bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of changes in land use and climate on the Runoff in the coastal areas of South China—A case study of the Nanliujiang catchment
Authors: Yang Mingzhi , Xiao Weihua , Zhao Yong , Huang Ya , Li Baoqi , Jiang Dachuan , Lu Fan , Hou Baodeng
Published: December 2018

The intense climate changes and human activities have a great impact on the variation of the runoff of the coastal area of South China. In this work, the Soil and Water Assessment Tool (SWAT) is used to quantify the impact of land use and climate change of the Nanliujiang catchment on the runoff by setting 4 scenarios of land-use and climate change. The results show the runoff of the simulated and measured values had a similar trend. The value of relevant coefficient is above 0.8, and the value of Nash-Sutcliffe efficiency coefficient is about 0.8, which indicate that the SWAT model is fit for the study area. The annual average runoff depth during the period from 1995 to 2013 has increased by 53.5mm, of which the land use change resulted in 13.0mm increase on the annual average runoff depth while the climate change resulted in 40.9mm increase on the annual average runoff depth, therefore, the climate change has greater effect then the land use change. This work will delineate some helpful information for the water resources management as well as ecological protection in the coastal area of South China.
The technique of construct water-saving agriculture
Authors: Ren Ji
Published: December 2018

A shortage of water resource in China, the water problem has become the bottleneck of China’s economic and social development. Agriculture consumes very large amounts of water resources and water waste is quite serious in our country, therefore, the construction of water-saving agriculture is urgent to solve the problem of water resource in our country. Implementation technology in the construction of water-saving agriculture was proposed in this paper, namely improve the canal water use coefficient, water saving irrigation methods and suitable irrigation mode.
Risk analysis and emergency countermeasures for oil pollution in main channel of South to North Water Transfer Project
Authors: Zhu Jie , Lei Xiaohui , Zheng Hezheng , Liang Jiankui , Quan Jin
Published: December 2018

The total length of the main channel of the South-to-North Water Transfer Project is 1432 kilometers. There are nearly 1, 000 supporting mechanical and electrical equipment along the channel gate station. At the same time, there are more than 1, 000 main roads with channel crossing roads along the route. Oil spills may occur due to various reasons such as equipment leakage or traffic accidents. Entering the channel directly causes pollution of water quality. The pollution of water quality will directly endanger the health of human beings. Therefore, it is essential to quickly and efficiently remove oil pollutants from the water supply channels. This paper analyzes the basic characteristics of the Middle Route Project of South-to-North Water Transfer, and the risk sources of sudden oil pollution, and the common degreasing devices such as oil booms, oil absorbing pads, and oil removal devices based on steel structure pontoons in the main trunk The applicability was analyzed. The results show that the traditional oil-absorbing felt, oil boom and other degreasing devices have poor applicability in the middle line, which can not meet the requirements of the mid-line water quality and channel flow rate, and the adaptability to the channel engineering characteristics is also insufficient. The degreasing device based on the steel structure pontoon can adapt to the current situation of the midline, and has good effects in preventing the oil film from escaping and splashing. Therefore, in general, the degreasing device based on the steel structure pontoon is suitable for the midline burst oil. Effective measures and means of pollution accidents
Planning of River System Connection Project in Panggong District of Xiangyang
Authors: Sun Lingkai , Zhang Wenlu , Zheng Hezhen
Published: December 2018

Panggong District, surrounded by the Han River on three sides, is close to Xiangyang Ancient City. It is the key area of strategic layout of Xiangyang’s urbanization development. The low-lying topography and high-level underground water with a lack of drainage channel and rainwater storage area cause a serious problem of drainage and waterlogging prevention in this region. A river system connection project was planned to solve this problem, in which new river systems were excavated and necessary gates and pumping stations were constructed to improve the capacity of drainage and waterlogging prevention of the region. Furthermore, the operation schemes of the connection project were determined in flood season and dry season, the project benefit was analysed, and related problems were discussed.
Drought Risk Assessment based on PDSI in the Daqinghe Watershed, North China
Authors: Liu Shaohua , Huang Huiyong , Hu Gang , Wan Hui , Wu Yongyan , Yan Yibo , Zeng Sidong
Published: December 2018

Drought is a worldwide natural disaster and has become an obstacle to the socio-economic development of the Daqinghe watershed in North China, the drought risk of which is analyzed in this study. PDSI is established and validated by the SPI, SRI, SMI, and agriculture drought-affect area in Baoding, a city in Daqinghe watershed. The result shows that PDSI performs well in describing the drought evolution, especially in the monthly scale. Then, the drought risk is assessed combining the drought hazard derived from PDSI with the exposed vulnerabilities consisting of the population, Gross Domestic Product (GDP), cropland area, and vegetation area. It indicates that the subwatersheds with high drought risk mainly concentrate in the downstream plain area.
The Simulation Research on Primary District Heating Fluid Network
Authors: Cheng Nan , Liu Zhong , Zhang Hongmei , Xing Lin , Zhang Zheng
Published: December 2018

According to the characteristics of multi-input, multi-output, multi-loop, non-linear and large hysteresis of fluid network, the mathematical model of node, regulating valve and pipeline are established respectively. Simulation based on Panysimu platform is carried out in this paper, and the influence of various disturbances on the entire primary fluid network is analyzed. The simulation results show that the circulation capability of the primary heating fluid network plays a vital role in the rational design of the whole heating system and the safe and economic operation.
Numerical simulation and prediction of groundwater environmental contamination in a coastal polyurethane plant based on GMS
Authors: Gao Haodong , Zhang Shanshan , Zhao Ruifeng , Xu Donghao , Zhu Liangchao
Published: December 2018

