bluuebunny/crossref_metadata_2025 huggingface dataset:
Neue Arzneimittel für Pferde und landwirtschaftliche Nutztiere 2019
Authors: Emmerich Ilka Ute
Published: April 2020

Im Jahr 2019 kam für Pferde und landwirtschaftliche Nutztiere ein neuer Wirkstoff auf den deutschen Tierarzneimittelmarkt. So steht erstmalig für Pferde eine Injektionssuspension mit chondrogen induzierten allogenen peripheren mesenchymalen Stammzellen aus dem Blut vom Pferd zur Verfügung (ArtiCell® Forte). Zwei Wirkstoffe erhielten eine Tierartenerweiterung. So wurde das Fasziolizid Oxyclozanid (Distocur®) aus der Gruppe der Salicylsäureanilide auch für Schafe und das synthetische Typ-I-Pyrethroid Permethrin (Z-Itch®) auch für Esel zugelassen. Außerdem kamen eine neue Wirkstoffkombination (Toltrazuril + Gleptoferron), 2 Wirkstoffe (Permethrin, Omeprazol) in einer neuen Darreichungsform, ein Wirkstoff (Lidocain) in einer neuen Anwendungsart, ein Wirkstoff (Amprolium) mit einem höheren Wirkstoffgehalt und ein Wirkstoff (Butylscopolaminiumbromid) in Monozubereitung für Pferde und landwirtschaftliche Nutztiere auf den Markt.
Das Curriculum Sportkardiologie
Authors: Berrisch-Rahmel Susanne , Preßler Axel , Dahm Johannes B. , Frey Norbert
Published: April 2020

Ziel der Zusatzqualifikation Sportkardiologie ist eine Standardisierung und Optimierung der sportkardiologischen Versorgung zu bewegungs- und lebensstilbasierten Fragestellungen. Inhaltlich werden für die spezialisierten Kompetenzen (Zusatzqualifikation) 3 Stufen unterschieden (Stufe 1 und 2: Schwerpunkt Prävention und Rehabilitation, Stufe 3: gesamtes sportkardiologisches Spektrum einschließlich Beurteilung von Leistungsportlern).
Körperliches Training bei Herzinsuffizienz
Authors: Preßler Axel
Published: April 2020

Zu den leitlinienempfohlenen Behandlungsmaßnahmen einer chronisch-stabilen Herzinsuffizienz gehört heutzutage unbedingt ein strukturiertes und regelmäßiges körperliches Training. Dieses steigert in erster Linie Belastbarkeit und Lebensqualität; Daten zur Verbesserung der Ventrikelfunktion, Senkung der Hospitalisierung oder Letalität werden divergent bewertet. Sowohl für Herzinsuffizienz mit reduzierter wie erhaltener Ejektionsfraktion gilt moderates Ausdauertraining weiterhin als Standardform. Trainiert wird i. d. R. auf Ergometern oder vergleichbaren Geräten zwischen 50 – 80% eines zur Trainingssteuerung gewählten Maximalparameters (z. B. Sauerstoffaufnahme, Herzfrequenz). Moderates Krafttraining stärkt bei den häufig muskulär dekonditionierten Patienten die Muskelkraft und ist additiv zu sehen. Hoch-intensives Intervalltraining hat sich zumindest für Patienten mit reduzierter Pumpfunktion nicht als vorteilhafter erwiesen und sollte daher aktuell zurückhaltend bewertet werden.
Delegation von Hausbesuchen und Qualifikation
nicht-ärztlicher Mitarbeiter in sächsischen Hausarztpraxen
– Ergebnisse der Querschnittstudie SESAM-5
Authors: Bortz Martin , Schübel Jeannine , Pochert Maik , Bergmann Antje , Voigt Karen
Published: April 2020

Hintergrund Um dem demografischen Wandel und dem Hausärztemangel
zu begegnen, wird die Delegierbarkeit von Hausbesuchen diskutiert. Bisher gibt
es wenig Evidenz, in welchem Ausmaß eine Delegation von Hausbesuchen
innerhalb Deutschlands erfolgt. Ziel dieses Artikels ist es, Unterschiede im
soziodemografischen und organisatorischen Profil delegierender bzw.
nicht-delegierender Hausärzte in Sachsen zu untersuchen sowie den
Qualifikationsstand nicht-ärztlicher Mitarbeiter zu beschreiben.

Methodik Diese Querschnittstudie ist Teil einer Serie epidemiologischer
Studien in der Allgemeinmedizin in Sachsen (SESAM). Alle in Sachsen
niedergelassenen Hausärzte wurden 2014 angeschrieben (n=2677),
wovon 11,2% an der Studie teilnahmen. In einem Zeitraum von 12 Monaten
sollten Hausarztpraxen alle Hausbesuche dokumentieren, welche innerhalb einer
zufällig zugeordneten Woche durchgeführt wurden. Des Weiteren
wurden soziodemografische und organisatorische Merkmale der Hausarztpraxen,
sowie der Qualifikationsstand der nicht-ärztlichen Mitarbeiter
abgefragt.

Ergebnisse Insgesamt nahmen 274 Hausarztpraxen an der Studie teil.
52,9% der teilnehmenden Hausärzte erklärten ihre
Bereitschaft zur Delegation von Hausbesuchen, jedoch wurden lediglich
8,5% der Hausbesuche durch nicht-ärztliche Mitarbeiter erbracht.
Es zeigten sich nicht-signifikante Trends zwischen Delegationsbereitschaft und
Selbstständigkeit vs. angestellter Tätigkeit (92,4 vs.
84,6%; p=0,06), sowie Niederlassung in einer Gemeinschafts- vs.
Einzelpraxis (35,2 vs. 31,4%; p=0,09) und höheren
Scheinzahlen pro Quartal (x̄+= 1183,08 vs.
1092,16; p=0,07). Die Gruppe der 224 nicht-ärztlichen
Praxismitarbeiter, welche an der Studie teilnahmen, war mehrheitlich ausgebildet
in der Gesundheits- und Krankenpflege (39,7%) oder als Medizinische
Fachangestellte (50,8%). Die überwiegende Mehrheit der
Praxismitarbeiter (82,5%) wies keine Weiterbildung oder
Zusatzqualifikation auf. 12,6 bzw. 7% absolvierten eine Weiterbildung
zur Versorgungsassistentin oder nicht-ärztlichen Praxisassistentin.

