bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited capsular release and controlled manipulation under anaesthesia for the treatment of frozen shoulder
Authors: Bidwai Amit S , Mayne Alistair IW , Nielsen Maryke , Brownson Peter 
Published: April 2015

Background In light of recent interest in the cost-effectiveness of the treatment options available for frozen shoulder, we aimed to determine the results of limited anterior capsular release and controlled manipulation under anaesthesia (MUA) in the treatment of primary frozen shoulder in terms of patient-related outcomes measure, range of motion and re-intervention rates. Methods This single-surgeon series included prospectively collected data on all patients undergoing capsular release with MUA from March 2011 until June 2013, with a minimum follow-up of 6 months from the index procedure. Outcome measures included pre- and postoperative Oxford Shoulder Score (OSS), range of motion and need for re-intervention. Results Fifty-four procedures were performed in 52 patients. Mean age 50 years (range 42 years to 59 years); male: female ratio = 11: 41. There was a highly statistically significant improvement in both pain and function modules of the OSS ( p < 0.005) and range of motion ( p < 0.005) at 6 months. The median postoperative score was 41 from a maximum of 48 points, with an average mean improvement of 24 points. Seventeen patients were diabetics. There was no significant difference in pre-operative and postoperative OSS or range of motion between the diabetic group and the non-diabetic groups. No patients required surgical re-intervention. Conclusions A combination of limited capsular release and MUA for the treatment of primary frozen shoulder is a safe and effective procedure resulting in marked improvement in pain, function and range of motion.
The impact of a Continuum of Care Resident Pharmacist on heart failure readmissions and discharge instructions at a community hospital
Authors: Truong Julie T , Backes Andrea C 
Published: April 2015

Purpose: To examine the impact of a Continuum of Care Resident Pharmacist on (1) heart failure 30-day hospital readmissions and (2) compliance with Joint Commission Heart Failure core measure 1 at a community hospital. Methods: The Continuum of Care Network led by a Continuum of Care Resident Pharmacist was established in August 2011. The Continuum of Care Resident Pharmacist followed Continuum of Care Network patients and retrospectively collected data from August 2011 to December 2012. Thirty-day readmission rates for Continuum of Care Network heart failure patients versus non-Continuum of Care Network heart failure patients were compared and analyzed. Joint Commission Heart Failure core measure 1 compliance rates were retrospectively collected from January 2011 and compared to data after establishment of the Continuum of Care Network. Results: In all, 162 Continuum of Care Network patients and 470 non-Continuum of Care Network patients were discharged with a diagnosis of heart failure from August 2011 to December 2012. Continuum of Care Network heart failure patients had a lower 30-day all-cause readmission rate compared to non-Continuum of Care Network heart failure patients (12% versus 24%, respectively; p = 0.005). In addition, Heart Failure core measure 1 compliance rates improved from the 80th percentile to the 90th percentile after implementation of the Continuum of Care Network (p  = 0.004). The top three interventions performed by the Continuum of Care Resident Pharmacist were discharge counseling (74.1%), providing a MedActionPlan™ (68.5%), and resolving medication reconciliation discrepancies (64.8%). Conclusion: The study findings suggest that a Continuum of Care Resident Pharmacist contributed to lowered heart failure readmission rates and improved Heart Failure core measure 1 compliance rates. Future randomized, controlled trials are needed to confirm these findings.
Outcome of probe‐based confocal laser endomicroscopy (pCLE) during endoscopic retrograde cholangiopancreatography: A single‐center prospective study in 45 patients
Authors: Löhr Johannes-Matthias , Lönnebro Ragnar , Stigliano Serena , Haas Stephan L , Swahn Fredrik , Enochsson Lars , Noel Rozh , Segersvärd Ralf , Chiaro Marco Del , Verbeke Caroline S , Arnelo Urban 
Published: April 2015

