bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entwicklung, Durchführung und Evaluierung eines
Präventionsprogrammes für Pflegekräfte (PFLEGEprevent)
– Studienprotokoll
Authors: Ehegartner Veronika , Kirschneck Michaela , Frisch Dieter , Schuh Angela , Kus Sandra 
Published: February 2020

ZusammenfassungGezielte Präventionsmaßnahmen können dabei helfen die
Mitarbeitergesundheit in Betrieben zu verbessern und die Ressourcen dieser
Personen zu stärken. Das Forschungsprojekt
„PFLEGEprevent“ (gefördert vom Bayerischen
Staatsministerium für Gesundheit und Pflege) hat zum Ziel ein
Präventionsprogramm zu entwickeln, das auf die spezifischen
Bedürfnisse von Pflegekräften ausgerichtet ist. Das Projekt
besteht aus vier Phasen: (1) Identifizierung von Bedürfnissen,
Arbeitsbelastungen und beruflichen Herausforderungen der
Pflegekräfte und deren wissenschaftlichen Evidenz (nationale
Expertenbefragung und systematischer Literaturreview), (2) Entwicklung des
Präventionsprogrammes für Pflegekräfte, (3)
Implementierung und Evaluierung des Präventionsprogrammes
(Interventionsstudie; DRKS00012870), (4) Ausarbeitung eines Manuals zur
Umsetzung der Maßnahme (Übertragbarkeit). Das
Studienprotokoll liefert eine Übersicht zu den vier Phasen des
Projektes.
Daumenmikrothrombose/Daumennekrose eines Patienten mit heparininduzierter Thrombozytopenie
Authors: Lucic Josip , Bakchoul Tamam , Althaus Karina 
Published: February 2020

ZusammenfassungWir berichten über einen 81-jährigen Patienten, der unter der Therapie mit unfraktioniertem Heparin (UFH) in prophylaktischer Dosierung eine heparininduzierte Thrombozytopenie mit Mikrothromben und beginnender Nekrose entwickelt hat. Die Prophylaxe wurde mit UFH durchgeführt. An Tag 10 kam es zu einem Thrombozytenabfall um > 50%. Eine Daumennekrose weckte den Verdacht auf eine heparininduzierte Thrombozytopenie (HIT). Der 4T-Score zeigte eine hohe Wahrscheinlichkeit für eine HIT auf (7 Punkte). Da der Schnelltest positiv ausfiel, wurde eine therapeutische Antikoagulation mit Argatroban (2 µg/kg/min) bereits vor vollständiger labortechnischer Abklärung begonnen. Sowohl die Thrombozytenzahl als auch der Daumen erholten sich innerhalb von 5 Tagen nach der Umstellung auf Argatroban. Unser Fallbeispiel zeigt, dass bei dem Verdacht auf HIT eine sofortige Umstellung auf alternative Antikoagulation in therapeutischer Dosis zur Reversion beginnender Nekrosen führen kann.
Rolle des Darmes bei der Multiplen Sklerose
Authors: Linker Ralf A. , Haghikia Aiden 
Published: February 2020

ZUSAMMENFASSUNGDie Multiple Sklerose (MS) ist eine autoimmunvermittelte Erkrankung des zentralen Nervensystems (ZNS), die in Deutschland ca. 230000 Menschen betrifft. Bis heute existiert für die MS keine Heilung. Als Ursachen werden genetische und Umwelt-Risikofaktoren angenommen, wobei letztere mit ca. 70 % des Risikos den Hauptanteil einnehmen. In diesem Zusammenhang weisen neuere Studien auf eine wichtige Rolle des Darms, des intestinalen Mikrobioms, d. h. der Gesamtheit aller Darmbakterien, und der Diät zur Erkrankungsmodulation hin. Hierdurch könnten neue Therapieansätze geliefert werden. In dieser Übersichtsarbeit diskutieren wir aktuelle Erkenntnisse zur Bedeutung des Darms und der Ernährung aus präklinischen Modellen der MS sowie aus translationalen Studien mit MS-Patienten. Diese Studien zeigen, dass Darmbakterien eine wichtige Rolle für die Entstehung und Erkrankungsprogression spielen können. Darüber hinaus existiert eine komplexe Interaktion zwischen der Diät und dem Mikrobiom sowie dem Immunsystem, was auf die Möglichkeit einer Modulation der MS auf diesem Wege hinweist. Diätetische Ansätze wie kurzkettige gesättigte Fettsäuren und Fasten können die MS und ihre experimentellen Modelle günstig beeinflussen. Derartige diätetische oder probiotische Ansätze werden in randomisierten klinischen Studien getestet.
Darmmikrobiom bei primären Hirntumoren
Authors: Anssar Tareq M. , Hau Peter 
Published: February 2020

