bluuebunny/crossref_metadata_2025 huggingface dataset:
Auf Hochtouren bringen
Authors: Schmidt Sabine
Published: June 2017

Michael Schumacher konnte kürzlich den Ferrari- Fahrer Felipe Massa nicht direkt nach dessen Unfall ersetzen – sein durch einen Motorrad unfall geschädigter Nacken würde den hohen Belastungen derzeitnicht stand halten. Der Formel-1-Sport ist eine enorme Herausforderung für die Fahrer – physiotherapeutische Unterstützung ist für sie unerlässlich.
Statistische Daten grafisch darstellen
Authors: Mehrholz Jan
Published: June 2017

Um Messungen und statistische Berechnungen schnell überblicken zu können, empfiehlt es sich, die Ergebnisse grafisch darzustellen. Welche Werte sich wie abbilden lassen, beschreibt dieser Artikel.
Von Vorschriften, Farben und Feng-Shui
Authors: Grobe Ilka
Published: June 2017

Die Einrichtung einer Physiotherapie-Praxis hat eine große Wirkung auf Stimmung und Wohlbefinden der Patienten. Für eine stimmige Atmosphäre in den Räumen können Sie Innenarchitekten, Ausstattungsfirmen oder Feng-Shui-Berater zu Rate ziehen. Ein Überblick über diese Möglichkeiten und über die Richtlinien, welche es einzuhalten gilt.
Gewebe unter Strom
Authors: Rostalski Walter
Published: June 2017

Elektrotherapie unterstützt Physiotherapie – sinnvoll und effektiv. Sie kann Schmerzen lindern, die Ödemresorption fördern und auf das Vegetativum wirken. Thieme-Autor Walter Rostalski gibt einen Überblick über gängige Stromformen und deren praktische Anwendung am Patienten.
Fast Track – ein neues Therapiemanagement
Authors: Hemmerich Birgit , Spatz Johann
Published: June 2017

Immer mehr sind Physiotherapeuten gefordert, effektiv und wirtschaftlich den Genesungsprozess von Patienten zu beeinflussen. In Kliniken stehen sie mit anderen Berufsgruppen in der Verantwortung, den Tagesablauf der Patienten so zu gestalten, dass alle notwendigen Maßnahmen sinnvoll ineinander greifen. Die Physiotherapeuten der Uniklinik Regensburg nutzten bei der Einführung des Fast-Track-Konzepts für bauchchirurgische Patienten die Chance, sich professionell in standardisierte Behandlungspfade einzubringen.
Aktiv gegen Schmerz und Müdigkeit
Authors: Oetiker-Streit Doris
Published: June 2017

Sie ist schwer zu diagnostizieren. Vor allem Frauen leiden an ihr, und es vergehen oft Jahre, bis Ärzte die Diagnose stellen. Die Rede ist von Fibromyalgie. Lesen Sie, was sich hinter dem Krankheitsbild verbirgt, und wie das aktuelle, interdisziplinäre Therapiekonzept aussieht.
Entwicklung fördern mit Phantasie
Authors: Baumann Elke
Published: June 2017

Psychomotorik – ein Begriff, den jeder kennt. Dennoch können nur wenige Physiotherapeuten genau sagen, wie die Therapie aufgebaut ist und auf welcher Theorie sie basiert. physiopraxis hat recherchiert.
Aus Erfahrung gut
Authors: Hoffmann Simone
Published: June 2017

Zu den großen Fortbildungen für Physiotherapeuten zählt das Bobath-Konzept. Diese Therapierichtung wird vor allem zur Behandlung neurologischer Patienten eingesetzt – Kinder wie Erwachsene. Lesen Sie hier, ob die Fortbildung auch Ihnen Spaß machen könnte. Und informieren Sie sich, wie viel Zeit und Geld Sie investieren müssen, wenn Sie das Zertifikat zum Bobath-Therapeuten erwerben wollen.
Den Lymphgefäßen auf der Spur
Authors: Rösler Wiebke
Published: June 2017

„Fortbildung in MLD erwünscht.” Physiotherapeuten stoßen in vielen Stellenanzeigen auf diese Formulierung. Die manuelle Lymphdrainage scheint im physiotherapeutischen Behandlungsspektrum immer wichtiger zu werden. Ob das so ist, wo man sich fortbilden kann und dass es verschiedene Richtungen der Lymphdrainage gibt, analysiert der Fortbildungsführer.
Haltung bitte!
Authors: Vetter Christine
Published: June 2017

Der Patient klagt über Rückenschmerzen, doch der Therapeut behandelt primär im Bereich der Hände und Füße. Denn die Region, in der sich Schmerz bemerkbar macht, ist nach dem Brügger-Konzept nicht unbedingt identisch mit der Region, in der er entsteht. Lesen Sie, was Brügger lehrt, welche Philosophie dahinter steht und wie man die Methode lernt.
Kranke Zellen in Schuss bringen
Authors: Bringmann Wolfgang
Published: June 2017

Lasertherapie als zweites finanzielles Standbein? Denkbar, denn Therapeuten können sie auch unabhängig von der ärztlichen Verordnung anwenden. Sie ist schonend, wirksam und erweitert das Therapiespektrum.
Wenn der Körper zum Gefängnis wird
Authors: Watzek Ina
Published: June 2017