GMS was used to simulate the groundwater pollution status during the operation period of a coastal polyurethane factory. Based on the geological and hydraulic data, the groundwater flow field model and solute transport model were established using the MODFLOW and MT3DMS module respectively by which the potential area and concentration of pollutant were predicted and the extent of groundwater pollution in the study area was evaluated. The simulation and prediction results showed that under abnormal conditions, the groundwater environment would be affected. As the characteristic pollutants, COD and ethylene glycol mainly migrated along the direction of water flow and exceeded the standard for a certain period of time. The migration distance and pollution range of contaminants expanded with time, and the peak concentration decreased with the increase of diffusion distance. After 50 years, the potential pollution area of COD and ethylene glycol would reach 225651.2m2 and 210947.5m2 respectively. During the migration process, the concentration of pollutants in the groundwater gradually recovered to the background value, and the over-standard area was reduced to zero. The comprehensive prediction model and risk assessment method of this study can help to formulate practical prevention and control measures for the protection of groundwater environment.
Multi-objective optimal of surface-groundwater resources in the Dongxiezong irrigation district
Authors: Yang Hengyue , Zhang Shaohui , Dai Wei , Li Yinong , Zeng Xin
Published: December 2018

the water cycle in irrigation districts is extremely complicated under the dual influence of strong human activities and the nature. To establish the multi-water source rational allocation model of irrigation district, this paper first establish a multi-objective function based on economic utility, ecological utility and irrigation performance and improve Hicks optimization method. Then, combine it with chaotic particle swarm optimization algorithm to carry out research on temporal and spatial distribution evolution and optimal allocation of water resources in irrigation districts and collaborative scheduling and regulation of surface-groundwater. The multi-objective rational allocation is an important basis for the efficient use of water resources in irrigation districts and ecological harmony. This paper takes the typical irrigation area of Dongxiezong in Heilongjiang Province as the object for the study of the optimal allocation method of water resources in the irrigation district.
Comprehensive Diagnosis of Runoff Series Discontinued Point in Longchuan River Basin
Authors: Jiang Ru-cheng , Cheng Jing , Gu Shi-xiang
Published: December 2018

With the influence of climate change and human activities, the runoff series will have discontinued point. The diagnosis of discontinued point is an important part of runoff analysis and calculation. This paper used the comprehensive diagnosis method to diagnosis the discontinued point of the tributary of the runoff series in Longchuan river basin, indicating that the flood mutated in 1979 and 1998, which are significant discontinued points. The result is consistent with the hydrological investigated results. The comprehensive diagnosis method can consider the advantages of various methods and avoid the limitation of single method.
Signal acquisition and processing system based on zynq dual core
Authors: Tan Jingjia , He Lesheng , Wang Jun
Published: December 2018

In order to speed up the acquisition and processing of signal, this paper has developed a signal acquisition and processing system based on zynq platform. Based on the ARM Cortex-A9 dual-core and editable logic unit architecture of Zynq AP SoC platform, this paper implements a fully functional signal acquisition and processing system by software and hardware collaborative design. ARM0 is the main processor that controls system and shared resources. ARM1 is the slave processor. ARM1 is responsible for receiving the data converted by the AD7606 analog-to-digital chip. The data is sent to the Hamming window function IP core created under vivado HLS through the AXI bus. After the data is processed by Hamming window function, it is sent to ARM1 again through AXI bus. OCM acts as the shared memory for ARM0 and ARM1 communication. The Linux system runs on ARM0. The processed data is sent to the upper computer through ethernet through UDP protocol. Utilizing the architecture of the Zynq platform, the system efficiency is improved, and the stability of the system is ensured, so that the FPGA can enter the field of embedded systems.
Hardware Platform Design for Baseband Data Transmission of WCDMA Based on USB3.0
Authors: Xiao Fu , Xiao Li-ming
Published: December 2018

This paper proposes a hardware platform for WCDMA baseband data transmission, which consists of USB3.0 interface, general purposes processor (GPP), and software defined radio (SDR) system. In view of the requirements of WCDMA system, the hardware platform consisting of USB3.0 controller, FPGA and DDRII was selected, which finally realized the high throughput rate and low delay transmission of baseband data of WCDMA system. The experimental results show that in this GPP software defined radio system, the interface speed of USB3.0 can reach 200MBps, and the loopback delay time of the system is about 0.7ms, which can meet the requirements of WCDMA system.
Log Data Real Time Analysis Using Big Data Analytic Framework with Storm and Hadoop
Authors: Lv Jia-Ke , Li Yang , Wang Xuan
Published: December 2018

The log data real-time processing platform which is built using Storm On YARN integrated MapReduce and Storm that use MapReduce to complete large-scale off-line data global knowledge extraction, sudden knowledge extraction of small-scale data in Kafka buffers through Storm, and continuous real-time calculation of streaming data in combination with global knowledge. We tested our technique with the well-known KDD99 CUP data set. The experimentation results prove the system to be effective and efficient.
Design and realization of relic augmented reality system of integration positioning and posture sensing technology
Authors: Huo Xin , Chen Hong , Ma YuHao , Wang Qing
Published: December 2018

