bluuebunny/crossref_metadata_2025 huggingface dataset:
Rumination im Zusammenhang mit dem Erreichen selbst gesetzter Ziele bei leistungssportlich-orientierten Schwimmern
Authors: Kröhler Alena , Berti Stefan
Published: April 2018

Zusammenfassung. Die Studie untersucht den Zusammenhang zwischen Rumination und der persönlichen Zielerreichung bei Leistungssportlern. Im Rahmen einer Längsschnittuntersuchung, haben 44 Schwimmer_innen an einer Onlinebefragung mit vier Messzeitpunkten während der Wettkampfsaison 2014/15 teilgenommen. Der Online-Fragebogen enthielt neben der deutschen Version des Rumination Response Style Questionnaires (RSQ-D; Kühner, Huffziger & Nolen-Hoeksema, 2007 ), Fragen zu persönlichen Zielen und biographische sowie sportbezogene Fragen. Unter Berücksichtigung der individuellen Angaben zur Zielerreichung am Ende der Wettkampfsaison, wurden die Sportler_innen einer Realisierungsgruppe (n = 17) oder Vergleichsgruppe (n = 27) zugeordnet. Mittels multivarianter Varianzanalyse (MANOVA) wurde getestet, ob globale Unterschiede in der Rumination zu Beginn und am Ende der Wettkampfsaison zwischen den Gruppen bestehen. Sportler_innen, welche ihr individuelles Ziel erreicht haben, weisen im Vergleich zu denjenigen, die ihre Ziele nicht erreicht haben, niedrigere Ruminationswerte auf. Die Ergebnisse legen nahe, dass Rumination im Kontext der Zielerreichung auftritt und ein relevanter Faktor für den Leistungssport darstellen könnte.
Strong Shaking Predicted in Tokyo From an Expected M7+ Itoigawa‐Shizuoka Earthquake
Authors: Denolle Marine A. , Boué Pierre , Hirata Naoshi , Beroza Gregory C.
Published: April 2018

The Itoigawa‐Shizuoka Tectonic Line (ISTL) is a major oblique left‐lateral crustal fault that is expected to host M7+ events in the near future. Its proximity to the Kanto sedimentary basin poses a threat to the population of Metropolitan Tokyo. This study constructs ground motion predictions for scenario earthquakes on the ISTL using virtual earthquakes. We use the ambient seismic field to calculate the cross‐correlation function that we assume proportional to the elastodynamic Green tensor between High‐Sensitivity Seismograph network stations, which act as sources located above the ISTL, and the stations of the dense Metropolitan Seismic Observation network, which act as receivers in the Kanto Basin. We use the virtual earthquake approach (Denolle et al., 2013, https://doi.org/10.1029/2012JB009603; Denolle, Dunham, et al., 2014, https://doi.org/10.1126/science.1245678) to predict ground motion from a suite of 270 kinematic sources and find that predicted ground motions are strong enough that nonlinear effects, which we do not model, may become important. We find that the shape of the sedimentary basin substantially alters the shaking by amplifying long‐period ground motions as seismic waves refract at the basin edge. Additionally, we quantify ground motion variability due to source uncertainty, surmise that ground motions are lognormally distributed with regard to source uncertainties, and suggest that the variability is affected (locally either enhanced or reduced) by the basin shape. Finally, we find a coupling point between source and wave paths for epicentral locations on the ISTL that generates almost twice the shaking as equivalent unilateral ruptures, despite directivity orientation that would favor southward ruptures.
Bathymetric Controls on Rotational Surfzone Currents
Authors: McCarroll R. Jak , Brander Robert W. , Scott Tim , Castelle Bruno
Published: April 2018

A multibeach Lagrangian data set was used to determine bathymetric controls on flow variability within the surfzone. Seven microtidal flow regimes were examined, six containing rip channels, under moderate shore normal waves. Three selected zones exemplified varying bathymetric control: (i) a alongshore uniform zone; (ii) a shallow rip channel at an oblique angle to shore normal; and (iii) a deep, shore‐normal rip channel. Bathymetric variables included alongshore nonuniformity (φ) and channel angle relative to shore normal (α). Low‐frequency flow (0.01 Hz) was described by velocity (U), velocity standard deviation (σU), angular deviation (σθ), and bias in direction of eddy rotation (ζbias). Observations of the exemplar zones indicated the following: (i) near‐zero mean flow with transient eddies within the alongshore uniform zone; (ii) low mean flow with high ζbias within the oblique channel; and (iii) strong mean flow with low ζbias in the deep channel. Bathymetry and flow variables were spatially averaged and linearly correlated, scaling for wave forcing. Normalized flow variables were found to be interdependent and were correlated with bathymetric variability, with [U ∝ φ], [(U/σU) ∝ φ], and [σθ ∝  − φ], all with (R2 ≥ 0.8). A correlation was determined between α and ζbias (R2 ≥ 0.7, increasing as zone width is decreased), with peak ζbias within oblique channels. Based on these results, a conceptual model is introduced to predict flow behavior for known bathymetry. Surfzone currents were found to span a dynamic continuum from transient eddies on alongshore uniform bathymetry, to channelized rip currents, forced by bathymetric three‐dimensionality and mediated by channel geometry.
Robust Inverse Modeling of Growing Season Net Ecosystem Exchange in a Mountainous Peatland: Influence of Distributional Assumptions on Estimated Parameters and Total Carbon Fluxes
Authors: Weber Tobias K. D. , Gerling Lars , Reineke Daniela , Weber Stephan , Durner Wolfgang , Iden Sascha C.
Published: April 2018