Meist fängt es mit einer Schwäche in den Händen oder Armen an. Später ist der ganze Körper davon betroffen. Amyotrophe Lateralsklerose (ALS) ist eine unaufhaltbare Krankheit. Zirka 6.000 ALS-Kranke gibt es in Deutschland, und jedes Jahr kommen ein bis zwei Menschen pro 100.000 Einwohner dazu. Physiotherapie ist ein wichtiger Baustein der Therapie. Denn sie hilft den Patienten, im Alltag zurecht zu kommen.
Ein Land im Aufbruch
Authors: Neumann Sabine
Published: June 2017

Trotz Ostblock-Historie – Lettland ist keineswegs rückständig, was die Physiotherapie betrifft. Ganz im Gegenteil: Ende 2004 feierte die Stradins Universität von Riga das zehnjährige Bestehen des Bachelor- Studiengangs Physiotherapie. Physiotherapiestudenten der FH Osnabrück besuchten den baltischen Staat.
Weber A, B und C funktionell behandeln
Authors: Münzing Christian
Published: June 2017

Zu den häufigsten Frakturen der unteren Extremität gehören Sprunggelenkfrakturen. Um die Patienten optimal zu behandeln, sollten Physiotherapeuten über Verletzungsmechanismen, Operationsart und biomechanische Konsequenzen Bescheid wissen. Auch wichtig: Kenntnisse über die Phasen der Wundheilung. Alle wichtigen Fakten hat Physiotherapeut Christian Münzing für Sie zusammengefasst.
Wenn Lassie lahmt und Hasso humpelt
Authors: Schwarze-Eicker Katja
Published: June 2017

Die meisten Physiotherapeuten haben Menschen als Patienten. Aber auch Tiere werden krank und profitieren von Physiotherapie. Vierbeiner als Patienten – eine interessante Alternative für Tierfreunde, zumal die Behandlung von Hunden und Pferden unabhängig ist von ärztlicher Verordnung und Gebührensätzen.
Oxygen Saturation in Pulse Oximetry in Hemoglobin Anomalies
Authors: Zur B. , Bagci S. , Ludwig M. , Stoffel-Wagner B.
Published: June 2017

Pulse oximetry is an essential diagnostic method in pediatric emergency medicine and pediatric intensive care. However, if undetected hemoglobin anomalies are the underlying cause measurements of low oxygen saturation can be interpreted incorrectly or may lead to unnecessary examinations. In 2 recently discovered hemoglobin anomalies, Hb Bonn and Hb Venusberg, this resulted in extensive and repeat cardiopulmonary examinations. This review aims to provide an overview of hemoglobin anomalies causing low oxygen saturation.

We describe the methods required for differential diagnosis of hemoglobin anomalies, such as hemoglobin electrophoresis, High Performance Liquid Chromatography, hemoglobin gene sequencing and spectral photometry, and the difficulties with the interpretation of results. Furthermore, with a review of the literature we provide an extensive overview of hemoglobin anomalies which result in low oxygen saturation measurement in pulse oximetry. With the examples of Hb Bonn, a novel hemoglobin mutation of the proximal α1-globin, which results in false low pulse oximetry measurements of oxygen saturation, and Hb Venusberg, a low oxygen-affine hemoglobin mutation of the β-globin, we highlight the difficulties arising from the respective case histories.

In pediatric medicine, hemoglobin anomalies must be included in the diagnosis as a possible underlying cause of low oxygen saturation in case of ambiguous or conflicting pulse oximetry findings.
Hemostaseological Management of Urological Operations in Patients Taking Aspirin Using the Thrombostat 4000
Authors: Ulshöfer Berthold , Dorst Vera , Kretschmer Volker , Köhl Horst , Riedmiller Hubertus
Published: June 2017

A clinical study was started in order to examine the suitability of the Thrombostat (in vitro bleeding test) (IVBT) as a diagnostic tool to prevent perioperative bleeding due to aspirin (ASA) and/or platelet function disorders of other origins. This report is based on preliminary data. Eighty three patients who had ingested ASA in the last two weeks and/or with a history of bleeding and/or documented hemorrhagic disorders requiring distinct urological operations, were included in the study. In all patients the IVBT with CaCl2 , in addition to common coagulation tests, were performed. Thirteen patients stopped ASA ingestion until IVBT became normal and did not show any increased bleeding tendency. The residual patients were classified by the various operations. The following operation groups were formed: Male genitals (n = 11), inguinal/suprapubic operations (n = 7), transurethral tumor resections of the bladder (TURB) (n = 17), transurethral prostate resection (TURP) (n = 12), tumor nephrectomy (n = 8), radical prostatectomy (n = 9). Thirty six patients with a history of ASA use, but normal IVBT, served as control group (C). Thirty one patients with a history of ASA ingestion had normal in vivo bleeding times (BT) and abnormal IVBT with CaCl2 (A). Seven patients had a bleeding history and/or documented hemorrhagic disorders (B). None of the patients (A) with abnormal IVBT but normal BT displayed clinically relevant bleeding. However, the blood loss was somewhat higher compared to the controls (C), especially in patients with TURB and radical prostatectomy (not significant). The only real bleeding complication occurred in an ASA patient (TURB), who was subjected to surgery by error. Anesthesia had already started, when abnormality of BT (>15 min) and IVBT (m“infinite ”) were measured. Operative revision was necessary and revealed that the blood loss (>3 L) was based on diffuse microvascular bleeding. The majority of the patients with a bleeding history and/or documented hemorrhagic disorders (B) showed an increased bleeding tendency, which could be managed without relevant blood loss, except in two patients, one with factor XIII deficiency (25%) and ASA intake, and the other with undetected mild congenital platelet disorder (storage pool disease?). The IVBT proved suitable as screening test for platelet function disorders. Major bleeding complications could be prevented by its use. A history of low-dose ASA ingestion without prolongation of BT, but abnormal IVBT, also seemed to increase the bleeding tendency; however, the clinical relevance has to be demonstrated by an extended clinical study.
Preoperative Evaluation of Primary Hemostasis in Patients with Thrombocytopenia Using the Thrombostat 4000
Authors: Edsfors Åleskog Anna , Killander Andreas , Olsson Karin , Eriksson Lars , Kristensen J
Published: June 2017

