bluuebunny/crossref_metadata_2025_split huggingface dataset:
EEG in psychiatric practice: to do or not to do?
Authors: Badrakalimuthu Vellingiri Raja , Swamiraju Radhika , de Waal Hugo 
Published: March 2011

SummaryElectroencephalography (EEG) is a non-invasive investigation that can aid the diagnosis of psychiatric and neuropsychiatric disorders. A good predictor of an abnormal EEG recording is the presence of an organic factor identified during the clinical assessment. The non-invasiveness and low cost of the procedure and its ability to measure spontaneous brain activity appear to attract clinicians to utilise this investigative tool. However, studies have reported that EEGs arising from psychiatric referrals have the lowest abnormality detection rate. The focus of this article is to improve this by highlighting the current pitfalls and providing recommendations for appropriate utilisation of EEG. We describe specific EEG changes associated with major psychiatric disorders. We conclude by offering pragmatic considerations when referring a patient for EEG, emphasising the fact that the information provided to the neurophysiologist plays a crucial role in interpreting the EEG recording in a diagnostically meaningful way.
Working with struggling teams
Authors: Undrill Guy , Gregory Nathan 
Published: March 2011

SummaryConsultant psychiatrists are often called to work in teams that are functioning suboptimally. This is a major challenge, both professionally and personally. This article gives advice and strategies for working with struggling teams. It recommends combining objective-, data- and procedure-driven approaches to technical challenges with ‘softer’ person-centred and relational strategies matched to the learning needs of the team.
Teaching medical undergraduates: the psychiatrist as medical teacher
Authors: Eng Bennett 
Published: March 2011

SummaryThis article is a brief review of the teaching role of psychiatrists and is directed at psychiatrists in the UK National Health Service who teach medical undergraduates. It reviews the responsibility of delivering teaching, the delineation of teaching duties, and the teaching roles of the psychiatrist in the changing environment of medical education. Application of good principles of clinical teaching and delivery of tomorrow's doctors in line with the General Medical Council's recommendations are discussed. The article also describes a recommended core curriculum in psychiatry for undergraduates, which lays out what should be taught.
Treatment of acute psychotic agitation: gaps in the evidence base
Authors: Brown Steve 
Published: March 2011

SummaryTreatment of psychotic agitation is an area that is very poorly evidenced, principally because research evidence from patients with moderate agitation may not generalise to the more severely agitated patients. There is a significant gap between current treatment recommendations and what is seen in clinical practice. There are also big differences in clinical practice between different units treating seemingly similar patient groups. This commentary considers possible reasons for these findings and also discusses non-pharmacological interventions, which probably contribute more to the management of psychotic agitation than does the choice of one antipsychotic drug over another.
Hospital treatment and management in relapse of schizophrenia in the UK: associated costs
Authors: Munro Janet , Osborne Sarah , Dearden Lindsay , Pascoe Katie , Gauthier Aline , Price Martin 
Published: March 2011

Aims and methodRelapse in schizophrenia carries a heavy burden. This study aimed to describe the characteristics of patients admitted to hospital for relapse and to explore the treatment, length of stay and associated in-patient costs. The sample comprised individuals discharged from a London National Health Service trust following a relapse of schizophrenia. The costs of hospital treatment were obtained by applying referenced unit costs.ResultsThe cohort comprised 71 patients. Treatment non-adherence was implicated in 76% of relapses. Mean length of hospital stay was 138.9 days (range 1 week-1.8 years). Mean admission cost was £25 852 (range £1270-120 000). Over 97% of costs were hospital costs and less than 3% drug costs.Clinical implicationsHospital treatment for relapse of schizophrenia carries a considerable economic burden, as shown in this study. Treatment non-adherence is a significant factor contributing to relapse.
The proportionality principle and what it means in practice
Authors: Curtice Martin , Bashir Fareed , Khurmi Sanjay , Crocombe Juli , Hawkins Tim , Exworthy Tim 
Published: March 2011

SummaryThe Mental Health Act 2007 and the Mental Capacity Act 2005 have been made compatible with the European Convention on Human Rights (as enacted in the UK by the Human Rights Act 1998). The respective Codes of Practice have now embedded within them a human rights-based approach. Central to this is the principle of proportionality, which is regarded as the dominant theme underlying the Convention. This article explores the legal basis of proportionality, specifically analysing its use in relation to the Mental Health Act and the Mental Capacity Act. In doing so, it considers the use of the principle of proportionality in clinical practice.
Prognostic Significance and Tumor Biology of Regional Lymph Node Disease in Patients With Rhabdomyosarcoma: A Report From the Children's Oncology Group
Authors: Rodeberg David A. , Garcia-Henriquez Norbert , Lyden Elizabeth R. , Davicioni Elai , Parham David M. , Skapek Stephen X. , Hayes-Jordan Andrea A. , Donaldson Sarah S. , Brown Kenneth L. , Triche Timothy J. , Meyer William H. , Hawkins Douglas S. 
Published: March 2011

