.71, 95% CI = 1.56–1.88). Dementia as underlying cause of death increased likelihood of care home death in Parkinson’s disease (PR: 1.25, 95% CI = 1.19–1.32), multiple sclerosis (PR: 1.73, 95% CI = 1.22–2.45) and motor neurone disease (PR: 2.36, 95% CI = 1.31–4.27). Conclusions: Underlying cause of death has a marked effect on place of death. The effects of coding rule changes are an essential consideration for all research using underlying cause of death to study place of death.
Clinical significance of differences between home and clinic systolic blood pressure readings in patients with hypertension
Authors: Masugata Hisashi , Senda Shoichi , Inukai Michio , Himoto Takashi , Hosomi Naohisa , Murao Koji , Okada Hiroki , Goda Fuminori 
Published: June 2013

Objectives To elucidate the clinical significance of differences between home- and clinic-measured systolic blood pressure (SBP) in patients with treated hypertension, and to assess the correlations between SBPs and arterial stiffness. Methods Patients with treated hypertension measured their blood pressure (BP) themselves once, at home, in the morning (<1 h after awakening) using an automated oscillometric sphygmomanometer. Clinic BP was measured once, at an outpatient clinic on the same day, using a similar instrument. Arterial stiffness was measured by cardio–ankle vascular index (CAVI). Differences between home and clinic SBPs, and the correlations between CAVI and home SBP, clinic SBP, and the difference between home and clinic SBPs, were analysed. Results Seventy-six patients with treated hypertension (mean age, 71 years) were evaluated. There was no statistically significant difference between home and clinic SBP (mean ± SD 132 ± 14 and 133 ± 16 mmHg, respectively). Home SBP showed no correlation with CAVI, whereas clinic SBP showed a weak correlation. The difference between the home and clinic SBP showed a stronger correlation with CAVI, and was statistically significant. Conclusions The difference between home- and clinic-measured SBP showed a better correlation with arterial stiffness than did either home or clinic SBP alone.
Reliability of the Active and Passive Knee Extension Test in Acute Hamstring Injuries
Authors: Reurink Gustaaf , Goudswaard Gert Jan , Oomen Henricus G. , Moen Maarten H. , Tol Johannes L. , Verhaar Jan A.N. , Weir Adam 
Published: June 2013

Background: Hamstring flexibility measurements are of clinical relevance for the prognosis of hamstring injury and for monitoring recovery after such injury. The active knee extension test (AKET) and passive knee extension test (PKET) are proven to be reliable in healthy subjects. Reliability has not been determined in patients with acute hamstring injuries. Purpose: The purpose of this study was to determine intertester reliability of the AKET and the PKET in patients with acute hamstring injuries. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifty consecutive athletes with acute hamstring injuries confirmed with magnetic resonance imaging were included in this study. For each subject, 2 testers performed the AKET and the PKET within 5 days after injury. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD) were determined. Results: In the injured leg, the ICC of the AKET was 0.89 and of the PKET 0.77, the SEM of the AKET was 5.3° and of the PKET 7.6°, and the MDD of the AKET of the 15° and of the PKET 21°. Conclusion: Good intertester reliability was found for the AKET and the PKET in injured hamstrings. Thus, both tests can be reliably used to assess flexibility in injured hamstrings, despite pain and discomfort during testing.
Quadriceps Tendon Injuries in National Football League Players
Authors: Boublik Martin , Schlegel Theodore F. , Koonce Ryan C. , Genuario James W. , Kinkartz Jason D. 
Published: June 2013

Background: Distal quadriceps tendon tears are uncommon injuries that typically occur in patients older than 40 years of age, and they have a guarded prognosis. Predisposing factors, prodromal findings, mechanisms of injury, treatment guidelines, and recovery expectations are not well described in high-level athletes. Hypothesis: Professional American football players with an isolated tear of the quadriceps tendon treated with timely surgical repair will return to their sport. Study Design: Case series; Level of evidence, 4. Methods: Fourteen unilateral distal quadriceps tendon tears were identified in National Football League (NFL) players from 1994 to 2004. Team physicians retrospectively reviewed training room and clinic records, operative notes, and imaging studies for each of these players. Data on each player were analyzed to identify variables predicting return to play. A successful outcome was defined as returning to play in regular-season NFL games. Results: Eccentric contraction of the quadriceps was the most common mechanism of injury, occurring in 10 players. Only 1 player had antecedent ipsilateral extensor mechanism symptoms. Eleven players had a complete rupture of the quadriceps tendon, and 3 had partial tears. There were no associated knee injuries. All ruptures were treated with surgical repair, 1 of which was delayed after failure of nonoperative treatment. Fifty percent of players returned to play in regular-season NFL games. There was a trend toward earlier draft status for those who returned to play compared with those who did not (draft round, 3.1 ± 2.5 vs 6.0 ± 2.9, respectively; P = .073). For those who returned to play, the average number of games after injury was 40.9 (range, 12-92). Conclusion: Quadriceps tendon tears are rare in professional American football players, and they usually occur from eccentric load on the extensor mechanism. Prodromal symptoms and predisposing factors are usually absent. Even with timely surgical repair, there is a low rate of return to play in regular-season games. There is a trend toward early draft rounds for those who successfully return to play.
High organosolubility of novel asymmetric polyimides-containing benzimidazole rings
Authors: Cheng Zenghan , Xia Qingming , Wang Xinyu , Dong Jie , Zhang Qinghua 
Published: June 2013