While boreal lowland bogs have been extensively studied using the eddy‐covariance (EC) technique, less knowledge exists on mountainous peatlands. Hence, half‐hourly CO2 fluxes of an ombrotrophic peat bog in the Harz Mountains, Germany, were measured with the EC technique during a growing season with exceptionally dry weather spells. A common biophysical process model for net ecosystem exchange was used to describe measured CO2 fluxes and to fill data gaps. Model parameters and uncertainties were estimated by robust inverse modelling in a Bayesian framework using a population‐based Markov Chain Monte Carlo sampler. The focus of this study was on the correct statistical description of error, i.e. the differences between the measured and simulated carbon fluxes, and the influence of distributional assumptions on parameter estimates, cumulative carbon fluxes, and uncertainties. We tested the Gaussian, Laplace, and Student's t distribution as error models. The t‐distribution was identified as best error model by the deviance information criterion. Its use led to markedly different parameter estimates, a reduction of parameter uncertainty by about 40%, and, most importantly, to a 5% higher estimated cumulative CO2 uptake as compared to the commonly assumed Gaussian error distribution. As open‐path measurement systems have larger measurement error at high humidity, the standard deviation of the error was modeled as a function of measured vapor pressure deficit. Overall, this paper demonstrates the importance of critically assessing the influence of distributional assumptions on estimated model parameters and cumulative carbon fluxes between the land surface and the atmosphere.
Will Cape Town Escape Its Water-Starved Fate?
Authors: Joel Lucas
Published: April 2018

Despite ramped-up conservation efforts and hopes lifted by a few recent rainstorms, residents of the South African metropolis still face the possibility of a water doomsday.
The Controlling Role of Boundary Layer Inertial Oscillations in Meiyu Frontal Precipitation and Its Diurnal Cycles Over China
Authors: Xue Ming , Luo Xia , Zhu Kefeng , Sun Zhengqi , Fei Jianfang
Published: April 2018

Convection‐permitting simulations are used to investigate the key mechanism of Meiyu precipitation diurnal cycle over China. Six days from the 2014 Meiyu season are used to produce a “north” composite rainband over the Yangtze‐Huaihe River Basin and another 6 days used to produce a “south” composite band. Both rainbands have peak rainfall in the early morning, while the south band has a secondary peak in the afternoon. Low‐level ageostrophic winds (AGWs) are found to exhibit diurnal cycles with clockwise rotations and their directions, and magnitudes depend on the background geostrophic monsoon flows. Net moisture flux into a control volume enclosing each rainband is almost purely due to AGWs. For both rainbands, net flux reaches maximum at ~04 LST, about 3–4 hr before morning precipitation peak. For the north band, a prominent minimum occurs at ~19 LST, 4 hr before the precipitation minimum. The moisture fluxes through the southern control volume boundary make the largest contributions to the net flux and its diurnal variations. The diurnal variations of the AGWs and their relationship with the background monsoon flows agree very well with the prediction of Blackadar boundary layer inertial oscillation theory, and the convergence forcing by the AGWs resulting from the inertial oscillations plays a paramount role in modulating the diurnal cycles of Meiyu front precipitation, including the creation of early morning peak and evening minimum. Feedback of latent heat release plays only a secondary role. The commonly recognized diurnal monsoon variability can be explained by the Blackadar inertial oscillation theory.
Patient-derived orthotopic xenograft models for cancer of unknown primary precisely distinguish chemotherapy, and tumor-targeting S. typhimurium A1-R is superior to first-line chemotherapy
Authors: Miyake Kentaro , Kiyuna Tasuku , Miyake Masuyo , Kawaguchi Kei , Yoon Sang Nam , Zhang Zhiying , Igarashi Kentaro , Razmjooei Sahar , Wangsiricharoen Sintawat , Murakami Takashi , Li Yunfeng , Nelson Scott D. , Russell Tara A. , Singh Arun S. , Hiroshima Yukihiko , Momiyama Masashi , Matsuyama Ryusei , Chishima Takashi , Singh Shree Ram , Endo Itaru , Eilber Fritz C. , Hoffman Robert M.
Published: April 2018

Cancer of unknown primary (CUP) is a recalcitrant disease with poor prognosis because it lacks standard first-line therapy. CUP consists of diverse malignancy groups, making personalized precision therapy essential. The present study aimed to identify an effective therapy for a CUP patient using a patient-derived orthotopic xenograft (PDOX) model. This paper reports the usefulness of the PDOX model to precisely identify effective and ineffective chemotherapy and to compare the efficacy of S. typhimurium A1-R with first-line chemotherapy using the CUP PDOX model. The present study is the first to use a CUP PDOX model, which was able to precisely distinguish the chemotherapeutic course. We found that a carboplatinum (CAR)-based regimen was effective for this CUP patient. We also demonstrated that S. typhimurium A1-R was more effective against the CUP tumor than first-line chemotherapy. Our results indicate that S. typhimurium A1-R has clinical potential for CUP, a resistant disease that requires effective therapy.
Low doses of LPS exacerbate the inflammatory response and trigger death on TLR3-primed human monocytes
Authors: Monguió-Tortajada Marta , Franquesa Marcella , Sarrias Maria-Rosa , Borràs Francesc E.
Published: April 2018