BackgroundDiagnosis of pre‐malignant and malignant lesions in the bile duct and the pancreas is sometimes cumbersome. This applies in particular to intraductal papillary mucinous neoplasia (IPMN) and bile duct strictures in primary sclerosing cholangitis (PSC).AimsTo evaluate in a prospective cohort study the sensitivity and specificity of probe‐based confocal laser microscopy (pCLE) during endoscopic retrograde cholangiopancreatography (ERCP).MethodsWe performed pCLE together with mother‐baby endoscopy (SpyGlass) during 50 ERCP sessions in 45 patients. The Miami and Paris criteria were applied. Clinical diagnosis via imaging was compared to pCLE and the final pathological diagnosis from surgically‐resected, biopsy, or cytology specimens. Patients were followed up for at least 1 year.ResultsWe were able to perform pCLE in all patients. Prior to endoscopy, the diagnosis was benign in 23 patients and undetermined (suspicious) in 16 patients, while six patients had an unequivocal diagnosis of malignancy. Sensitivity was 91% and specificity 52%. The positive (PPV) and negative predictive value (NPV) was 82% and 100%, respectively. Apart from mild post‐ERCP pancreatitis in two patients, no complications occurred.ConclusionsOur study showed that pCLE is a safe, expert endoscopic method with high technical feasibility, high sensitivity and high NPV. It provided diagnostic information that can be helpful for decisions on patient management, especially in the case of IPMN and unclear pancreatic lesions, in individuals whom are at increased risk for pancreatic cancer.
Financial Implications of Hospital Readmission After Hip Fracture
Authors: Kates Stephen L. , Shields Edward , Behrend Caleb , Noyes Katia K. 
Published: April 2015

Introduction: Hip fracture is the leading orthopedic discharge diagnosis associated with 30-day readmission in terms of numbers. Because readmission to the hospital following a hip fracture is so common, it adds considerably to the costs on an already overburdened health care system. Methods: Patients aged 65 and older admitted to a 261-bed university-affiliated level 3 trauma center between April 30, 2005, and September 30, 2010, with a unilateral, native, nonpathologic low-energy proximal femur fracture were identified from a fracture registry and included for analysis. Readmissions within 30 days of hospital discharge, costs, and outcomes were collected and studied. Results: Of 1081 patients, 129 (11.9%) were readmitted within 30 days. The average hospital length of stay for readmissions was 8.7 ± 18.8 days, which was significantly longer than the initial stay (4.6 ± 2.3 days) ( P = .03). Nineteen percent (24 patients ∼19%) died during readmission versus 2.8% during the index admission. These patients accumulated an average hospital charge of US$16 308 ± US$6400 during their initial hospitalization for compared with charges for their readmissions of US$14 191 ± US$25 035 ( P = .36). Discussion: Readmission was usually associated with serious medical or surgical complications of the original hospitalization. Conclusions: Readmission after hip fracture is costly and harmful. Charges were similar between the original fracture admission and the readmission. Patients were readmitted most frequently for medical diagnoses following their original hospital stay. Some of these readmissions may have been avoidable.
How I treat and manage strokes in sickle cell disease
Authors: Kassim Adetola A. , Galadanci Najibah A. , Pruthi Sumit , DeBaun Michael R. 
Published: April 2015

AbstractNeurologic complications are a major cause of morbidity and mortality in sickle cell disease (SCD). In children with sickle cell anemia, routine use of transcranial Doppler screening, coupled with regular blood transfusion therapy, has decreased the prevalence of overt stroke from ∼11% to 1%. Limited evidence is available to guide acute and chronic management of individuals with SCD and strokes. Current management strategies are based primarily on single arm clinical trials and observational studies, coupled with principles of neurology and hematology. Initial management of a focal neurologic deficit includes evaluation by a multidisciplinary team (a hematologist, neurologist, neuroradiologist, and transfusion medicine specialist); prompt neuro-imaging and an initial blood transfusion (simple followed immediately by an exchange transfusion or only exchange transfusion) is recommended if the hemoglobin is >4 gm/dL and <10 gm/dL. Standard therapy for secondary prevention of strokes and silent cerebral infarcts includes regular blood transfusion therapy and in selected cases, hematopoietic stem cell transplantation. A critical component of the medical care following an infarct is cognitive and physical rehabilitation. We will discuss our strategy of acute and long-term management of strokes in SCD.
Pak2 restrains endomitosis during megakaryopoiesis and alters cytoskeleton organization
Authors: Kosoff Rachelle E. , Aslan Joseph E. , Kostyak John C. , Dulaimi Essel , Chow Hoi Yee , Prudnikova Tatiana Y. , Radu Maria , Kunapuli Satya P. , McCarty Owen J. T. , Chernoff Jonathan 
Published: April 2015

