bluuebunny/crossref_metadata_2025 huggingface dataset:
Fast Augmented STPA
Authors: Haugen Odd Ivar , Rokseth Børge
Published: February 2019

All elements (agents) in the STPA control structure (control algorithm, actuator, sensor system, process model) consist of a set of functions. These can be visualised and analysed using the Functional Analysis System Technique (FAST). The control action is executed by the control algorithm agent. By using FAST we can analyse the sub-functions of the control action and identify scenarios that may cause unsafe control actions. In the same way, the actuator agent, sensor agent and the process model agent can be visualised and analysed through FAST to identify scenarios that may cause unsafe control actions. When identifying scenarios that may lead to unsafe control actions, analysts tacitly create a mental model of these dependencies. One of the strengths of STPA is in agent analysis, by identifying the system agents responsible for enforcing safety constraints as well as other agents whose actions (or lack of them) may cause unsafe control actions. The strength of FAST is function analysis through making the functional dependencies explicit. Small FAST trees within the STPA control structure increase the information density without creating too much clutter. The semantics in FAST are relatively easy and quick to learn for Subject Matter Experts (SMEs) and others. FAST trees can guide refinement of the control structure by identifying functions as new lower-level or higher-level control actions that need further investigation in new control structures. The original purpose of FAST was to spark the creativity to find an alternative solution to a problem, or alternative ways of achieving a function. This is valuable early in the concept and design phase of any system development, including when using STPA in early system safety engineering phases.
Application of fibre composite grids as reinforcement of foamed PC and GP concrete
Authors: Krzywoń Rafał , Hulimka Jacek , Jędrzejewska Agnieszka , Górski Marcin
Published: February 2019

Cellular concretes cannot be reinforced as easily as traditional ones. Generally porous materials do not ensure sufficient bond of reinforcement; additionally, due to limited amount of aggregate, interlock between aggregate particles and reinforcement ribs is not satisfactory. The idea of reinforcement presented in the paper incorporates bi-directional composite reinforcing grids placed in tensile zone of the cellular concrete slab where transverse fibres are ensuring anchorage for fibres located in the main direction of stresses. The concept is based on geotechnical applications where grids are commonly used as soil stabilization, but the grids adopted in this solution are much stronger thanks to introduction of high strength fibres as composite reinforcement.
Intravascular papillary endothelial hyperplasia: a case report
Authors: Nayl Catherine , Fenelon Mathilde , Catros Sylvain , Fricain Jean-Christophe
Published: February 2019

Case report: A 71-year-old patient, with no notable medical-surgical history, was referred for a specialized consultation with Oral Mucosal Pathology for tumefaction on the dorsal side of the tongue. It was a nodular lesion measuring one centimeter long, purplish, and painless. There was nothing found through palpation. Surgical excision with a laser diode was performed under local anesthesia. The postoperative follow-up was simple. The patient was seen 3 months later without any sign of recurrence. Histopathological analysis revealed a vegetative intravascular hemangioendothelioma. Comments: This case is rare because of the location of the tumor, and moreover because the subject is male. A laser diode was chosen to resect the lesion because of the purple color which could have resulted in a possible vascular lesion. Indeed, the limits of excision were coagulated, which facilitated the surgery time and any limited postoperative hemorrhagic complications that could have occurred.
Psycho-stomatodynia
Authors: Boucher Yves
Published: February 2019

Introduction:Burning mouth syndrome is an enigmatic condition whose etiopathogenic origin remains largely unknown and whose treatment remains unsatisfactory. It is often considered to be of “psychosomatic” origin, and this etiology is frequently reported in the French medical literature.Corpus:This narrative review examines the arguments supporting this point of view, in its historical, clinical, and therapeutic aspects, in order to shed light on the patientʼs point of view.Conclusion:The etiopathogenic uncertainty does not let us give the patient an erroneous conception of the affliction.
Extensive amalgam tattoo (amalgam pigmentation) on the palatal mucosa: a short case report
Authors: Kamal Fiqhi Mohammed , Essaoudi Mohammed Amine , Khalfi Lahcen , Elkhatib Karim
Published: February 2019

Introduction: An amalgam tattoo is the most common form of exogenous oral pigmentation caused by the diffusion of dental amalgam into the soft tissue. Observation: Here we describe a case of diffuse pigmentation of amalgam on the hard palate. Discussion: Mucosal hyperpigmentation can occasionally be confused with melanotic lesions, thereby requiring a biopsy for differential diagnosis. Once the diagnosis of an amalgam tattoo has been established, the removal of the lesion is not necessary, except for aesthetic reasons.
Potential of a Nigerian biotite-rich kaolinite ore to industrial alumina by hydrometallurgical process
Authors: Baba Alafara A. , Raji Mustapha A. , Muhammed Muhammed O. , Abdulkareem Aishat Y. , Olasinde Fausat T. , Ayinla Kuranga I. , Adekola Folahan A. , Bale Rafiu B.
Published: February 2019

