bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entwicklung eines Konsenses zu wichtigen Zielgrößen in der Physiotherapie bei Nackenschmerzen – Eine Delphi-Studie
Authors: Michalk Katrin , Schöttker-Königer Thomas , Probst Annette , Lüdtke Kerstin 
Published: May 2020

Zusammenfassung
Hintergrund Nackenschmerzen sind in der Physiotherapie ein häufiger Behandlungsanlass. Die Messung von Behandlungsergebnissen findet im Praxisalltag oftmals nur unzureichend statt. Ein Core Outcome Set (COS) für die physiotherapeutische Praxis fehlt derzeit.
Ziel Einen Konsens zu wichtigen Zielgrößen zu entwickeln, die in der physiotherapeutischen Praxis für die Messung der Behandlungsergebnisse bei Patienten mit unspezifischen Nackenschmerzen verwendet werden sollten.
Methode Zur Identifizierung von Zielgrößen wurde zunächst eine systematische Recherche durchgeführt. Anschließend fand eine Delphi-Befragung von Physiotherapeuten und Patienten statt, bei der die Teilnehmenden die Wichtigkeit der Zielgrößen anhand einer 9-Punkte-Ratingskala beurteilten. Es wurden Lage- und Streuungsmaße für jede Zielgröße berechnet.
Ergebnisse Es nahmen 62 Physiotherapeuten und neun Patienten an der ersten Fragerunde teil. Weitere Fragerunden mit den Patienten wurden aufgrund der geringen Teilnehmerzahl eingestellt. Die Patienten erachten das „Bewegungsausmaß der Halswirbelsäule in verschiedene Bewegungsrichtungen“ sowie die „gesundheitsbezogene Lebensqualität“ als wichtige Zielgrößen. 50 (81 %) bzw. 37 (74 %) Physiotherapeuten beendeten die zweite bzw. dritte Fragerunde. Für sie sind wichtige Zielgrößen „Beschwerden und Probleme bei alltäglichen Aktivitäten durch die Nackenschmerzen“ und die „Fähigkeit zum selbstverantwortlichen Umgang mit den Nackenschmerzen“.
Schlussfolgerung Es wurde ein erster Konsens zu wichtigen Zielgrößen aus Sicht der Physiotherapeuten erreicht. In Zukunft sind aufbauende Studien für die Entwicklung eines COS erforderlich, um u. a. die benannten Zielgrößen zu bestätigen und die Sicht der Patienten mit einzubeziehen.
Sialoszintigrafie
Authors: Schmidt-Kreppel Barbara , Gaertner Florian C. , Essler Markus 
Published: May 2020

ZusammenfassungEine physiologische Funktion der Speicheldrüsen ist wichtig zum Erhalt der Mundschleimhaut, des Geschmackssinns und der Zahngesundheit. Schädigungen können zu einer verminderten oder gar ausbleibenden Speichelbildung führen, was vielfältige Beschwerden zur Folge haben und nicht zuletzt mit einer Einschränkung der Lebensqualität der Betroffenen einhergehen kann. Mit der Sialoszintigrafie ist eine funktionelle simultane Beurteilung der großen Speicheldrüsen mittels einer einzigen kostengünstigen und nicht invasiven Untersuchung möglich. Klinisch relevant ist auch die Möglichkeit der Quantifizierung; Voraussetzung hierfür ist ein standardisiertes Protokoll bei der Durchführung und Auswertung. Aus den vielfältigen Ursachen, die mit einer subjektiv empfundenen Xerostomie einhergehen können, ergeben sich auch die verschiedenen Einsatzbereiche für eine Sialoszintigrafie. Auch aufgrund der in den letzten Jahren zunehmenden Radionuklidtherapien mit PSMA-Liganden besitzt die Speicheldrüsenszintigrafie weiterhin einen hohen klinischen Stellenwert. In der vorliegenden Arbeit wird ein Überblick gegeben über die Durchführung, die Indikationen und den klinischen Stellenwert dieser Untersuchung.
Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen am Becken
Authors: Pohlemann Tim , Herath Steven 
Published: May 2020