It is difficult to estimate the risk of hemorrhage that may follow an invasive or surgical procedure in patients with thrombocytopenia or platelet dysfunction. Conventional functional tests for the evaluation of primary hemostasis have been questioned. We have evaluated the in vitro bleeding time (IVBT) using the Thrombostat 4000 in 25 patients with thrombocytopenia in order to estimate the risk of bleeding following an invasive or surgical procedure. Using the IVBT, it was possible to suggest and evaluate preoperative treatment in order to restore primary hemostasis. All patients studied had their operations without bleeding complications. From these observations we conclude that the IVBT is a convenient and useful tool in the evaluation of primary hemostasis in these patients.
Quality Control of Platelet Concentrates by the Thrombostat 4000
Authors: Böck Markus , Groh Joachim , Glaser Anle , Storck Klaus , Kratzer Michael , Böck Markus , Heim Marcell
Published: June 2017

Quality control of platelet concentrates (PC) is an important prerequisite for good transfusion praxis. However, direct measurement of platelet function is complex, since available methods (e.g. aggregometry, serotonin release) are time consuming and require special equipment. Therefore a test system is needed, which is easy to handle, fast, and achieves reliable results. The present paper compares the results of conventional platelet function tests with those of a modified in-vitro bleeding test (IVBT) (Thrombostat 4000) in liquid-stored and cryopreserved PCs. A high correlation between aggregometry, serotonin release, GMP 140 expression upon stimulation, and IVBT was demonstrated. Therefore IVBT seems to be a good alternative to the conventional platelet function tests for quality control of PCs. In addition, a good correlation between the results of IVBT of patients’ blood after PC transfusion and IVBT of patients blood before transfusion supplemented with platelets of the respective PC could be found. Therefore IVBT seems to be able to predict PC transfusion success. However, since these data were obtained in a small sample undergoing bone marrow transplantation, further studies are needed to verify this hypothesis.
Preliminary Data from a Field Trial of the PFA-100™ System
Authors: Mammen Eberhard , Alshameeri Rasheed , Comp Philip
Published: June 2017

The PFA-100™ system *(Dade International Inc., Miami, FL) is a platelet function anaIyzer, the design of which is based on the technology of the Thrombostat 4000 VDG, Seeon, Germany. † It was developed to measure primary, platelet dependent hemostasis in citrated whole blood in vitro. A first pilot study was conducted with the instrument to assess performance characteristics. Healthy subjects (normals) who had not ingested any medications, and patients (abnormals) with primary, platelet-related hemostasis defects, which included users of aspirin, were studied with two test cartridges; collagen/ADP and collagen/epinephrine. Before the study certain variables were tested that ascertained that blood drawn into either 3.8% or 3.2% sodium citrate containing vacutainers (rather than syringes) could be used for testing. Tests must be performed within a five-hour time span from drawing to testing, and blood must be kept at room temperature. Normal reference values were 77–133 seconds closure times for collagen/ADP and 98-185 seconds for collagen/ epinephrine. Precision testing revealed a CV of >10% for within-day and between-day (five days) analyses on collagen/ADP cartridges and a CV of 5–14% for both runs on the collagen/epinephrine cartridges. No clinically important differences were found between measurements in the two positions of the instrument, although one follows the other. Tests on 99 normals and 70 abnormals were performed and data expressed as receiver/operator characteristics (ROC) curves that assess the combined sensitivity and specificity of a procedure. An area under the curve of 1.0 means that all samples (normals + abnormals) were accurately identified; a value of 0.5 indicates that the test is noninformative. Using collagen/ADP cartridges a value of 0.76 was found when testing 99 normals and 52 abnormals. All aspirin users had been omitted from the abnormals. With the collagen/epinephrine cartridges, evaluating 99 normals and 70 abnormals, a value of 0.89 was obtained. This analysis entailed also aspirin users. Of 24 known aspirin users the collagen/epinephrine cartridges identified 20 that had normal closure times with the collagen/ADP cartridges. Three aspirin users had abnormal values with both cartridges, one subject was normal with both. When the traditional Ivy bleeding times were plotted as an ROC curve, an area under the curve of 0.698 was found. The data suggest that the PFA-100™ system identifies normals and abnormals (subjects with primary, platelet related hemostasis defects) with greater sensitivity and specificity than the present widely used bleeding time. The instrument is easy to use and could be adapted to routine laboratory use. The data presented are preliminary and need to be confirmed by additional testing.