Increasing demands for aluminium and aluminium oxide with diverse industrial applications have prompted the development of a low-cost and eco-friendly technique as a substitute for conventional ore treatments by reduction-roasting route, requiring high energy consumption. For example, the demand for high-grade industrial alumina (Al2O3) as valuable materials in refractories, pigments, adsorbents, catalysis, water purification, aluminium production and metallurgical applications cannot be over emphasized. Thus, the upgrading of a Nigerian biotite-rich kaolinite ore containing admixture of kaolinite (Al2.00Si2.00O9.00: 96-900-9231), biotite (Mg6.55Fe3.46Al5.29Ti1.34Si11.36K4.00O48.00: 96-900-0844) and quartz (Si3.00O6.00: 96-900-9667) impurities by hydrometallurgical route was investigated in phosphoric acid media. During leaching, parameters such as leachant concentration, particle size and reaction temperature on the extent of ore dissolution were accordingly examined. At optimal leaching conditions (2.0 mol/L H3PO4, 75 °C), 87.0% of the initial 10 g/L ore reacted within 120 min. The activation energy of 16.6 kJ/mol supported the diffusion control reaction mechanism. The unreacted product (∼13.0%) analyzed by XRD was found to contain siliceous impurities including iron silicate and manganese silicate which could serve as valuable by-products for some defined industries. The leach liquor at optimal leaching conditions was accordingly treated to obtain pure aluminium solution which was further beneficiated to obtain high-grade alumina (α-Al2O3) of industrial value with 96.3% purity.
Effect of slag-metal composite cored wire feeding on the cleanness of Al-containing steel
Authors: Zhao Shuo , Ge Yangyang , Zhang Fuli , Lyu Jingcai , Yan Tao , Spooner Stephen
Published: February 2019

The metal yield is low in traditional calcium treatment processing and secondary oxidation of molten steel can be serious. As such, it is of great interest to control the inclusions in steels by feeding the CaO-Al2O3-Ca composite cored wire as an alternative treatment where calcium is protected from sublimation until in contact with the melt. To analyse the effect of composite cored wire on cleanliness of the liquid steel, the evolution of inclusions in steel has been investigated. The initial composition of the calcium aluminate in composite cored wire was changed systematically, and reacted with Al-containing steel to study the effects of starting composition. It can be concluded that when the content of calcium aluminate in the core powder is 80 wt-% to 90 wt-% (the yield is 10%) or the content is 90 wt-% (the yield is 20%), the typical inclusions which have a lower melting point in the steel are spherical CaO-MnO-SiO2-Al2O3, when the calcium aluminate content reaches to 70 wt-% (the yield is 10%) or the content reaches to 70 wt-% to 80 wt-% (the yield is 20%), CaO-MgO-Al2O3 or CaO-Al2O3 is more easily generated in the steel, Al2O3 is gradually reduced.
Einsatz der spinalen Navigation in der Wirbelsäulenchirurgie – Kontra
Authors: Halm Henry , Berlin Clara
Published: February 2019

Instrumentierte spinale Fusionen in der Wirbelsäulenchirurgie sind häufig durchgeführte operative Eingriffe bei verschiedensten Pathologien und werden in allen Bereichen der Wirbelsäule angewandt. Das freihändige Setzen von Pedikelschrauben nach Identifikation zuverlässiger, anatomischer Landmarken mit intraoperativer fluoroskopischer Kontrolle ist ein standardisiertes, anerkanntes und in der Literatur vielfach beschriebenes Vorgehen mit relativ geringen Komplikationsraten. Neuere Verfahren ersetzen die freihändige Technik mit Röntgen- oder CT-basierten Navigationssystemen. Diese werden insbesondere von der Industrie als bedeutend risikoärmere und exaktere Verfahren beworben, wobei sie diesen Nachweis bisher schuldig geblieben sind. Ein beispielhafter Vergleich unserer Daten bei Skoliosen, die mit Freihandtechnik instrumentiert wurden, mit Daten von CT-gestützt eingebrachten Pedikelschrauben aus einer anderen Studie belegt eine etwa 10-fach erhöhte Strahlenbelastung in der navigierten Studie, was gerade bei jugendlichen Patienten inakzeptabel ist, zumal in der Freihandtechnik in keinem einzigen Fall eine schraubenassoziierte Komplikation auftrat und auch in den letzten 8 Jahren bei insgesamt 472 Skoliosen nicht aufgetreten ist. Auch sind die Sachkosten und der Zeitaufwand bei Navigation unverhältnismäßig höher. Entscheidend für ein optimales Outcome bei der Freihandtechnik ist eine exzellente Ausbildung der Wirbelsäulenchirurgen mit exakter Kenntnis der Anatomie bzw. Pathoanatomie.
Sagittales Profil der Wirbelsäule: Was ist sinnvoll, was gefährdet den Patienten, was ist Hype? Kontra: Patienten- und morbiditätsadjustiertes Vorgehen
Authors: Meyer Bernhard , Shiban Ehab
Published: February 2019

Hintergrund Der Zusammenhang zwischen der globalen sagittalen Balance und dem klinischen Outcome bei adulter spinaler Deformität hat in den letzten 30 Jahren sehr stark an Bedeutung zugenommen. Allerdings ist die Evidenzlage mit diesem Hype nicht mitgewachsen.

Ziele der Arbeit In dieser Arbeit wird die Evidenzlage kritisch diskutiert und ein abgestuftes Behandlungsvorgehen vorgestellt.

Material und Methoden Es erfolgte eine ausführliche Literaturrecherche über Medline sowie die Zusammenfassung der Meinung der Autoren.

Ergebnisse Bis auf wenige systematische Reviews haben alle publizierten Arbeiten Evidenzlevel III oder IV. Die absolute Mehrheit dieser Veröffentlichungen berichten über Korrelationen zwischen radiologischen Parametern der spinopelvinen Balance und dem klinischen Befinden des Patienten. Eine prospektive randomisierte Studie über die Effektivität der Wiederherstellung der sagittalen Balance gibt es nicht. Erschwerend hinzu werden die sehr hohe Komplikations- und Reoperationsraten nach Operationen zu Wiederherstellung der sagittalen Balance beobachtet.