Purpose Regional lymph node disease (RLND) is a component of the risk-based treatment stratification in rhabdomyosarcoma (RMS). The purpose of this study was to determine the contribution of RLND to prognosis for patients with RMS. Patients and Methods Patient characteristics and survival outcomes for patients enrolled onto Intergroup Rhabdomyosarcoma Study IV (N = 898, 1991 to 1997) were evaluated among the following three patient groups: nonmetastatic patients with clinical or pathologic negative nodes (N0, 696 patients); patients with clinical or pathologic positive nodes (N1, 125 patients); and patients with a single site of metastatic disease (77 patients). Results Outcomes for patients with nonmetastatic alveolar N0 RMS were significantly better than for patients with N1 RMS (5-year failure-free survival [FFS], 73% v 43%, respectively; 5-year overall survival [OS], 80% v 46%, respectively; P < .001). Patients with a single site of alveolar metastasis had even worse FFS and OS (23% FFS and OS, P = .01) when compared with patients with N1 RMS; however, the differences was not as large as the differences between patients with N0 RMS and N1 RMS. For embryonal RMS, there was no statistically significant difference in FFS or OS (P = .41 and P = .77, respectively) for patients with N1 versus N0 RMS. Gene array analysis of primary tumor specimens identified that genes associated with the immune system and antigen presentation were significantly increased in N1 versus N0 alveolar RMS. Conclusion RLND alters prognosis for alveolar but not embryonal RMS. For patients with N1 disease and alveolar histology, outcomes were more similar to distant metastatic disease rather than local disease. Current data suggest that more aggressive therapy for patients with alveolar N1 RMS may be warranted.
Late Recurrence of Childhood T-Cell Acute Lymphoblastic Leukemia Frequently Represents a Second Leukemia Rather Than a Relapse: First Evidence for Genetic Predisposition
Authors: Szczepański Tomasz , van der Velden Vincent H.J. , Waanders Esmé , Kuiper Roland P. , Van Vlierberghe Pieter , Gruhn Bernd , Eckert Cornelia , Panzer-Grümayer Renate , Basso Giuseppe , Cavé Hélène , Stadt Udo zur , Campana Dario , Schrauder André , Sutton Rosemary , van Wering Elisabeth , Meijerink Jules P.P. , van Dongen Jacques J.M. 
Published: March 2011

Purpose Relapse of childhood T-cell acute lymphoblastic leukemia (T-ALL) often occurs during treatment, but in some cases, leukemia re-emerges off therapy. On the basis of previous analyses of T-cell receptor (TCR) gene rearrangement patterns, we hypothesized that some late recurrences of T-ALL might in fact represent second leukemias. Patients and Methods In 22 patients with T-ALL who had late relapses (at least 2.5 years from diagnosis), we studied TCR gene rearrangement status at first and second presentation, NOTCH1 gene mutations, and the presence of the SIL-TAL1 gene fusion. We performed genome-wide copy number and homozygosity analysis by using oligonucleotide- and single nucleotide polymorphism (SNP) –based arrays. Results We found evidence of a common clonal origin between diagnosis and relapse in 14 patients (64%). This was based on concordant TCR gene rearrangements (12 patients) or concordant genetic aberrations, as revealed by genome-wide copy number analysis (two patients). In the remaining eight patients (36%), TCR gene rearrangement sequences had completely changed between diagnosis and relapse, and gene copy number analysis showed markedly different patterns of genomic aberrations, suggesting a second T-ALL rather than a resurgence of the original clone. Moreover, NOTCH1 mutation patterns were different at diagnosis and relapse in five of these eight patients. In one patient with a second T-ALL, SNP analysis revealed a germline del(11)(p12;p13), a known recurrent aberration in T-ALL. Conclusion More than one third of late T-ALL recurrences are, in fact, second leukemias. Germline genetic abnormalities might contribute to the susceptibility of some patients to develop T-ALL.
Implementing a Geriatric Assessment in Cooperative Group Clinical Cancer Trials: CALGB 360401
Authors: Hurria Arti , Cirrincione Constance T. , Muss Hyman B. , Kornblith Alice B. , Barry William , Artz Andrew S. , Schmieder Linda , Ansari Rafat , Tew William P. , Weckstein Douglas , Kirshner Jeffrey , Togawa Kayo , Hansen Kurt , Katheria Vani , Stone Richard , Galinsky Ilene , Postiglione John , Cohen Harvey Jay 
Published: March 2011