Key PointsBone marrow-specific deletion of Pak2 is associated with macrothrombocytopenia and abnormal megakaryocyte morphology and function. Pak2 deletion is associated with defects in megakaryocyte endomitosis and the activation of Aurora-A and LIM kinase.
Perivascular deletion of murine Rac reverses the ratio of marrow arterioles and sinusoid vessels and alters hematopoiesis in vivo
Authors: Ciuculescu Marioara F. , Park Shin-Young , Canty Kimberly , Mathieu Ronald , Silberstein Leslie E. , Williams David A. 
Published: April 2015

Key Points
Rac deletion in Nestin+ cells reverses the arteriolar-to-sinusoid ratio in marrow. Rac-deleted Nestin+ cells differentially alter long-term HSC and hematopoietic progenitors.
A clinical decision support system for the diagnosis of probable migraine and probable tension-type headache based on case-based reasoning
Authors: Yin Ziming , Dong Zhao , Lu Xudong , Yu Shengyuan , Chen Xiaoyan , Duan Huilong 
Published: April 2015

AbstractBackgroundThe overlap between probable migraine (PM) and probable tension-type headache (PTTH) often confuses physicians in clinical practice. Although clinical decision support systems (CDSSs) have been proven to be helpful in the diagnosis of primary headaches, the existing guideline-based headache disorder CDSSs do not perform adequately due to this overlapping issue. Thus, in this study, a CDSS based on case-based reasoning (CBR) was developed in order to solve this problem.MethodsFirst, a case library consisting of 676 clinical cases, 56.95% of which had been diagnosed with PM and 43.05% of which had been diagnosed with PTTH, was constructed, screened by a three-member panel, and weighted by engineers. Next, the resulting case library was used to diagnose current cases based on their similarities to the previous cases. The test dataset was composed of an additional 222 historical cases, 76.1% of which had been diagnosed with PM and 23.9% of which had been diagnosed with PTTH. The cases that comprised the case library as well as the test dataset were actual clinical cases obtained from the International Headache Center in Chinese PLA General Hospital.ResultsThe results indicated that the PM and PTTH recall rates were equal to 97.02% and 77.78%, which were 34.31% and 16.91% higher than that of the guideline-based CDSS, respectively. Furthermore, the PM and PTTH precision rates were equal to 93.14% and 89.36%, which were7.09% and 15.68% higher than that of the guideline-based CDSS, respectively. Comparing CBR CDSS and guideline-based CDSS, the p-value of PM diagnoses was equal to 0.019, while that of PTTH diagnoses was equal to 0.002, which indicated that there was a significant difference between the two approaches.ConclusionsThe experimental results indicated that the CBR CDSS developed in this study diagnosed PM and PTTH with a high degree of accuracy and performed better than the guideline-based CDSS. This system could be used as a diagnostic tool to assist general practitioners in distinguishing PM from PTTH.
Integrating host gene expression and the microbiome to explore disease pathogenesis
Authors: Byrd Allyson L , Segre Julia A 
Published: April 2015

AbstractIn a recent study, rich clinical assessment and longitudinal study design are combined with host gene expression and microbial sequencing analyses to develop a framework for exploring disease etiology and outcomes in the context of human inflammatory disease.See related article: http://dx.doi.org/10.1186/s13059-015-0637-x
Optimal joint transmission and harvested energy scheduling for renewable energy harvesting enabled cellular network under coordinated multi-point transmission
Authors: Wang Zejue , Li Hongjia , Hu Dan , Ci Song 
Published: April 2015