Diskussion Solange keine eindeutige Evidenz besteht, muss die Indikation zur Korrekturoperation extrem zurückhaltend gestellt werden. Wenn diese Form der Chirurgie überleben will, muss sie sich den Kriterien einer evidenzbasierten Evaluation unterziehen.
Mobbing im Kindes- und Jugendalter
Authors: Jantzer Vanessa , Resch Franz , Kaess Michael
Published: February 2019

Gegenstand und Ziel Mobbing ist häufig unter Kindern und Jugendlichen; es besteht ein kausaler Zusammenhang zwischen Mobbingerfahrungen und der Ausbildung zahlreicher psychischer und physischer Störungen. Der negative Einfluss von Mobbing betrifft viele Lebensbereiche der Opfer: psychologisch, sozial und ökonomisch. Im Kontext Schule kann und sollte Mobbing effektiv entgegengewirkt werden. Insbesondere präventive Programme für die gesamte Schule, wie das hier vorgestellte „Olweus Präventions-Programm gegen Mobbing und antisoziales Verhalten“, erscheinen vielversprechend.

Schlussfolgerungen Mobbing hat weitreichende Konsequenzen für die betroffenen Opfer sowie für die ganze Gesellschaft. Es braucht verstärkte Anstrengungen in der Entwicklung, Erforschung und Dissemination von präventiven Ansätzen.

Klinische Relevanz Angesichts der klinischen Folgen von Mobbing kann davon ausgegangen werden, dass Betroffene häufiger mit dem Gesundheitssystem in Kontakt kommen als nicht gemobbte Gleichaltrige. Eine erhöhte Sensibilisierung bezüglich der Wichtigkeit der Beziehung zu Gleichaltrigen hat das Potenzial, betroffene Kinder in diesem Kontext effektiver zu erkennen und zu behandeln.
Adipositas in der Antike
Authors: Schubert Charlotte
Published: February 2019

Dickleibigkeit ist in der Geschichte unserer westlichen Gesellschaft seit der
Antike ein vielbehandeltes Thema, das nicht nur in der Medizin, sondern
gleichermaßen auch in gesellschaftlich-historischem Kontext begegnet. In der
antiken Medizin wurde die Dickleibigkeit auf Maßlosigkeit der Nahrungsaufnahme,
auf zu große Trägheit, aber auch auf von Umwelt und Lebensweise bedingte
Konstitution zurückgeführt. Dagegen findet sich in der
historisch-philosophischen Literatur vor allem die Betonung der Maßlosigkeit,
die als moralisch minderwertig betrachtet wurde.
Bullying unter Geschwistern
Authors: Witt Andreas , Fegert Jörg M.
Published: February 2019

Gegenstand und Ziel Gewalt und Bullying unter Geschwistern ist bislang ein wenig beachtetes Thema. Im vorliegenden Beitrag soll ein Überblick über aktuelle Erkenntnisse zum Thema Bullying unter Geschwistern gegeben werden.

Methoden Die vorliegende Arbeit ist eine Übersichtsarbeit, in der aktuelle Literatur zum Thema Bullying unter Geschwistern zusammengefasst wird.

Ergebnisse Studien zeigen, dass Bullying unter Geschwistern ein häufiges Phänomen darstellt. Die Folgen für die Betroffenen sind vergleichbar mit den Folgen von Bullying durch Gleichaltrige. Bislang bestehen kaum evidenzbasierte Interventions- und Präventionsprogramme.

Schlussfolgerung Bullying unter Geschwistern in ein häufiges Phänomen und stellt einen Risikofaktor für die Entwicklung von Kindern und Jugendlichen dar. Die Entwicklung von evidenzbasierten Interventionen ist notwendig.

Klinische Relevanz Aufgrund der Häufigkeit und der Folgen sollte Bullying unter Geschwistern in der Anamneseerhebung beachtet werden.
Nachwuchsproblematiken für Praxen und Kliniken: Herausforderung der Generationen
Authors: Klingenheben Thomas , Perings Stefan , Perings Christian
Published: February 2019

Die Sicherung des medizinischen Nachwuchses in Kliniken und Praxen stellt eine Herausforderung für die Weiterentwicklung der medizinischen Versorgung in Deutschland dar. Die aktuelle Entwicklung ist gekennzeichnet durch eine Überalterung der Ärzteschaft, eine zunehmende Inanspruchnahme von Teilzeitarbeit sowie durch die Tatsache, dass mehrheitlich Frauen das Medizinstudium abschließen und in die kurative Tätigkeit eintreten („Feminisierung“ der Medizin). Dieser Entwicklung muss mit der Entwicklung flexibler Arbeitszeitmodelle, modernisierten organisatorischen Abläufen sowie Maßnahmen zur Steigerung der Attraktivität sowohl von Niederlassungsmöglichkeiten als auch von Möglichkeiten einer klinischen Karriere bis in leitende Positionen unter Gewährleistung der Vereinbarkeit von Beruf und Familie sowohl für Männer als auch Frauen begegnet werden.
Risikokommunikation und Inanspruchnahme von Präventionsangeboten des Diabetes mellitus Typ 2 mithilfe des Deutschen Diabetes-Risiko-Tests
Authors: Valenta Vera , Sailer Corinna , Mühlenbruch Kristin , Fritz Jana , Roller Gottfried , Kaiserauer Andreas , Müller Gerhard , Häring Hans-Ulrich , Schulze Matthias , Fritsche Andreas
Published: February 2019

Diabetes mellitus Typ 2 ist eine chronische Erkrankung, deren Manifestation bei Risikopersonen in klinischen Studien durch Umstellung des Lebensstils verhindert werden kann. Ziel der Studie war es zu prüfen, ob in der Allgemeinbevölkerung 1. über postalische Informationsschreiben der gesetzlichen Krankenkassen die Bereitstellung eines Selbsttests (DIfE – Deutscher Diabetes-Risiko-Test® (DRT)) zu einer verstärkten Inanspruchnahme von Präventionsangeboten im Vergleich zu Standardinformationen führt und ob 2. eine einmalige Risikobestimmung und Beratung zu einer Senkung des Diabetesrisikos führt.