†Not commercially available in the U.S.A.
Wenn Patienten Noten geben – Arztbewertungsportale im Internet
Authors: Hartmann Dirk
Published: June 2017

Auch Ärztinnen und Ärzte können den sozialen Netzwerken im Internet nicht mehr entkommen. In speziellen Online-Portalen wird ihre Leistung von Patienten bewertet. Doch was tun, wenn Bewertungen zur Schmähkritik werden?
Schwerpunkte der Nachsorge und Langzeiterfolg nach der Katheterablation des Vorhofflimmerns
Authors: Gaspar Thomas , Piorkowski Christopher , Strasser Ruth
Published: June 2017

Übersicht
Hamartomatous Polyps and Associated Syndromes
Authors: Cone Molly
Published: June 2017

Hamartomatous polyps of the gastrointestinal tract can occur sporadically, however, for several hereditary syndromes, their presence is one of the major clinical features. Peutz–Jeghers syndrome, juvenile polyposis syndrome, and the PTEN hamartoma syndromes are autosomal dominant inherited disorders that predispose to formation of such polyps, especially in the colon and rectum. These can lead to increased colorectal cancer risk and should be followed and managed appropriately. In this article, the three major hereditary hamartomatous syndromes are described, including presentation, colorectal surveillance, and management.
Can Mean Platelet Volume Be Used as a Predictor of Vascular Disease? Problems and Pitfalls
Authors: Laffan Mike , Arachchillage Deepa
Published: June 2017

Platelets play a pivotal role in both hemostasis and thrombosis. Increased platelet volume has several etiologies and may be secondary to a genetic variant, platelet activation, increased platelet turnover, or in response to inflammatory stimuli. There are several hereditary syndromes in which an increased mean platelet volume (MPV) occurs in association with a reduction in platelet number and function. An acquired increase in platelet size is often associated with increased platelet reactivity, shortened bleeding time, and increased platelet aggregation. Many studies have shown that high MPV is associated with increased risk of venous and arterial thrombosis, but genome-wide association analyses found a weak inverse association between the risk of coronary heart disease and MPV. The disease associations of MPV suggest that it could provide a useful contribution to risk assessment algorithms for both venous thromboembolism and arterial thrombosis. However, owing to the problems associated with reliably assessing MPV, it does not yet constitute a practically useful biomarker for this purpose. Before MPV can be adopted for wider clinical use, the methodological problems involved in obtaining accurate and interlaboratory comparable results must be resolved. In particular, a major degree of standardization is required, as are local reference ranges calculated with respect to specified time intervals from venipuncture to laboratory analysis. We discuss here the potential role of MPV in predicting the risk of acquired thrombotic disorders in addition to roles in congenital thrombocytopenic disorders, as well as the problems and pitfalls associated with use of MPV in these settings.
Inferior Vena Cava Agenesis and Deep Vein Thrombosis in the Young: A Review of the Literature and Local Experience
Authors: Cannavacciuolo Francesca , Gianno Adriana , Cerbone Anna , Mangiacapra Sara , Coppola Antonio , Amitrano Maria , Tufano Antonella
Published: June 2017

Congenital agenesis of the inferior vena cava (AIVC) is a rare vascular abnormality with a prevalence of 0.0005 to 1% in the general population. This condition is found in almost 5% of young patients (younger than 30 years) with proximal, typically bilateral, deep venous thrombosis (DVT) of the lower limbs, often in the absence of apparent risk factors. However, AIVC in young patients with DVT is probably underestimated because AIVC cannot be detected by the standard DVT diagnostic workup. Inherited thrombophilia has been reported in patients with AIVC-associated DVT, as an additional risk factor, but its role is poorly investigated. The best therapeutic strategy and the optimal duration of anticoagulant treatment of DVT in patients with AIVC are still unclear. Here, we describe 14 young patients (2 females and 12 males, mean age at first DVT: 27.8 ± 10.1 years), with color Doppler ultrasound (US) and abdominal computed tomography scan confirmed AIVC-associated DVT and discuss their characteristics in the framework of a literature review on this topic. Our patients were mainly males (10/12) and experienced proximal DVT events, not complicated by pulmonary embolism. DVT-precipitating factors were detected only in five cases, the two female patients (oral contraceptives and puerperium), and three male patients (one after leg fracture and two after abdominal surgery). Thrombophilic abnormalities were found in eight patients (heterozygous factor V Leiden mutation, n = 3; mild/moderate hyperhomocysteinemia, n = 3; reduced protein C activity, n = 1; antiphospholipid syndrome, n = 1). The majority of patients (13/14) were treated with long-term oral anticoagulant therapy and elastic stockings (ES), with a very low rate of DVT recurrence (1/14, mean follow-up 7 years). These clinical characteristics were largely consistent with those of 161 patients identified by review of the literature. On the whole, although many aspects are still poorly known, our case series and literature review suggest that a search should be undertaken for AIVC in young patients with proximal idiopathic, particularly when bilateral, DVT, which should then be treated with prolonged anticoagulation and ES.
Phytotherapeutische Beratung von Rheumapatienten in der Apotheke
Authors: Pönitz Melanie , Michael Sebastian
Published: June 2017

Die Beratung von Patienten, deren Leiden dem rheumatischen Formenkreis zuzuordnen sind, ist in der Apotheke Tagesgeschäft. An erster Stelle stehen Fragen zur Verträglichkeit der ärztlichen Therapie. Wichtige Ziele einer zusätzlichen phytotherapeutischen Behandlung sind die Reduzierung von (Langzeit-) Nebenwirkungen und Dosierungen sowie eine Verlangsamung des Fortschreitens der Erkrankung bzw. eine Reduktion von Schubstärke und -häufigkeit. Idealerweise erfolgt jegliche Intervention in Absprache oder Kenntnisnahme durch den behandelnden Arzt.
Die Rechtsfrage: Kann ich einer Klientin mit Kleptomanie nach Diebstahl in meiner Praxis ein Hausverbot erteilen?
Authors: Pitz Andreas
Published: June 2017

„Eine Klientin mit einer Persönlichkeitsstörung ist Kleptomanin. Bisher beaufsichtigten wir sie bei ihren Terminen in unserer Praxis. Nun kam sie eine Stunde früher und bestahl eine andere Klientin im Wartebereich. Es wurde Anzeige erstattet, und die Polizei kam. Darf ich der Klientin ein Hausverbot aussprechen – das Haus gehört mir – oder muss ich sie weiter behandeln?”