ZusammenfassungKorrekturbedürftige Fehlheilungen und Pseudarthrosen sind nach aktuellen Prinzipien folgendener Primärbehandlung der Verletzung in Deutschland selten. Korrektureingriffe sind indiziert, wenn erheblicher, sicher beckenbedingter, Leidensdruck besteht und Fehlstellungen mit und ohne knöcherner Heilung vorliegen. Eine umfassende präoperative Diagnostik, Analyse und Planung ist die Grundlage von korrigierenden Eingriffen. Diese risikobeladenen, aufwendigen Operationen sollten daher nur spezialisierten Zentren vorbehalten werden. Bei strenger Indikationsstellung und konsequenter Operationsdurchführung ist in vielen Fällen allerdings eine deutliche Steigerung der Lebensqualität erreichbar.
Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art
Authors: Müller Daniela , Müller Oliver 
Published: May 2020

ZusammenfassungDie spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.
Arzneimittelinteraktionen in der Intensivmedizin
Authors: Drust Andreas 
Published: May 2020

ZusammenfassungArzneimittelinteraktionen sind auf Intensivstationen ein häufiges Problem. Dabei spielt die Gesamtmenge der verschriebenen Medikamente bei kritisch kranken Patienten eine große Rolle: Durchschnittlich werden hier 25 – 35 Medikamente pro Patient eingesetzt. Fundierte Kenntnisse über entsprechende pharmakodynamische und pharmakokinetische Mechanismen sind für die Behandlungssicherheit daher essenziell.
Über Möglichkeiten und Einsatzfelder
Authors: Bensch Sandra 
Published: May 2020

ZusammenfassungServicewägen, die auf digitale Rufe reagieren, Roboter, die mit Bewohnern singen und spielen, Apps, die Anamnesen erheben. Digitale Technologien kommen in der Pflegewelt an – wenn sie bedienfreundlich und einfach zu reparieren sind.
Organische und funktionelle Durchblutungsstörungen der Hand – differenzialdiagnostische Aspekte
Authors: Wahl Uwe 
Published: May 2020

ZusammenfassungDie Abklärung von venösen und arteriellen Durchblutungsstörungen sowie Lymphödemen gehört zur täglichen Praxisroutine des Gefäßmediziners. Nicht selten werden von chirurgischen Kollegen Patienten mit Beschwerden im Schulter-, Arm- und Handbereich zum Ausschluss einer vaskulären Ursache vorgestellt. Der wohl häufigste Abklärungsgrund im Handbereich ist das Raynaud-Phänomen. Neben arteriosklerotischen Durchblutungsstörungen und der Thrombangiitis obliterans sind das Hypothenar-/Thenar-Hammer-Syndrom und das Vibrationssyndrom in den Fingern eher wenig bekannte Entitäten, deren Kenntnis jedoch neben dem medizinischen Vorgehen auch versicherungsrelevante Konsequenzen haben kann. Während beim Hypothenar-/Thenar-Hammer-Syndrom eine organische Durchblutungsstörung vorliegt, beinhaltet das Vibrationssyndrom der Finger eine funktionell vaskuläre sowie eine nervale Komponente, die eine Trennung vom Karpaltunnelsyndrom erschwert. Bei beiden Entitäten ist eine Berufsanamnese häufig hilfreich. Schon der Verdacht auf eine Berufskrankheit muss nach Gesetzeslage zur Anzeige gebracht werden. Der Artikel beschreibt die wesentlichen pathophysiologischen Mechanismen beider Entitäten und stellt diagnostische und therapeutische Optionen dar. Die Kenntnis beider Erkrankungen erweitert die differenzialdiagnostische Vorgehensweise in der täglichen Praxisroutine bei Patienten mit Schulter-Arm-Hand-Beschwerden und bei Patienten mit Raynaud-Phänomen.
Double-balloon endoscopy facilitates efficient endoscopic resection of duodenal and jejunal polyps in patients with familial adenomatous polyposis
Authors: Sekiya Mariko , Sakamoto Hirotsugu , Yano Tomonori , Miyahara Shoko , Nagayama Manabu , Kobayashi Yasutoshi , Shinozaki Satoshi , Sunada Keijiro , Lefor Alan Kawarai , Yamamoto Hironori 
Published: May 2020