TLR sensing of pathogens triggers monocyte activation to initiate the host innate immune response to infection. Monocytes can dynamically adapt to different TLR agonists inducing different patterns of inflammatory response, and the sequence of exposure to TLRs can dramatically modulate cell activation. Understanding the interactions between TLR signalling that lead to synergy, priming and tolerance to TLR agonists may help explain how prior infections and inflammatory conditioning can regulate the innate immune response to subsequent infections. Our goal was to investigate the role of MyD88-independent/dependent TLR priming on modulating the monocyte response to LPS exposure. We stimulated human blood monocytes with agonists for TLR4 (LPS), TLR3 (poly(I:C)) and TLR7/8 (R848) and subsequently challenged them to low doses of endotoxin. The different TLR agonists promoted distinct inflammatory signatures in monocytes. Upon subsequent LPS challenge, LPS- and R848-primed monocytes did not enhance the previous response, whereas poly(I:C)-primed monocytes exhibited a significant inflammatory response concomitant with a sharp reduction on cell viability. Our results show that TLR3-primed monocytes are prompted to cell death by apoptosis in the presence of low endotoxin levels, concurrent with the production of high levels of TNFα and IL6. Of note, blocking of TNFR I/II in those monocytes did reduce TNFα production but did not abrogate cell death. Instead, direct signalling through TLR4 was responsible of such effect. Collectively, our study provides new insights on the effects of cross-priming and synergism between TLR3 and TLR4, identifying the selective induction of apoptosis as a strategy for TLR-mediated host innate response.
Publisher Correction: Experimental identification of non-classicality of noisy twin beams and other related two-mode states
Authors: Arkhipov Ievgen I. , Peřina Jan
Published: April 2018

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
Anisotropic band splitting in monolayer NbSe2: implications for superconductivity and charge density wave
Authors: Nakata Yuki , Sugawara Katsuaki , Ichinokura Satoru , Okada Yoshinori , Hitosugi Taro , Koretsune Takashi , Ueno Keiji , Hasegawa Shuji , Takahashi Takashi , Sato Takafumi
Published: April 2018

Realization of unconventional physical properties in two-dimensional (2D) transition-metal dichalcogenides (TMDs) is currently one of the key challenges in condensed-matter systems. However, the electronic properties of 2D TMDs remain largely unexplored compared to those of their bulk counterparts. Here, we report the fabrication of a high-quality monolayer NbSe2 film with a trigonal prismatic structure by molecular beam epitaxy, and the study of its electronic properties by scanning tunneling microscopy, angle-resolved photoemission spectroscopy, and electrical transport measurements, together with first-principles band-structure calculations. In addition to a charge density wave (CDW) with 3 × 3 periodicity and superconductivity below 1.5 K, we observed sizable (~0.1 eV) band splitting along the Γ-K cut in the Brillouin zone due to inversion symmetry breaking in the monolayer crystal. This splitting is highly anisotropic in k space, leading to a spin-split van-Hove singularity in the band structure. The present results suggest the importance of spin–orbit coupling and symmetry breaking for unconventional superconductivity and CDW properties in monolayer TMDs.
Highly efficient bacterial removal and disinfection by magnetic barium phosphate nanoflakes with embedded iron oxide nanoparticles
Authors: Song Junyi , Zhang Fan , Huang Yuxiong , Keller Arturo A. , Tang Xiaoxiu , Zhang Wanning , Jia Weibin , Santos Jerome
Published: April 2018

Highly efficient bacterial removal and disinfection of drinking water by recyclable magnetic barium phosphate nanoflakes with embedded iron oxide nanoparticles.
Correction: ROCK inhibitor Y-27632 attenuated early endothelial dysfunction caused by occupational environmental concentrations of carbon black nanoparticles
Authors: Yan J. Y. , Huang C. C. , Lung S. C. C. , Wang W. C. , Suo G. L. , Lin Y. J. , Lai C. H. , Lin C. H.
Published: April 2018

Correction for ‘ROCK inhibitor Y-27632 attenuated early endothelial dysfunction caused by occupational environmental concentrations of carbon black nanoparticles’ by J. Y. Yan et al., Environ. Sci.: Nano, 2017, 4, 1525–1533.
Efficient elimination of U(vi) by polyethyleneimine-decorated fly ash
Authors: Pang Hongwei , Huang Shuyi , Wu Yihan , Yang Dongxu , Wang Xiangxue , Yu Shujun , Chen Zhongshan , Alsaedi Ahmed , Hayat Tasawar , Wang Xiangke
Published: April 2018

The easily-synthesized FA@PEI showed an excellent performance in the elimination of U(vi) from wastewater, with the adsorption mechanism being explored.
Sr5ZnGa6S15: a new quaternary non-centrosymmetric semiconductor with a 3D framework structure displaying excellent nonlinear optical performance
Authors: Lin Hua , Li Bing-Xuan , Chen Hong , Liu Peng-Fei , Wu Li-Ming , Wu Xin-Tao , Zhu Qi-Long
Published: April 2018

A novel phase-matchable material Sr5ZnGa6S15 with a non-centrosymmetric 3D framework structure, which exhibits excellent properties for MFIR NLO applications, is discovered for the first time.
Correction: Soft modes and strain redistribution in continuous models of amorphous plasticity: the Eshelby paradigm, and beyond?
Authors: Cao Xiangyu , Nicolas Alexandre , Trimcev Denny , Rosso Alberto
Published: April 2018

Correction for ‘Soft modes and strain redistribution in continuous models of amorphous plasticity: the Eshelby paradigm, and beyond?’ by Xiangyu Cao et al., Soft Matter, 2018, DOI: 10.1039/c7sm02510f.
PSR J1618−3921: a recycled pulsar in an eccentric orbit
Authors: Octau F. , Cognard I. , Guillemot L. , Tauris T. M. , Freire P. C. C. , Desvignes G. , Theureau G.
Published: April 2018

Context.The 11.99 ms pulsar PSR J1618−3921 orbits a He white dwarf companion of probably low mass with a period of 22.7 d. The pulsar was discovered in a survey of the intermediate Galactic latitudes at 1400 MHz that was conducted with the Parkes radio telescope in the late 1990s. Although PSR J1618−3921 was discovered more than 15 years ago, only limited information has been published about this pulsar, which has a surprisingly high orbital eccentricity (e≃ 0.027) considering its high spin frequency and the likely low mass of the companion.