Michael Schiewack aus Kamenz
Efficacy of delaying cotton defoliation to mitigate compaction risk at wet harvest
Authors: Roberton Stirling D. , Bennett John McL.
Published: June 2017

A recent rapid change in the cotton harvesting system has increased the risk of soil compaction within the cotton industry with the inception of the John Deere 7760 cotton harvester, a round-bale module builder that weighs >36 Mg. This project involved a novel approach to reducing the risk of soil compaction, whereby cotton defoliation was delayed at times of high field moisture so that the evapotranspiration demands of the crop could be used to dry down the soil profile and consequently reduce the compaction risk at harvest. A field trial at Aubigny, Queensland, was used to evaluate the merit of the proposed management strategy in the 2014–15 growing season, in conjunction with a modelling approach to assess the long-term effectiveness of the strategy in several Australian cotton-growing regions. Although the proposed strategy did reduce the compaction risk, the risk reduction was insufficient for the strategy to be deemed effective. Nonetheless, a strong correlation was found between small changes in soil moisture and changes in observable compaction. An observed 10% increase in soil bulk density after traffic suggested damage to soil pore networks. Furthermore, the depth of compaction was observed well beyond the feasible cultivation depth (to 80 cm).
Network dynamics of social influence in the wisdom of crowds
Authors: Becker Joshua , Brackbill Devon , Centola Damon
Published: June 2017

Significance

Since the discovery of the wisdom of crowds over 100 years ago theories of collective intelligence have held that group accuracy requires either statistical independence or informational diversity among individual beliefs. Empirical evidence suggests that allowing people to observe the beliefs of others leads to increased similarity of individual estimates, reducing independence and diversity without a corresponding increase in group accuracy. As a result, social influence is expected to undermine the wisdom of crowds. We present theoretical predictions and experimental findings demonstrating that, in decentralized networks, social influence generates learning dynamics that reliably improve the wisdom of crowds. We identify general conditions under which influence, not independence, produces the most accurate group judgments.
Horizontal ground reaction forces to stationary running performed in the water and on dry land at different physiological intensities
Authors: Alberton Cristine Lima , Pinto Stephanie Santana , Nunes Gabriela Neves , Rau Douglas Guerreiro dos Santos , Finatto Paula , Antunes Amanda Haberland , Tartaruga Marcus Peikriszwili , Bergamin Marco , Cadore Eduardo Lusa , Kruel Luiz Fernando Martins
Published: June 2017

The aim of the present study was to compare the peak anterior–posterior (Fy) and medio–lateral (Fx) ground reaction forces (GRFs) of women performing stationary running at different intensities in aquatic and dry land environments. Fourteen young women performed the stationary running exercise at three cadences (first ventilatory threshold, second ventilatory threshold and maximum effort, as determined during exercise in water) in aquatic and dry land environments. Two‐way repeated measures ANOVA was used to analyse the data (α = .05). As a result, significantly lower peak Fy anterior, Fy posterior, Fx medial and Fx lateral values were observed for the aquatic environment, except for the Fy posterior at the first ventilatory threshold. Significant differences were observed between cadences in the peak Fy anterior, Fy posterior, Fx medial and Fx lateral values, with higher values for the cadence corresponding to maximum effort compared to the first ventilatory threshold, except for the Fy posterior and Fx medial in the aquatic environment. The results indicate that the horizontal GRFs are reduced in the aquatic environment and depend on the intensity of stationary running exercise performance.
Experimental and Numerical Analysis of Thermal and Thermomechanical Behavior of a Power Inductor Accompanied by a Reliability Study
Authors: Bendaou Om , Gautrelet C , Elhami A , Agouzoul M
Published: June 2017

In practice, when feeding the electrical and electronic components, they generate heat by Joule’s effect, which will cause an increase in temperature and provoking mechanical deformations related to the expansion of the materials. It is therefore this aspect that is the subject of our study on the thermal and thermomechanical characterization of a ferrite power inductor by experimental and numerical channels. For this purpose, a finite element model was developed and calibrated by comparing its results to the experimental results obtained via thermal measurements and measurements by speckle interferometry system. A reliability analysis on the power inductor was performed numerically, based on the coupling between finite element model validated and the methods of Monte Carlo, FORM and SORM.
Mechanical Property Analysis on Sandwich Structured Hybrid Composite Made from Natural Fibre, Glass Fibre and Ceramic Fibre Wool Reinforced with Epoxy Resin
Authors: Bharat K R , Abhishek S , Palanikumar K
Published: June 2017

Natural fibre composites find wide range of applications and usage in the automobile and manufacturing industries. They find lack in desired properties, which are required for present applications. In current scenario, many developments in composite materials involve the synthesis of Hybrid composite materials to overcome some of the lacking properties. In this present investigation, two sandwich structured hybrid composite materials have been made by reinforcing Aloe Vera-Ceramic Fibre Wool-Glass fibre with Epoxy resin matrix and Sisal fibre-Ceramic Fibre Wool-Glass fibre with Epoxy resin matrix and its mechanical properties such as Tensile, Flexural and Impact are tested and analyzed. The test results from the two samples are compared and the results show that sisal fibre reinforced hybrid composite has better mechanical properties than aloe vera reinforced hybrid composite.
Intermetallic Growth Retardation with the Addition of Graphene in the Sn-3.5Ag Lead-free Solder
Authors: Mayappan R , Salleh A
Published: June 2017

