bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isochrone-cloud fitting of the extended main-sequence turn-off of young clusters
Authors: Johnston C. , Aerts C. , Pedersen M. G. , Bastian N. 
Published: October 2019

Context. Extended main-sequence turn-offs (eMSTOs) are a commonly observed property of young clusters. A global theoretical interpretation for eMSTOs is still lacking, but stellar rotation is considered a necessary ingredient to explain eMSTOs.
Aims. We aim to assess the importance of core-boundary and envelope mixing in stellar interiors for the interpretation of eMSTOs in terms of one coeval population.
Methods. We constructed isochrone-clouds based on interior mixing profiles of stars with a convective core calibrated from asteroseismology of isolated galactic field stars. We fitted these isochrone-clouds to the measured eMSTO to estimate the age and core mass of the stars in the two young clusters NGC 1850 and NGC 884, assuming one coeval population and by fixing the metallicity to the one measured from spectroscopy. We assessed the correlations between the interior mixing properties of the cluster members and their rotational and pulsational properties.
Results. We find that stellar models based on asteroseismically-calibrated interior mixing profiles lead to enhanced core masses of eMSTO stars. Additionally, these models can explain a significant fraction of the observed eMSTOs of the two considered clusters in terms of one coeval population of stars, which have similar ages to those in the literature, given the large uncertainties. The rotational and pulsational properties of the stars in NGC 884 are not sufficiently well known to perform asteroseismic modelling as it is achieved for field stars from space photometry. The stars in NGC 884 for which we have v sin i and a few pulsation frequencies show no correlation between these properties and the core masses of the stars that set the cluster age.
Conclusions. Future cluster space asteroseismology may allow for the interpretation of the core masses in terms of the physical processes that cause them, based on the modelling of the interior mixing profiles for the individual member stars with suitable identified modes.
The Development of Safety Performance Functions for Roundabouts in Amman, Jordan
Authors: AL- Nabulsi Diana , Jadaan Khair 
Published: October 2019

It is now well established that crash occurrences at roadway segments or intersections are associated with a large variety of factors. Safety Performance Functions (SPF) are statistical models developed to predict crash frequencies for various design variables.
In Jordan, almost half of all road crashes occur at intersections, mostly in urban areas. There is a significant number of roundabouts throughout Amman which is increasing without evaluating their safety performance. To assess safety benefits of this kind of intersections, transportation professionals need the powerful statistical tool; the SPF.
This study aims to develop SPFs for roundabouts in Amman. The models consider the crash frequency, traffic volume and geometric features of all the studied 20 roundabouts. The developed SPFs were statistically significant (R^2 = 0.91) .The findings of the study revealed that crash frequency has a strong relation with the AADT, roundabout entry angle-degrees, entry path radius, splitter radius, pedestrian crossing structure, inscribed diameter, central diameter, circulating width, entry width, number of circle legs. The developed SPFs are evaluated through a comparison with others from developed countries.
Fully covered self-expanding metal stents for refractory pancreatic duct strictures in symptomatic chronic pancreatitis, US experience
Authors: Sharaiha Reem Z. , Novikov Aleksey , Weaver Kristen , Marfatia Pawan , Buscaglia Jonathan M. , DiMaio Christopher J. , Diehl David , Gabr Moamen M. , Gaidhane Monica , Siddiqui Ali , Kahaleh Michel 
Published: October 2019

Abstract
Background and study aims Fully covered self-expanding metal stents (FCSEMS) have been used to treat refractory pancreatic duct strictures. We aimed to evaluate the feasibility, safety, and efficacy of FCSEMS in chronic pancreatitis with refractory pancreatic duct strictures.
Patients and methods This was a retrospective multicenter cases series of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with FCSEMS placement in the main pancreatic duct (MPD) at five tertiary care centers between February 2010 and June 2016. Primary endpoints were technical success, clinical success, and procedure-related morbidity. Secondary endpoints were pain relief at the end of follow-up and resolution of the pancreatic stricture on ERCP.
Results Thirty-three patients with previously drained stents, 76 % of whom were male, underwent ERCP with FCSEMS placement. Mean duration of follow-up was 14 months. All of the patients had prior therapy. The technical success rate for FCSEMS placement was 100 % (n = 33) and the clinical success rate was 93 % (was n = 31). Stents were removed after a median duration of 14.4 weeks. After stent removal, the diameter of the narrowest MPD stricture had increased significantly from 1 mm to 4.5 mm (P < 0.001). There was a statistically significant improvement on the Visual Analogue Scale (VAS) from a median of 8.5 to 2.5. At the end of the study, (n = 27) 87.1 % of patients reported significant pain reduction with reduced narcotic use.
Conclusion FCSEMS appeared to be a feasible, safe, and potentially effective Intervention in patients who had not responded to endoscopic therapy with plastic stents.
Carl Wernicke (1848–1905) und die „Wernicke-Kleist-Leonhard Schule“. Beziehungen zur „Erlanger Schule“ der Psychiatrie
Authors: Braun Birgit 
Published: October 2019