Aims.The focus of this work is a precise measurement of the spin and the astrometric and orbital characteristics of PSR J1618−3921. This was done with timing observations made at the Nançay Radio Telescope from 2009 to 2017.

Methods.We analyzed the timing data recorded at the Nançay Radio Telescope over several years to characterize the properties of PSR J1618−3921. A rotation ephemeris for this pulsar was obtained by analyzing the arrival times of the radio pulses at the telescope.

Results.We confirm the unusual eccentricity of PSR J1618−3921 and discuss several hypotheses regarding its formation in the context of other discoveries of recycled pulsars in eccentric orbits.
The influence of the carbon addition on the microstructure of a U-Nb alloy and the features of Nb2C inclusions
Authors: Chen Dong , Ma Rong , Chen Xianglin , Wang Zhenhong , Su Bin , Zhang Xinjian , Meng Daqiao
Published: April 2018

The effects of the carbon addition on the morphology, composition, size distribution and formation mechanism of inclusions in a U-5.5 Nb alloy were discussed. The influence of the carbon content on the microstructure and hardness were also investigated. The methods used in the present study were scanning electron microscopy coupled with energy dispersive X-ray spectroscopy, optical microscopy, and hardness measurements. The results show that the carbon content obviously affects the morphology, size distribution and area fraction of the Nb2C inclusions. Moreover, characterization of the inclusion morphology shows that the Nb2C inclusions form in the liquid and subsequently grow, collide and agglomerate to form clusters. Meanwhile, the average grain size significantly decreases, and the hardness increases with increasing carbon content in the U-5.5 Nb alloy.
Robotics in Total Hip Arthroplasty—A Current Review
Authors: Allen Mark , Myerthall Steven , Jacofsky David
Published: April 2018

Robotic-assisted total hip arthroplasty (THA) is gaining popularity among surgeons and patients alike. This technology has been available clinically in some form for over two decades. This technology claims to improve component positioning, decrease complications, and improve clinical outcomes. Historical and modern systems have shown both advantages and disadvantages while assisting THA procedures. Robotic arms and milling systems have been utilized with both fully active and semi active technology platforms designed to perform or assist the surgeon with various portions of the procedure. The future design objectives include precise planning and even further improved consistent intraoperative execution. Robotics has proven to be beneficial, reliable, and cost effective in numerus other industries and is likely to continue to expand in the field of orthopaedic surgery. This article will review the historical and current technology being utilized for robotic-assisted THA.
New Technologies for Diagnosis of Periprosthetic Hip Infection
Authors: Shohat Noam , Parvizi Javad , Tarabichi Majd
Published: April 2018

Periprosthetic joint infection (PJI) is a devastating mode of failure following total joint arthroplasty, imposing a serious burden on the healthcare system and society at large. Increasing demand for elective arthroplasty, as well as independent predictions demonstrating future rise in the prevalence of PJI, will lead to an increasing financial burden imposed by this dreadful complication. This challenge is further compounded by disturbing trends, such as drug-resistant organisms among others as a cause of PJI. The aim of this review is to provide the latest updates in the diagnosis of PJI, with a view to identifying areas in need of further research.
Indikation und Besonderheiten der Knochendichtemessungen im Kindes- und Jugendalter
Authors: Semler O. , Hoyer-Kuhn H.-K. , Stark C. , Schönau E. , Rehberg M.
Published: April 2018

Primäre Erkrankungen des Skelettsystems (z. B. Osteogenesis imperfecta, idiopathische, juvenile Osteoporose) sind im Kindesalter selten. Frakturen dagegen treten häfig auf. Zunehmend sind Erkrankungen, welche sekundär mit einer erhöhten Frakturneigung einhergehen, wie zum Beispiel chronische, entzündliche und immobilisierende Erkrankungen. Die Aufgabe des Kinderarztes ist es, Kinder mit primären Knochenerkrankungen zu erkennen, sowie gegebenenfalls ein sekundär erhöhtes Frakturrisiko bei schweren und chronischen Grunderkrankungen nachzuweisen, um es adäquat therapieren zu können.

Die Knochendichte beziehungsweise die Knochenmasse sind Surrogatparameter für die Knochengesundheit in diesen Situationen. Wir stellen im vorliegenden Text Begrifflichkeiten und physikalische Grundlagen der Knochendichtemessung vor, sowie die verschiedenen, in der Pädiatrie gebräuchlichen technischen Methoden zur Messung. Die Goldstandardmethode ist die Dual-energy X-ray absorptiometry (DXA)-Untersuchung. Für diese Methode stellen wir die Besonderheiten bei der Indikationsstellung und der Interpretation der Ergebnisse vor. Abschließend fassen wir die konkreten Empfehlungen der internationalen Gesellschaft für klinische Densitometrie zusammen.
Neue therapeutische Ansätze bei seltenen Skeletterkrankungen im Kindesalter
Authors: Rehberg M. , Stark C. , Semler O. , Hoyer-Kuhn H.
Published: April 2018

Die Diagnose und Therapie seltener Erkrankungen im Kindes- und Jugendalter nimmt zunehmend einen großen Stellenwert in der pädiatrischen Praxis ein. Die hohe Anzahl seltener Erkrankungen mit jeweils nur einzelnen Betroffenen stellt eine besondere Herausforderung an die alltäglichen Versorgungsstrukturen dar. Durch die detaillierte Entschlüsselung der jeweiligen genetischen und pathophysiologischen Grundlage vieler der monogenetisch bedingten seltenen Erkrankungen ist es jedoch in den letzten Jahren gelungen, gezielte Therapieansätze zu entwickeln, welche derzeit in der klinischen Erprobung sind. Aktuell werden Studien im Kindes- und Jugendalter bei Patienten mit Achondroplasie, Osteogenesis imperfecta, Hypophosphatasie, hypophosphatämischer Rachitis und Fibrodysplasia ossificans progressiva durchgeführt. Die zugrunde liegenden genetischen Veränderungen, deren pathophysiologische Auswirkungen bis hin zum translationalen Therapieansatz werden in dieser Übersichtsarbeit schematisch dargestellt.
Seltene Ursache für sekundäres Fanconi-Syndrom
Authors: Terliesner N. , Beblo S. , Arélin M. , Abou Jamra R. , Dittrich K. , Schitke J.
Published: April 2018