In this study, the effect of 0.07 wt.% graphene nanosheets (GNSs) on the thermal, microstructure and intermetallic compounds (IMC) growth kinetics were investigated. Experimental results showed that addition of GNSs to the Sn-3.5Ag solder alloy slightly increased the melting temperature. Scanning electron microscope (SEM) micrograph revealed that with the addition of GNSs has transformed the morphologies of the interfacial IMC from scalloped to more planar-shaped after isothermal aging for 500 hours. Growth kinetics calculations show that the k value was reduced from 9.08 × 10-14 cm2/s to 5.73 × 10-14 cm2/s with the addition of graphene. Thereby, it indicates that the addition of GNSs suppressed the growth of the IMC layers hence retarded the IMC’s growth.
Static Strength of Adhesively-bonded Woven Fabric Kenaf Composite Plates
Authors: Hilton Ahmad , Lee Sim Yee , Supar Khairi
Published: June 2017

Natural fibers are potentially used as reinforcing materials and combined with epoxy resin as matrix system to form a superior specific strength (or stiffness) materials known as composite materials. The advantages of implementing natural fibers such as kenaf fibers are renewable, less hazardous during fabrication and handling process; and relatively cheap compared to synthetic fibers. The aim of current work is to conduct a parametric study on static strength of adhesively bonded woven fabric kenaf composite plates. Fabrication of composite panels were conducted using hand lay-up techniques, with variation of stacking sequence, over-lap length, joint types and lay-up types as identified in testing series. Quasi-static testing was carried out using mechanical testing following code of practice. Load-displacement profiles were analyzed to study its structural response prior to ultimate failures. It was found that cross-ply lay-up demonstrates better static strength compared to quasi-isotropic lay-up counterparts due to larger volume of 0° plies exhibited in cross-ply lay-up. Consequently, larger overlap length gives better joining strength, as expected, however this promotes to weight penalty in the joining structure. Most samples showed failures within adhesive region known as cohesive failure modes, however, few sample demonstrated interface failure. Good correlations of parametric study were found and discussed in the respective section.
Analysis of the Machining Depth over Time in Wet Etching for Fabrication of Invar Thin Film Shadow Mask
Authors: Moon G C , Choi W K , Kim S H , Choi S G , Lee E S
Published: June 2017

Invar is made up of 64% iron and 36% nickel. Invar has a characteristic of low thermal expansion coefficient that hardly causes a change of dimension according to temperature change. It is used for shadow mask fabrication by using this feature. Shadow mask is an important element for enhancing the pixels of the display. Therefore, Wet etching is an important machining technique because it is economical and mass-producible to make shadow mask. In this study, the machining depth was compared and analyzed with the machining time by using a 30μm invar thin film. As the machining time increased, the machining depth of the hole increased and a perfect hole array occurred when the machining time was 5 minutes. Through the same processing conditions, a 5.5-inch large-area shadow mask with uniform hole size was fabricated.
The classical Artin approximation theorems
Authors: Hauser Herwig
Published: June 2017

The various Artin approximation theorems assert the existence of power series solutions of a certain qualityQQ(i.e., formal, analytic, algebraic) of systems of equations of the same qualityQQ, assuming the existence of power series solutions of a weaker qualityQ′>QQ’ > Q(i.e., approximated, formal). The results are frequently used in commutative algebra and algebraic geometry. We present a systematic argument which proves, with minor modifications, all theorems simultaneously. More involved results, such as, e.g., Popescu’s nested approximation theorem for algebraic equations or statements about the Artin function, will only be mentioned but not proven. We complement the article with a brief account of the theory of algebraic power series, two applications of approximation to singularities, and a differential-geometric interpretation of Artin’s proof.
Development of an electronic medical record–based child physical abuse alert system
Authors: Berger Rachel P , Saladino Richard A , Fromkin Janet , Heineman Emily , Suresh Srinivasan , McGinn Tom
Published: June 2017

Objective

Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes.

Methods

Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center. The system was run in “silent mode”; physicians were unaware of the system, but study personnel received data on children who triggered the alert system. Sensitivity, specificity, and negative and positive predictive values of the child abuse alert system for identifying physical abuse were calculated.

Results

Thirty age-specific triggers were embedded into the electronic medical record. From October 21, 2014, through April 6, 2015, the system was in silent mode. All 226 children who triggered the alert system were considered subjects. Mean (SD) age was 9.1 (6.5) months. All triggers were activated at least once. Sensitivity was 96.8% (95% CI, 92.4–100.0%), specificity was 98.5% (95% CI, 98.3.5–98.7), and positive and negative predictive values were 26.5% (95% CI, 21.2–32.8%) and 99.9% (95% CI, 99.9–100.0%), respectively, for identifying children < 2 years old with possible, probable, or definite physical abuse.

Discussion/Conclusion

Triggers embedded into the electronic medical record can identify young children with who need to be evaluated for physical abuse with high sensitivity and specificity.
High-Dose Nadroparin Following Endovascular Aneurysm Treatment Benefits Outcome After Aneurysmal Subarachnoid Hemorrhage
Authors: Post Rene , Zijlstra IJsbrand A.J , Berg Rene van den , Coert Bert A , Verbaan Dagmar , Vandertop W Peter
Published: June 2017

BACKGROUND

Delayed cerebral ischemia (DCI) is one of the major causes of delayed morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH).