Schlussfolgerung Unter den sächsischen Hausärzten
herrscht eine hohe Delegationsbereitschaft, welche jedoch nicht in ausreichendem
Maße umgesetzt werden kann. Ein Großteil der Delegation erfolgte
zum Zeitpunkt der Studienerhebung eher auf persönlicher Vertrauensbasis
ohne formale Weiterbildung. Qualifizierte Delegation sichert eine hochwertige
Patientenversorgung und dieses Potenzial scheint in der sächsischen
Primärversorgung, insbesondere in ländlichen Gegenden mit
drohender Unterversorgung, noch nicht ausgeschöpft. Eine vermehrte
Aufklärungsarbeit über Chancen und Möglichkeiten der
qualifizierten Delegation erscheint nötig.
Sport bei Herzklappenerkrankungen
Authors: van Buuren Frank , Mellwig Klaus-Peter
Published: April 2020

Herzklappenerkrankungen sind meist ein degenerativer Prozess, der eher Patienten ab der 5. Lebensdekade betrifft. Zudem gibt es aber auch eine bedeutende Anzahl jüngerer Menschen, die einen Herzklappenfehler aufweisen, vollkommen beschwerdefrei sind und sich gerne im Sport aktiv engagieren möchten. Bisher ist noch nicht ausreichend bekannt, wie sich regelmäßige und intensive sportliche Aktivität auf einen Herzklappenfehler an sich und die linksventrikuläre Funktion auswirkt. Einige Untersuchungen zeigen, dass die erhöhte Vorlast und Nachlast des Herzens im Rahmen von Sport die Dysfunktion einer Klappe verstärken können. Dieses kann zu kardialem Remodeling, pulmonaler Hypertonie und einer verstärkten Neigung zu Arrhythmien führen. Angesichts dessen sind sportkardiologische Untersuchungen mit Nachweis von Herzklappenfehlern häufig eine Herausforderung in der Medizin. Oft werfen solche Befunde die Frage nach zu empfehlender und zulässiger sportlicher Belastung auf. Sportarten können, abhängig von der vorherrschenden Belastung (dynamische Belastung, isometrische Belastung) in verschiedene Gruppen unterteilt werden. Diese Klassifikation hat sich im Alltag bewährt. Sportarten mit überwiegend dynamischer Komponente führen eher zu einer Volumenbelastung, isometrische Belastung eher zu einer Druckbelastung und einem verminderten Schlagvolumen durch den reduzierten Zufluss zum Herzen. Grundsätzlich sind natürlich alle Sportarten eine Kombination aus diesen beiden Komponenten. Die transthorakale Echokardiografie, ein EKG und die körperliche Untersuchung bilden die Erstuntersuchungen zur Evaluation eines möglichen Klappenvitiums. In einigen Fällen liefern aber auch die transösophageale Echokardiografie, ein Belastungstest, eine Stressechokardiografie sowie eine MRT wichtige zusätzliche Hinweise, um die Belastbarkeit und die mögliche Progression des Vitiums adäquat einschätzen zu können. Der vorliegende Text gibt einen Überblick über die aktuelle Literatur und zeigt wichtige Entscheidungskriterien auf, um einen Sportler mit einem Herzklappenfehler adäquat beraten zu können.
Where Is Bacosine in Commercially Available Bacopa monnieri?
Authors: Ritter Stefanie , Urmann Corinna , Herzog Rainer , Glaser Jan , Bieringer Sebastian , Geisberger Thomas , Eisenreich Wolfgang , Riepl Herbert
Published: April 2020

Bacopa monnieri is an Ayurvedic plant with rising interest in the pharmacological effects of its extract and constituents, including flavonoids, saponins, and triterpenes such as cucurbitacins, betulinic acid, and bacosine. The latter two compounds are isomeric 3-hydroxy lupenoic acids, which vary only in the arrangement of the carboxylic acid group and the methyl group at C-27 and C-28 and the orientation of the hydroxy group at C-3. In this study, we have reinvestigated the contents of betulinic acid and bacosine, respectively, in extracts from various commercially available B. monnieri powders and food supplements. To our surprise, HPLC-ion trap time-of-flight analyses identified only betulinic acid, but not bacosine, in all extracts under study, which was verified by GC-MS, HPLC-ELSD, 1D NMR (1H,13C), and 2D NMR (1H,1H COSY, 1H,13C HMBC, 1H,13C HSQC, 1H,1H NOESY) experiments. Moreover, it turned out that commercially available reference samples of bacosine were structurally identical with betulinic acid.
Anti-biofilm and Virulence Factor-Reducing Activities of Essential Oils and Oil Components as a Possible Option for Bacterial Infection Control
Authors: Reichling Jürgen
Published: April 2020

Pathogenic biofilm-associated bacteria that adhere to biological or nonbiological surfaces are a big challenge to the healthcare and food industries. Antibiotics or disinfectants often fail in an attempt to eliminate biofilms from those surfaces. Based on selected experimental research, this review deals with the potential biofilm-inhibiting, virulence factor-reducing, and biofilm-eradicating activities of essential oils and single essential oil compounds using Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Chromobacterium violaceum as model organisms. In addition, for the bacteria reviewed in this overview, different essential oils and essential oil compounds were reported to be able to modulate the expression of genes that are involved in the formation of autoinducer molecules, biofilms, and virulence factors. The anti-quorum sensing activity of some essential oils and single essential oil compounds was demonstrated using the gram-negative bacterium C. violaceum. Reporter strains of this bacterium produce the violet-colored compound violacein whose synthesis is regulated by quorum sensing autoinducer molecules called acylhomeserinlactones. Of great interest was the discovery that enantiomeric monoterpenes affected the quorum sensing regulation system in different ways. While the (+)-enantiomers of carvone, limonene, and borneol increased violacein formation, their (−)-analogues inhibited violacein production.