Abstract
On-grid energy consumption of base stations (BSs) contributes up a significant fraction of the total carbon dioxide (CO2) emissions of cellular networks, among which remote radio units (RRUs) absorb most of the energy consumption. To eliminate the on-grid energy consumption and the corresponding CO2 emission, we propose a new transmission framework, in which all RRUs and associated power amplifiers (PAs) are powered by hybrid energy sources including on-grid energy source and off-grid renewable energy source. Based on the framework, we pursue a systematic study on the joint transmission and harvested energy scheduling algorithm for the hybrid energy powered cellular transmission system under coordinated multi-point (CoMP) transmission. Firstly, we formulate an optimal offline transmission scheduling problem with a priori knowledge about channel state information (CSI), under constraint of available amount of harvested energy and stored energy at each transmission time interval. Considering a practical constraint of limited pre-knowledge about CSI, we further transform the offline problem into an energy-aware energy efficient transmission problem. To solve the proposed problems, we undertake a convex optimization method to the optimal offline transmission scheduling problem and design corresponding optimal offline joint transmission and energy scheduling algorithm, which provides the upper bound on actual system performance. Then, we extend the non-linear fractional programming to the transmission scheduling problem with limited pre-knowledge about CSI and design corresponding joint transmission and energy scheduling algorithm, named as online algorithm. Numerical results show that the performance of the proposed online algorithm is close to that of the obtained upper bound and outperforms the existing algorithm. We also find that at each transmission time interval during the finite transmission period, the transmit power of each RRU is proportional to the weighted channel-gain-to-noise ratio (CNR) of each sub-channel.
Renaming schizophrenia to reduce stigma: comparison with the
case of bipolar disorder
Authors: Ellison Nell , Mason Oliver , Scior Katrina 
Published: April 2015

SummaryRenaming disorders to change public beliefs and attitudes remains
controversial. This study compared the potentially destigmatising effects of
renaming schizophrenia with the effects of renaming bipolar disorder by
comparing the label ‘schizophrenia’ to ‘integration disorder’, and ‘bipolar
disorder’ to ‘manic depression’, in 1621 lay participants. ‘Bipolar
disorder’ was associated with less fear and social distance than ‘manic
depression’. ‘Integration disorder’ was associated with increased
endorsement of a biopsychosocial cause and reduced attributions of
dangerousness but also increased social distance, highlighting the complex
effects renaming has on stigma.
Interventions to improve the experience of caring for people
with severe mental illness: systematic review and
meta-analysis
Authors: Yesufu-Udechuku Amina , Harrison Bronwyn , Mayo-Wilson Evan , Young Norman , Woodhams Peter , Shiers David , Kuipers Elizabeth , Kendall Tim 
Published: April 2015

BackgroundInformal caregiving is an integral part of the care of people with severe
mental illness, but the support needs of those providing such care are
not often met.AimsTo determine whether interventions provided to people caring for those
with severe mental illness improve the experience of caring and reduce
caregiver burden.MethodWe conducted a systematic review and meta-analyses of randomised
controlled trials (RCTs) of interventions delivered by health and social
care services to informal carers (i.e. family or friends who provide
support to someone with severe mental illness).ResultsTwenty-one RCTs with 1589 carers were included in the review. There was
evidence suggesting that the carers' experience of care was improved at
the end of the intervention by psychoeducation (standardised mean
difference −1.03, 95% CI −1.69 to −0.36) and support groups (SMD =–1.16,
95% CI −1.96 to −0.36). Psychoeducation had a benefit on psychological
distress more than 6 months later (SMD =–1.79, 95% CI −3.01 to −0.56) but
not immediately post-intervention. Support interventions had a beneficial
effect on psychological distress at the end of the intervention (SMD
=–0.99, 95% CI −1.48 to −0.49) as did problem-solving bibliotherapy (SMD
=–1.57, 95% CI −1.79 to −1.35); these effects were maintained at
follow-up. The quality of the evidence was mainly low and very low.
Evidence for combining these interventions and for self-help and
self-management was inconclusive.ConclusionsCarer-focused interventions appear to improve the experience of caring
and quality of life and reduce psychological distress of those caring for
people with severe mental illness, and these benefits may be gained in
first-episode psychosis. Interventions for carers should be considered as
part of integrated services for people with severe mental health
problems.
Lawfulness of preventive recall from a community treatment
order
Authors: Dawson John 
Published: April 2015

