bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strukturiertes Feedback im Kommunikationstraining zur präoperativen Aufklärung: unterschiedliche Bewertungsquellen nutzbar machen
Authors: Kahr Philipp , Sippel Sonia , König Sarah 
Published: December 2019

Zusammenfassung
Einleitung Ärztliche Kommunikation wird vielerorts bereits im Studium eingeübt. Das Aufklärungsgespräch vor einer Operation ist ein spezifischer Kommunikationsanlass, der einer differenzierten Rückmeldung an die Studierenden bedarf. Ziel war es, im Rahmen eines Kommunikationstrainings die Rückmeldung verschiedener Feedbackgeber (ärztlicher Experte, geschulte Tutorinnen und Tutoren, Studierende der Peer Group, Aufklärende selbst und Simulationspersonen) anhand von Bewertungschecklisten zu strukturieren und die Ergebnisse zu vergleichen.
Material und Methoden 171 Humanmedizinstudierende des 8. Semesters der Universität Würzburg nahmen in Kleingruppen an einem Training zur präoperativen Aufklärung teil. 50 Personen davon führten ein Aufklärungsgespräch und erhielten Feedback. Im Fokus der Gespräche standen „Kommunikation“ sowie „Komplikationen“. Die Studierenden bereiteten sich mittels Unterrichtsmaterialien auf der universitätseigenen E-Learning-Plattform vor. Gegenstand der statistischen Auswertungen waren die Testgüte der Bewertungschecklisten, die Bewertungspunkte in den Skalen und die Übereinstimmung der Bewertungen auf Basis des Intraklassenkorrelationskoeffizienten (ICC).
Ergebnisse Die Bewertungschecklisten wiesen zufriedenstellende Werte für interne Konsistenz, Itemschwierigkeit und Trennschärfe auf. Die Mittelwerte der Scores zur „Kommunikation“ unterschieden sich teilweise signifikant durch die 5 Bewertungsquellen, wobei hier die Selbsteinschätzung durch die studentischen Aufklärenden am strengsten ausfiel. Die studentischen Tutorinnen und Tutoren bewerteten identisch zum Experten. In Bezug auf die „Komplikationen“ gab es keine signifikanten Abweichungen zwischen den Bewertenden.
Diskussion/Schlussfolgerung Es konnte gezeigt werden, dass innerhalb des hochspezifischen Settings eines Simulationstrainings und nach geplanter Vorbereitung geschulte studentische Tutoren/innen eine vergleichbar gute Rückmeldung wie der ärztliche Experte geben können. Bei überwiegenden Übereinstimmungen im strukturierten Feedback darf somit der Rückmeldung durch Tutoren/innen oder Peers zukünftig ein höherer Stellenwert eingeräumt werden.
The Long and Winding Road to Personalized Glycemic Control in the Intensive Care Unit
Authors: Tickoo Mayanka 
Published: December 2019

AbstractIn the critically ill adult, dysglycemia is a marker of disease severity and is associated with worse clinical outcomes. Close monitoring of glucose and use of insulin in critically ill patients have been done for more than 2 decades, but the appropriate target glycemic range in critically ill patients remains controversial. Physiological stress response, levels of inflammatory cytokines, nutritional intake, and level of mobility affect glycemic control, and a more personalized approach to patients with dysglycemia is warranted in critically ill intensive care unit (ICU) patients. We discuss the pathophysiology and downstream effects of altered glycemic response in critical illness, management of glycemic control in the ICU, and future strategies toward personalization of critical care glycemic management.
Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome
Authors: Luetz Alawi , Grunow Julius J. , Mörgeli Rudolf , Rosenthal Max , Weber-Carstens Steffen , Weiss Bjoern , Spies Claudia 
Published: December 2019

AbstractDelirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in “Post-ICU Syndrome” (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep–wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.
Emerging Ethical Challenges in Critical Care for the 21st Century: A Case-Based Discussion
Authors: Lee Jisoo , Ward Nicholas S. 
Published: December 2019