Abstract
Background Many patients with familial adenomatous polyposis (FAP) have adenomatous polyps of the duodenum and the jejunum. We aimed to elucidate the long-term outcomes after double-balloon endoscopy (DBE)-assisted endoscopic resection of duodenal and jejunal polyps in patients with FAP.
Methods We retrospectively reviewed patients who underwent more than two sessions of endoscopic resection using DBE from August 2004 to July 2018.
Results A total of 72 DBEs were performed in eight patients (median age 30 years, range 12–53; 1.4 DBE procedures/patient-year) during the study period, and 1237 polyps were resected. The median observation period was 77.5 months (range 8–167). There were 11 adverse events, including seven delayed bleeds and four episodes of acute pancreatitis. No delayed bleeding occurred after cold polypectomy. Although, in one patient, one endoscopically resected duodenal polyp was diagnosed as being intramucosal carcinoma, none of the patients developed an advanced duodenal or jejunal cancer during the study period.
Conclusions Endoscopic resection of duodenal and jejunal polyposis using DBE in patients with FAP can be performed safely, efficiently, and effectively.
Concept of Mental Health and Disease for Practical Implementation: A Case-Based Teaching for Undergraduate Students—Part I of Basic and Applied Psychology
Authors: Yadav Rajesh Ramkunwar 
Published: May 2020

Abstract
Background Mental health has been conceptualised by the World Health Organisation (WHO) as not just the absence of illness but as a state of well-being in which the individual can cope with normal stresses of life, work productively and fruitfully, and make a contribution to the community. To achieve this or to explain it to the stakeholders, a doctor needs to be well versed with the normal functioning of the human mind. Homoeopathic doctors must have this knowledge to help them understand and treat their patients or advise prevention. Lack of this knowledge in the undergraduate years fails to suitably equip them, thereby hampering their own growth and clinical functions. These papers (in two parts) will deal with the teaching of basic and applied psychology and abnormal psychology and psychiatry to homoeopathic undergraduates.
Aim The main aim of this study is to teach homoeopathic undergraduate students the basic psychological concepts required for understanding human behaviour through cased based presentations
Methodology Plan of teaching psychology to undergraduate students with a case-based approach was formulated by the Psychiatric Department of Dr. M.L. Dhawale Homoeopathic Institute (MLDMHI), Palghar. Postgraduate students prepared topics with the help of a lesson plan template under the guidance of faculty. Peer evaluation along with student feedback helped to gauge the impact of the lectures and to design improvements.
Results Thirteen topics, one each week, covered the assigned portion for basic psychology. Reports of around 30 students and 2 lecturers for each lecture over 3 years were evaluated. These indicated satisfaction with contents and desire to have more such lectures. Multiple choice questions post lectures allowed to identify the changes in knowledge and interest of students in the subject.
Discussion Basic and comprehensive knowledge of psychology will allow students/physicians to look at the cases not only from the view point of physical antecedents but also from a more holistic and comprehensive point of view.
Conclusion Educational ethos demands the incorporation of case-based teaching in undergraduates especially in the teaching of psychology, to expose the shades of normal and abnormal states of mind through case-based teachings.
The Impact of the Ligamentous Injury Pattern and Associated Neurovascular Injury on Ultimate Knee Function in Patients with Traumatic Knee Dislocations
Authors: Kilicoglu Onder I. , Pehlivanoglu Tuna , Demirel Mehmet , Chodza Mechmet , Balcı Halil I. , Asık Mehmet 
Published: May 2020

AbstractThe present study aims to investigate whether there is a relationship between the ligamentous injury pattern and concomitant neurovascular injury with long-term functional outcomes in patients with traumatic knee dislocations (TKDs). A total of 42 patients with TKDs were categorized according to the Schenck's classification based on the pattern of ligamentous injury. Concomitant vascular and neural injuries were recorded. Long-term functional outcomes were assessed using several objective and subjective outcome measures. This retrospective study was conducted in two phases: (1) to analyze the impact of ligamentous injury pattern on functional outcomes of patients with TKDs in the overall study population, by comparing all the variables among Schenck's grades; (2) to determine the impact of concomitant vascular and neural injury on ultimate knee function based on the subgroup analyses. In the overall study statistical differences were determined among each pattern of ligamentous injury in the total range of motion (ROM) and scoring systems (chi-squared test, p = 0.254). The overall rates of vascular and neural injury were 26 and 28%, respectively. In subgroup analyses, 40 patients were divided into three subgroups: group A (isolated concomitant neural injury), group B (isolated concomitant vascular injury), group C (without concomitant major vascular or neural injury). The analysis revealed a significant difference in the total ROM (p = 0.005), flexion measurements (p = 0.004), and the loss of extension (p = 0.003). Group A had the lowest total knee ROM and the mean flexion degrees, as well as the highest loss of extension. Concerning functional scoring systems including the combined Knee Society Score (knee score + function score), Lysholm knee scoring scale, and International Knee Documentation Committee score, subgroup analyses revealed significant differences among the groups (p = 0.001, p < 0.01 for all scores). All the scores were found to be lowest in group A. Evidence from the current study showed that the ligamentous pattern and concomitant neurovascular injury both may have a significant impact on ultimate knee function in patients with TKDs. This is a Level III-retrospective comparative study.
Functional Dart-Throwing Motion: A Clinical Comparison of Four-Corner Fusion to Radioscapholunate Fusion Using Inertial Motion Capture
Authors: Babazadeh Sina , Ling Ferraby , Nguyen Nhan B. , Pham Trieu H. , Pathirana Pubudu N. , Eng Kevin , Page Richard 
Published: May 2020