On the purpose of presenting the old appearance of the relics through digitalization, and overlapping the virtual scenes with the actual scenes at the relic site, in this paper, we introduced the positioning technology, posture sensing technology and system development technology, put forward constructing cultural relic tourism platform based on integration positioning and posture sensing technology, we conducted detailed research and analysis on the users’ experienced process of cultural tourism, designed a relic augmented reality system of integration positioning and posture sensing technology. This augmented reality system mainly utilizes positioning technology to guide the users to the correct location of the relic on the corresponding map, and then overlaps the virtual object with the real relic, achieveing a 360-degree view of the overlapping effect, and the presentation effect of near-small, far-big. The system mainly employs Unity to develop the system and realize the above system on mobile terminal. It is no longer limited to a fixed point experience environment, and is suitable for outdoor natural scenes, it makes a breakthrough on the traditional overlapping of virtual scenes and real scenes, realizes the precise overlap of virtual 3D scenes with actual images, and enables the users to feel the vicissitudes of history along the movement of the mobile device in outdoor natural scenes, so as to inherit the history and culture, enrich the information and add some fun to the displayed scene, it has the advantages of bringing people more immersive feelings compared with the traditional virtual display platform.
An Improved Extreme Learning Machine Based on Full Rank Cholesky Factorization
Authors: Liu Zuozhi , Wu JinJian , Wang Jianpeng
Published: December 2018

Extreme learning machine (ELM) is a new novel learning algorithm for generalized single-hidden layer feedforward networks (SLFNs). Although it shows fast learning speed in many areas, there is still room for improvement in computational cost. To address this issue, this paper proposes an improved ELM (FRCFELM) which employs the full rank Cholesky factorization to compute output weights instead of traditional SVD. In addition, this paper proves in theory that the proposed FRCF-ELM has lower computational complexity. Experimental results over some benchmark applications indicate that the proposed FRCF-ELM learns faster than original ELM algorithm while preserving good generalization performance.
A novel method of 3D motion object’s position perception
Authors: Wei Tan , Liu Xuan , Yi Chen , Yang Erfu
Published: December 2018

With the development of industrial automation, location measurement of 3D objects is becoming more and more important, especially as it can provide necessary positional parameters for the manipulator to grasp the object accurately. In view of the disabled object which is in widespread use currently, its image is captured to obtain positional parameters and transmitted to manipulators in industry. The above process is delayed, affecting the work efficiency of the manipulator. A method for calculating the position information of target object in motion is proposed. This method uses monocular vision technology to track 3D moving objects，then uses contour sorting method to extract the minimum constrained contour rectangle, and combines the video alignment technology to realize the tracking. Thus, the measurement error is reduced. The experimental results and analysis show that the adopted measurement method is effective.
Multi source asynchronous information fusion technology based on cross prompts and its application
Authors: Daozhi Wei , Da Huang , Shucai Huang
Published: December 2018

Several modern local high-tech wars have shown that the development of war is determined by the precise strike weapons at both ends of attack and defense. In this paper, the urgent requirement of defense ballistic missile target is taken as traction, and the heterogeneous multi-sensor cross-prompt technology is used as support to study the heterogeneous multi-sensor cross-prompt and its application in target detection. On the basis of fully studying the basic theory of heterogeneous multi-sensor cross-prompting, a cross-prompting network structure model based on typical anti-missile combat mission driving and a data fusion model based on asynchronous information are established, and a multi-sensor cross-prompting method based on fuzzy decision is designed. The model and method proposed in this paper are applied to target detection and tracking, and the model and method involved in this paper are verified by simulation.
Deflection Tomography Reconstruction Based on Diagonal Total Variation
Authors: Li Huaxin , Pan Jinxiao
Published: December 2018

In view of the shortages of the reconstruction algorithm based on Total Variation (TV) minimum under the framework of measured field compressed sensing, we study the measured field sparse representation method and solving method of optimization equation, and propose the measured field reconstruction algorithms based on Diagonal Total Variation (DTV). When there is no obvious change in the reconstruction iteration of TV, gradient transformation of diagonal direction is introduced, the multi-directional information is used to obtain a more sparse representation of the measured field in the reconstruction. Under the condition of sparse projections, experimental results of this algorithm are demonstrated and compared with the results from the TV method. Comparisons show that this method can reconstruct high-quality measured field.
A new design of portable intelligent detection equipment in chemical emergency rescue
Authors: Li Siwei , Liang Yansong , Feng Yanran
Published: December 2018

This paper proposed a portable intelligent mobile detection equipment aimed at emergency treatment of chemical accidents, and mainly introduces the function, features, structure design and key technology of the equipment. The function is realized mainly through internal real-time monitoring and leakage source location calculation. using this unmanned detection equipment can effectively reduce casualties and risks of emergency personnel, and make rescue work easier and safer.
Stay hungry
Authors: Hertlein Margit
Published: December 2018

Neugierde ist kein Attribut, mit dem sich Führungskräfte oder Mitarbeiter attraktiver machen. Schade, findet unsere Autorin. Denn sie ist der Meinung,
dass uns etwas Neugierde, wie sie Kinder uns vorleben, durchaus im Beruf gut stehen würde.
Kardiomyopathien in der MRT
Authors: Horvath Cornelia
Published: December 2018

Neben EKG, Thoraxröntgen, Herzultraschall und Herzkatheter bietet die MRT eine Möglichkeit zur Diagnostik von Kardiomyopathien. Durch die kardiale MRT lassen sich Rückschlüsse über Morphologie, Funktion, Perfusion und auf eventuell vorhandenes Narbengewebe des Herzens ziehen. Die kardiale MRT ist eine nicht invasive Methode, welche ohne ionisierende Strahlung eine Möglichkeit zur Diagnostik von Kardiomyopathien bietet.
Hoffnung oder Risiko?
Authors: Risse Ludger
Published: December 2018

Über das Thema Personaluntergrenzen im Krankenhaus wird derzeit viel diskutiert und spekuliert. Der Bundesverband Pflegemanagement hat sich nun dem Thema
genähert und versucht, mit einer Stichprobe, Daten als Grundlage zu erheben.
Röntgen auf Intensivstation – Hygiene und Strahlenschutz aus Sicht des MTRA
Authors: Wiertz Michael
Published: December 2018