Der Sohn konsanguiner syrischer Eltern war ab Säuglingsalter mit einem großem Bauch und einer Gedeihstörung aufgefallen. Es bestanden Polydipsie, primäre Harninkontinenz sowie eine ausgeprägte Obstipation mit Enkopresis. Auf der Flucht nach Deutschland erlitt er nach geringen Traumata Frakturen beider Oberschenkel. Bei der Erstvorstellung mit sieben Jahren zeigte sich ein stark kleinwüchsiger, blonder Junge mit fehlenden oberen Schneidezähnen, massiven Rachitiszeichen und ausgeprägter Hepatomegalie. Laborchemisch bestanden eine metabolische Azidose und Hypophosphatämie bei Hyperphosphaturie, Hyperkalziurie, Ketonurie, Glukosurie, Mischproteinurie und Aminoazidurie. Klinisch bestand der Eindruck einer „Speichererkrankung“ mit gestörter Tubulusfunktion. Eine ausführliche Stoffwechseldiagnostik sowie Biopsien von Niere und Leber führten nicht zur Diagnosestellung. Eine molekulargenetische Untersuchung sicherte schließlich ein Fanconi-Bickel-Syndrom durch den Nachweis einer homozygoten, pathogenen Variante im SLC2A2-Gen.
Neonatal Outcomes Based on Duration of Exposure to Antenatal Corticosteroids in Indicated Preterm Deliveries
Authors: Kuper Spencer , Dimperio Lisa , Tita Alan , Biggio Joseph , Harper Lorie , Cawyer Chase
Published: April 2018

Objective To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries.

Study Design This is a retrospective cohort of all indicated singleton preterm deliveries (23–34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death. Analyses were stratified by delivering gestational age (230/7–276/7, 280/7–316/7, and 320/7–336/7 weeks). Multivariate logistic regression refined point estimates and adjusted for confounders.

Results In total, 301 women delivered >48 hours after initial ACS dose, 230 delivered within 2 to 7 days, and 71 delivered >7 days. Infants with an interval of >7 days had no significant increase in the unadjusted composite neonatal outcome (p = 0.42), but when adjusted, the composite neonatal outcome (adjusted odds ratio [AOR]: 2.7; 95% confidence interval [CI]: 1.18–6.31) and neonatal death (AOR: 4.20; 95% CI: 1.39–12.69) were significantly increased with an ACS interval of >7 day.

Conclusion In this cohort, the benefit of ACS diminished >7 days after administration, particularly when delivery occurred at <32 weeks.
Sarkopenie
Authors: Jakob F. , Sieber C. , Kemmler W.
Published: April 2018

Sarkopenie ist eine altersassoziierte Erkrankung, deren Prävalenz mit der zunehmenden Lebenserwartung ansteigt. Der Verlust an Muskelmasse und Funktion geht mit einer erhöhten Mortalität und mit einem hohen Risiko der Behinderung und der Hospitalisierung einher. Die Angaben über die Häufigkeit in selbstständig lebenden Populationen sind sehr inkonsistent. Wichtige Risikofaktoren sind genetische/epigenetische Faktoren, Immobilisation, Fehlund Mangelernährung, Hormonmangelzustände, chronische Entzündung und ein Anstieg der inhibitorischen Faktoren der Geweberegeneration. Trotz hoher Forschungsintensität und intensiver Diskussion in Konsensus-Konferenzen über die diagnostischen Kriterien besteht noch keine einheitliche Definition der Sarkopenie. Eine ganze Reihe von Interventionsstrategien werden klinisch getestet. Trainings-Regimes, Ernährungsprogramme, Hormonersatztherapien und pharmakologische Ansätze mit anabolen Prinzipien wie SARMs, Ghrelin/Wachstumshormon und Myostatin-Antagonisten sind in der klinischen Evaluationsphase. Aus den wenigen bereits publizierten Studienergebnissen wird deutlich, dass Trainingsprogramme und Medikamente ein hohes Potenzial haben. Nicht wenige Studien zeigen aber über die Verbesserungen der Surrogatparameter hinaus keine eindrucksvollen Funktionsverbesserungen. Zukünftige Strategien müssen multimodale Interventionen zum Inhalt haben und im Design verbessert werden.
Das Problem der Osteitis bei der periprothetischen Gelenkinfektion
Authors: Schmolders J. , Zillekens A. , Strauss A. , Hischebeth G. , Randau T. , Gravius S. , Wirtz D.C. , Koob S.
Published: April 2018

Die Therapie der periprothetischen Osteitis im Rahmen einer Endoprotheseninfektion ist nicht nur ein Determinant der vollständigen Sanierung des Situs, sondern auch ein entscheidender Faktor für die Auswahl und Stabilität des Revisionsimplantats. Nach einer nur eingeschränkt möglichen präoperativen bildmorphologischen Detektion von osteitischen Arealen im periimplantären Gewebe ist die gründliche und vor allem radikale Resektion von avitalen, biofilmtragenden Knochensequestern die Grundlage für eine nachhaltige Keimfreiheit des Prothesenlagers. Des weiteren zählen ein adäquates Totraummanagement, z. B. durch antibiotikatragende Spacer, und die hochkonzentrierte systemische Antibiose zu den Grundpfeilern der Osteitistherapie. Der vorliegende Artikel beschreibt die zugrundeliegende Pathophysiologie, bildgebende Diagnostika im Osteitisnachweis und gibt einen Einblick in die zuvor genannten Therapiegrundsätze.
Zu guter Letzt: Ein Scharfrichter mit orthoädischen Kenntnissen
Authors: Beaumont Gernot
Published: April 2018