Abstract
Background Dart-throwing motion (DTM) is an important functional arc of the wrist from radial extension to ulna flexion. An aim of partial fusion surgery of the wrist is to maintain maximal functional motion while addressing the pathology. The radioscapholunate (RSL) fusion, accompanied with partial resection of the distal scaphoid, is thought to allow better DTM than other partial wrist fusions such as the four-corner fusion (4CF).
Question Does an RSL fusion allow better functional DTM than 4CF, and how does this range compare with healthy wrists and the patient's contralateral wrist?
Patients and Methods Patients who have undergone an RSL fusion or 4CF at our tertiary center were identified and invited to present to have their DTM arc measured. To accurately measure DTM, a previously validated inertial measurement device was used. Patient's functional DTM arc was measured in both unrestrained (elbow and shoulder free to move) and restrained (elbow and shoulder immobilized) fashions. This was compared with their contralateral wrist and a group of healthy control volunteers.
Results Overall five RSL fusions, 10 4CF and 24 control patients were enrolled in the study. There was no significant difference between functional DTM when 4CF and RSL fusion were compared. Both had significantly reduced functional DTM arc than control patients. There was no significant difference between the operated wrist compared with the patient's contralateral unoperated wrist.
Conclusion RSL fusion is not significantly better at maintaining functional DTM when compared with 4CF. Both surgeries result in decreased functional DTM arc when compared with control patients. This is a cohort study and reflects a level of evidence IV.
Level of Evidence This is a Leve IV, cohort study.
Should Off Label Antiepileptic Drugs Be Used for Treatment of Infancy and Childhood Epilepsy? Discussions Based on a Dravet Syndrome Case Report
Authors: Vintan Mihaela-Adela 
Published: May 2020

AbstractEpilepsy represents a burdensome neurological disorder with higher incidence before the age of 18 years. The treatment is medical and involves long-term administration of antiepileptic drugs (AED). There are known high-resistant syndromes with onset in infancy and childhood, Dravet syndrome, being one of them. It is a well-known fact that early seizures treatment prevents associated comorbidities, cognitive and motor disabilities, and improve long-term prognosis. There are several AEDs available but not all of them are approved for use in infants. This is due to the need for additional toxicology studies at this age and for development of suitable formulations.A 14-month-old girl with Dravet syndrome was presented here. Prompt diagnosis was made based on clinical features and confirmed by the genetic tests. She partially responded to valproate and clobazam but continued to have prolonged febrile seizures. We added stiripentol after consulting reports of studies in infants younger than 2 years and after obtaining family consent. She responded well with decrease in episodes of status epilepticus and improvement in psychomotor development and stiripentol was tolerated well. Off label use of certain AEDs can benefit infants when there are no major pharmacokinetic differences in comparison to older children.
Glycosaminoglycans accelerate biomimetic collagen mineralization in a tissue-based in vitro model
Authors: Wojtas Magdalena , Lausch Alexander J. , Sone Eli D. 
Published: May 2020

Significance
Collagen mineralization is required for bone and dentin formation, but the molecular mechanism of that process is not completely understood. Using an in vitro model based on mouse dental tissues, we show that glycosaminoglycans (GAGs) promote collagen mineralization in mineralized tissues, rather than inhibiting mineralization of the ligament. Moreover, the mineralization promoting effect of GAGs is larger than for phosphoproteins, the most frequently studied controlling factor in crystal nucleation and growth. Our model enabled the study of molecular factors on collagen mineralization independently, without changing the expression pattern of other factors, and under conditions as close to native tissue as possible. Evidence that matrix GAGs promote collagen biomineralization has important implications for understanding control of mineralization in connective tissue more generally.
Context-dependent and dynamic functional influence of corticothalamic pathways to first- and higher-order visual thalamus
Authors: Kirchgessner Megan A. , Franklin Alexis D. , Callaway Edward M. 
Published: May 2020