Purpose Factors captured in a geriatric assessment can predict morbidity and mortality in older adults, but are not routinely measured in cancer clinical trials. This study evaluated the implementation of a geriatric assessment tool in the cooperative group setting. Patients and Methods Patients age ≥ 65 with cancer, who enrolled on cooperative group cancer trials, were eligible to enroll on Cancer and Leukemia Group B (CALGB) 360401. They completed a geriatric assessment tool before initiation of protocol therapy, consisting of valid and reliable geriatric assessment measures which are primarily self-administered and require minimal resources and time by healthcare providers. The assessment measures functional status, comorbidity, cognitive function, psychological state, social support, and nutritional status. The protocol specified criteria for incorporation of the tool in future cooperative group trials was based on the time to completion and percent of patients who could complete their portion without assistance. Patient satisfaction with the tool was captured. Results Of the 93 patients who enrolled in this study, five (5%) met criteria for cognitive impairment and three did not complete the cognitive screen, leaving 85 assessable patients (median age, 72 years). The median time to complete the geriatric assessment tool was 22 minutes, 87% of patients (n = 74) completed their portion without assistance, 92% (n = 78) were satisfied with the questionnaire length, 95% (n = 81) reported no difficult questions, and 96% (n = 82) reported no upsetting questions. One hundred percent of health care professionals completed their portion. Conclusion This brief, primarily self-administered geriatric assessment tool met the protocol specified criteria for inclusion in future cooperative group clinical trials.
Prognostic Factors After Relapse in Nonmetastatic Rhabdomyosarcoma: A Nomogram to Better Define Patients Who Can Be Salvaged With Further Therapy
Authors: Chisholm Julia C. , Marandet Julien , Rey Annie , Scopinaro Marcelo , de Toledo Jose Sánchez , Merks Johannes H.M. , O‘Meara Anne , Stevens Michael C.G. , Oberlin Odile 
Published: March 2011

Purpose Previous studies suggest poor outcome in children with relapsed rhabdomyosarcoma (RMS). A better understanding is needed of which patients can be salvaged after first relapse. Patients and Methods The analysis included children with nonmetastatic RMS and embryonal sarcoma enrolled onto the International Society of Paediatric Oncology (SIOP) Malignant Mesenchymal Tumor (MMT) 84, 89, and 95 studies who relapsed after achieving complete local control with primary therapy. All patients included in the analysis had follow-up for ≥ 3.0 years after the last event. The clinical features, initial treatment characteristics, and features of the relapse were correlated with survival in univariate and multivariate analyses. Results In all, 474 eligible patients were identified for the study. At ≥ 3.0 years from the last event, 176 (37%) were alive (“cured”). In a full-model multivariate analysis, the factors identified at first relapse that most strongly associated with poor outcome were metastatic relapse (odds ratio [OR], 4.19; 95% CI, 2.0 to 8.5), prior radiotherapy treatment (OR, 3.64; 95% CI, 2.1 to 6.4), initial tumor size > 5 cm (OR, 2.53; 95% CI, 1.5 to 4.1), and time of relapse < 18 months from diagnosis (OR, 2.20; 95% CI, 1.3 to 3.6). Unfavorable primary disease site, nodal involvement at diagnosis, alveolar histology, and previous three- or six-drug chemotherapy were also independently associated with poor outcome. To estimate chance of cure for individual patients, a nomogram was developed, which allowed for weighting of these significant factors. Conclusion Some children with relapsed RMS remain curable. It is now possible to estimate the chance of salvage for individual children to direct therapy appropriately toward cure, use of experimental therapies, and/or palliation.
Prevalence and Predictors of Cognitive Dysfunction in Opioid-Treated Patients With Cancer: A Multinational Study
Authors: Kurita Geana P. , Sjøgren Per , Ekholm Ola , Kaasa Stein , Loge Jon H. , Poviloniene Irena , Klepstad Pål 
Published: March 2011