Patienten und Methoden Die Studie bestand aus 2 Teilprojekten. a) Am Kreisgesundheitsamt Reutlingen wurde eine Sprechstunde zur Diabetesprävention initiiert. AOK-Versicherte ohne Diabetes zwischen 30 und 70 Jahren im Umkreis von 50 km erhielten randomisiert ein Informationsschreiben über die Diabetespräventionssprechstunde (n = 5000, Kontrollgruppe) oder zusätzlich zum Informationsschreiben einen DRT (n = 5000, Interventionsgruppe). b) Es wurde an Gesundheitstagen im Kreis Reutlingen bei 110 Personen HbA1c-Messungen durchgeführt und mithilfe des DRT über das Diabetesrisiko aufgeklärt. 78 Personen stimmten einer Studienteilnahme zu. Nach 6 Monaten wurde das Diabetesrisiko mit dem DRT und der HbA1c-Wert erneut bestimmt.

Ergebnisse a) Von den 10 000 angeschriebenen AOK-Versicherten nahmen lediglich 0,11 % das Angebot der Präventionssprechstunde wahr. Die geringe Beteiligungsrate erlaubte keine Auswertung der primären Fragestellung. b) Bei der Interventionsstudie konnte ein Follow-up bei 58 % der Studienteilnehmer erhoben werden. Es wurden keine signifikanten Veränderungen der HbA1c-Werte (Eingangsuntersuchung 5,5; 95 %-Konfidenzintervall 5,4 – 5,5 vs. Follow-up 5,4; 95 %-Konfidenzintervall 5,3 – 5,4, p = 0,30) und des DRT-Scores über 6 Monate (mediane Punktzahl: Eingangsuntersuchung 39, 95 %-Konfidenzintervall 37 – 45 vs. Follow-up 42, 95 %-Konfidenzintervall 38 – 45, p = 0,95) festgestellt. Es zeigten sich keine Gewichtsänderungen im Interventionszeitraum (p = 0,87). Jedoch gaben 28 % der Probanden an, ihr Ernährungsverhalten nach dem Beratungsgespräch verändert zu haben.

Schlussfolgerung Unsere Ergebnisse zeigen, dass das bloße Angebot einer Präventionsberatung über Informationsschreiben einer gesetzlichen Krankenkasse nicht ausreicht, um erfolgreich zur Teilnahme an einer Diabetespräventionsmaßnahme zu motivieren. Eine einmalige Risikobestimmung mit Beratung in der Allgemeinbevölkerung führt zu keiner messbaren Reduktion des Diabetesrisikos.
Kardiovaskuläre Intensivmedizin im Krankenhaus
Authors: Hennersdorf Marcus , Münz Sebastian , Hoffmeister Hans M. , Perings Christian
Published: February 2019

Kardiovaskuläre Intensivmedizin stellt einen wesentlichen Bestandteil der gesamten internistischen Intensivmedizin dar und andererseits der Tätigkeit des interventionell tätigen Kardiologen. In größeren Krankenhäusern werden Intensivstationen separat durch Anästhesisten bzw. Internisten geleitet. Dabei sind die internistischen Leitungen in den meisten Fällen auch Kardiologen. Dennoch bestehen Sorgen über ausreichenden Nachwuchs an qualifizierten Intensivmedizinern. Also sind Veränderungen nötig, welche die Ausbildung, die Rotationsmodelle und die Besetzungen der Intensivstationen betreffen, um die Motivation zu erhöhen, sich für die Intensivmedizin zu begeistern und zu engagieren. Es gibt die Zusatzweiterbildung „Intensivmedizin“ und zukünftig ein Curriculum Intensivmedizin der Deutschen Gesellschaft für Kardiologie. Am Ende muss es das Ziel sein, die Qualität der intensivmedizinischen Versorgung in der Behandlung meist schwer und oft interdisziplinär kranker Patienten weiter zu verbessern.
Bilanz 2018
Authors: Braitmaier Dr. Helmine
Published: February 2019

Jahr für Jahr erkranken immer mehr Menschen an Hautkrebs. In der Bevölkerung herrscht oft der Irrglaube, dass Sonnencreme vor Hautkrebs schützen würde. Künftig könnten auf künstlicher Intelligenz basierende Verfahren Ärzten helfen, bösartigen Hautkrebs frühzeitig zu erkennen. Für Patienten mit metastasiertem Hautkrebs oder für diejenigen mit erhöhtem Rückfallrisiko nach erfolgreicher Operation haben sich die Therapieoptionen nochmal erweitert.
Phonological Treatment Options for Children with Expressive Language Impairment
Authors: Hoover Jill
Published: February 2019

The vast majority of treatment efficacy research in the area of phonology focuses on issues relevant to children who have significant limitations in productive phonology but are “typically developing” in most other ways. The base of evidence to guide clinicians on planning intervention for children with phonological and cooccurring expressive language difficulties (PD + LI) is less well developed. Thus, the goal of this paper is to summarize the evidence on two treatment procedures designed to facilitate growth in phonological inventory for children who also require direct intervention to target other aspects of expressive language. We first review what is known about the delicate interaction between phonology and grammatical morphology. We focus the remainder of the summary on what is known about how to best address the more complex needs of children with PD + LI in intervention.
Medulloblastom
Authors: Krome Dr. Susanne
Published: February 2019

Medulloblastome sind die häufigsten Gehirntumoren bei Kindern. Die Kombination von Operation, Bestrahlung und Chemotherapie bewirkt hohe Heilungsraten. Der optimale Bestrahlungsbeginn ist aber unklar. Bisher gingen Experten davon aus, dass eine frühe Radiatio zu weniger Rezidiven und einem längeren Überleben führt. Die Studienresultate von 1338 Erkrankten bestätigten dies nicht.
Kleinzelliges Bronchialkarzinom
Authors: Klein Friederike
Published: February 2019