SummaryPreventive recall to hospital of a patient on a community treatment order
can be lawful when it is based on a convincing prediction that relapse in
illness would otherwise occur. The legislation for England and Wales
provides several indications that authorising preventive recall in those
circumstances is a purpose of the community treatment order regime.
Venous thromboembolism prophylaxis in mental healthcare: do the benefits outweigh the risks?
Authors: Patel Rashmi 
Published: April 2015

SummaryVenous thromboembolism is an important cause of morbidity and mortality. In recent years, growing awareness has led to the development of strategies to prevent venous thromboembolism in individuals admitted to hospital who are deemed to be at high risk. However, there remains a considerable degree of uncertainty over whether these strategies are of overall benefit and there are few published studies on people who are admitted to psychiatric hospitals. In this editorial I review current clinical practice and areas of uncertainty with respect to venous thromboembolism prophylaxis and its implementation in mental healthcare settings.
London's liaison psychiatry services: survey of service provision
Authors: Naidu Smitha , Bolton Jim , Smith Jared 
Published: April 2015

Aims and methodTo describe the liaison psychiatry services of all 30 general hospitals in Greater London and to determine whether services met national recommendations. The results were compared with a similar survey conducted 8 years previously to determine whether there had been significant service development.ResultsWe identified wide variations in service provision across London. Fifteen hospitals (50%) had 24-hour services and one had no service. There had been a significant increase in services that assessed older adults. Increases in the size of teams and consultant psychiatry staff were not significant.Clinical implicationsDespite an increasing emphasis on the effectiveness of liaison psychiatry services, no London hospital had staffing levels consistent with national recommendations. Recent evidence for the cost-effectiveness of liaison psychiatry and an emphasis on parity between physical and mental health in National Health Service policy may provide further impetus for growth.
Children and Young People's Improving Access to Psychological Therapies: inspiring innovation or more of the same?
Authors: Timimi Sami 
Published: April 2015

SummaryIn 2007 the UK Government announced a substantial expansion of funding for psychological therapies for those presenting with common mental health problems. This ‘Improving Access to Psychological Therapies’ (IAPT) project was widely welcomed, however, evidence backed, economic, and conceptual critiques were voiced from the start and the project remains controversial. In 2011, the UK government announced it was extending the IAPT project to encompass services for children and young people with the aim of ‘transforming’ the way mental health services are delivered to them. Here I critically reflect on the problems associated first with IAPT and then with CYP-IAPT and ponder whether CYP-IAPT is significantly different to the problematic adult IAPT project or more of the same.
Cost-Effectiveness Analysis of Routine Surveillance Imaging of Patients With Diffuse Large B-Cell Lymphoma in First Remission
Authors: Huntington Scott F. , Svoboda Jakub , Doshi Jalpa A. 
Published: April 2015

Purpose Surveillance imaging of asymptomatic patients with diffuse large B-cell lymphoma (DLBCL) in first remission remains controversial. A decision-analytic Markov model was developed to evaluate the cost-effectiveness of follow-up strategies following first-line immunochemotherapy. Patients and Methods Three strategies were compared in 55-year-old patient cohorts: routine clinical follow-up without serial imaging, routine follow-up with biannual computed tomography (CT) scans for 2 years, or routine follow-up with biannual [18F]-fluorodeoxyglucose positron emission tomography–computed tomography (PET/CT) for 2 years. The baseline model favored imaging-based strategies by associating asymptomatic imaging-detected relapses with improved clinical outcomes. Lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for each surveillance strategy. Results Surveillance strategies utilizing 2 years of routine CT or PET/CT scans were associated with minimal survival benefit when compared with clinical follow-up without routine imaging (life-years gained: CT, 0.03 years; PET/CT, 0.04 years). The benefit of imaging-based follow-up remained small after quality-of-life adjustments (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). Costs associated with imaging-based surveillance strategies are considerable; ICERs for imaging strategies compared with clinical follow-up were $164,960/QALY (95% CI, $116,510 to $766,930/QALY) and $168,750/QALY (95% CI, $117,440 to 853,550/QALY) for CT and PET/CT, respectively. Model conclusions were robust and remained stable on one-way and probabilistic sensitivity analyses. Conclusion Our cost-effectiveness analysis suggests surveillance imaging of asymptomatic DLBCL patients in remission offers little clinical benefit at substantial economic costs.