AbstractEthical challenges for doctors and other health care professionals have existed since the practice of medicine began. Many of the oldest challenges live on to this day, such as who has more authority to make key decisions (autonomy vs. paternalism) and what are the boundaries of life at the beginning and at the end. Two powerful driving forces are new technologies and an ever-changing culture and society. The practice of medicine in intensive care units (ICUs) has been the source of many ethical challenges. Once firmly fixed concepts, such as death or “brain death” are now coming under increasing debate. In other areas, the concept of patient autonomy has been used to request life-prolonging therapies, once thought “futile.” New technologies for procreation have necessitated new ethical challenges as well. In this paper, we will use a series of cases, based on experiences from our hospital ethics committee, that occurred over the course of several years and illustrate ethical challenges which are either new to us or not new but growing in frequency due to technological or societal changes. Each one of these topics is complex and worthy of its own large review but for this overview, we will briefly discuss the key points of each dilemma.
Recurrent Encephalopathy with Transverse Myelitis: An Uncommon Presentation of Neurobrucellosis
Authors: Anadure Ravi K. , Goel Jitesh , Sahu S. , Vidhale Tushar 
Published: December 2019

Abstract
Brucellosis (malta fever) is a zoonotic infection caused by a gram-negative coccobacillus which is a facultative intracellular pathogen. It causes a chronic granulomatous infection, similar in histology to tuberculosis. Brucellosis remains a diagnostic dilemma due to misleading, nonspecific manifestations and increasing trend of unusual presentations. In brucellosis, the nervous system involvement occurs in only 5 to 7% of untreated patients, and it may manifest with encephalitis, meningoencephalitis, radiculitis, and peripheral and cranial neuropathies. Transverse myelitis is an unusual occurrence. Here, the authors are reporting an unusual case of neurobrucellosis in an elderly male patient who visited multiple hospitals with recurring febrile encephalopathy and paraparesis. The diagnosis was suspected by his occupational history of working as an abattoir worker and was confirmed by the presence of high titers of Brucella immunoglobulin (Ig) M and IgG antibodies in the serum. The patient was managed with injection gentamicin for 2 weeks along with oral course of doxycycline and rifampicin for 6 weeks. He made a good clinical recovery and went back to work with mild residual deficits.
Indiscriminate Use of Antibiotics in Neurotrauma Patients Referred for Expert Neurosurgical Care in a Developing Country
Authors: Oyemolade Toyin A. , Malomo Toluyemi A. , Adeleye Amos O. 
Published: December 2019

Abstract

Background In Nigeria, pre-neurosurgical care of most neurotrauma patients usually involves administration of many empirical agents including antibiotics with no apparent indications. This practice is fraught with two particular dangers: increase in health care costs and development of drug resistance. This study aimed to interrogate antibiotic stewardship in the pre-neurosurgical care of neurotrauma patients referred to our practice.

Materials and Methods This 7-month prospective descriptive study was performed in one University Teaching Hospital of a developing country. Clinical data on all admitted neurotrauma patients with information on the pre-neurosurgical treatment received were captured and analyzed.

Results There were 113 patients, 87(77.0%) males; 103(91.2%) had head injury, and 10(8.8%) spinal cord injury. Associated systemic injuries occurred in 47(41.6%): 40 involved skeletal and soft tissue systems, and 12(10.6%) presented with aspiration pneumonitis. These patients were referrals from public health facilities including primary health facilities (PHF), secondary (SHF), and tertiary (THF), as well as private clinics (PC). Antibiotics were given to 74 (65.5%) patients, with a probabilistic indication in only 17.6% (13/74) of these. The proportional distribution of this antibiotic administration according to the referral base was not statistically significant (χ2 =6.87, p = 0.3): 70% (14/20) from PHF, 56% (14/25) from SHF, 71% (23/32) from THF, and 63% (23/36) from PC. The antimicrobial agent administered was specified in 40 cases: Ceftriaxone was the commonest antibiotic agent implicated.