Beim kleinzelligen Bronchialkarzinom (SCLC) hinkt die Suche nach therapeutischen Zielstrukturen den Erfolgen beim nicht-kleinzelligen Bronchialkarzinom (NSCLC) noch hinterher. Doch beim ESMO-Kongress 2018 wurden jetzt viel versprechende neue Ergebnisse vorgestellt.
Frühjahrstagung der Arbeitsgemeinschaft Knochentumoren 2018
Authors: Prietzel Torsten , Richter Andy , Zajonz Dirk , Schmidt Michael , Schleifenbaum Stefan , Hammer Niels , Grunert Ronny
Published: February 2019

Die Schonung und Rekonstruktion der Hüftgelenkkapsel in Kombination mit dem Einsatz eines Duokopfs führte im untersuchten Patientengut zu einer um mehr als 90 % reduzierten Luxationsrate, weshalb dieses Vorgehen empfohlen werden kann, vorausgesetzt es ist im Einzelfall operationstechnisch realisierbar. Der Einsatz des Trevira-Anbindungsschlauches scheint die weichteil-assoziierten Komplikationen zu vermindern. Diesbezüglich sind jedoch weitere Untersuchungen erforderlich.
Behandlung an die Therapieziele anpassen
Authors: Kretzschmar Dr. Alexander
Published: February 2019

Besonders bei Patienten mit chronischer lymphatischer Leukämie (CLL) mit eingeschränktem Gesundheitszustand in der rezidivierten/refraktären Situation ist die MRD-Negativität nicht das primäre therapeutische Ziel, auch aufgrund der zu hohen Toxizitäten der dafür notwendigen Kombinationen. Hier steht oft eine langfristige Krankheitskontrolle im Vordergrund.
Accuracy of Routine Prenatal Genetic Screening in Patients Referred for Genetic Counseling
Authors: Gilstrop Thompson Marisa , Corsetti Stephanie , Jain Vanita , Ruhstaller Kelly , Sciscione Anthony
Published: February 2019

Objective The American College of Obstetricians and Gynecologists (ACOG) guidelines recommend routine prenatal screening for genetic diseases that could affect the pregnancy. We sought to determine the rate of missed genetic information in the general obstetrician's routine prenatal genetic screening process.

Study Design This is a sequential case series of women referred for genetic counseling between March and August of 2015. Once identified, all women completed a personalized genetic history/exposure intake form (GHEF) created by our certified genetic counselors, followed by an in-person genetic counseling session with pedigree generation. The corresponding prenatal record was reviewed for genetic history obtained by the referring provider, most often utilizing the standardized ACOG prenatal intake form's genetic and family history sections. This information was then compared with that discovered in the GHEF and through the in-person genetic counseling session. Missed genetic information was defined as information discovered on the GHEF or during the in-person genetic counseling session which was not noted on the prenatal genetic screening document from the obstetric provider. Missing genetic information that lead to a change in clinical care, either through additional laboratory screening tests, fetal imaging or prenatal diagnostic testing through chorionic villus sampling, or amniocentesis was considered significant. We also assessed the study population as to maternal race, parity, and referral source. Statistical significance was assessed using Chi-squared testing with p < 0.05 identifying significance.

Results A total of 299 patients underwent genetic counseling. Of them, 57.5% patients were referred from private providers, 28.1% from academic faculty practice, and 14.4% from a federally funded clinic. Missed genetic information was discovered in 171/299 (57.2%) of patients in the genetic counseling process. Of these 171 patients, 28.7% were identified via the GHEF and 52.6% during the in-person genetic counseling session. Of the 171 patients who had new genetic information discovered, 73 (42.7%) findings were significant. There was no statistical difference in patient race or referring office setting in the occurrence of new information found.

Conclusion In our population, genetic history obtained in the general obstetrician's office, regardless of practice type, missed genetic information in over half of cases with approximately 40% of that information leading to a subsequent change in clinical care. Developing a genetic intake form similar to our pregenetic counseling form, or modification/clarification of the “Family History and Genetic Screening” section within the standardized ACOG prenatal genetic history form, used at most practices in our region may decrease missed genetic information in the general obstetrician's office.
Effect of Albendazole Treatment in an Experimental Model of Neurocysticercosis-Induced Hydrocephalus
Authors: Fogaroli Marcelo , Oliveira Marcelo , Filho Pedro , Moraes Marcelo , Vulcano Luiz , Bazan Rodrigo , Zanini Marco , Fleury Agnès
Published: February 2019

Hydrocephalus is a major concern in neurocysticercosis (NCC), and its management is more challenging than that of hydrocephalus caused by other etiologies. Even though albendazole is a well-established drug for the treatment of NCC, the death of the parasites may worsen the clinical symptoms and eventually, deteriorate the course of hydrocephalus. The aim of this study was to analyze the effects of treatment with albendazole on the course of hydrocephalus as well as on animal behavior in a rat model of NCC-induced hydrocephalus in order to verify whether the course of hydrocephalus and the animal behavior were changed. Ventricle volumes before and after treatment showed a slight but non-statistically significant difference (168.11 mm3 versus 184.98 mm3, p = 0.45). The distribution and location of the cysts were unaffected. In addition, the behavioral patterns before and after the treatment were not significantly different, as assessed by the open field test. On histologic assessment, mononuclear leukocyte infiltration was present in diverse sites, such as the perivascular and peri-ependymal regions, choroid plexus, and meningeal membranes. A positive correlation was found between the degree of ventricle enlargement and tissue damage. Further studies with long-term comparisons are required.
Laparoscopic Repair of a Left Retrocaval Ureter in a 16-Year-Old Girl
Authors: Kadar Anna , Vatra Lorena , Avram Anca , Stoica Daniela , Oancea Marcel
Published: February 2019