Significance
Layer 6 corticothalamic (L6CT) projections play important modulatory roles in thalamic processing, yet how this modulation is executed is unclear. While some studies suggest fundamentally inhibitory influence of L6CTs over first-order thalamus, potential complex, frequency-dependent effects have not been investigated in vivo. Moreover, how L6CTs affect higher-order nuclei in vivo has not been explored. This study utilizes various optogenetic manipulations of L6CTs with single-unit recordings from multiple thalamic nuclei in awake mice to address these questions. Our results illustrate similar effects of L6CTs on first- and higher-order visual thalamic nuclei, yet very different effects within-nucleus depending on how L6CTs are engaged. These findings suggest that L6CT modulation is not simply inhibitory by nature, but instead is dynamic and context-dependent.
Cultural evolution of conformity and anticonformity
Authors: Denton Kaleda Krebs , Ram Yoav , Liberman Uri , Feldman Marcus W. 
Published: May 2020

Significance
The evolutionary dynamics of cultural variants under conformist- and anticonformist-biased transmission have implications for humans and nonhuman animals. Humans display both conformist and anticonformist biases, and models of conformist-biased transmission have been proposed to explain large-scale human cooperation. Nonhuman animals have been shown to display conformist biases in mating and foraging decisions. Here, we investigate established mathematical models of conformist and anticonformist bias with and without selection and find complex dynamics, including multiple stable polymorphic equilibria, stable cycles, and chaos. Using modifier theory, we show that evolution will reduce anticonformist bias against a culturally advantageous variant. Migration between subpopulations subject to different selection and conformity pressures can produce interesting polymorphisms or eliminate between-group differences.
A focus on language in the immersion language arts curriculum
Authors: Bateman Blair , Child Michael , Berlendis Bueno Eliane 
Published: May 2020

AbstractGrounded in research on explicit and implicit knowledge and on the role of conscious awareness in language learning, this interpretive case study examined the efforts of one Portuguese teacher to implement a focus on language within a language arts curriculum based on literary genres with a class of fourth grade (9-year-old) students over the course of an academic year. The study found that lessons on authentic literary texts provided a meaningful context for calling students’ attention to nominal and verbal agreement patterns in Portuguese. By the end of the year, students’ nominal and verbal agreement had improved dramatically on a written test, but only their nominal agreement had improved significantly in an unstructured interview, although they had begun to use a greater variety of verb forms. Students were also able to correct many of their own errors and to use metalinguistic terminology to explain the language patterns involved.
A sequential regularization based image reconstruction method for limited-angle spectral CT
Authors: Sheng Wenjuan , Zhao Xing , Li Mengfei 
Published: May 2020

Abstract
In spectral computed tomography (CT), the object is respectively scanned under different x-ray spectra. Multiple projection data can be collectively used for reconstructing basis images and virtual monochromatic images, which have been used in material decomposition, beam-hardening correction, bone removal, and so on. In practice, projection data may be obtained in a limited scanning angular range. Images reconstructed from limited-angle data by conventional spectral CT reconstruction methods will be deteriorated by limited-angle related artifacts and basis image decomposition errors. Motivated by observations of limited-angle spectral CT, we propose a sequential regularization-based limited-angle spectral CT reconstruction model and its numerical solver. Both simulated and real data experiments validate that our method is capable of suppressing artifacts, preserving edges and reducing decomposition errors.
Web-based Knowledge Management System for Camarines Norte State College
Authors: Maligat D E , Torio J O , Bigueras R T , Arispe M C , Palaoag T D 
Published: May 2020

Abstract
One of the issues of the academic institution is knowledge management. How the academe disseminate information over the academic community on real time and the availability of knowledge anytime and anywhere is challenging task in every institution. The objective of this study is to develop Knowledge Management System for Camarines Norte State College that is capable of knowledge sharing, creating and knowledge repository. The developed KM system is designed specifically to cater the requirements of the academic institutions especially Camarines Norte State College in terms of knowledge management. A usability test was conducted to find out how far the academic community can interact efficiently and effectively and how far the system application provides user guidance, provide information, and provide consistent interaction. The pooled mean of the overall usability test was 4.55 with adjectival rating of SA or strongly agree, which means that the system has the functionality needed by the users, easy to use and the system is very useful. Moreover, KMS in Higher Education Institution (HEI) could help in the growth of learner centered knowledge and action learning, growth in work-related learning, movement from closed to open knowledge systems and extensive development in computer-based communication technologies.