Eines Nachts in den späten 1730er-Jahren klopfte ein ungewöhnlicher Besucher an eine Nebenpforte des imposanten Hauses des Festungskommandanten der preußi- schen Stadt Stettin. Der Besucher war kein anderer als der Scharfrichter der Stadt ...
Annual survival estimates and risk of fluoroacetate (1080) secondary poisoning for New Zealand falcons (Falco novaeseelandiae) in a managed exotic forest
Authors: Horikoshi Chifuyu , Battley Phil F. , Minot Edward O.
Published: April 2018

Context The risk of secondary poisoning to native fauna during pest control operations is an issue of global concern. In New Zealand, non-target impacts during sodium fluoroacetate (1080) operations are particularly contentious. 1080 is used extensively for pest control for conservation, bovine tuberculosis control, and in plantation forestry for seedling protection from herbivores. The endemic New Zealand falcon (Falco novaeseelandiae) breeds in Kaingaroa forest, an intensively managed pine plantation where regular 1080 poison operations are conducted; however, causes of mortality and risks of secondary poisoning by 1080 are not well documented. Aims We aimed to investigate mortality and survival of adult falcons with an emphasis on assessing the possible role of 1080 poisoning in annual mortality. Methods Using radio-telemetry and visual observations, we monitored 37 marked adult falcons before and after 1080 operations in 2013–14 (16 through carrot-bait and 21 through cereal-bait operations) and assessed mortality causes through post-mortem examinations. Using Program MARK, the annual survival rates for adults and independent juveniles were estimated from long-term banding data (2003–2014). Key results Survival of falcons was high through both cereal-bait (21/21) and carrot-bait (15/16) 1080 operations (overall 95% CI for survival = 84–100%). The exception was a radio-tagged male that died of unknown causes within a fortnight of an operation and tested negative for 1080 residues. Three falcons were depredated by introduced mammals. One falcon was found dead in an emaciated condition but evidently died from head injury through Australasian magpie (Cracticus tibicen) attack. The annual survival rate of falcons estimated from long-term banding was 80 ± 6.0% (mean ± s.e.) for adults and 29 ± 0.1% for juveniles. Conclusions No adult falcon death was attributable to 1080 poisoning in this study. Identifiable mortalities were attributable to depredation by introduced mammals and an injury from an Australasian magpie. The annual survival rate of Kaingaroa falcons was comparable to those of other raptor species worldwide. Implications The risk to adult falcons from 1080 secondary poisoning is likely low. Whether this is also true for juveniles requires further study.
Maternal Cardiac Arrest: Where is Our Data Coming From? [4A]
Authors: Shields Andrea D. , Battistelli Jacqueline , Thomson Brook , Hutchison Brian , Nielsen Peter
Published: April 2018

INTRODUCTION:

Maternal Cardiac Arrest (MCA) is a rare event that is estimated to affect 1 in 12,000 admissions in the United States. We surveyed national databases and registries in the United States for in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA), defined by pregnancy or postpartum status.

METHODS:

We reviewed data dictionaries of 8 separate national registries for IHCA, OHCA and maternal deaths, searching for maternal indicators (pregnancy, pregnancy within 42 days, pregnancy within 1 year).

RESULTS:

The largest databases for OHCA in the United States, Cardiac Arrest Registry to Enhance Survival (CARES) and The Resuscitation Outcomes Consortium (ROC) Epistry, do not track pregnant/postpartum data. The National Emergency Services Medical Information System (NEMSIS) database, the largest EMS database in the country on OHCA, tracks pregnancy/childbirth but not postpartum status. Get With the Guidelines ® -Resuscitation, formerly the National Registry for Cardiopulmonary Resuscitation (NRCPR), is the largest database on IHCA and only tracks pregnancy data in relation to neonatal outcome and contraindication for hypothermia. The National Inpatient Sample of the Agency for Healthcare Research and Quality (NIS) includes both pregnancy/postpartum status, although collection of data varies by state. The pregnancy morality surveillance system (PMSS), and the National Vital Statistics both include pregnancy/postpartum data, although data collection is limited deaths during pregnancy.

CONCLUSION:

Current national surveillance of IHCA and OHCA do not consistently account for pregnancy and postpartum status. Standardization of all databases to include pregnancy and postpartum status up to 1 year will allow policymakers better access to performance, trends and outcomes in MCA.
Impact of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on Preterm Birth [6A]
Authors: Chavan Niraj R. , McDaniel Honour , Williams Corrine M.
Published: April 2018

INTRODUCTION:

This study was undertaken to evaluate the differential impact of pre-pregnancy body mass index (PPBMI) and gestational weight gain (GWG) on preterm birth (PTB).

METHODS:

Vital statistics (birth) data collected by the National Center for Health Statistics (NCHS) was utilized. Using the 2015 data for singleton gestations, GWG was calculated and PPBMI was categorized as per WHO guidelines. Each PPBMI category was further stratified based on the adequacy of GWG - into inadequate, adequate and excess GWG subgroups using the 2009 IOM guidelines. Multivariate logistic regression analyses were used to predict the risk for preterm birth (<37 weeks) in each PPBMI and GWG group while adjusting for age, race, education, marital status, insurance and smoking status.