OBJECTIVE

To evaluate the effect of high-dose nadroparin treatment following endovascular aneurysm treatment on the occurrence of DCI and clinical outcome.

METHODS

Medical records of 158 adult patients with an aSAH were retrospectively analyzed. Those patients treated endovascularly for their ruptured aneurysm were included in this study. They received either high-dose (twice daily 5700 AxaIE) or low-dose (once daily 2850 AxaIE) nadroparin treatment after occlusion of the aneurysm. Medical charts were reviewed and imaging was scored by 2 independent neuroradiologists. Data with respect to in-hospital complications, peri-procedural complications, discharge location, and mortality were collected.

RESULTS

Ninety-three patients had received high-dose nadroparin, and 65 patients prophylactic low-dose nadroparin. There was no significant difference in clinical DCI occurrence between patients treated with high-dose (34%) and low-dose (31%) nadroparin. More patients were discharged to home in patients who received high-dose nadroparin (40%) compared to low-dose (17%; odds ratio [OR] 3.13, 95% confidence interval [95% CI]: 1.36-7.24). Furthermore, mortality was lower in the high-dose group (5%) compared to the low-dose group (23%; OR 0.19, 95% CI: 0.07-0.55), also after adjusting for neurological status on admission (OR 0.21, 95% CI: 0.07-0.63).

CONCLUSION

Patients who were treated with high-dose nadroparin after endovascular treatment for aneurysmal SAH were more often discharged to home and showed lower mortality. High-dose nadroparin did not, however, show a decrease in the occurrence of clinical DCI after aSAH. A randomized controlled trial seems warranted.
Simple Preoperative Patient-Reported Factors Predict Adverse Outcome After Elective Cranial Neurosurgery
Authors: Reponen Elina , Korja Miikka , Tuominen Hanna
Published: June 2017

BACKGROUND

Patient-reported preoperative factors hold promise in improving the prediction of postoperative adverse events, but they have been poorly studied.

OBJECTIVE

To study the role of patient-reported factors in the preoperative risk stratification of elective craniotomy patients.

METHODS

A prospective, unselected cohort of 322 adult patients underwent elective craniotomy in Helsinki, Finland. We preoperatively recorded the American Society of Anesthesiologists (ASA) score, Helsinki ASA score, and 3 questionnaire-based patient-reported factors including overall health status, ability to climb 2 flights of stairs, and cognitive function (Test Your Memory test). Outcome measures comprised in-hospital major and overall morbidity. Receiver-operating characteristic curves served to calculate area under the curve (AUC) values for a composite score of patient-reported factors and both ASA scores with regard to outcomes.

RESULTS

In-hospital major and overall morbidity rate was 15.2%. Only preoperatively diminished cognitive function remained a significant predictor of major morbidity after multivariable logistic regression analysis (P < .001, odds ratio 1.1, confidence interval 1.0-1.1). A composite score of our 3 patient-reported factors had a higher AUC (0.675) for major morbidity than original ASA score (0.543) or Helsinki ASA score (0.572). In elderly patients, the composite score had an AUC of 0.726 for major morbidity.

CONCLUSION

Preoperative patient-reported factors had higher sensitivity for detecting major morbidity compared to the ASA scores in this study. Particularly, the simple composite score seems to predict adverse outcomes in elective cranial surgery surprisingly well, especially in the elderly. These results are interesting and worth confirming in other centers.
Highlighting Huntington disease
Authors: Perkins Amanda
Published: June 2017

Get the facts about one of the most common hereditary brain disorders.
Suicide
Authors: Smith Erin Murphy
Published: June 2017

Nurses are at the frontline of risk assessment and prevention.
Risk reduction
Authors: McCarthy Jessica , Stagg Denise
Published: June 2017

Due to its frequency, nurses are likely to encounter IPV victims and perpetrators. We offer preventive strategies for this complex issue.
Race and Ethnicity Have a Mixed Effect on the Treatment of Tibial Plateau Fractures
Authors: Driesman Adam , Mahure Siddharth A. , Paoli Albit , Pean Christian A. , Konda Sanjit R. , Egol Kenneth A.
Published: June 2017

Objectives:

To determine whether racial or economic disparities are associated with short-term complications and outcomes in tibial plateau fracture care.

Design:

Retrospective cohort study.

Setting:

All New York State hospital admissions from 2000 to 2014, as recorded by the New York Statewide Planning and Research Cooperative System database.

Patients/Participants:

Thirteen thousand five hundred eighteen inpatients with isolated tibial plateau fractures (OTA/AO 44), stratified in 4 groups: white, African American, Hispanic, and other.

Intervention:

Closed treatment and operative fixation of the tibial plateau.

Main Outcome Measurements:

Hospital length of stay (LOS, days), in-hospital complications/mortality, estimated total costs, and 30-day readmission.

Results:

There were no significant differences regarding in-hospital mortality, infection, deep vein thrombosis/pulmonary embolism, or wound complications between races, even when controlling for income. There was a higher rate of nonoperatively treated fractures in the racial minority populations. Minority patients had on average 2 days longer LOS compared with whites (P < 0.001), costing on average $4000 more per hospitalization (P < 0.001). Multivariate logistic regression found that neither race nor estimated median family income were independent risk factors for readmission.