Unter dem Begriff Hygiene verstehen wir einerseits “Reinlichkeit” und “Gesundheitspflege”, aber er ist auch Teil des Ausdrucks „medizinische Strahlenhygiene“, wobei Hygiene im Sinne von Reduktion der Strahlenexposition zu verstehen ist – sowohl für Patient als auch für medizinisches Personal. Hygiene – sei es nun Reinlichkeit oder Strahlenschutz – ist ein wichtiger Bestandteil der täglichen beruflichen Tätigkeit von MTRA.
Generalistik mit Hintertür
Authors: Kutschke Thomas
Published: December 2018

Eigentlich sollte die Ausbildung der Pflegefachmänner- und frauen mit einem generalistischen Berufsabschluss enden. Nun soll es künftig sieben Varianten in den
Berufsurkunden geben. Der große Verlierer dabei scheint die Altenpflege zu sein. Mehr auch über die Pflegeausbildung an der Hochschule.
Liebe Leserinnen und Leser
Authors: Buchner Helmut
Published: December 2018

Liebe Leserinnen und Leser,

Das vierte Heft 2018 liegt vor Ihnen und bietet Ihnen eine spannende und vielfältige Winterlektüre. Fragen Sie sich auch wo das Jahr geblieben ist? Und erinnern Sie sich noch an den Einen oder Anderen Artikel in der Klinischen Neurophysiologie 2018?
Ist eine eigenständige Geburtshilfe in einem Haus der Grund- und Regelversorgung sinnvoll und führt sie zu messbaren Veränderungen in der Versorgung?
Authors: Reitter Anke , Doehring Norman , Maden Zerrin , Hessler Phillip A. , Misselwitz Björn
Published: December 2018

Einleitung Eine eigenständig, konzeptionell neu ausgerichtete Geburtshilfe in einem Haus der Grund- und Regelversorgung kann innerhalb kurzer Zeit Veränderungen in der Versorgungsqualität zeigen.

Material und Methode Die geburtshilflichen Daten eines Krankenhauses mit einer Geburtshilfe der Versorgungstufe (VS) IV (VS IV) in Frankfurt, Deutschland werden untersucht. Im Vergleich werden ausgewählte Daten aus der externen stationären Qualitätssicherung (EsQS) von 2013 (gemeinschaftliche geburtshilfliche und gynäkologischen Abteilung) vs. 2016 (eigenständige Geburtshilfe) vorgestellt.

Ergebnisse Die Geburtenzahl ist im Untersuchungszeitraum um 46,4% (von 803 Geburten auf 1176 Geburten) angestiegen. Die Gesamtsectiorate sank um 8,9 von 34,9% auf 26% (p<0,01). Die vaginal operativen Geburten stiegen um 5,2% (p<0,01). Die Verlegungsrate von Neonaten sank von 5,6  auf 3,1% (p<0,01). Die Interventionen Einleitung (10,1 auf 9,4%; p=0,632) und Episiotomierate (13,4 auf 1,1%; p<0,01) sind gesunken. Die Rate der peripartalen schweren Azidosen ist von keinem Fall in 2013 auf 2 Fälle in 2016 angestiegen (p<0,05). Bei der Anzahl an Erst-Sectiones und der Rate an Re-Sectio zeigt sich ein nicht-signifikanter fallender Trend.

Schlussfolgerung Die Schaffung einer chefärztlich geleiteten geburtshilflichen Abteilung an einem Haus der Grund- und Regelversorgung kann innerhalb kurzer Zeit zu messbaren Veränderungen und Qualitätssteigerungen in der Versorgung führen.
Pflegeakademiker in der Praxis
Authors: Eberhardt Doris
Published: December 2018

Seit 2014 etabliert das Klinikum Neumarkt in der Pflege akademische
Berufsrollen, um Theorie, Forschung und Praxis systematisch zu
verknüpfen. Welche Konzepte hinter der Entwicklung und Implementierung stehen,
erfahren Sie hier.
Neue Rollen in der Pflege
Authors: Eberhardt Doris
Published: December 2018

Den Schritt zur Akademisierung in der Pflege unterstützt das Klinikum Neumarkt
mit sogenannten Praxisentwicklungsstationen. Sie sollen unter anderem helfen,
neues Wissen in die Praxis zu integrieren und innovatives
Pflegehandeln ermöglichen.
Transkranielle elektrische Stimulation und ihre Bedeutung
in der Neurorehabilitation
Authors: Hummel Friedhelm C.
Published: December 2018

Jährlich treten ca. 1,5 Mio. neue Schlaganfälle in Europa auf. Trotz
Weiterentwicklung der Akutbehandlung mit flächendeckenden Stroke Units,
Thrombolyse und Thrombektomie und der postakuten Neurorehabilitation erholt sich
immer noch nur ein Teil der Patienten. Seit etwas mehr als 10 Jahren wird
transkranielle elektrische Stimulation eingesetzt, um residuale Funktion und
funktionelle Erholung nach Schlaganfall zu verbessern. Der folgende
Übersichtsartikel fokussiert auf Limitationen, Herausforderungen und Chancen
dieser Methodik.
Akademisierung in der Pflege
Authors: Eberhardt Doris
Published: December 2018

Mit inzwischen fast 15 Absolventen des Leadership-Programms und ebenso vielen
Bachelor-Absolventen will das Klinikum Neumarkt künftig weitere
„Praxisentwicklungsstationen“ etablieren. Ein Überblick über erste
Erfahrungen aus dem Klinikalltag.
Stellenwert der lipidsenkenden Therapie in der
Sekundärprophylaxe bei KHK
Authors: Hinck Annely , Sechtem Udo
Published: December 2018

Eine LDL-Cholesterin Senkung in der Sekundärprophylaxe der koronaren
Herzerkrankung wird in allen Leitlinien empfohlen. Angestrebt werden soll ein
LDL-Wert < 70 mg/dl oder mindestens eine Halbierung des Werts, wenn das LDL
initial < 35 mg/dl betrug. Die aktuellen Studien Daten sprechen für ein
LDL-Therapieziel „je niedriger desto besser“.