RESULTS:

The rate of preterm birth was noted to be 7.65% (276,820/3,619,295 deliveries). In comparison to women with adequate GWG, those with inadequate GWG [OR = 1.637 (95% CI 1.621 – 1.653)] had an overall increased risk for PTB across all PPBMI categories. Specifically, inadequate GWG was noted to increase the risk for PTB in normal weight [OR = 1.976 (95% CI 1.948 – 2.004)], underweight [OR = 2.384 (95% CI 2.286 – 2.486)], overweight [OR = 1.435 (95% CI 1.404 – 1.468)] and obese women [OR = 1.161 (95% CI 1.138 – 1.185)] as compared to women in the matched PPBMI categories with adequate GWG in the adjusted regression analyses.

CONCLUSION:

In this cohort, weight gain outside of the IOM recommendations was noted to significantly impact the risk for PTB across all PPBMI categories.
Prediction of Spontaneous Vaginal Delivery in Women with Prolonged Second Stage of Labor Undergoing TOLAC [11A]
Authors: Gimovsky Alexis , Amdur Richard , Macri Charles , Ahmadzia Homa
Published: April 2018

INTRODUCTION:

To develop a prediction model for spontaneous vaginal delivery (SVD) in women with prolonged second stage (PSS) of labor undergoing a trial of labor after cesarean (TOLAC).

METHODS:

Secondary analysis of the MFMU Cesarean Registry. Inclusion criteria: term, singleton gestation, TOLAC, no prior vaginal delivery, who reached 10 cm cervical dilation. Women with PSS (≥3 hours with epidural or ≥2 hours without epidural) were compared to women with a normal second stage. Primary outcome: development of a model for predicting SVD. Univariate analysis, multivariable logistic regression were used to examine independent association of PSS with outcomes. A simple risk score was created using the regression model to calculate maximum likelihood estimates of probabilities for each subject. The association of probability quintile with incidence of SVD was examined.

RESULTS:

There were 364 women with PSS with epidural and no women with PSS without epidural anesthesia; therefore analysis was conducted only for women with epidurals. SVD occurred in 96 cases (26.4%). In univariate analyses, SVD was associated with birth weight, insurance, indication for previous cesarean and male sex. The multivariate model predicting SVD, showed no independent predictors. The simple risk score was calculated. Incidence of SVD was 13.9% in the lowest risk quintile and 42.5% in the highest risk quintile. Risk quintile based on the prediction model was significantly associated with SVD (p = 0.006).

CONCLUSION:

A prediction model for SVD in women with singleton gestation undergoing TOLAC with PSS and epidural may be useful to clinicians facing decisions regarding delivery.
Pelvic Floor Dysfunction after Prolonged Second Stage of Labor [12A]
Authors: Gimovsky Alexis , Amero Molly , Phillips Jaclyn , Levine Jordan , Berghella Vincenzo
Published: April 2018

INTRODUCTION:

To evaluate whether extending the length of labor in nulliparas with prolonged second stage (PSS) affects the incidence of self-reported pelvic floor dysfunction.

METHODS:

Planned follow up survey to our randomized controlled trial of PSS using the Pelvic Floor Distress Inventory- 20 (PFDI-20): composed of the Pelvic Organ Prolapse Distress Inventory (POPDI-6), Colorectal-Anal Distress Inventory (CRADI-8) and Urinary Distress Inventory (UDI-6). Primary outcome: PFDI-20 summary score. Secondary outcomes: POPDI-6, CRADI-8, UDI-6 scores. Inclusion criteria: nulliparas, singleton gestation, 36.0 - 41.6 weeks, PSS. Women surveyed were previously enrolled in a study that assigned them randomly to extended labor (EL)- at least 1 additional hour in the 2nd stage, or to usual labor (UL)- expedited delivery via cesarean/operative vaginal delivery at the diagnosis of PSS. Women were surveyed at 12 - 36 months postpartum.

RESULTS:

Survey response rate was 43.6% (34/78). Maternal demographics were similar between groups. PFDI-20 summary score was 13.8 ± 23.3 in the EL and 13.1 ± 20.9 in the UL group (p = 0.9). POPDI-6 was 1.2 ± 2.9 in the EL group and 2.7 ± 6.4 in the UL group (p = 0.4). CRADI- 8 was 0.8 ± 2.8 in the EL group and 2.1 ± 4.0 in the UL group (p = 0.6). UDI- 6 was 11.8 ± 21.1 in the EL group and 8.3 ± 14.5 in the UL group (p = 0.6).

CONCLUSION:

Extending the length of labor in nulliparas with singleton gestation and PSS did not have an impact on PFDI-20 scores at 12-36 months postpartum.
Placental Pathology: Useful for Undiagnosed Small for Gestational Age Neonates? [14A]
Authors: Leftwich Heidi , Novak Brittany , Masiero Jessica , Nicasio Erica , Leung Katherine , Vanguri Vijay
Published: April 2018

INTRODUCTION:

Up to 75% of babies born growth restricted were undiagnosed prior to delivery. Certain placental changes have associated with growth restriction. Our objective is to determine if these changes are increased in cases with ultrasound estimated fetal weight (EFW) 10-20%.

METHODS:

Retrospective analysis on singleton placentas from 2011 to 2016. Exclusion criteria were less than 24 weeks’ gestation or EFW <10%, multiple anomalies, known aneuploidy. Primary outcome was decreased placental weight. Secondary outcomes were infarcts, villitis, fibrin deposition, calcium deposition and a composite of outcomes. Pathology reports, ultrasound reports, and the electronic medical records were reviewed. Chi square was used for categorical variables and logistic regression for adjusted analyses.