Zusammenfassung
Hintergrund: Anlässlich seines 170. Geburtstages soll Carl Wernicke als Hauptvertreter einer neurobiologischen Psychiatrie im ausgehenden 19. Jahrhundert gewürdigt werden. Anliegen der vorliegenden Arbeit ist es, mögliche Beziehungen Wernickes und der „Wernicke-Kleist-Leonhard (WKL) Schule“ zur „Erlanger Schule“ der Psychiatrie näher zu beleuchten.
Methoden: Primär- und Sekundärliteratur wurden unter dem Aspekt der Hypothesenprüfung ausgewertet. Quellenarbeit erfolgte.
Ergebnisse: Wernickes Bemühen um die klinische Umsetzung seines nosologischen Systems wurde von seinem jüngsten Hallenser Schüler Karl Kleist (1879–1960) fortgesetzt. Nach Wernickes frühem Unfalltod wurde Kleist zum Schüler Gustav Spechts (1860–1940) in Erlangen. Geprägt von der „Erlanger Schule“ Spechts entwickelte der spätere Kleist-Schüler Karl Leonhard (1904–1988) auf der Grundlage der Forschungen Wernickes und Kleists eine sehr differenzierte Aufteilung endogener Psychosen.
Diskussion: Die von Specht begründete klassische „Erlanger Schule“ der Psychiatrie stellt möglicherweise ein Bindeglied in der Entwicklung der „Wernicke-Kleist-Leonhard Schule“ dar. Wernickes Beschreibung der „Angstpsychose“ veranlasste Specht zu einer Abhandlung über den Angstaffekt im „manisch-depressiven Irresein“. Diese wiederum regte Karl Leonhard zu seiner späteren Konzeption der „Angst-Glücks-Psychose“ an. Generell hatte Leonhard unter Spechts Leitung ein Gespür für Bipolaritäten als entscheidenden Aspekt seines späteren Konzeptes der zykloiden Psychosen entwickelt. Spechts Darstellung zum „pathologischen Affekt“ in der Paranoia beeinflusste das Leonhardsche Konzept der „affektvollen Paraphrenie“.
Schluss: Moderne Verfahren der funktionellen Bildgebung eröffnen dem Lokalisationsgedanken Wernickes neue Perspektiven. Die naturwissenschaftlich-philosophische „Doppelausrichtung“ der WKL-Schule kann zu einer erneut vermehrten Integration von philosophischen Elementen (Ethik, Religiosität, Spiritualität) im psychiatrisch-psychosomatischen und psychotherapeutischen Berufsfeld anregen.
Das Management der Mid-Portions-Achillessehnentendinopathie in der Physiotherapie – eine systematische Literaturrecherche
Authors: Heitkamp Hauke S. J. , Kapitza Camilla 
Published: October 2019