In der Regel erreicht man die Zielwerte mit den zurzeit auf dem Markt verfügbaren
Statinen ggf. in Kombination mit Ezetimib. Mit den PCSK9-Antikörpern stehen nun
neue Medikamente zur Verfügung, um den angestrebten Zielwert bei unzureichender
Wirkung der bisherigen Therapie oder Statin Unverträglichkeit zu erreichen. Bei
der Verordnung müssen jedoch gewisse Vorgaben eingehalten werden.

Obwohl Lipoprotein (a) wahrscheinlich kausal für die Entwicklung einer
Arteriosklerose ist, gibt es derzeit kein Medikament, das kardiovaskuläre
Ereignisse bei Senkung des Lipoprotein (a) nachweisbar reduziert. In
Einzelfällen kommt eine Lipoprotein-Apherese in Betracht.
Geht nicht, gibt‘s nicht
Authors: Ruhl Stefan , Krüttgen Nicole , Eberts Elke
Published: December 2018

Transformational führen heißt, den Mitarbeitern ein Vorbild zu sein, ihre
Kreativität zu fördern und sie emotional einzubinden. Im zweiten Teil geht es
darum, wie das Führungsmodell in den Klinikalltag überführt und erfolgreich
gelebt werden kann.
The Role of Caspase-3, Apoptosis-Inducing Factor, and B-cell Lymphoma-2 Expressions in Term Premature Rupture of Membrane
Authors: Negara Ketut Surya , Suwiyoga Ketut , Pemayun Tjokorda Gede Astawa , Sudewi Anak Agung Raka , Astawa Nyoman Mantik , Arijana I Gusti Nyoman Kamasan , Tunas Ketut
Published: December 2018

Objective To determine the role of caspase-3, apoptosis-inducing factor (AIF), and B-cell lymphoma-2 (Bcl-2) expressions in term premature rupture of membrane (PROM).

Methods An analytic observational study with case-control design was conducted, involving 52 subjects (37–42 weeks of gestation) who were divided into 2 groups: 26 cases of term delivery with PROM, and 26 controls of term delivery without PROM. The expressions of caspase-3, AIF, and Bcl-2 in the amniotic membrane were determined by immunohistochemistry. Data were analyzed using the chi-squared test. The risk of PROM was expressed by odds ratio (OR).

Results There were no significant differences in age, parity and body mass index between the two groups (p > 0.05). High caspase-3 and AIF expressions increased the risk of PROM 17.64 times (OR = 17.64; 95% CI = 4.44–70.07; p = 0.001) and 9.45 times (OR = 9.45; 95% CI= 2.62–34.07; p = 0.001), respectively, while low Bcl-2 expression increased 10.39 times (OR = 10.39; 95% CI = 2.73–39.56; p = 0.001)the risk of PROM .

Conclusion High caspase-3 and AIF expressions and low Bcl-2 expression were risk factors for term PROM. Caspase-dependent and independent pathways of apoptosis were involved in the mechanism of PROM in term pregnancy.
60 Minuten, die Ihre Klinik ruinieren
können
Authors: Landzettel Nicolai
Published: December 2018

Ist Ihre Klinik sicher vor Cyber-Angriffen? Sind die Mitarbeiter im Umgang
mit dem Computer entsprechend geschult? Lesen Sie in unserem Schwerpunkt mehr
darüber, wie wichtig es heutzutage auch für Krankenhäuser ist, ihre sensiblen
Daten zu schützen.
Personalberechnung im Intensiv- und
IMC-Bereich
Authors: Plücker Wolfgang
Published: December 2018

Für Intensiv- und IMC-Stationen gibt es noch immer keinen verbindlichen
Personalschlüssel – trotz zunehmender Arbeitsdichte. Wolfgang Plücker,
Geschäftsführer der DKI GmbH, zeigt, wie eine adäquate, zeitgemäße
Personalausstattung möglich wird.
Markenbildung durch Standardisierung
Authors: Solcher Bertram
Published: December 2018

Eine konsequente Standardisierung von Abläufen - das ist das Erfolgsrezept des
Unternehmens Surgical Process Institute. Ziel ist es, Ergebnisse,
Wirtschaftlichkeit und Service zu verbessern – vor allem im OP. Ein
Fallbeispiel.
Beliebt um jeden Preis?
Authors: Probst Karin
Published: December 2018

Macht macht nicht unbedingt beliebt. Führungskräfte müssen immer mal wieder unpopuläre Entscheidungen treffen, was ihnen oft nicht leicht fällt. Wie Sie
es schaffen, souverän „Ja“ und „Nein“ zu sich selbst und anderen zu sagen, lesen Sie hier.
Wenn Gefährdungsanzeigen zur Gefahr werden
Authors: Leydecker Julia , Kutscher Jan
Published: December 2018

Gefährdungsanzeigen sind ein branchenspezifisches Problem in Gesundheitseinrichtungen. Nachhaltig verbessern sie meist leider
nichts. Lesen Sie, warum die „Gefährdungsanzeigenkultur“ in der Pflege nicht weiterführt.
Bilanz zum Leadership-Programm
Authors: Eberhardt Doris
Published: December 2018

Das Resümee der Leadership-Teilnehmer fällt positiv aus: So hilft das Konzept ihrer Meinung nach, eingefahrene Strukturen und
Denkmuster kritischer zu hinterfragen und das eigene Berufsverständnis weiterzuentwickeln. Ein erster Erfahrungsbericht.
An einem Strang ziehen
Authors: Sprenger Walburga , Wittchen Susanne
Published: December 2018