For the successful eradication of biofilms and the bacteria living inside them, it is absolutely necessary that the lipophilic volatile substances can penetrate into the aqueous channels of biofilms. As shown in recent work, hydrophilic nano-delivery systems encapsulating essential oils/essential oil compounds with antibacterial effects may contribute to overcome this problem.
Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis
Authors: Jung Sung Hoon , Yoon Jai Hoon , Choi Hyuk Soon , Nam Seung-Joo , Kim Kyoung Oh , Kim Do Hoon , Kim Jung-Wook , Sohn Won , Hyun Yil Sik , Park Chan Hyuk , Lee Hang Lak ,   for the Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity
Published: April 2020

Background The comparative efficacy of bariatric endoscopic procedures has not been completely elucidated. We aimed to comprehensively evaluate the efficacy of bariatric endoscopic procedures.

Methods We searched for randomized controlled trials investigating the efficacy of bariatric endoscopic procedures, including the use of an intragastric balloon, duodenal-jejunal bypass liner (DJBL), aspiration therapy, primary obesity surgery endoluminal (POSE) procedure, and botulinum toxin injection to the stomach. Network meta-analyses were performed to determine the percentage of weight loss (%weight loss) and percentage of excess weight loss (%EWL).

Results 22 studies with 2141 patients were included in the meta-analysis. Most endoscopic procedures showed superior efficacy in terms of %weight loss compared with the control (mean difference [MD] [95 % confidence interval (CI)]: aspiration therapy 10.4 % [7.0 % to 13.7 %]; fluid-filled balloon 5.3 % [3.4 % to 7.2 %]; POSE 4.9 % [1.7 % to 8.2 %]; and DJBL 4.5 % [1.4 % to 7.7 %]). In terms of %EWL, aspiration therapy, fluid-filled balloon, POSE, and DJBL were superior to the control (MD [95 %CI]: 27.3 % [15.3 % to 39.3 %]; 22.4 % [15.4 % to 29.4 %]; 15.3 % [2.5 % to 28.0 %]; and 13.0 % [4.9 % to 21.2], respectively). The gas-filled balloon and botulinum toxin injection did not show a significant difference in %weight loss or %EWL compared with the control. For the fluid-filled balloon, the %EWL and %weight loss tended to decrease after balloon removal at 6 months after the procedure.

Conclusion All bariatric endoscopic procedures, except for gas-filled balloon and botulinum toxin injection to the stomach, showed superior short-term efficacy in terms of %weight loss or %EWL compared with lifestyle modification.
Effektivität und Verbesserungspotenziale von „Reha vor Pflege“: Ergebnisse einer Befragung
Authors: Haering Alexander , Heger Dörte , Korfhage Thorben
Published: April 2020

Als zentraler präventiver Mechanismus im Umgang mit Pflegebedürftigkeit ist im deutschen Sozialgesetzbuch der Grundsatz „Reha vor Pflege“ festgelegt (§ 31 SGB XI). Ziel dieses Grundsatzes ist die Überwindung, Minderung oder das Entgegenwirken einer Verschlimmerung von Pflegebedürftigkeit.

Zielsetzung Das Ziel der vorliegenden Studie ist es, die Wirksamkeit von geriatrischer Rehabilitation zur Reduzierung von Pflegebedarfen zu untersuchen und Verbesserungspotenziale bei der Gestaltung von geriatrischen Rehabilitationsmaßnahmen aufzuzeigen.

Methodik Grundlage der Analyse ist eine Befragung von Experten für geriatrische Rehabilitation aus Praxis und Wissenschaft.

Ergebnisse Unsere Auswertung legt nahe, dass das hohe Potenzial von geriatrischer Rehabilitation bisher nicht voll ausgeschöpft wird. Häufig werden die Maßnahmen zu spät eingeleitet und sind zu wenig auf die Bedürfnisse älterer Menschen zugeschnitten.

Schlussfolgerung Die Ergebnisse legen nahen, dass der Eintritt in die Pflegbedürftigkeit durch ein besseres System zur Früherkennung von Pflegebedarfen und der Ausweitung des Angebots mobiler geriatrischer Rehabilitation in vielen Fällen verhindert, verschoben oder abgeschwächt werden könnte.
Avaliação pós-operatória de pacientes submetidos a reparo artroscópico de instabilidade anterior do ombro
Authors: Storti Thiago Medeiros , Lima Renato de Almeida , Costa Eloíse de Barros e Silva , Simionatto João Eduardo , Simionatto Carolina , Paniago Alexandre Firmino
Published: April 2020

Objetivo Avaliar clinicamente os resultados de pacientes submetidos a tratamento cirúrgico artroscópico de instabilidade anterior do ombro.

Métodos Estudo retrospectivo de 94 pacientes. Com seguimento mínimo de 24 meses, buscamos correlacionar as características dos pacientes e da cirurgia, como idade, gênero, tipo de lesão (traumática ou atraumática) e posição do paciente na cirurgia (decúbito lateral e cadeira de praia) com os resultados obtidos, avaliando o índice de recidivas de luxação, a perda de rotação lateral, a dor residual, e os escores funcionais de Carter-Rowe, da University of California at Los Angeles (UCLA) e de Constant-Murley.

Resultados Observamos uma taxa de recidiva de luxação de 11,7%, perda de rotação lateral em 37,23% dos pacientes, e algum grau de dor residual em 51,6%. Obtivemos uma pontuação média no escore de Carter Rowe de 85,37, representando 86% de resultados bons/excelentes. No escore da UCLA, obtivemos 88% de resultados bons/excelentes, índice semelhante aos encontrados no escore de Constant-Murley (86%).

