Effect of the addition of a mental health specialist for evaluation of undiagnosed patients in centres for rare diseases (ZSE-DUO): a prospective, controlled trial with a two-phase cohort design.

Background: People with complex symptomatology but unclear diagnosis presenting to a centre for rare diseases (CRD) may present with mental (co-)morbidity. We hypothesised that combining an expert in somatic medicine with a mental health specialist working in tandem will improve the diagnostic outcome.

Methods: Patients aged 12 years and older who presented to one of the 11 participating German CRDs with an unknown diagnosis were recruited into this prospective cohort trial with a two-phase cohort design.

Revisiting the Contribution of Additives to the Long-Term Mechanical Stability and Hydrolytic Resistance of Highly Crystalline Polylactide Fibers.

Additives are widely used to improve the processability, toughness, and hydrolytic resistance of poly(lactic acid) (PLA)-based materials. This study compares neat PLA fibers and fibers made from PLA blends with either poly(butylene succinate) (PBS) as a plasticizer or poly(d-lactic acid) (PDLA) as a nucleating agent. The fibers have been characterized with regard to their physical and structural properties after fabrication as well as after artificial aging at elevated temperature and humidity conditions.

[ZSE-DUO - dual guidance structure at the centre for rare diseases].

Background: Patients with an unclear diagnosis and suspected rare disease pose special challenges to physicians, among others.

Aim Of The Study (research Question): The ZSE-DUO project aims to establish whether patient care under the joint supervision of a somatic expert and a mental health expert can improve diagnostic efficacy and precision, as well as shorten the time to diagnosis.

Material And Methods: ZSE-DUO has successfully recruited more than 1000 patients at eleven national centres for rare diseases in a control and an intervention group.

Dual guidance structure for evaluation of patients with unclear diagnosis in centers for rare diseases (ZSE-DUO): study protocol for a controlled multi-center cohort study.

Background: In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process.