ZusammenfassungHintergrund Die Mid-Portions-Achillessehnentendinopathie (MPAT) ist ein Beschwerdebild, welches häufig sowohl bei Sportlern als auch bei Nicht-Sportlern auftritt. Während gute Evidenz zur Wirksamkeit von Wadentraining besteht, existiert keine aktuelle Literaturarbeit zur Ermittlung der Wirksamkeit von Physiotherapie, die das Gesamtspektrum physiotherapeutischer Möglichkeiten berücksichtigt.Fragestellung Welche Rolle spielen manuelle Techniken und aktive Herangehensweisen beim physiotherapeutischen Management von MPAT bezogen auf Schmerz, Funktion und Lebensqualität?Methoden Die Recherche erfolgte in den Datenbanken MEDLINE, Cinahl, SPORTDiscuss, PEDro und Cochrane, ergänzend in Journalen, grauer Literatur und über eine Handsuche. Inkludiert werden sollten ausschließlich randomisierte kontrollierte Studien (RCTs). Es folgte eine narrative Synthese. Die Beurteilung der Evidenz unterschiedlicher physiotherapeutischer Herangehensweisen erfolgte nach der „Body-of-Evidence-Matrix“ des NHMRC Australiens.Ergebnisse 19 RCTs mit insgesamt 792 Patienten wurden inkludiert. In jeder dieser Studien kam ein exzentrisches Training (ET) zur Anwendung, wobei das Alfredson-Protokoll das am häufigsten genutzte war. Zum einen wurden die Wirkungsweisen unterschiedlicher Formen eines ET miteinander verglichen. Des Weiteren fanden Vergleiche zwischen ET und anderen Trainingsformen, zwischen ET und Wadendehnungen, zwischen ET und therapeutischem Ultraschall und zwischen ET und diversen nicht physiotherapeutischen Therapieformen statt. Keine inkludierte Studie befasste sich mit der alleinigen oder ergänzenden Wirksamkeit von manuellen Herangehensweisen.Diskussion Die größte Evidenz existiert für ein ET insbesondere nach dem Alfredson-Protokoll. Auch wenn für Tendinopathien häufig ein Heavy-Slow-Resistance-Training empfohlen wird, ist die Beweislage für die Behandlung von MPAT noch dürftig. Andere Übersichtsarbeiten, die sich ausschließlich mit der Wirksamkeit von Wadentraining beschäftigten, kamen auf vergleichbare Ergebnisse. Wichtige Kriterien beim Training scheinen Intensität, Progression, Geschwindigkeit bzw. Spannungsdauer und der Umgang mit Schmerz zu sein.Schlussfolgerung Eine aktive Therapie in Form eines exzentrischen Wadentrainings oder eines Heavy-Slow-Resistance-Trainings sind nach aktueller Beweislage die empfehlenswertesten Therapieformen bei MPAT. Nach dieser Arbeit gehend existiert keine Evidenz zur alleinigen oder ergänzenden Wirksamkeit von manuellen Techniken bei diesem Beschwerdebild.
Sarcoma of the Uterus. Guideline of the DGGG and OEGGG (S2k Level, AWMF Register Number 015/074, February 2019)
Authors: Denschlag Dominik , Ackermann Sven , Battista Marco Johannes , Cremer Wolfgang , Egerer Gerlinde , Follmann Markus , Haas Heidemarie , Harter Philipp , Hettmer Simone , Horn Lars-Christian , Juhasz-Boess Ingolf , Kast Karin , Köhler Günter , Kröncke Thomas , Lindel Katja , Mallmann Peter , Meyer-Steinacker Regine , Mustea Alexander , Petru Edgar , Reichardt Peter , Schmidt Dietmar , Strauss Hans-Georg , Tempfer Clemens , Thiel Falk , Ulrich Uwe , Vogl Thomas , Vordermark Dirk , Gass Paul , Beckmann Matthias W. 
Published: October 2019

Abstract
Aims This is an official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). Because of their rarity and heterogeneous histopathology, uterine sarcomas are challenging in terms of how they should be managed clinically, and treatment requires a multidisciplinary approach. To our knowledge, there are currently no binding evidence-based recommendations for the appropriate management of this heterogeneous group of tumors.
Methods This S2k guideline was first published in 2015. The update published here is the result of the consensus of a representative interdisciplinary group of experts who carried out a systematic search of the literature on uterine sarcomas in the context of the guidelines program of the DGGG, OEGGG and SGGG. Members of the participating professional societies achieved a formal consensus after a moderated structured consensus process.
Recommendations The consensus-based recommendations and statements include the epidemiology, classification, staging, symptoms, general diagnostic work-up and general pathology of uterine sarcomas as well as the genetic predisposition to develop uterine sarcomas. Also included are statements on the management of leiomyosarcomas, (low and high-grade) endometrial stromal sarcomas and undifferentiated uterine sarcomas and adenosarcomas. Finally, the guideline considers the follow-up and morcellation of uterine sarcomas and the information provided to patients.
Maintaining the blind in sham controlled interventional trials: lessons from the EPISOD study
Authors: Cotton Peter , Pauls Qi , Wood April , Durkalski-Mauldin Valerie 
Published: October 2019