Conclusions:

Although nature of initial injury, use of external fixator, comorbidity burden, age, insurance type, and LOS were independent risk factors for readmission, race and estimated median family income were not. In patients who sustained a tibial plateau fracture, race and ethnicity seemed to affect treatment choice, but once treated racial minority groups did not demonstrate worse short-term complications, including increased mortality and postoperative readmission rates.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Pull-out K-wire Anchorage: The “Shepherd’s Crook” Technique
Authors: De Spirito Daniele , Giunchi Dario
Published: June 2017

Traditional pull-out techniques for tendon and ligament repair are still widely used in hand surgery, despite constant refinements and the development of other methods of fixation. We propose a modification of the classic technique which utilizes a K-wire as an external strut instead of the classic button. This fixation system can be usefully applied in the fixation of extensor and flexor tendons and reinsertions. It is particularly applicable in situations where a transarticular K-wire is to be used anyway, in situations of temporary joint immobilization and in other situations.
Spiritual Nursing Care Education An Integrated Strategy for Teaching Students
Authors: White Donna M. , Hand Mikel
Published: June 2017

The failure of nursing schools to integrate spiritual nursing care education into the curriculum has contributed to a lack in nurses' spiritual care ability. Developing, integrating, and testing a Spiritual Care Nursing Education strategy in an Associates of Science nursing program significantly increased the perceived spiritual care competence of student nurses. Utilizing a faculty team to develop learning activities to address critical spiritual care attributes offers a method to integrate spiritual nursing care content throughout the curriculum in ASN and BSN programs.
Academic Achievement and Risk Factors for Adolescents with Attention-Deficit Hyperactivity Disorder in Middle School and Early High School
Authors: Zendarski Nardia , Sciberras Emma , Mensah Fiona , Hiscock Harriet
Published: June 2017

Objective:

Examine academic achievement of students with attention-deficit hyperactivity disorder (ADHD) during the early high school period and identify potentially modifiable risk factors for low achievement.

Method:

Data were collected through surveys (adolescent, parent, and teacher) and direct assessment of Australian adolescents (12–15 yr; n = 130) with ADHD in early high school (i.e., US middle and high school grades). Academic achievement outcomes were measured by linking to individual performance on the National Assessment Program-Literacy and Numeracy (NAPLAN) tests, direct assessment of reading and math, and teacher report of academic competence. Linear regression models examined associations between adolescent, parent/family, and school factors and NAPLAN domain scores.

Results:

Students with ADHD had lower NAPLAN scores on all domains and fewer met minimum academic standards in comparison with state benchmarks. The poorest results were for persuasive writing. Poor achievement was associated with lower intelligence quotient across all academic domains. Adolescent inattention, bullying, poor family management, male sex, and attending a low socioeconomic status school were associated with lower achievement on specific domains.

Conclusion:

Students with ADHD are at increased academic risk during the middle school and early high school period. In addition to academic support, interventions targeting modifiable factors including inattention, bullying, and poor family management may improve academic achievement across this critical period.
Effects of Aroma Gargling, Cold Water Gargling, and Wet Gauze Application on Thirst, Halitosis, and Sore Throat of Patients After Spine Surgery
Authors: Oh Kyung Eun , Song Ae Ran , Sok Sohyune R.
Published: June 2017

This study compared and examined the effects of aroma gargling, cold water gargling, and wet gauze application on thirst, halitosis, and sore throat in patients after spine surgery. A quasiexperimental pretest/posttest control group design was employed. Samples were total 70 patients (aroma gargling: 24 samples, cold gargling: 24 samples, and wet gauze: 22 samples) after spine surgery in K Hospital in Seoul, Korea. The aroma gargle solution as an experimental intervention was prepared by blending peppermint, tea tree, and lemon oils at a ratio of 1:2:2. A 60 cc of aroma gargle solution was used 3 times for 15 to 20 seconds. The visual analog scale was used to measure the degrees of thirst and sore throat, and a portable device was used to examine the degree of halitosis. There were significant differences in the degrees of thirst, halitosis, and sore throat according to interaction between group and duration. In the comparison among 3 groups, aroma gargling provided better oral health by decreasing thirst, halitosis, and sore throat for patients with spine surgery. Aroma gargling can be utilized as an effective nursing intervention for decreasing thirst, halitosis, and sore throat for patients with spine surgery in clinical practice. Results suggest, therefore, that health professionals should consider an array of methods including aroma gargling for patients after spine surgery.
My Child, My Patient
Authors: Kumar Rashmi
Published: June 2017

Many times, we make decisions in our lives that have unanticipated impacts. Decisions made can change our careers and outlook toward life. As a younger doctor, I considered illness and disease abstractions, and good management with optimal outcomes for the patient was our focus, as we strive toward our professional goals. But having experienced the real pain and helplessness that patients and their parents undergo during critical illnesses, the importance of empathy together with the knowledge and skills needed to treat a child should never be undervalued.
Posture-Dependent Dysphagia After Botulinum Toxin Type A Injection at Sternocleidomastoid in a Patient With Athetoid Cerebral Palsy
Authors: Chang Won Kee , Kim Keewon , Seo Han Gil , Leigh Ja-ho , Bang Moon Suk
Published: June 2017

Cervical dystonia is a common issue in patients with athetoid cerebral palsy. Botulinum toxin injection to dystonic cervical muscles is a well-recognized treatment option, but it is known to be associated with dysphagia. Previously reported cases of dysphagia after botulinum toxin injection to the sternocleidomastoid muscle were related to the regional spread of toxin to the pharyngeal muscles. We report a unique case of posture-dependent dysphagia due to preactivation of the suprahyoid and infrahyoid muscles to compensate for impaired head stabilization by the weakened sternocleidomastoid muscle while swallowing. This case suggests a possible mechanism of dysphagia in patients with athetoid cerebral palsy.