Damit ein Grade- und Skill-Mix gelingen kann, müssen Strukturen und Prozesse im Krankenhaus verändert werden. Es muss klar
sein, wer was mit welcher Ausbildung und Kompetenz übernimmt. Und es müssen alle Berufsgruppen mitziehen, um die Ziele gemeinsam
zu verfolgen.
Er war stets bemüht …
Authors: Balzert Daniel
Published: December 2018

Um die Zeugnissprache ranken unzählige Mythen. Viele Arbeitnehmer vermuten einen Geheimcode und interpretieren jedes Wort. Das führt dazu, dass
Arbeitsgerichte sich immer häufiger mit Zeugniswortlauten beschäftigen müssen. Hier einige Fakten.
Quo vadis Pflegekraft?
Authors: Sprenger Walburga , Wittchen Susanne
Published: December 2018

Die Diskussion um die Aufgabenteilung im Krankenhaus ist nicht neu – aber dringlicher denn je. Ein Problem: Jede Berufsgruppe
möchte zwar Aufgaben abgeben, aber dennoch Stellenanteile behalten. Hier Möglichkeiten zur Verschiebung von
Tätigkeiten.
Schlummernde Talente nutzen
Authors: Ebner Markus
Published: December 2018

Positive Leadership setzt darauf, Talente der Mitarbeiter zu entdecken und zu
fördern. Werkzeuge helfen dabei, die Personalentwicklung messbar zu
machen. Mehr dazu erläutert Organisationspsychologe Dr. Markus Ebner.
Zukunft gestalten
Authors: Spenner Katharina , Frommherz Gertrud
Published: December 2018

Den Horizont erweitern, andere Perspektiven einnehmen und jede Menge Rüstzeug für eine aktive Mitarbeit bei der Gestaltung einer spannenden
Unternehmenszukunft – das lernen die Teilnehmer des Projektes „Wir Zukunft“ an den Kliniken des Landkreises Lörrach.
Pain sensitivity in fish.
Authors: Schroeder P.
Published: December 2018

The question of whether fish have the capacity to experience a state akin to pain was first empirically addressed by Jan Verheijen's seminal study on carps in 1983. Subsequently, comprehensive evidence has been presented not only on the anatomical prerequisites for a pain system in several fish species, but also for a behavioural component. Opinions against fish perceiving pain focus on the difference in neuroanatomy between higher mammals and lower vertebrates that do not possess a neocortex. Finally, the successful (behaviour sparing) use of analgesics can be interpreted as further evidence that fish are able to perceive pain and can be adversely affected by a painful event.
Anesthesia Exposure in Children: Practitioners Respond to the 2016 FDA Drug Safety Communication
Authors: Pinyavat Teeda , Saraiya Neeta R. , Chen Jerri , Ferrari Lynne R. , Goffman Dena , Imahiyerobo Thomas A. , Middlesworth William , Hyman Joshua E. , Hyun Grace , Houck Constance S.
Published: December 2018

In December 2016, the US Food and Drug Administration (FDA) issued a drug safety warning stating that 11 commonly used anesthetic and sedative medications had potential neurotoxic effects when used in children under the age of 3 years and in pregnant women during the third trimester. A panel presentation at the sixth biennial Pediatric Anesthesia Neurodevelopmental Assessment (PANDA) symposium addressed the FDA announcement in a session entitled “Anesthesia Exposure in Children During Surgical and Non-Surgical Procedures: How Do We Respond to the 2016 FDA Drug Safety Communication?” Panelists included representatives from pediatric anesthesiology, obstetrics, pediatric surgery, and several pediatric surgical subspecialties. Each panelist was asked to address the following questions: How has the FDA labelling change affected your clinical practice including patient discussions, timing, and frequency of procedures? Has your professional society provided any guidelines for this discussion? Has there been any discussion of this topic at your national meetings? The panelists provided important perspectives specific to each specialty, which generated a lively discussion and a detailed response from the Deputy Director of the Division of Anesthesia and Addiction of the FDA describing the FDA procedures that led to this drug safety warning.
Epidemiology and Resource Utilization of Simple Febrile Seizure-associated Hospitalizations in the United States, 2003-2012
Authors: Huang Yolanda Y. , Li Guohua , Sun Lena S.
Published: December 2018

Background:

Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States.

Materials and Methods:

This study is a serial, retrospective analysis of the Healthcare Cost and Utilization Project Kids’ Inpatient Databases for the years 2003, 2006, 2009, and 2012. SFS-associated hospitalizations were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis code 780.31. We calculated the proportion of hospitalizations in pediatric patients under 6 years of age due to SFS and all other nonbirth causes, the rate of SFS-associated hospitalizations per 100,000 population, the mean length of stay and inflation-adjusted hospital costs of SFS-associated hospitalizations, as well as patient demographics and hospital characteristics.

Results:

From 2003 to 2012, the weighted proportion of hospitalizations due to SFS declined from 0.83% to 0.41% (P<0.01) and the annual rate of SFS-associated hospitalizations per 100,000 population decreased from 48.0 to 18.7 (P<0.01). However, use of computed tomography, electroencephalogram, and lumbar puncture in SFS-associated hospitalizations decreased significantly (all P<0.001), but the utilization rate of magnetic resonance imaging remained stable (P=0.53). The mean length of stay for SFS-associated hospitalizations decreased from 2.03 days in 2003 to 1.74 days in 2012, and the mean hospital costs (exclusive of professional payment) decreased from $3830 in 2003 to $3223 in 2012 (both P<0.001).