Left retrocaval ureter is an extremely rare congenital malformation which is associated with situs inversus, duplicated or translated inferior vena cava (IVC). We report a female adolescent who presented with a history of intermittent, colicky lumbar pain. Diagnostic workup revealed left retrocaval ureter and left ureterohydronephrosis. The girl underwent laparoscopy. The renal pelvis and ureter posterior to the vena cava were dissected, transected at the caudal point of the dilated ureteral segment, and uncrossed and repositioned lateral to the vena cava. Ureteroureterostomy was performed over a double-J ureteral stent after spatulation of the distal ureter. The postoperative course was uneventful and the ureteral stent removed after 5 weeks. During follow-up, the patient is symptom-free. Our case demonstrates that our laparoscopic approach is feasible in this rare anatomic anomaly.
Quadrangular Fixation of Pectus Bars to Prevent Displacement in Nuss Procedure
Authors: Yoo Gyeol , Shin Jeonghwan , Rha Eun Young , Jeong Jin Yong , Lee Jun , Noh Giyong , Park Soo Seog
Published: February 2019

Background Double pectus bars are sometimes inserted to correct pectus excavatum. Method of double-bar fixation to prevent bar displacement has been rarely reported. We have used quadrangular fixation of the double pectus bars. The objective of this study was to compare results of the quadrangular fixation procedure with those of the classic separate fixation procedure.

Methods From September 2011 to January 2016, 86 patients underwent Nuss procedure with double-bar insertion. In 44 patients, each bar was fixed separately (group A). In 42 patients, quadrangular fixation of the bars was performed with metal plates (group B). Patient demographics, Haller index (HI), bar displacement index (BDI), and reoperation rate were compared between the two groups.

Results The mean patient age was 17.2 years (range: 3–40 years) in group A and 17.8 years (range: 4–30 years) in group B. There was no significant difference in preoperative or postoperative HIs between the two groups (all p >0.05). Early complication rates were 15.9% in group A and 9.5% in group B (p > 0.05). In group A, three patients underwent surgery to correct bar displacement (6.8% of reoperation rate), whereas there was no corrective surgery in group B. BDIs of the two groups were significantly different (p < 0.01).

Conclusions When quadrangular fixation was performed with upper and lower pectus bars bilaterally fixed by connecting each bar with plates, bar displacement was prevented more effectively than separate fixation, thus minimizing reoperation.
Joule heating-induced particle manipulation on a microfluidic chip
Authors: Kunti Golak , Dhar Jayabrata , Bhattacharya Anandaroop , Chakraborty Suman
Published: February 2019

We develop an electrokinetic technique that continuously manipulates colloidal particles to concentrate into patterned particulate groups in an energy efficient way, by exclusive harnessing of the intrinsic Joule heating effects. Our technique exploits the alternating current electrothermal flow phenomenon which is generated due to the interaction between non-uniform electric and thermal fields. Highly non-uniform electric field generates sharp temperature gradients by generating spatially-varying Joule heat that varies along the radial direction from a concentrated point hotspot. Sharp temperature gradients induce a local variation in electric properties which, in turn, generate a strong electrothermal vortex. The imposed fluid flow brings the colloidal particles at the centre of the hotspot and enables particle aggregation. Furthermore, maneuvering structures of the Joule heating spots, different patterns of particle clustering may be formed in a low power budget, thus opening up a new realm of on-chip particle manipulation process without necessitating a highly focused laser beam which is much complicated and demands higher power budget. This technique can find its use in Lab-on-a-chip devices to manipulate particle groups, including biological cells.
Circadian clock protein Rev-erbα regulates neuroinflammation
Authors: Griffin Percy , Dimitry Julie M. , Sheehan Patrick W. , Lananna Brian V. , Guo Chun , Robinette Michelle L. , Hayes Matthew E. , Cedeño Michelle R. , Nadarajah Collin J. , Ezerskiy Lubov A. , Colonna Marco , Zhang Jinsong , Bauer Adam Q. , Burris Thomas P. , Musiek Erik S.
Published: February 2019

Circadian dysfunction is a common attribute of many neurodegenerative diseases, most of which are associated with neuroinflammation. Circadian rhythm dysfunction has been associated with inflammation in the periphery, but the role of the core clock in neuroinflammation remains poorly understood. Here we demonstrate that Rev-erbα, a nuclear receptor and circadian clock component, is a mediator of microglial activation and neuroinflammation. We observed time-of-day oscillation in microglial immunoreactivity in the hippocampus, which was disrupted in Rev-erbα
−/−
mice. Rev-erbα deletion caused spontaneous microglial activation in the hippocampus and increased expression of proinflammatory transcripts, as well as secondary astrogliosis. Transcriptomic analysis of hippocampus from Rev-erbα
−/−
mice revealed a predominant inflammatory phenotype and suggested dysregulated NF-κB signaling. Primary Rev-erbα
−/−
microglia exhibited proinflammatory phenotypes and increased basal NF-κB activation. Chromatin immunoprecipitation revealed that Rev-erbα physically interacts with the promoter regions of several NF-κB–related genes in primary microglia. Loss of Rev-erbα in primary astrocytes had no effect on basal activation but did potentiate the inflammatory response to lipopolysaccharide (LPS). In vivo, Rev-erbα
−/−
mice exhibited enhanced hippocampal neuroinflammatory responses to peripheral LPS injection, while pharmacologic activation of Rev-erbs with the small molecule agonist SR9009 suppressed LPS-induced hippocampal neuroinflammation. Rev-erbα deletion influenced neuronal health, as conditioned media from Rev-erbα–deficient primary glial cultures exacerbated oxidative damage in cultured neurons. Rev-erbα
−/−
mice also exhibited significantly altered cortical resting-state functional connectivity, similar to that observed in neurodegenerative models. Our results reveal Rev-erbα as a pharmacologically accessible link between the circadian clock and neuroinflammation.
Unnatural verticilide enantiomer inhibits type 2 ryanodine receptor-mediated calcium leak and is antiarrhythmic
Authors: Batiste Suzanne M. , Blackwell Daniel J. , Kim Kyungsoo , Kryshtal Dmytro O. , Gomez-Hurtado Nieves , Rebbeck Robyn T. , Cornea Razvan L. , Johnston Jeffrey N. , Knollmann Bjorn C.
Published: February 2019