Conclusion There is apparent unnecessary exposure of patients to antibiotics in the pre-neurosurgical care of neurotrauma in this study. There is, therefore, need for education on antibiotic stewardship to the group of health workers involved.
Device-Associated Meningitis by Linezolid-Resistant Staphylococcus haemolyticus in a Vancomycin- Hypersensitive Patient
Authors: Vijayan Priya , Srinivas Dwarakanath , Siddaiah Nagarathna , Bahubali Veena Kumari Haradara 
Published: December 2019

Abstract
Postsurgical device-related meningitis caused by multidrug-resistant coagulase-negative staphylococci often complicates the treatment options. We report a rare and, to our knowledge, the first clinical case report of drain-associated meningitis caused by methicillin- and linezolid-resistant Staphylococcus haemolyticus following linezolid therapy in a vancomycin-hypersensitive patient subsequently treated with cotrimoxazole, resulting in clinical improvement. The molecular mechanisms responsible for linezolid resistance were found to be the presence of G2576T mutation in domain V of 23srRNA region, which often arises during linezolid usage and also carriage of cfr gene, which promotes resistance independent of antibiotic pressure. We emphasize on monitoring the rational use of linezolid to avoid the spread of resistance and also comprehensive perioperative care to prevent health care-associated infection.
Fibrous Meningioma with Skull Invasion
Authors: Ichimura Shinya , Takahara Kento , Fujii Koji 
Published: December 2019

AbstractIn patients with meningiomas, the presence of skull invasion is known to be a predictor of aggressive clinical behavior, which may negatively influence patient outcomes. In the present report, we discuss a case of fibrous meningioma with skull invasion. A 42-year-old woman was referred to our department presenting with hyperostosis in the right parietal bone. T1-weighted magnetic resonance imaging with gadolinium enhancement revealed prominent enhancement of the intraosseous lesion and dura mater. Following the removal of the tumor body and bone lesion, we performed immunohistochemical staining for osteopontin (OPN), matrix metalloproteinase- 2 (MMP2), and integrin β-1 (CD29). The tumor body was immunoreactive for OPN and CD29, but not MMP2, whereas, the bone lesion was immunoreactive for all the three antigens. The present case suggests that OPN, MMP2, and CD29 play key regulatory roles in bone invasion.
Supergiant Cavernous Carotid Aneurysm: Successful Management with Ligation of Internal Carotid Artery and STA–MCA Bypass
Authors: Singla Navneet , Aggarwal Ashish , Praneeth Kokkula , Ahuja Chirag 
Published: December 2019

Abstract
Supergiant cerebral aneurysm (size > 6 cm) is a rare and challenging cerebrovascular disease with few documented cases in literature. We describe a simple, safe, and effective treatment option for supergiant cavernous carotid aneurysm and discuss the proposed mechanisms for a favorable outcome.
Mental Health Care Delivery for Older Adults in Rural Greece: Unmet Needs
Authors: Peritogiannis Vaios , Lixouriotis Charalampos 
Published: December 2019

AbstractMental disorders may go unrecognized and undertreated in older adults. This is the rationale for the launch of specialized mental health services for the elderly in high resourced settings. Rural areas, however, do not receive adequate mental health care owing to socioeconomic and geographical reasons, and this is the case of rural Greece, where research on mental health of the elderly is scarce. This article discusses the challenges of providing mental health care for older adults in rural Greece and the available options. Care can be delivered through the existing rural mental health services that are the mobile mental health units and through the primary care physicians. Training in psychogeriatrics for the personnel of the former and in mental health for the latter is warranted.
Phospholipid membrane dynamics at the solid–liquid interface studied with grazing incidence neutron spin echo spectroscopy
Authors: Holderer Olaf , Jaksch Sebastian , Zolnierczuk Piotr , Ohl Michael , Frielinghaus Henrich 
Published: December 2019

Abstract
Neutron spin echo spectroscopy has been used under grazing incidence conditions to study the dynamics of SoyPC phospholipid membranes at the solid-liquid interface. The use of advanced neutron optical components such as a neutron prism and a resonator structure at the interface for an increase in intensity near the interface helped to study partially elastic waves in the phospholipid membrane as well as the influence of Ibuprofen on the membrane elasticity. Previously observed phase transitions of the surface layers of SoyPC from a lamellar structure to surface crystalline phases also showed their imprint in a suppresion of the phospholipid membrane dynamics.
Polarized beam option for the time-of-flight spectrometer NEAT
Authors: Günther G , Mezei F , Füzi J , Gainov R , Krist Th , Sánta Zs , Russina M 
Published: December 2019