Two tetramethyl-substituted diphenylmethane diamines, α,α-bis(4-amino-3,5-dimethylphenyl) phenylmethane (BADP) and 3,3′,5,5′-tetramethyl-4,4′-diaminodiphenylmethane (TMDA), were synthesized. Two series of novel soluble polyimides (PIs) with high glass transition temperature ( Tg) were derived from 3,3′4,4′-benzophenone tetracarboxylic dianhydride with 6,4′-diamino-2-phenylbenzimidazole and BADP (or TMDA) via one-pot synthesis using anhydrous N-methyl-2-pyrrolidone as a solvent. Precipitation or gelation does not occur during polymerization and imidization, and the resulting products dissolve well in polar aprotic solvents and phenolic solvents. The two series of PI films have good transparency in the visible light region, with a cutoff wavelength at 365 nm and higher than 50% of the transmittance at 450 nm. Tgs are in the range of 381–431°C, and 10% weight loss in nitrogen occurs above 530°C in all cases. Upon increasing BADP (or TMDA) moieties content, the Tg values decrease, whereas the thermal stability tends to increase. Moreover, the PIs-containing TMDA units have a higher thermal stability than those containing BADP units.
Preparation and properties of flame retardant rigid polyurethane foam with phosphorus–nitrogen intumescent flame retardant
Authors: Wu Denghui , Zhao Peihua , Zhang Mei , Liu Yaqing 
Published: June 2013

Ethanolamine spirocyclic pentaerythritol bisphosphonate (EMSPB), a novel intumescent flame retardant, was synthesized and used to improve the flame retardancy of rigid polyurethane foam (RPUF). The effects of EMSPB on the flammability, thermal stability, and mechanical properties of RPUF were discussed, respectively. Scanning electron microscopy (SEM) and compression strength tests showed that the EMSPB had favorable compatibility with the RPUF matrix and did not deteriorate the mechanical properties of the RPUF. Flammability of RPUF systems containing various contents of EMSPB was investigated by vertical burning test (UL-94) and limiting oxygen index (LOI) test. Results indicated that when the content of EMSPB was 25 wt%, the LOI of flame retardant RPUF could reach 27.5%, and a UL-94 V-0 rating was achieved. Thermogravimetric analysis showed that RPUF-containing EMSPB had a high yield of residual char at high temperatures, indicating that EMSPB was an effective charring agent. From the SEM observations of the residues of the flame retardant systems burned, the compact charred layers could be seen, which form protective shields to protect effectively the internal structure and inhibited the transmission of heat and heat diffusion during contacting fire.
Synthesis and characterization of highly branched sulfonated poly(aryl ether ketone) copolymers as proton exchange membranes
Authors: Guo Wancai , Pang Jinhui , Zhang Limei , Jiang Zhenhua , Zhang Shuling 
Published: June 2013

Highly branched sulfonated poly(aryl ether ketone) copolymers (Br-SPAEKs) were synthesized based on 4,4′-(hexafluoroisopropylidene) diphenol (A2 monomer), 4,4′-difluorobenzophenone (unsulfonated B2 monomer), 3,3′-disodiumsulfonyl-4,4′-difluorobenzophenone (sulfonated B2 monomer), and 3,4′,5-trifluoro-benzophenone (branched BB2′ monomer). Structures of Br-SPAEKs were confirmed by Fourier transform infrared spectroscopy and nuclear magnetic resonance. Compared to the linear SPAEK (L-SPAEK) copolymer membrane with similar ion exchange capacity, the Br-SPAEK-30 (branched monomer of 20 mol% and sulfonated monomer of 30 mol%) membrane showed higher proton conductivity and lower methanol permeability. This synergistic effect on proton conductivity and methanol permeability was mainly due to the characteristics of large free volume and similar cross-linking architecture arising due to the introduction of the branched monomers. Moreover, the selectivity of the Br-SPAEK-30 membrane is almost three times higher than that of the L-SPAEK membrane. Proton conductivities of Br-SPAEK membranes are higher than 10−2 S cm−1 and increase gradually with increasing temperature. At 80°C, the proton conductivity of the Br-SPAEK-50 (branched monomer of 20 mol% and sulfonated monomer of 50 mol%) membrane reaches 0.127 S cm−1, comparable to that of Nafion-117 (0.139 S cm−1). Additionally, the methanol permeability of Br-SPAEK-50 is one order magnitude lower than that of Nafion-117.