RESULTS:

1748 ultrasounds had with EFW >10th%. Pregnancies with EFW 10-20% were more likely in women who were younger, nulliparous, had lower BMI, less gestational weight gain, and delivered less than a week earlier (p<0.05). Rates of SGA at birth were also increased (69.2% vs 8.7%, p<0.001). Placental pathology was sent in 35 (37%) of EFW 10-20% pregnancies and 281 (17%) those with EFW>20%. There were more placentas with decreased placental weight in the EFW 10-20% group (p<0.005). There was a trend toward increase in the incidence of infarcts, villitis, no differences in any of the other secondary outcomes, except decreased placental weight and one other placental finding (p=0.005).

CONCLUSION:

Placentas from pregnancies with EFW 10-20% had higher rates of decreased placental weight. No difference found in secondary outcomes, but with small numbers, further research is needed to assess these outcomes.
Genomic Alterations Found in Recurrent Uterine Sarcomas of African-American Women [18A]
Authors: Geisler John , Manahan Kelly , Webb Kathryn , Bryant Allison , Moore Crystal
Published: April 2018

INTRODUCTION:

To describe the frequency of genomic alterations found in tumors from a population of African-American women with recurrent uterine sarcomas

METHODS:

Medical records were analyzed for all African American women with recurrent uterine sarcomas who underwent next generation sequencing of their tumors. Demographics were collected as well as all tumor genomic alterations. Data was evaluated by SPSS to see if any consistent genomic alterations were found.

RESULTS:

Twenty-four African-American women had next-generation sequencing on their recurrent uterine sarcomas with 12 having high-grade leiomyosarcomas (LMS), 11 having carcinosarcomas (MMMT), and one having an undifferentiated uterine sarcoma. The mean age of the patients was 54 years (median 52 years, 95%CI 51.2-57.7). The mean mutation burden/Mb was 6.4 mutations/Mb (median 4.5, 95%CI 1.7-11.1). Nineteen tumors had 1-5 mutations/Mb, 4 had 6-10 mutations/Mb and 1 had >10 mutations/Mb. p53 mutations occurred in the majority of tumors (LMS 66.7%, MMMT 63.6%; respectively). The gene with the second most alterations was PIK3CA (LMS 8.3%, MMMT 45.5%). BRCA2 mutations were the only other genomic alterations to occur in >10% of recurrent uterine sarcomas (LMS 16.7%, MMMT 27.3%).

CONCLUSION:

In this population of African-American women with recurrent uterine sarcomas, the 3 genes found to most commonly harbor genomic alterations were p53, PIK3CA, and BRCA2.
Correlation of Preoperative HgbA1c in Diabetic Patients and Postoperative Outcomes [23A]
Authors: Gelhaus Kelsey
Published: April 2018

INTRODUCTION:

The surgical literature has demonstrated an association between high perioperative HgbA1c and increased surgical morbidity in cardiac surgical procedures. However, there is a lack of information for abdominopelvic surgical procedures. The objective of this study was to determine if there is an association between HgbA1c levels and postoperative complications in diabetic gynecologic oncology patients undergoing laparotomy, and to determine if there is a HgbA1c cut-off at which the postoperative complications increases.

METHODS:

A retrospective cohort study was performed. Preoperative HgbA1c level within 3 months of surgery, as well as other key preoperative, intraoperative and postoperative variables were abstracted. Descriptive statistics were performed on demographic and baseline data. A Student’s t-test was used to determine if there was a difference in HgbA1c between patients who did and did not experience a postoperative complication. Regression analysis was performed to determine if there was a HgbA1c cut-off at which the rate of complications significantly increased.

RESULTS:

113 diabetic gynecologic oncology patients with HgbA1c levels available were identified between 1/1/2009 to 12/30/2013. There was no statistically significant difference in HgbA1c between those who experienced any complication (6.99 vs 6.95; p=0.86), any serious complication (6.90 vs. 7.14; p=0.44) or wound complication (7.0 vs 6.96; p=0.05). A HgbA1c cut-off where the risk of complications increased could not be determined (AUC 0.51, 0.53, 0.49 for any complication, serious complication, wound complication, respectively).

CONCLUSION:

A mildly elevated HgbA1c is not associated with increased postoperative or wound complications, and surgery should not be delayed for patients with a suspected or confirmed malignancy.
Management of Female-to-Male Transgender Patients with Hereditary Gynecologic Cancer Syndromes [26A]
Authors: Palavalli Parsons Lavanya , Pitt Taylor , Spirtos Alexandra , Lea Jayanthi
Published: April 2018

INTRODUCTION:

There are screening guidelines for hereditary gynecologic cancers to aid with prevention and early detection of these cancers, however, there are no clear guidelines for those patients that are transgender. This case report describes management of two distinct female-to-male transgender patients with hereditary cancer syndromes.

METHODS:

The clinical cases were analyzed followed by literature review of transgender patients undergoing screening and management of hereditary cancer syndromes.

RESULTS:

A 28-year-old female-to-male transgender patient presented with a new diagnosis of Lynch Syndrome with a known MLH1 mutation. Secondary to his low socioeconomic status, he had not been able to access transgender health resources. Traditional work up for Lynch syndrome were bypassed secondary to being a vaginal virgin. He was planned for a hysterectomy and bilateral salpingectomy with possible oophorectomy, secondary to the patient not potentially having future resources for hormonal replacement. In contrast, a 19-year-old female-to-male transgender patient presented with a known BRCA 2 mutation. He has been engaged in counseling regarding gender issues and has been receiving testosterone injections since the age of 16. At age 17, he underwent a prophylactic mastectomy for risk reduction. At the age of 18, he underwent laparoscopic hysterectomy and bilateral salpingo-oophorectomy.

CONCLUSION:

This is the first body of research to our knowledge describing management of gynecologic hereditary cancer syndromes in transgender patients. Considerations that need to be taken into account on an individualized basis include the patient’s desire to undergo gender-affirming surgery, resources for obtaining hormonal replacement, future fertility, and comfort level for pelvic exams.