Abstract
We present the basic design of the incoming neutron beam polarizer system recently installed at the TOF spectrometer NEAT at HZB and the first experimental test results. The recent upgrade of the instrument resulted in beam flux on the sample, which is one of the highest worldwide for this class of instruments. The substantial intensity gain obtained in the upgrade provides good conditions for polarized neutron experiments, considering the inherent cuts of neutron intensity by polarizing the beam. The neutron beam polarizer is placed inside a 3.8 m long evacuated neutron “guide changer”, which allows us to move into the beam delivery guide one of 3 alternative straight neutron guide sections mounted in parallel on a linear translation stage. The new transmission polarizer takes up the inside volume of a 1.33 m long, 60 mm x 125 mm cross section straight guide portion. The focusing of the beam after the polarizer to the 30 mm x 50 mm sample area happens over a total length of 3.5 m, of which 2.92 cm is a converging guide assembly with m=4 supermirror coating and parabolic end. This guide section leaves 58 cm space between guide exit and sample axis for sample environment equipment, in particular for high field cryomagnets. The transmission polarizer contains 8 “V cavity” channels with non-polarizing supermirror coated, opaque side walls and neutron-transparent Si cavity plates, coated by m=3 polarizing supermirror on both sides. The nominal operational wavelength band width of the polarizer is 2.5 – 8 Å, with measured polarization efficiency between 92 and 96 % for well collimated beam. The beam transmission efficiency for the preferred neutron spin state is about 65 %. The first 110 cm of the neutron spin guide field after the exit of the polarizer is provided by the stray fields of the magnet around the polarizer and of a permanent guide field magnet acting in the same direction. This section contains a wavelength tunable single coil Mezei flipper with flipping efficiency > 99 %. The rest of the guide field magnets are solenoids around the glass neutron beam guide. The supermirror coating in the polarized neutron section of the beam guide has been manufactured using a non-magnetic Ni alloy, the guide exchanger housing and its mechanical parts are made of non-magnetic alloys, primarily stainless steel. The polarized beam delivery system is by now operational and it is available for polarized neutron beam experiments on samples in a magnetic field. A 14 T vertical field cryomagnet is on hand at the HZB Sample Environment Group for use on NEAT. The NEAT sample chamber has been designed and built with non-magnetic or weakly magnetic materials in order to allow both for polarized neutron beam experiments and for polarization analysis work.
Polarization analysis in small-angle neutron scattering with a transportable neutron spin filter based on polarized protons
Authors: Quan Y. , van den Brandt B. , Kohlbrecher J. , Hautle P. 
Published: December 2019

Abstract
We present the status of development of a novel neutron spin filter based on the strong spin dependence of the neutron scattering on protons. Using photo-excited triplet states for the dynamic nuclear polarization (DNP) process, proton polarization values of 80% can now be achieved in pentacene doped single crystals of naphthalene at a field of 0.36 T in a simple helium flow cryostat. Careful sample preparation lead to extremely long polarization decay times under moderate conditions that allowed us to develop a transportable device. The filter is polarized in the lab under well controlled conditions and is then transferred to the neutron beam line where it can be operated during several days with almost constant polarization while requiring only a minimum of equipment. We describe briefly the main features of the spin filter and its use as a spin analyzer in a small-angle neutron scattering (SANS) experiment probing the magnetic structure of a nanocrystalline soft magnetic material. Furthermore the procedure for performing the background and spin leakage corrections of the neutron data is outlined in detail.
Setup for polarized neutron diffraction using a high-Tc superconducting magnet on the instrument POLI at MLZ and its applications
Authors: Thoma H , Deng H , Roth G , Hutanu V 
Published: December 2019