Conclusão O tratamento artroscópico da instabilidade anterior do ombro apresenta resultados satisfatórios e baixo índice de complicações importantes, podendo ser o método de escolha para a maioria dos pacientes.
Avaliação radiográfica dos pacientes submetidos a fixação percutânea com parafuso maciço para tratamento de fraturas da extremidade distal do radio
Authors: Gaibor Gonzalo Guamán , Thomaz Leonardo Dalla Giacomassa Rocha , Borges Cristian Stein , Ruschel Paulo Henrique , Pignataro Milton Bernardes
Published: April 2020

Objetivo Apresentar o resultado das avaliações radiográficas dos pacientes com fraturas extra-articulares do rádio distal submetidos a fixação percutânea com parafuso maciço de 3.5mm.

Métodos Série de casos, analítica, descritiva e retrospectiva de 16 pacientes com avaliação dos parâmetros radiográficos da técnica utilizada.

Resultados A média de idade da população estudada foi de 46,5 anos (25–60 anos), sendo 81,25% do sexo feminino. O tempo de espera até a cirurgia foi de 8,8 dias (4–14 dias). O tilt volar médio pré-procedimento foi - 7,41° (−23,48°–5,29°, desvio padrão [DP] ± 6,59°). O tilt volar imediatamente após o procedimento cirúrgico foi de 5,93° (DP ± 6,23°, p < 0,001). Sem diferença estatística nos valores de tilt volar ao final de 6 meses de evolução. A altura radial pré-procedimento foi de 4,13 mm (−7,8°–9,5°, DP ± 5,06°). Aumento estatisticamente significativo no pós-operatório imediato para 10,04 mm (p = 0,002). Redução significativa ao final de 6 meses para 9,55 mm (p = 0,012). Atingimos 100% de consolidação com a técnica utilizada, com índice mínimo de complicações. Nenhum paciente apresentou infecção ou precisou ser reoperado.

Conclusão A técnica mostrou-se eficaz para o tratamento de fraturas extra-articulares da extremidade distal do rádio ao final de 6 meses, com baixo índice de complicações e parâmetros radiográficos aceitáveis e próximos dos valores anatômicos.
Urothelial Papilloma of the Urinary Bladder in Children: Report of Two Cases
Authors: Davidovics Kata , Davidovics Sandor , Farkas Andras , Benedek Noemi , Tornoczki Tamas , Kardos Daniel , Davidovics Anna , Vajda Peter
Published: April 2020

Urothelial neoplasms of the bladder (UNB) are considerably rare throughout the pediatric population. UNB develops from the urothelial tissue in the form of a benign disease, generally favoring a successful prognosis in the majority of cases. The authors present the diagnosis and treatment regarding two medical case reports in which urothelial papilloma was diagnosed and effectively treated. Case 1: A 15-year-old male patient was presented to our clinic complaining of a painless yet distinctive, macroscopic form of hematuria. Following a routine examination, which included ultrasound (US) and intravenous pyelography, the urethrocystoscopy revealed an intravesical solitary lesion positioned in the vicinity of the left ureteral orifice. Additionally, histology confirmed urothelial papilloma. During the follow-up, laboratory, urinary control tests, and US results all proved negative. Case 2: A 13-year-old male patient was admitted to our clinic and examined, in regard to complaints associated with recurrent abdominal pain. The pathology was discovered incidentally on abdominal US. Preoperative US and magnetic resonance imaging (MRI) studies ensued, resulting in a scheduled MRI, followed by urethrocystoscopy, which confirmed an intravesical solitary lesion positioned near the right ureteral orifice. Histology revealed urothelial papilloma. During the follow-up control cystoscopy, one resection was repeated due to the presence of a residual tumor. Today, 10 years since the presence of uroepithelial papilloma, both patients are asymptomatic and tumor-free. If there is likely suspicion of recurrence, cystoscopy is recommended.
Pronator Quadratus to Extensor Carpi Radialis Brevis Nerve Transfer in C5–C7 or C5–C8 Brachial Plexus Injuries for Independent Wrist Extension
Authors: Bhatia Anil , Salama Mahmoud
Published: April 2020

Background Patients with lesions affecting C7 and C8 roots (in addition to C56) demonstrate loss of independent wrist dorsiflexion in addition to loss of shoulder abduction and elbow flexion. Traditionally, this deficit has been addressed using tendon transfers after useful function at the shoulder and elbow has been restored by primary nerve surgery. Confidence with nerve transfer techniques has prompted attempts to replace this method by incorporating procedures for wrist dorsiflexion in the primary operation itself.

Aim The objective of this study was to report the results of pronator quadratus motor branch transfers to the extensor carpi radialis brevis motor branch to reconstruct wrist extension in C5–C8 root lesions of the brachial plexus.

Patients and Methods Twenty-three patients, average age 30 years, with C5–8 root injuries underwent operations an average of 4.7 months after their accident. Extrinsic extension of the fingers and thumb was weak or absent in two cases while the remaining 18 patients could open their hand actively. The patients lacked independent wrist extension when they were examined with the fingers flexed as the compensatory action of the extrinsic finger extensors was removed. The average follow-up was 21 months postoperative with the minimal follow-up period was at least 12 months.

Results Successful reinnervations of the extensor carpi radialis brevis (ECRB) were demonstrated in all patients. In 17 patients, wrist extension scored M4, and in 3 patients it scored M3.