Abstract
Objective and study aims This study was designed to demonstrate the techniques used and the effectiveness of blinding in the EPISOD study (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). This was a large sham-controlled trial evaluating the efficacy of endoscopic sphincterotomy treatment for patients with suspected sphincter of Oddi dysfunction.
Patients and methods We describe the methods intended to ensure that the subjects, caregivers and those assessing the outcomes were blinded to the treatment allocation and systematically assess the success of subject blinding procedures using the Bang’s Blinding Index (BI) for each treatment arm as an indicator of potential unblinding.
Results Blinding procedures proved to be acceptable and adhered to by the study team at each site. The BI indicated “wishful thinking” by the subjects regardless of treatment assignment, even when they were confident in their opinions.
Conclusion We conclude that it is possible to design and maintain a system for blinding the treatment allocation in a sham-controlled interventional study. Treatment guess plus confidence in the guess should be collected to examine the success of blinding procedures. The EPISOD study provides a blueprint for future sham-controlled trials in endoscopy.
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types
Authors: Rigter Lisanne S. , Rijkmans Eva C. , Inderson Akin , van den Ende Roy P.J. , Kerkhof Ellen M. , Ketelaars Martijn , van Dieren Jolanda , Veenendaal Roeland A. , van Triest Baukelien , Marijnen Corrie A.M. , van der Heide Uulke A. , van Leerdam Monique E. 
Published: October 2019

Abstract
Background and study aims To facilitate image guidance during radiotherapy of rectal cancer, we investigated the feasibility of fiducial marker placement. This study aimed to evaluate technical success rate and safety of two endoscopic ultrasound (EUS)-guided placement strategies and four fiducial types for rectal cancer patients.
Patients and methods This prospective multicenter study included 20 participants who were scheduled to undergo rectal cancer treatment with neoadjuvant short-course radiotherapy or chemoradiation. EUS-guided endoscopy was used for fiducial placement at the tumor site (n = 10) or in the mesorectal fat and in the tumor (n = 10). Four fiducial types were used (Visicoil 0.75 mm, Visicoil 0.50 mm, Cook, Gold Anchor). The endpoints were technical success rate and retention of fiducials, the latter of which was evaluated on cone-beam computed tomography scans during the first five radiotherapy fractions.
Results A total of 64 fiducials were placed in 20 patients. For each fiducial type, at least three fiducials were successfully placed in all patients. Technical failure consisted of fiducial blockage within the needle (n = 2) and ejection of two preloaded fiducials at once (n = 4). No serious adverse events were reported. In three patients, one of the fiducials was misplaced without clinical consequences; two in the prostate and one in the intraperitoneal cavity. After a median time of 17 days after placement (range 7 – 47 days), a total of 42/64 (66 %) fiducials were still present (24/44 intratumoral vs. 18/20 mesorectal fiducials, P = 0.009).
Conclusions Placement of fiducials in rectal cancer patients is feasible, however, retention rates for intratumoral fiducials were lower (55 %) than for mesorectal fiducials (90 %).
Validity and safety of endoscopic biliary stenting for biliary stricture associated with IgG4-related pancreatobiliary disease during steroid therapy
Authors: Kuraishi Yasuhiro , Muraki Takashi , Ashihara Norihiro , Ozawa Makiko , Nakamura Akira , Watanabe Takayuki , Ito Tetsuya , Hamano Hideaki , Kawa Shigeyuki 
Published: October 2019

Abstract
Background Patients with IgG4-related sclerosing cholangitis and autoimmune pancreatitis frequently develop obstructive jaundice, which requires endoscopic biliary stenting (EBS) during steroid therapy to prevent bile duct infection from cholestasis and adverse steroid effects. However, it is controversial whether EBS during steroid therapy is advisable, because the procedure itself carries a risk of cholangitis and procedure-related adverse events. This study aimed to clarify the validity and safety of EBS for patients with biliary stricture associated with IgG4-related pancreatobiliary disease (IgG4-PBD) during steroid therapy.
Methods We enrolled 59 patients who presented with biliary stricture exhibiting jaundice or liver dysfunction and who were treated with EBS. The incidences of recurrent biliary obstruction and acute cholangitis were compared for EBS cases with and without steroid administration.
Results EBS was present in 55 periods with steroid administration and 110 periods without. The incidence of recurrent biliary obstruction was significantly lower in cases with steroids than in those without (1-month no obstruction rate: 100 % vs. 82 %; log-rank test P = 0.0015). The incidence of acute cholangitis related to stenting was significantly lower in cases with steroids than in those without (1-month no acute cholangitis rate: 100 % vs. 90 %; log-rank test P = 0.0278). Biliary stents could be removed without acute cholangitis, liver dysfunction, or stent replacement in 96 % of patients who underwent endoscopic retrograde cholangiopancreatography 1 month after commencing steroid administration.
Conclusions EBS during steroid administration was both valid and safe in patients with biliary stricture associated with IgG4-PBD. Stents could be safely removed 1 month after steroid initiation.
Predicting pathology on small bowel capsule endoscopy: a good FIT
Authors: Judge Ciaran , Tighe Donal , Barry Lillian , O’Neill Julie , Wong Jenny , Shahin Amir , Moran Neil , Stack Roisin , Hussey Mary , Breslin Niall , O’Connor Anthony , Ryan Barbara , Buckley Martin , McNamara Deirde 
Published: October 2019