Abstract
A new polarized neutron diffraction setup has been developed for the hot neutron single crystal diffractometer POLI at the Maier-Leibnitz Zentrum (MLZ) in Germany. This setup consists of a 3He spin filter cell for polarization, a Mezei type double coil flipper optimized for short-wavelength neutrons, and a new high-Tc superconducting magnet producing fields up to 2.2 T. Because the magnet provides a symmetric field configuration, a dedicated guide field system was designed in order to avoid neutron depolarization in the zero-field node. The polarization transport efficiency of the whole setup was numerically simulated and optimized using COMSOL Multiphysics®. The polarization losses between the polarizer and the sample were confirmed to be smaller than 1.5% over the total field range of the magnet and the stray fields of the magnet did not affect the relaxation time T
1 of the 3He spin filter polarizer. First experiments with antiferromagnetic and paramagnetic samples using the new setup have been successfully performed. Using the CCSL software, a reconstruction of the field induced spin density distribution in the weak ferromagnet MnCO3 was performed in the paramagnetic state. Our results show the high performance and good resolution of the new setup.
µ-metal magnetic cavities for polarization and maintenance of polarization of 3He gas
Authors: Babcock Earl , Salhi Zahir , Barnsley Lester , Voigt Jörg , Mattauch Stefan , Ioffe Alexander 
Published: December 2019

Abstract
Low gradient magnetic holding fields are required for maintaining the polarization of polarized 3He, as diffusion though non-ideal gradients can cause total relaxation rates much greater than the intrinsic total 3He relaxation rate of a particular 3He cell in optimal conditions. For neutron scattering applications we often rely on µ-metal cavities to provide a degree of shielding from the many other sources of magnetic fields and gradient experienced on a typical neutron instrument. The JCNS utilizes two concepts for such cavities, one based on inexpensive plastic-bonded magnets to provide magnetic flux, and the other based on field coils wound on the sides of the µ-metal cavity. 2 different sized of permanent magnet cavities and three different geometries of coil-based cavities have been produced. Both types of boxes will be presented with magnetic design as well as mechanical construction details along with the achieved performance of the constructed devices.
Attributing ocean acidification to major carbon producers
Authors: Licker R , Ekwurzel B , Doney S C , Cooley S R , Lima I D , Heede R , Frumhoff P C 
Published: December 2019

Abstract
Recent research has quantified the contributions of CO2 and CH4 emissions traced to the products of major fossil fuel companies and cement manufacturers to global atmospheric CO2, surface temperature, and sea level rise. This work has informed societal considerations of the climate responsibilities of these major industrial carbon producers. Here, we extend this work to historical (1880–2015) and recent (1965–2015) acidification of the world’s ocean. Using an energy balance carbon-cycle model, we find that emissions traced to the 88 largest industrial carbon producers from 1880–2015 and 1965–2015 have contributed ∼55% and ∼51%, respectively, of the historical 1880–2015 decline in surface ocean pH. As ocean acidification is not spatially uniform, we employ a three-dimensional ocean model and identify five marine regions with large declines in surface water pH and aragonite saturation state over similar historical (average 1850–1859 to average 2000–2009) and recent (average 1960–1969 to average of 2000–2009) time periods. We characterize the biological and socioeconomic systems in these regions facing loss and damage from ocean acidification in the context of climate change and other stressors. Such analysis can inform societal consideration of carbon producer responsibility for current and near-term risks of further loss and damage to human communities dependent on marine ecosystems and fisheries vulnerable to ocean acidification.
Assessing dengue vector abundance in Penang Island by cluster analysis
Authors: Hashim N A , Ahmad A H , Talib A , Suwarno  
Published: December 2019

Abstract
Dengue is one of the deadliest mosquito-borne diseases in the world. Aedes albopictus and Aedes aegypti are the two responsible vectors for the disease. In this study, self-organizing map (SOM) was applied for ordination, clustering and mapping of the Ae. aegypti and Ae. albopictus abundance with their breeding container sizes. It was found that the abundance of vector related with the size of breeding container. Regardless of urbanization level, Ae. albopictus was more abundant in medium size containers, while Ae. aegypti was found more abundant in large containers. This finding suggested that for control efforts, eliminating medium and large breeding containers will significantly reduce Aedes population in Penang Island.