Purpose To identify prevalence and associated factors of cognitive dysfunction in opioid-treated patients with cancer. Patients and Methods EPOS (European Pharmacogenetic Opioid Study) is a prospective cross-sectional multicenter study in which adult patients with cancer who received treatment with opioids for moderate or severe pain for at least 3 days were included. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). MMSE scores were categorized into definite cognitive dysfunction (scores < 24), possible cognitive dysfunction (scores 24-26), and no cognitive dysfunction (scores > 26). Factors potentially associated with cognitive dysfunction were assessed. Associations between MMSE and explanatory variables were analyzed by ordinal logistic regression models. Results We included 1,915 patients with cancer from 17 centers. MMSE scores less than 27 were observed in 32.9% of patients. Patients with lung cancer had higher odds (adjusted odds ratio, 1.46; 95% CI, 1.09 to 1.95) for having lower MMSE scores compared with patients with other cancer diagnoses. Patients receiving daily opioid doses of 400 mg or more (oral morphine equivalents) had 1.75 (95% CI, 1.25 to 2.46) times higher odds of having lower MMSE scores compared with those receiving daily doses less than 80 mg. Other risk factors for cognitive dysfunction were older age, low Karnofsky performance status (KPS), time since diagnosis (< 15 months), and absence of breakthrough pain (BTP). Conclusion One third of opioid-treated patients with cancer had possible or definite cognitive dysfunction. Lung cancer, daily opioid doses of 400 mg or more (oral morphine equivalents), older age, low KPS, shorter time since cancer diagnosis, and absence of BTP were predictors for cognitive dysfunction.
Synthesis of Structurally Diverse 2-Azetidinones via Staudinger Reaction on a Solid Support
Authors: Jarrahpour Aliasghar , Fadavi Abdolhamid , Zarei Maaroof 
Published: March 2011

Abstract
Trimellitic anhydride was attached to Merrifield resin and a ketene was generated from polymer-bound phthaloylglycine. Then this polymer reacted with imines in the presence of Vilsmeier reagent and triethylamine to afford the solid-phase-tethered β-lactam products. Selective cleavage of supported β-lactams by trifluoroacetic acid and methylhydrazine gave 4-carboxyphthalimido- and 3-amino-β-lactams, respectively. The trans-stereochemistry was found in all products.
Hybridized Organic Nanocrystals for Optically Functional Materials
Authors: Oikawa Hidetoshi 
Published: March 2011

Abstract
Organic nanocrystals (NCs) are in the mesoscopic phase between a single molecule and the corresponding bulk crystals, and are expected to exhibit peculiar optical properties, depending on crystal size and shape. In the present Award Accounts, recent progress on hybridized organic NCs and ordered array structure of encapsulated organic NCs will be introduced in detail for optically functional materials toward next-generation organic device application. Hybrid material (or hybridization) is an important area in current material science. Our attention is now focused on core–shell type hybridized organic NCs, which seem to be the best suited nanostructure for providing novel optoelectronic properties and photonic function induced by core–shell interface interaction. On the other hand, it may be necessary to arrange and integrate organic NCs, including hybridized materials, on a substrate so as to receive and transmit input and output signals by electronically and/or optically accessing organic devices. Hence, encapsulations of organic NCs, patterned substrates, and tapered cell method have been employed suitably to fabricate and control ordered array structure of organic NCs on a substrate. Finally, the future scope in the relevant fields of optoelectronics and photonics will be discussed in brief.
Reaction of Benzyne with Formamides and Acetylimidazole
Authors: Okuma Kentaro , Nojima Akiko , Nakamura Yuki , Matsunaga Nahoko , Nagahora Noriyoshi , Shioji Kosei 
Published: March 2011

Abstract
The reaction of DMF with o-trimethylsilylphenyl triflate in the presence of CsF afforded dimethyldiphenylammonium triflate, xanthene, and xanthone in 62%, 16%, and 24% yields, respectively. On the other hand, the reaction of dimethylthioformamide with triflate and CsF resulted in diphenyl sulfide, xanthene, and xanthone in 62%, 10%, and 12% yields, respectively. The reaction of acetylimidazole with benzyne gave 9-N,N-diphenylaminoanthracene in 85% yield.
Synthesis, Characterization, and Chiral Assembly Structure of a Self-Complementary Iron(III) Complex, [FeIII(H2L5-Me)(HL5-Me)](ClO4)2·EtOH (H2L5-Me: N-[(5-Methylimidazol-4-yl)methylidene]histamine)
Authors: Hagiwara Hiroaki , Nishi Koshiro , Matsumoto Naohide , Sunatsuki Yukinari , Kojima Masaaki , Iijima Seiichiro 
Published: March 2011