Significance

This report highlights a rare and exciting discovery of an unnatural enantiomer of a natural product [a cyclooligomeric depsipeptide (COD)] that potently inhibits ryanodine receptor type 2 (RyR2), a target for therapeutic development for which there are no known selective inhibitors. To our knowledge, there are no examples where the unnatural enantiomer of a natural product is highly potent at its protein target while the natural enantiomer is inactive. This discovery raises the question whether the enantiomers of other natural products harbor potent biological activity but will remain undiscovered until they are prepared or, alternatively, a mirror-image protein is used to screen natural product libraries.
The relationship between burnout and personality
Authors: Araghian Roya , Ghonsooly Behzad
Published: February 2019

This study is an attempt to address the issue of examining the relationship between burnout and personality among translation students. Recent trends in student/academic burnout have led to a proliferation of studies which have heightened the need for the exploration of this construct that is well-grounded in personality influences. Despite increasing concern over these two concepts, no report has been found so far surveying their association within the translation discipline. To this end, 73 Iranian translation students completed a 33-item student translator burnout scale and the 44-item Big Five Inventory of Personality. This was also accomplished by building a causal structural model through which the associations among these constructs were estimated. The results demonstrated that the proposed model has a good overall fit with the empirical data. Findings further provide evidence that there are significant correlations between agreeableness, neuroticism, and burnout.
The roles of explicit instruction and guided practice in the proceduralization of a complex grammatical structure
Authors: Shintani Natsuko
Published: February 2019

This chapter reports a classroom-based experimental study focusing on the effects of providing metalinguistic explanation (ME) before asking learners to perform a practice activity involving story reconstruction on their acquisition of a grammatical structure. The task required learners to comprehend the oral narrative with the help of a written script and illustrations describing the story and then to reconstruct the story while referring to the illustrations and a list of keywords. Three instructional conditions were compared: the ME+Task where the learners received ME and then completed a story reconstruction task, the Task Only, where learners just completed the task, and the ME Only where they just received the ME. This chapter also considers the relevance of the study to classroom practice. It will provide suggestions for teaching limited-proficiency learners a complex grammatical structure. The chapter concludes with a consideration of the ecological validity and pedagogical implications of this study.
The effects of multiple exposures to explicit information
Authors: Prieto Botana Goretti , DeKeyser Robert M.
Published: February 2019

The role of explicit information (EI) has long been debated in second language acquisition. Numerous studies report null effects for EI (e.g., VanPatten and Oikennon, 1996) calling for its diminution, whereas just as many point to its facilitative potential (e.g., VanPatten et al., 2013 and others), suggesting it should remain part of instruction. Previous EI studies varied with respect to the targeted learning problem, practice conditions, and EI accessibility throughout the experiment, factors which could hold the key to the divergent results found in the literature. In order to address this, a study was conducted to assess the effects of (a) multiple vs. no exposure to EI when targeting (b) learnability problems of structural vs. semantic nature and (c) under task-essential (TE) and non-task-essential practice conditions. One hundred and thirty learners of Spanish were randomly assigned to eight experimental conditions and a control group. After treatment, participants completed picture-matching, fill-in-the-gap and sentence interpretation tasks. Immediate posttest results revealed that EI was crucial for benefits to obtain under non-TE conditions whereas under TE conditions it appeared to be expendable depending on the task.
CALL in ISLA
Authors: Leow Ronald P. , Cerezo Luis , Caras Allison , Cruz Gorky
Published: February 2019

Despite the current curricular push for hybridization in language programs, research on ISLA provides little guidance as to what and how syllabus content can be migrated online. Cerezo, Caras, and Leow (2016) recently showed that videogames using guided induction (GI) can successfully promote robust learning outcomes and deep processing of a complex L2 grammatical structure, Spanish gustar constructions. This study addressed Cerezo et al.’s various limitations by comparing the effects of two videogame versions (GI vs. deductive instruction or DI) on both learning outcomes and processes of a lexically-driven, L2 form (Spanish para and por prepositions). Different from Cerezo et al. (2016), results showed no significant edge of GI over DI, suggesting that type of linguistic item might moderate the effectiveness of GI and that “one size may not fit all” in the hybridization of syllabus content. Beyond pedagogical and curricular implications, our discussion also focuses on the advantages and challenges of incorporating CALL in ISLA research.
Lexical development in the writing of intensive English program students1
Authors: Juffs Alan
Published: February 2019

This paper focuses on vocabulary development in intensive English program (IEP) students, comparing free writing data from an IEP to previous research in more controlled contexts. These free writing data derive from writing assignments collected from students with three language backgrounds: Arabic (n = 22), Chinese (n = 20) and Korean (n = 19), who studied at the intermediate and subsequently the advanced levels of an IEP in the USA. The main finding was that a purely text-based measure of diversity, vocD, did not capture gains in lexical development, whereas a measure of lexical sophistication, Advanced Guiraud (AG), did show measureable improvement. Discussion focuses on a more theoretically complex conceptualization of lexical development, how experimental methods compare with ‘messy’ classroom corpus data, and the problem of text length. Specific pedagogical recommendations include more focus more on lexical quality (Perfetti & Hart, 2002) and words at lower frequency bands (3000–9000).
The group in the self
Authors: Calzada Pérez María
Published: February 2019