Conclusions The pronator quadratus (PQ) to ECRB nerve transfer in C5–C7 or C5–C8 brachial plexus injuries for independent wrist extension reconstruction gives consistently good results with minimal donor morbidity.
MRI Pattern of Various Cochlear Implant Electrodes In Vivo
Authors: Sudhoff Holger , Riemann Conrad , Gehl Hans Björn , Todt Ingo
Published: April 2020

Introduction Recent developments regarding cochlear implant magnets (e.g., a bipolar diametral magnet) and refined surgical technique (e.g., implant positioning) have made a significant impact on the relation between a cochlear implant and magnetic resonance imaging (MRI). MRI scanning has changed from a contraindication to a diagnostic tool. For the first time, a pain-free in vivo evaluation of the cochlea’s fluid state, following the insertion of an electrode, has become possible via MRI scanning. The aim of this study was to evaluate various cochlear implant electrodes’ MRI-specific patterns.

Materials and Methods In a retrospective study, we evaluated the MRI pattern of casting iron (CI) electrodes in a 3T T2 turbo spin echo (TSE) sequence after a surgery with Medel Flex 28, Flex 24, AB HFMS, and MRI at 1.5 T T2 TSE with the Oticon EVO array.

Results A generally different axial MRI pattern between the “lateral wall” electrodes and the “modiolar” electrodes at the basal turn could be observed. A difference in terms of electrode length/insertion depth could not be found at the present scan resolution. Electrode contacts have an impact on the MRI signal-diminishing pattern.

Conclusion At T2 sequences, an electrode design-specific MRI pattern can be observed.
Simultaneous Bilateral Facial Nerve Paralysis in a 4-Year-Old Child: A Rare Occurrence
Authors: Mehta Madhuri , Gupta Vani Krishana , Pandurangi Aniketh , Mehta Navroz
Published: April 2020

Paralysis of the facial nerve (cranial nerve VII) is a relatively uncommon entity in children. It not only results in weakness of the facial musculature affecting the facial expressions, eye closure, and oral competence, but also causes psychological and emotional trauma to the child and parents. Unilateral palsy is usually idiopathic, whereas bilateral palsy usually has an underlying cause. We report a case of a 4-year-old girl who presented to us with simultaneous facial nerve paralysis where the second side was involved within 7 days of the first, before its complete resolution. Evaluation of the patient and the possible etiologies of bilateral facial palsy have been discussed further.
How to Determine the Role of an Additive on the Length of Supramolecular Polymers?
Authors: Weyandt Elisabeth , Mabesoone Mathijs F. J. , de Windt Lafayette N. J. , Meijer E. W. , Palmans Anja R. A. , Vantomme Ghislaine
Published: April 2020

In polymer chemistry, modulation of sequence and control over chain length are routinely applied to alter and fine-tune the properties of covalent (co)polymers. For supramolecular polymers, the same principles underlying this control have not been fully elucidated up to this date. Particularly, rational control over molecular weight in dynamic supramolecular polymers is not trivial, especially when a cooperative mechanism is operative. We start this review by summarizing how molecular-weight control has been achieved in seminal examples in the field of supramolecular polymerizations. Following this, we propose to classify the avenues taken to control molecular weights in supramolecular polymerizations. We focus on dynamic cooperative supramolecular polymerization as this is the most challenging in terms of molecular weight control. We use a mass-balance equilibrium model to predict how the nature of the interaction of an additive B with the monomers and supramolecular polymers of component A affects the degree of aggregation and the degree of polymerization. We put forward a classification system that distinguishes between B acting as a chain capper, a sequestrator, a comonomer, or an intercalator. We also highlight the experimental methods applied to probe supramolecular polymerization processes, the type of information they provide in relation to molecular weight and degree of aggregation, and how this can be used to classify the role of B. The guidelines and classification delineated in this review to assess and control molecular weights in supramolecular polymers can serve to reevaluate exciting systems present in current literature and contribute to broaden the understanding of multicomponent systems.
Expanding Role of Proton Magnetic Resonance Spectroscopy: Timely Diagnosis and Treatment Initiation in Partial Ornithine Transcarbamylase Deficiency
Authors: Sen Kuntal , Castillo Pinto Carlos , Gropman Andrea L.
Published: April 2020

We report the case of a 3-year-old male patient who presented with a 3-day history of altered mental status, emesis, and abdominal pain in the setting of a viral illness. A rapid screening revealed a high ammonia level and after reviewing his proton magnetic resonance spectroscopy (1H MRS) which showed the classic triad of high glutamate, low choline, and myoinositol, a diagnosis of ornithine transcarbamylase deficiency (OTCD) was made within 6 hours of presentation. Therapy with sodium phenylbutyrate and sodium benzoate was initiated and patient was discharged after 3 days with no neurologic disability. Biochemical and molecular testing eventually confirmed the diagnosis. 1H MRS is a practical and fast neuroimaging modality that can aid in diagnosis of OTCD and enables faster initiation of treatment in acute settings.
A Case Report of Idiopathic Ketotic Hypoglycemia Masquerading as Epilepsy
Authors: Dudipala Sai Chandar , Battu Krishna Chaithanya , Mandapuram Prashanthi , Ch Laxman Kumar
Published: April 2020

Idiopathic ketotic hypoglycemia (IKH) is characterized by recurrent neurohypoglycemic symptoms with ketosis. Hypoglycemic episodes typically occur during early mornings, especially either with illness and/or prolonged fasting. We reported a case of IKH which presented with recurrent episodes of seizures during early morning with intercurrent illness and which was labeled as epilepsy and started on antiepileptic medication. The purpose of this case report is to alert clinicians about this condition, which is not an uncommon entity, but rarely thought of. Therefore, in view of keeping the IKH in mind, which can be prevented with proper diet advice during illness, unnecessary long-term antiepileptic therapy can be avoided.
Hemolysis due to Alpha-Hemolytic Enterococcus Urinary Infection: A Rare Cause of Early and Severe Unconjugated Hyperbilirubinemia in a Neonate
Authors: Karabulut Birol , Gafil Esin Alpagut
Published: April 2020