Conclusions:

SFS-associated hospitalizations and resource utilization in children under 6 years of age have decreased markedly in the United States, probably due to improved clinical adherence to the practice parameters set forth by the American Academy of Pediatrics for managing patients with SFS.
Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss
Authors: Judge Paul D. , Jorgensen Erik , Lopez-Vazquez Monica , Roush Patricia , Page Thomas A. , Moeller Mary Pat , Tomblin J. Bruce , Holte Lenore , Buchman Craig
Published: December 2018

Objectives:

To (1) identify the etiologies and risk factors of the patient cohort and determine the degree to which they reflected the incidence for children with hearing loss and (2) quantify practice management patterns in three catchment areas of the United States with available centers of excellence in pediatric hearing loss.

Design:

Medical information for 307 children with bilateral, mild-to-severe hearing loss was examined retrospectively. Children were participants in the Outcomes of Children with Hearing Loss (OCHL) study, a 5-year longitudinal study that recruited subjects at three different sites. Children aged 6 months to 7 years at time of OCHL enrollment were participants in this study. Children with cochlear implants, children with severe or profound hearing loss, and children with significant cognitive or motor delays were excluded from the OCHL study and, by extension, from this analysis. Medical information was gathered using medical records and participant intake forms, the latter reflecting a caregiver’s report. A comparison group included 134 children with normal hearing. A Chi-square test on two-way tables was used to assess for differences in referral patterns by site for the children who are hard of hearing (CHH). Linear regression was performed on gestational age and birth weight as continuous variables. Risk factors were assessed using t tests. The alpha value was set at p < 0.05.

Results:

Neonatal intensive care unit stay, mechanical ventilation, oxygen requirement, aminoglycoside exposure, and family history were correlated with hearing loss. For this study cohort, congenital cytomegalovirus, strep positivity, bacterial meningitis, extracorporeal membrane oxygenation, and loop diuretic exposure were not associated with hearing loss. Less than 50% of children underwent imaging, although 34.2% of those scanned had abnormalities identified. No single imaging modality was preferred. Differences in referral rates were apparent for neurology, radiology, genetics, and ophthalmology.

Conclusions:

The OCHL cohort reflects known etiologies of CHH. Despite available guidelines, centers of excellence, and high-yield rates for imaging, the medical workup for children with hearing loss remains inconsistently implemented and widely variable. There remains limited awareness as to what constitutes appropriate medical assessment for CHH.
Extradiscal Epiduroscopic Percutaneous Endoscopic Discectomy for Upper Lumbar Disc Herniation A Technical Note
Authors: Shin Myung-Hoon , Bae Jung-Sik , Cho Hyung-Lea , Jang Il-Tae
Published: December 2018

Study Design:

This study was a technical case report.

Objectives:

To introduce a new transforaminal percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of upper lumbar disc herniation using an extradiscal epiduroscopic approach.

Summary of Background Data:

Although upper lumbar disc herniation accounts for only 1%–2% of all cases of lumbar disc herniation, the treatment is difficult and shows relatively poor outcomes compared with lower lumbar disc herniation. The anatomic characteristics of the upper lumbar spine are somewhat different from those of the lower lumbar spine. Thus, conventional transforaminal PELD may fail to remove the herniated disc.

Methods:

In the setting of extradiscal epiduroscopic PELD for upper lumbar disc herniation, the approach angle on the axial plane is ~30 degrees, which is less than that of the conventional transforaminal endoscopic discectomy and the working cannula is directly targeted to the herniated disc. Four patients who presented with back and/or leg pain due to disc herniation at L1–L2 or L2–L3 disc space were treated with extradiscal epiduroscopic PELD.

Results:

The patients experienced relief from symptoms and were discharged the next day.

Conclusions:

Extradiscal epiduroscopic PELD is a promising treatment strategy for upper lumbar disc herniation, which may otherwise lead to a poor outcome.
Norway's Kirkens Bymisjon Leads the Way in Care of the Vulnerable
Authors: Cone Pamela H.
Published: December 2018

Caring for vulnerable persons is a global humanitarian and nursing concern. The Norwegian Kirkens Bymisjon system cares for vulnerable people groups in 40 cities, serving as a model for other countries. In 2009, church–city–mission collaborations in Bergen, Trondheim, and Tromsø were visited; follow-up data were collected in 2014. At each site, a combination of the diaconal organization, the city or municipality, and donors from the private sector identify and establish a governing board, analyze vulnerable groups most in need of service, and build programs to meet needs.
Preoperative Modeling for Mirror Hand: Simplifying a Difficult Problem Using 3-Dimensional Printing and Simulation
Authors: Podolsky Dale J. , Borschel Gregory H.
Published: December 2018

Mirror hand is an extremely rare congenital anomaly. We modeled and simulated the reconstruction of mirror hand in a 2-year-old boy utilizing a preoperative 3-dimensional model to aid surgical planning. A soft-tissue hand model was created using preoperative imaging, 3-dimensional printing, and silicone casting, and the model was used to perform trial surgery. Given the complexity of the deformity, the model greatly facilitated the final operative plan for reconstruction.
Acute Appendicitis After Umbilical Cord Blood Transplant
Authors: Curtis Caitlin
Published: December 2018

Acute appendicitis is a common pediatric surgical problem. Management of acute appendicitis in immunocompromised children is a clinical challenge. This case study discusses the management of acute appendicitis with a laparoscopic appendectomy in a 13-year-old male 21 days after unrelated umbilical cord blood transplant with urgent laparoscopic appendectomy without complication.
Getting Everyone in the Same Room: The Combined Therapist Approach to Teaching Independence in Clean Intermittent Catheterization
Authors: Singh Ranjit Kaur Jarneal , Sng Jamie , Yeong Melissa May Yan , Nadeson Vannaja , Ong Caroline Choo Phaik
Published: December 2018

Introduction

Most pediatric patients with neurogenic bladder require clean intermittent catheterization (CIC), several times daily, for maintenance of continence and health. CIC is performed by the caregiver until the child is developmentally ready to learn self-CIC. Children with associated mobility, dexterity, and cognitive deficits tend to take much longer to learn self-CIC. We piloted a combined pediatric urotherapy and occupational therapy clinic to address this problem.