Abstract
A low-spin FeIII complex, [FeIII(H2L5-Me)(HL5-Me)](ClO4)2·EtOH, was prepared by the reaction of FeII(ClO4)2·6H2O and H2L5-Me in ethanol with 1:2 molar ratio and in air, where H2L5-Me: N-[(5-methylimidazol-4-yl)methylidene]histamine. Each complex molecule of [Fe(H2L5-Me)(HL5-Me)]2+ has both fully protonated ligand and mono-deprotonated ligand and acts as a chiral self-complementary building block to produce the homochiral imidazole–imidazolate-bridged zigzag-chain structure. The X-ray analysis confirmed that the adjacent chains with the same chirality are stacked in a crystal lattice to give a chiral crystal (conglomerate). Low-spin FeIII was revealed by the magnetic susceptibility and Mössbauer measurements.
The history and evolution of sutures in pelvic surgery
Authors: Muffly Tyler M , Tizzano Anthony P , Walters Mark D 
Published: March 2011

Summary The purpose of the study is to review the history and innovations of sutures used in pelvic surgery. Based on a review of the literature using electronic- and hand-searched databases we identified appropriate articles and gynaecology surgical textbooks regarding suture for wound closure. The first documented uses of suture are explored and then the article focuses on the use of knotted materials in pelvic surgery. The development of suture of natural materials is followed chronologically until the present time where synthetic suture is implanted during countless surgeries every day. This millennial history of suture contains an appreciation of the early work of Susruta, Celsus, Paré and Lister, including a survey of some significant developments of suture methods over the last 100 years. Most surgeons know little about the history and science of sutures. A retrospective view of suture is critical to the appreciation of the current work and development of this common tool.
Proximal humeral replacement using a fixed-fulcrum endoprosthesis
Authors: Griffiths D. , Gikas P. D. , Jowett C. , Bayliss L. , Aston W. , Skinner J. , Cannon S. , Blunn G. , Briggs T. W. R. , Pollock R. 
Published: March 2011

Between 1997 and 2007, 68 consecutive patients underwent replacement of the proximal humerus for tumour using a fixed-fulcrum massive endoprosthesis. Their mean age was 46 years (7 to 87). Ten patients were lost to follow-up and 16 patients died. The 42 surviving patients were assessed using the Musculoskeletal Tumor Society (MSTS) Score and the Toronto Extremity Salvage Score (TESS) at a mean follow-up of five years and 11 months (one year to ten years and nine months). The mean MSTS score was 72.3% (53.3% to 100%) and the mean TESS was 77.2% (58.6% to 100%). Four of 42 patients received a new constrained humeral liner to reduce the risk of dislocation. This subgroup had a mean MSTS score of 77.7% and a mean TESS of 80.0%. The dislocation rate for the original prosthesis was 25.9; none of the patients with the new liner had a dislocation at a mean of 14.5 months (12 to 18). Endoprosthetic replacement for tumours of the proximal humerus using this prosthesis is a reliable operation yielding good results without the documented problems of unconstrained prostheses. The performance of this prosthesis is expected to improve further with a new constrained humeral liner, which reduces the risk of dislocation.
An accelerated Ponseti versus the standard Ponseti method
Authors: Harnett P. , Freeman R. , Harrison W. J. , Brown L. C. , Beckles V. 
Published: March 2011

We conducted a prospective randomised controlled trial to compare the standard Ponseti plaster method with an accelerated method for the treatment of idiopathic congenital talipes equinovarus. The standard weekly plaster-change method was accelerated to three times per week. We hypothesised that both methods would be equally effective in achieving correction. A total of 40 consecutive patients (61 feet) were entered into the trial. The initial median Pirani score was 5.5 (95% confidence interval 4.5 to 6.0) in the accelerated group and 5.0 (95% confidence interval 4.0 to 5.0) in the standard control group. The scores decreased by an average 4.5 in the accelerated group and 4.0 in the control group. There was no significant difference in the final Pirani score between the two groups (chi-squared test, p = 0.308). The median number of treatment days in plaster was 16 in the accelerated group and 42 in the control group (p < 0.001). Of the 19 patients in the accelerated group, three required plaster treatment for more than 21 days and were then assigned to the standard control method. Of the 40 patients, 36 were followed for a minimum of six months. These results suggest that comparable outcomes can be achieved with an accelerated Ponseti method. The ability to complete all necessary manipulations within a three-week period facilitates treatment where patients have to travel long distances.