The reason for reporting this case is to remind that some microorganisms may cause hemolysis leading to early and severe hyperbilirubinemia by secreting hemolysin in cases; where bilirubin levels cannot be successfully decreased despite effective phototherapy, intravenous immunoglobulin, and even exchange transfusion, or in cases of increased rebound bilirubin (although urinary tract infection is associated with increased conjugated bilirubin fraction and prolonged jaundice). The most common causes of hemolysis are ABO/Rh incompatibility and enzyme deficiencies such as glucose-6-phosphate dehydrogenase (G6PDH), pyruvate kinase (PK), and galactose-1-phosphate uridyltransferase (GALT). Our patient was a male infant, weighing 3,160 g, at 38 + 4 gestational week; he was referred to our unit with total bilirubin level of 14.7 mg/dL recorded at the postnatal 20th hour and was initiated treatment with intensive phototherapy and prepared for exchange transfusion. The G6PD, PK, and GALT enzyme levels studied at the postnatal 96th hour and reducing substances in urine were detected to be normal/negative, whereas complete urinalysis revealed pyuria (7 leukocytes per each high power field). α-hemolysis-producing 105 colony-forming unit/mL Enterobacter cloacae grew on blood agar in the urine culture. As reported in our case, hemolysin-secreting α and β-hemolytic bacteria can lead to severe and early hemolysis and unconjugated hyperbilirubinemia, as in blood type incompatibility and enzyme deficiencies.
Set-up Errors and Determination of Planning Target Volume Margins Protocol for Different Anatomical Sites in a Newly Established Tertiary Radiotherapy Centre in India
Authors: Mandal Avik , Singh Pritanjali , Bera Soumen , Kumar Avajeet , Singh Dharmendra , Verma Manika , Rakesh Amrita , Sinha Arkaprava
Published: April 2020

Objective Our study aimed to assess the set-up errors for image-guided radiotherapy at a newly established tertiary radiation center in India and to establish the departmental protocol of clinical target volume–planning target volume (CTV–PTV) margins for different anatomical sites.

Materials and Methods This study enrolled the first 200 patients who were treated with curative intent at All India Institute of Medical Sciences, Patna, from February 2019 to September 2019. Number of patients were 53, 26, 53, 11, 6, 47, and 4 for head and neck, brain, breast, thorax, abdomen, pelvis, and craniospinal irradiation (CSI), respectively. The translational vectors for total 1,463 kV cone-beam computed tomography (CBCT) images were collected from the treatment record.

Results For the systematic error, the largest value is found for the thoracic subset on the X and Y directions, and for breast patients on Z axis, whereas the smallest values were found for CSI. For random error, the largest value was found for pelvic in the X, Y direction, and for breast subset on Z axis, whereas the smallest values on X and Z axes were found in the brain and for head and neck on the Y axis. Largest value for systemic error is smaller than 5 mm in all directions and for all anatomical subsets. The highest random error value is 5.07 mm in Y axis for pelvic subset. The largest values for CTV–PTV margin are found for thoracic subset and the smallest for CSI followed by the brain. Significant reduction of set-up error observed for the last hundred patients as compared to the first half of the patient population.

Conclusion Use of thermoplastic cast along with breast board and respiratory motion management should be recommended to reduce set-up error for breast and thoracic subset. Six degrees of freedom robotic couch system can also further rectify the set-up error in image-guided radiotherapy.
Und plötzlich ist alles anders
Authors: Freye Carolin
Published: April 2020

Innerhalb von zwei Monaten haben sich die Prioritäten der Kliniken und somit auch des Klinikeinkaufs massiv verschoben.
Erfahrungsbericht: Integration eines vollautomatisierten Kommissioniersystems in der Krankenhausapotheke
Authors: Solcher Juliane , Schmiedel Matthias
Published: April 2020

Das APEK-Versorgungszentrum des Heinrich-Braun-Klinikums verfügt seit 2018 über ein vollautomatisiertes Kommissioniersystem für die Ein- und Auslagerung von Arzneimitteln und Medizinprodukten. Neben der effizienteren Gestaltung der logistischen Prozesse in der Arzneimittelversorgung konnte die Umsetzung der EU-Fälschungsschutzrichtlinie 2011/62/EU bzw. securPharm e. V. zum Schutz des Patienten vor Arzneimittelfälschungen in der legalen Lieferkette vollständig in das Projekt integriert werden.
High precision determination of the Planck constant by modern photoemission spectroscopy
Authors: Huang Jianwei , Wu Dingsong , Cai Yongqing , Xu Yu , Li Cong , Gao Qiang , Zhao Lin , Liu Guodong , Xu Zuyan , Zhou X. J.
Published: April 2020

The Planck constant, with its mathematical symbol h, is a fundamental constant in quantum mechanics that is associated with the quantization of light and matter. It is also of fundamental importance to metrology, such as the definition of ohm and volt and the latest definition of kilogram. One of the first measurements to determine the Planck constant is based on the photoelectric effect; however, the values thus obtained so far have exhibited a large uncertainty. The accepted value of the Planck constant, 6.626 070 15 × 10−34 J s, is obtained from one of the most precise methods, the Kibble balance, which involves the quantum Hall effect, the Josephson effect, and the use of the international prototype of the kilogram or its copies. Here, we present a precise determination of the Planck constant by modern photoemission spectroscopy technique. Through the direct use of Einstein’s photoelectric equation, the Planck constant is determined by accurately measuring the energy position of the gold Fermi level using light sources with various photon wavelengths. The precision of the Planck constant as measured in this work, 6.626 10(13) × 10−34 J s, is improved by four to five orders of magnitude from the previous photoelectric effect measurements. We propose that this direct method of photoemission spectroscopy has potential to further increase its measurement precision of the Planck constant to be comparable to the most accurate methods available at present.
Effect of antimony doping on the energy of optical transitions in n-Ge layers grown on Si (001) and Ge (001) substrates
Authors: Yurasov D. V. , Novikov A. V. , Baidakova N. A. , Aleshkin V. Ya. , Bushuykin P. A. , Andreev B. A. , Yunin P. A. , Drozdov M. N. , Yablonskiy A. N. , Dubinov A. A. , Krasilnik Z. F.
Published: April 2020