Methods

Five children (6–14 years old) and their parents attended combined therapist sessions for 6 months. Explanation of self-CIC was done using show-and-tell method followed by doll play and/or supervised practice. Patients' mastery difficulties were identified by demonstration and collaborative discussion. Specific tasks and activities were recommended for home practice after task assessment and analysis. Reasons for slow progress in learning self-CIC were documented.

Results

All five children had motor and cognitive difficulties. Previously, caregivers regularly overassisted, which prevented patient practice and exposure. Task assessment, analysis, and recommendation had been suboptimal because patients' different combinations of disabilities caused unique difficulties with self-CIC that were unrecognized when attending individual therapist sessions. After the combined clinic, patients increased participation in the preparatory phase of self-CIC, functional mobility and dressing tasks.

Discussion

Despite longer session duration and scheduling constraints, the combined therapist approach was more efficient and effective for this category of patients, with fewer return sessions needed to achieve the desired outcome. We recommend early identification and referral of appropriate patients for a combined therapy clinic.
Congenital Combined Deficiency of the Vitamin K-dependent Clotting Factors (VKCFD): A Novel Gamma-glutamyl Carboxylase (GGCX) Mutation
Authors: Al Absi Hebah S. , Abdullah Mohammad F.
Published: December 2018

Congenital combined vitamin K-dependent clotting factors deficiency (VKCFD) is a very rare autosomal recessive bleeding disorder. Here we report a case of a girl with novel variant in the gamma-glutamyl carboxylase (GGCX) gene leading to VKCFD. A 3-month-old girl presented to our hospital with a history of bleeding from puncture site. Laboratory evaluation showed markedly prolonged partial thromboplastin time and activated partial thromboplastin time. Activities of vitamin K-dependent factors were all low. Genetic analysis revealed a homozygous currently unreported variant in the GGCX gene further supporting a diagnosis of VKCFD type 1. VKCFD due to GGCX mutation has an overall good prognosis
Confronting Clinical Rotations
Authors: Boston-Fleischhauer Carol
Published: December 2018

The pace and scope of change in the US healthcare industry has been relentless. Organizational and system responses include dramatic redesign of structures, processes, and services to support cross-continuum care. The education of nursing students must keep up with rapid delivery system change. Beyond significant curricular revision, innovation in undergraduate clinical rotations to better prepare students for cross-continuum practice will be key.
Prevalence, Evolution, and Extent of Impaired Cerebral Autoregulation in Children Hospitalized With Complex Mild Traumatic Brain Injury*
Authors: Lele Abhijit V. , Watanitanon Arraya , Lakireddy Viharika , Clark-Bell Crystalyn , Moore Anne , Zimmerman Jerry J. , Chesnut Randall M. , Armstead William , Vavilala Monica S.
Published: December 2018

Objectives:

To examine cerebral autoregulation in children with complex mild traumatic brain injury.

Design:

Prospective observational convenience sample.

Setting:

PICU at a level I trauma center.

Patients:

Children with complex mild traumatic brain injury (trauma, admission Glasgow Coma Scale score 13–15 with either abnormal head CT, or history of loss of consciousness).

Interventions:

Cerebral autoregulation was tested using transcranial Doppler ultrasound between admission day 1 and 8.

Measurements and Main Results:

The primary outcome was prevalence of impaired cerebral autoregulation (autoregulation index < 0.4),determined using transcranial Doppler ultrasonography and tilt testing. Secondary outcomes examined factors associated with and evolution and extent of impairment. Cerebral autoregulation testing occurred in 31 children 10 years (sd, 5.2 yr), mostly male (59%) with isolated traumatic brain injury (91%), median admission Glasgow Coma Scale 15, Injury Severity Scores 14.2 (sd, 7.7), traumatic brain injury due to fall (50%), preadmission loss of consciousness (48%), and abnormal head CT scan (97%). Thirty-one children underwent 56 autoregulation tests. Impaired cerebral autoregulation occurred in 15 children (48.4%) who underwent 19 tests; 68% and 32% of tests demonstrated unilateral and bilateral impairment, respectively. Compared with children on median day 6 of admission after traumatic brain injury, impaired autoregulation was most common in the first 5 days after traumatic brain injury (day 1: relative risk, 3.7; 95% CI, 1.9–7.3 vs day 2: relative risk, 2.7; 95% CI, 1.1–6.5 vs day 5: relative risk, 1.33; 95% CI, 0.7–2.3). Children with impaired autoregulation were older (12.3 yr [sd, 1.3 yr] vs 8.7 yr [sd, 1.1 yr]; p = 0.04) and tended to have subdural hematoma (64% vs 44%), epidural hematoma (29% vs 17%), and subarachnoid hemorrhage (36% vs 28%). Eight children (53%) were discharged home with ongoing impaired cerebral autoregulation.

Conclusions:

Impaired cerebral autoregulation is common in children with complex mild traumatic brain injury, despite reassuring admission Glasgow Coma Scale 13–15. Children with complex mild traumatic brain injury have abnormal cerebrovascular hemodynamics, mostly during the first 5 days. Impairment commonly extends to the contralateral hemisphere and discharge of children with ongoing impaired cerebral autoregulation is common.