Abstract
Background and study aims Small bowel capsule endoscopy [SBCE) has an established role in investigating suspected small bowel bleeding [SSBB). Identification of a biomarker to predict pathology would maximize utility of this valuable diagnostic modality. This study aimed to investigate if fecal immunochemical test [FIT) could predict likelihood of small bowel pathology on SBCE.
Patients and methods Patients referred for SBCE to investigate anaemia or suspected small bowel bleeding were prospectively recruited. All patients had negative upper and lower endoscopy prior to referral. A FIT ≥ 45 ug Hb/g was considered positive. SBCE was positive if a potential source of SSBB was identified. The primary endpoint was correlation between FIT and positive SBCE. Secondary endpoints were correlation between anemia and SBCE and a combination of anemia plus FIT and SBCE.
Results Fifty-one patients were included in the final study cohort. 29.4 % had a positive FIT, 33.3 % were anemic, and 25.5 % patients had significant SBCE findings. There was a statistically significant association between positive FIT and pathology on SBCE (OR 12, 95 % CI [2.8 – 51.9), P = 0.001). Sensitivity and specificity of positive FIT in predicting SBCE findings were 69 % and 84 %, respectively. A normal Hb had an NPV of 83 % (OR 0.30, P = 0.09). Combining Hb and FIT was statistically significant in predicting pathology on SBCE (OR 9.14, 67 % PPV, 82 % NPV, P = 0.025).
Conclusion FIT ≥ 45 ug Hb/g is a useful tool in predicting small bowel pathology on SBCE. Use of this biomarker alone, or in combination with serum haemoglobin, has value as a screening tool and may help to better triage patients referred for SBCE.
Upstream and downstream revenue of upper gastrointestinal endoscopic ultrasound determined with an episode-of-care approach
Authors: Maeng Daniel , Wall Beth , Hassen Dina , Diehl David L. 
Published: October 2019

Abstract
Background and study aims Upper gastrointestinal endoscopic ultrasound (EUS) has clinical advantages that can lead to improved patient outcome. This study seeks to characterize and quantify the upstream and downstream healthcare utilizations and revenues.
Patients and methods A retrospective claims data analysis of upper gastrointestinal EUS procedures was conducted at a large health system. Types of care and total revenues associated with each episode of care were characterized by descriptive statistics. Comparisons were made between patients who had Medicare Advantage and commercial plans as well as those with and without cancer diagnoses during the downstream period.
Results A total of 436 cases were identified. The most frequent downstream healthcare utilizations consisted of radiology (31 %), pathology services (28 %), and high-revenue services including chemotherapy and inpatient admissions. The most common upstream utilizations included radiology (18 %) and lab services (22 %). Average total downstream revenue was $ 34 231 (95 %CI: $ 28 561 – $ 39 901) per case, and average total upstream revenue was $4373 (95 %CI: $3227 – $ 5519). Average total revenue per case did not differ significantly between Medicare Advantage and commercial plan members. However, patients who were diagnosed with cancer at or immediately following EUS (20 %) were associated with significantly higher total revenue compared to those without cancer diagnosis (P < 0.0001).
Conclusions This episode-of-care approach to quantifying the revenue impact of upper gastrointestinal EUS to the providers suggests there are substantial downstream as well as upstream revenues associated with upper gastrointestinal EUS procedures, driven by patients who are diagnosed with cancer by the EUS procedures and subsequently require oncologic care.