Comparative studies of the bandgap narrowing in antimony doped Ge layers grown on Si(001) and Ge(001) substrates are reported. The doping level in Ge:Sb layers was varied in such a way as to obtain structures with both full and partial electrical activation of the impurity atoms. It was shown that the direct bandgap narrowing as a function of electron concentration can be fitted rather well by a root power dependence in Ge layers grown on both types of substrates. Taking into account the doping-induced deformation of Ge lattices and a careful determination of electron concentration made it possible to accurately distinguish the “structural” contribution to the bandgap narrowing caused by the embedding of large Sb atoms into the Ge matrix and the “electrical” one caused by the interaction of charge carriers. The presented results shed light on some optical properties of heavily and ultra-heavily doped n-Ge and, thus, can be useful for the development of Ge-based electronic or photonic devices.
Enhancing electrostatic coupling in silicon quantum dot array by dual gate oxide thickness for large-scale integration
Authors: Lee N. , Tsuchiya R. , Shinkai G. , Kanno Y. , Mine T. , Takahama T. , Mizokuchi R. , Kodera T. , Hisamoto D. , Mizuno H.
Published: April 2020

We propose a structure with word/bit line control for a two-dimensional quantum dot array, which allows random access for arbitrary quantum dots with a small number of control signals. To control multiple quantum dots with a single signal, every quantum dot should have a wide operating voltage allowance to overcome the property variations. We fabricate two-dimensional quantum dot arrays using silicon-complementary-metal-oxide-semiconductor technology with an alternating dual-standard gate oxide thickness. The quantum dots are designed to have an allowable operating voltage window of 0.2 V to control the number of electrons, which is a window one order of magnitude wider than that of previous works. The proposed structure enables both easy fabrication and operation for multiple quantum dots and will pave the way for practical use of large-scale quantum computers.
The effects of carbon incorporation on the refractive index of PECVD silicon oxide layers
Authors: Torda Benjamin , Rachdi Lazhar , Mohamed Okasha Mohamed Okasha Asmaa , Saint-Cast Pierre , Hofmann Marc
Published: April 2020

Silicon oxide (SiOx) has many applications, including as a low-refractive index material. Plasma enhanced chemical vapor deposition (PECVD) processes are facile, low temperature routes to produce thin SiOx layers. A route to decrease the refractive index of SiOx films is to increase the layer porosity although maintaining structural and optical stability remains challenging. Organic carbon-containing sacrificial layers have been shown to modify the growth and resulting structure of PECVD SiOx layers. In this work, we study the effect of adding methane (CH4) to the standard SiOx process gas mixture (silane and nitrous oxide) and varying deposition temperatures and microwave power in an industrial-scale, microwave PECVD reactor. Spectral ellipsometry was used to measure the optical properties of deposited layers, Fourier-transformed infrared (FTIR) spectroscopy to determine bonding and the layer porosity, and optical emission spectroscopy to characterize the plasma. We propose two regimes characterized by whether adding CH4 increases or decreases the refractive index and porosity of deposited layers compared to SiOx layers grown under standard conditions. However, the magnitude of the effect of adding CH4 was not large and would not find industrial application. Furthermore, the deposited layers’ refractive indices increased over time, indicating that the effects of adding CH4 to the process gas mixture were not stable. To help explain our results and to provide guidance for future efforts to better control the refractive index of PECVD SiOx layers via carbon incorporation while maintaining layer stability, we propose possible growth pathways for our layers considering both plasma reactions and surface processes.
Design study of a combined interferometer and polarimeter for a high-field, compact tokamak
Authors: Creely Alexander J. , Milanese Lucio M. , Tolman Elizabeth A. , Irby James H. , Ballinger Sean B. , Frank Samuel , Kuang Adam Q. , Linehan Bryan L. , McCarthy William , Montes Kevin J. , Mouratidis Theodore , Picard Julian F. , Rodriguez-Fernandez Pablo , Rosenthal Aaron M. , Sandberg Alexander J. , Sciortino Francesco , Simpson Raspberry A. , Tinguely R. Alexander , Zhou Muni , White Anne E.
Published: April 2020

This article is the first design study of a combined interferometer and polarimeter on a compact, high-field, high-density, net-energy tokamak. Recent advances in superconducting technology have made possible designs for compact, high magnetic field fusion power plants, such as ARC [Sorbom et al., Fusion Eng. Des. 100, 378 (2015)], and experiments, such as SPARC [Greenwald et al., PSFC Report No. RR-18-2 (2018)]. These new designs create both challenges and opportunities for plasma diagnostics. The diagnostic proposed in this work, called InterPol, takes advantage of unique opportunities provided by high magnetic field and density to measure both line-averaged density and poloidal magnetic field with a single set of CO2 and quantum cascade lasers. These measurements will be used for fast density feedback control, constraint of density and safety factor profiles, and density fluctuation measurements. Synthetic diagnostic testing using a model machine geometry, called MQ1 (Mission Q ≥ 1), and profiles simulated with Tokamak Simulation Code indicate that InterPol will be able to measure steady state density and poloidal magnetic field, as well as fluctuations caused by toroidal Alfvén eigenmodes and other phenomena on a high-field compact tokamak.
Noncanonical perfect vortex beams enabled via nonuniformly varying phase gradient
Authors: Gu Zhongzheng , Yin Da , Nie Shouping , Feng Shaotong , Xing Fangjian , Ma Jun , Yuan Caojin
Published: April 2020