Drawing on theoretical approaches to personal/group behaviour, and informed by Michael Hoey’s priming theory, this paper presents a corpus-assisted discourse study of European Parliament interventions from 2004 to 2011. The study aims to identify the group in the self and the various selves in the individual. For the analysis, three corpora from the European Comparable and Parallel Corpus Archive are explored: EP_EN (with EP interventions: 26,959,446 tokens), HC (with House of Commons interventions: 70,567,728), and SandD_david_martin (with member of European Parliament – MEP – David Martin’s interventions: 116,781). The main tool of analysis is the keyword, as generated by WordSmith 7.0. The analysis proceeds in three stages: stage 1, where the EP_EN and HC wordlists are compared, resulting in EP key priming; stage 2, where the SandD_david_martin and HC wordlists are compared, exposing David Martin’s idiosyncratic productions; and stage 3, where the EP_EN and SandD_david_martin keyword lists are manually compared, leading to the identification of EP priming in David Martin’s interventions.
Home care reimbursement for intravenous ganciclovir therapy
Authors: Mozaffari Essy , Sullivan Sean D.
Published: February 2019

Variability in reimbursement for home i.v. ganciclovir therapy among three types of payers was investigated.

A survey was developed to estimate reimbursement for drug and medical supplies and nursing services associated with preparing i.v. ganciclovir and administering it to persons with cytomegalovirus (CMV)-associated retinitis in the home care setting. The questionnaire was mailed to 45 home health care agencies and 11 nursing agencies.

Of the 56 surveys mailed, 26 (46%) were returned and considered usable. Of the 26 respondents, 22 were home health care companies, 4 were nursing ageiicies, 22 served patients covered by managed care or state assistance that reimbursed on a per diem trasis, and 9 did not provide care to fee-for-service patients. The mean total daily-reimbursement rate (for ganciclovir, supplies, and nursing services) from managed care per diem plans was $137.69 per patient, compared with $I29.18 from fee-for-service plans and $72.68 from state assistance per diem plans. The dissimilarity may have been due to geographic variations in reimbursement and different mechanisms of reimbursement.

Providers of home i.v. ganciclovir therapy for persons with CMV retinitis received the highest tnean total daily reimbursement from managed care per diem plans, followed by fee-for-service plans and state assistance per diem plans.
SPIM workflow manager for HPC
Authors: Kožusznik Jan , Bainar Petr , Klímová Jana , Krumnikl Michal , Moravec Pavel , Svatoň Václav , Tomančák Pavel
Published: February 2019

Here we introduce a Fiji plugin utilizing the HPC-as-a-Service concept, significantly mitigating the challenges life scientists face when delegating complex data-intensive processing workflows to HPC clusters. We demonstrate on a common Selective Plane Illumination Microscopy image processing task that execution of a Fiji workflow on a remote supercomputer leads to improved turnaround time despite the data transfer overhead. The plugin allows the end users to conveniently transfer image data to remote HPC resources, manage pipeline jobs and visualize processed results directly from the Fiji graphical user interface.

Availability and implementation

The code is distributed free and open source under the MIT license. Source code: https://github.com/fiji-hpc/hpc-workflow-manager/, documentation: https://imagej.net/SPIM_Workflow_Manager_For_HPC.

Supplementary information

Supplementary data are available at Bioinformatics online.
Nucleotide Archival Format (NAF) enables efficient lossless reference-free compression of DNA sequences
Authors: Kryukov Kirill , Ueda Mahoko Takahashi , Nakagawa So , Imanishi Tadashi
Published: February 2019

DNA sequence databases use compression such as gzip to reduce the required storage space and network transmission time. We describe Nucleotide Archival Format (NAF)—a new file format for lossless reference-free compression of FASTA and FASTQ-formatted nucleotide sequences. Nucleotide Archival Format compression ratio is comparable to the best DNA compressors, while providing dramatically faster decompression. We compared our format with DNA compressors: DELIMINATE and MFCompress, and with general purpose compressors: gzip, bzip2, xz, brotli and zstd.

Availability and implementation

NAF compressor and decompressor, as well as format specification are available at https://github.com/KirillKryukov/naf. Format specification is in public domain. Compressor and decompressor are open source under the zlib/libpng license, free for nearly any use.

Supplementary information

Supplementary data are available at Bioinformatics online.
Identification of specific modules and hub genes associated with the progression of gastric cancer
Authors: Gong Congcong , Hu Yang , Zhou Mao , Yao Maojin , Ning Zhengxiang , Wang Zhi , Ren Jiaoyan
Published: February 2019

Gastric cancer (GC) has high morbidity and mortality rates worldwide. Abundant literature has reported several individual genes and their related pathways intimately involved in tumor progression. However, little is known about GC progression at the gene network level. Therefore, understanding the underlying mechanisms of pathological transition from early stage to late stage is urgently needed. This study aims to identify potential vital genes and modules involved in the progression of GC. To understand the gene regulatory network of GC progression, we analyzed micro RNAs and messenger RNA s expression profiles by using a couple of bioinformatics tools. miR-205 was identified by differentially expressed analysis and was further confirmed through using multiple kernel learning-based Kronecker regularized least squares. Using weighted gene co-expression network analysis, the gastric cancer progression-related module, which has the highest correlation value with cancer progression, was obtained. Kyoto Encyclopedia of Genes and Genomes pathways and biological processes of the GCPR module genes were related to cell adhesion. Meanwhile, large-scale genes of GCPR module were found to be targeted by miR-205, including two hub genes SORBS1 and LPAR1. In brief, through multiple analytical methods, we found that miR-205 and the GCPR module play critical roles in GC progression. In addition, miR-205 might maintain cell adhesion by regulating SORBS1 and LPAR1. To screen the potential drug candidates, the gene expression profile of the GCPR module was mapped connectivity map (Cmap), and the mTOR inhibitor (Sirolimus) was found to be the most promising candidate. We further confirmed that Sirolimus can suppress cell proliferation of GC cell in vitro.