A method is proposed for generating noncanonical perfect vortex beams (PVBs) based on a theory deduced from the definition of topological charge. Varying the phase gradient of the light field in the region of the decomposed integral provides arbitrary control over the nonuniform phase distribution in the transverse plane. To correct the distorted beam shape, the traditional “perfect” method of controlling the global amplitude distribution is modified and used to adjust the local beam diameter and produce what are known as noncanonical scalar PVBs. Moreover, noncanonical vector PVBs with tunable azimuthal polarization can be obtained by combining two orthogonal circularly polarized scalar PVBs. The results of experiments and numerical simulations show that the structure of the inhomogeneous phase and polarization can be tuned arbitrarily.
The effect of temperature on water desalination through two-dimensional nanopores
Authors: K. Vishnu Prasad , Sathian Sarith P.
Published: April 2020

Two-dimensional (2D) materials such as graphene, molybdenum sulfide, and hexagonal boron nitride are widely studied for separation applications such as water desalination. Desalination across such 2D nanoporous membranes is largely influenced by the bulk transport properties of water, which are, in turn, sensitive to the operating temperature. However, there have been no studies on the effect of temperature on desalination through 2D nanopores. We investigated water desalination through hydrogen functionalized graphene nanopores of varying pore areas at temperatures 275.0 K, 300.0 K, 325.0 K, and 350.0 K. The water flux showed a direct relation with the diffusion coefficient and an inverse relation with the hydrogen-bond lifetime. As a direct consequence, the water flux was found to be related to the temperature as per the Arrhenius equation, similar to an activated process. The results from the present study improve the understanding on water and ion permeation across nanoporous 2D materials at different temperatures. Furthermore, the present investigation suggests a kinetic model, which can predict the water and ion permeation based on the characteristics of the nanopore.
Utilizing exfoliated clay–poly(norbornene) nanocomposite prepared by metal-mediated surface-initiated polymerization as model end-tethered polymers on an organoclay substrate
Authors: Penaloza David P. , Seery Thomas A. P.
Published: April 2020

Current interest in dispersion strategies for nanoparticle fillers is driving research into covalently attached polymer brushes. The primary need for these “hairy nanoparticles” is for testing and developing new technologies based on polymer nanocomposites. To that end, we have prepared polymer nanocomposites with covalently tethered chains on a naturally occurring montmorillonite clay template via a metal-mediated surface-initiated ring opening metathesis polymerization approach. The nanocomposites were characterized in terms of polymer:clay composition and of various chain architecture parameters such as molecular weight, polydispersity index, and grafting density.
A structural phase boundary due to oxygen octahedral tilt–untilt transition in Bi0.5Na0.5TiO3-based piezoelectric ceramics
Authors: Yan Kang , Ren Shuai , Wang Fangfang , Wu Dawei , Zhu Kongjun , Ren Xiaobing
Published: April 2020

The investigation of fine structural evolutions around the morphotropic phase boundary (MPB) is important to understand the origin of the high piezoelectricity in ferroelectric ceramics. Here, we report a new phase boundary associated with oxygen octahedral tilt–untilt transition by exploring average and local structural evolutions in the vicinity of MPB in Bi0.5Na0.5TiO3–PbTiO3 (BNT–PT) ceramics. It is found that the local structural change of the oxygen octahedral tilt–untilt transition is decoupled with the average structural change of the rhombohedral-to-tetragonal phase transition at MPB in BNT–PT. The slight octahedral tilting distortion at MPB is responsible for the large high-field-induced electrostrain and small low-field-induced piezoelectricity in BNT–PT. The crucial difference of MPB between BNT–PT and the classical piezoelectric Pb(Zr,Ti)O3 is discussed from their local structural evolutions of octahedral tilting to the performance changes at MPB. It helps us to figure out the origin of large high-field-induced electrostrain but small piezoelectricity in BNT-based ceramics.
A single-ion monitor based on coincident measurement of secondary electrons for single event effect research
Authors: Jin Ying , Zhang Yuezhao , Liu Junliang , Yu Deyang , Wang Hui , Meng Jun , Guo Tao , Hui Xinfei , Li Xiaoxiao
Published: April 2020

Single-ion monitoring is a key requirement for many energetic heavy-ion experiments, e.g., the laboratory simulation of the single event effect of semiconductor devices under heavy ion bombardments. We have developed a two-dimensional position-sensitive and timing monitor of individual ions. It is composed of a thin aluminum foil, a pair of microchannel plate detectors, and electrostatic and magnetic fields. When energetic heavy ions pass through the aluminum foil, secondary electrons generated on each side of the foil are guided by the fields to the corresponding detector. Both the hitting position and the arrival time of the secondary electrons on corresponding detectors are measured in coincidence. A test with an 241Am α source shows that the present monitor is capable of discriminating true events from heavy background radiations. A position resolution of 1.0 mm and a recording time resolution of 50 ns have been realized in the test.
Propagation characteristics of a hollow Gaussian laser beam in a tapered plasma channel
Authors: Hong Xue-Ren , Zheng You-Lian , Tang Rong-An , Liu Tiao-Fang , Liu Xiao-Ping
Published: April 2020

The propagation characteristics of a hollow Gaussian laser beam (HGB) in a tapered plasma channel are studied by simultaneously considering the effects of relativistic self-focusing, ponderomotive self-channeling, and preformed channel focusing. A differential equation of the laser width parameter is derived by using the paraxial like approximation, and the critical surface that classifies the evolution behaviors of the HGB into focusing and defocusing is obtained theoretically. For verification, some numerical results are also given. It is found that the focusing ability of the HGB is proportional to the density of the tapered plasma channel, but it weakens with the increase in the order of the HGB. Furthermore, we also find that for the Gaussian laser beam, when the transverse plasma density is homogeneous, its focusing ability is stronger than that of the HGB with n = 3, while the trend just reverses when the transverse plasma density is parabolic.
New electron gun improves imaging resolution of low-voltage scanning electron microscopy
Authors: Frank Jodi Ackerman
Published: April 2020

A negative electron affinity photocathode used to develop a prototype.