ZUSAMMENFASSUNGPrimäre Hirntumoren kommen weniger häufig vor als andere Tumorentitäten. Das Glioblastom ist der häufigste primäre Hirntumor bei Erwachsenen und hat eine sehr schlechte Prognose. Die Pathophysiologie vieler Hirntumoren ist nur unzureichend verstanden. Eine kurative Therapie existiert bis auf wenige Ausnahmen nicht. Bei einigen soliden und hämatologischen Tumoren konnte in den letzten Jahren ein Zusammenhang zwischen Tumorentstehung und -progression mit Veränderungen im intestinalen Mikrobiom festgestellt werden. Zusammenhänge zwischen Mikrobiota und primären Hirntumoren wurden hingegen nicht publiziert.In der vorliegenden Arbeit werden Mechanismen dargestellt, die bei einer möglichen Interaktion zwischen Mikrobiom und Hirntumoren eine Rolle spielen können. Dabei steht die Schranke vom Darmepithel zum peripheren Blut und vom peripheren Blut zum Gehirn im Mittelpunkt des Interesses. Im Hinblick auf die Darm-Blutschranke sind Interaktionen zwischen Mikrobiom und Immunphänotyp sowie Metaboliten im peripheren Blut bekannt. Im Hinblick auf die Blut-Hirnschranke bestehen mögliche Assoziationen des Immunphänotyps und der Metaboliten im peripheren Blut mit der Immuninfiltration im Gehirn und der Induktion pathogeneserelevanter Signalkaskaden.
Migräne und der Gastrointestinaltrakt
Authors: Straube Andreas , Ruscheweyh Ruth 
Published: February 2020

ZUSAMMENFASSUNGMigräne ist die häufigste neurologische Erkrankung und betrifft ca. 10–12 % der Bevölkerung. Frauen sind etwa 2- bis 3-fach häufiger betroffen als Männer. Als neurophysiologisches Korrelat der Migräne wird eine Aktivierung von trigeminalen und parasympathischen Verbindungen vom und zum Hirnstamm und den Meningen gesehen. Dort kommt es zu einer neurogen induzierten Entzündung mit konsekutiver Weitstellung der Gefäße in diesem Gebiet. Gastrointestinale Symptome, insbesondere Übelkeit und Erbrechen, sind typische Begleiterscheinungen der Migräne. Dies zeigt, dass die Migräne Einfluss auf den Gastrointestinaltrakt nehmen kann. Andererseits gibt es zahlreiche Hinweise, dass der Gastrointestinaltrakt die Migräne beeinflussen kann. Ein Ansatz geht von einer Modulation vagaler, sensorischer Afferenzen aus dem Darm zu den zentralen parasympathischen Arealen aus, die dann das zentrale antinozizeptive System beeinflussen. Eine weitere Verbindung zwischen Migräne und Magen-Darm-Trakt ist durch die Calcitonin-gene-related peptide (CGRP)-Ausschüttung in den intrinsischen sensorischen Neuronen des Darmtraktes gegeben. In den letzten Jahren wurde wiederholt gezeigt, dass verschiedene Darmerkrankungen, die meist mit einer gesteigerten Entzündungsaktivität einhergehen, mit einer Migräne vergesellschaftet sind (z. B. Morbus Crohn). Eine mögliche Erklärung ist, dass diese Erkrankungen zu einem vermehrten Durchtritt von Toxinen durch die Darmwand in die Zirkulation führen („leaky gut“) und dieses schließlich zu einer vermehrten entzündlichen Aktivität an den meningealen Gefäßen führt. Schon länger ist bekannt, dass eine systemische proinflammatorische Aktivität zu häufigeren Migräneattacken führen kann. Ein Weg, die Durchlässigkeit der Darmschleimhaut zu beeinflussen sind Probiotika, die durch eine gezielte Änderung des Besatzes mit Darmbakterien die Darmschleimhaut stabilisieren sollen. Die Datenlage zum Einsatz von Probiotika bei Migräne ist jedoch heterogen und lässt eine eindeutige Aussage zur Wirksamkeit nicht zu.
Effect of Chin-Down Position on Vocal Mean Pitch and Intensity
Authors: Joseph Bennet Elsa , Mathew Mable , Raj Keerthana Kulath Purath 
Published: February 2020

Abstract
Background Voice, a unique characteristic of each individual, is an outcome of the configuration and function of various components of the vocal tract. Pitch and loudness, being integral parts of voice, vary with changes in factors such as muscle tension, subglottal pressure, and position. Chin down is often the recommended voice therapy for lowering pitch. But there is no literature available as to by how much does it actually change the mean pitch and intensity. The present study was undertaken to understand the effect on the vocal mean pitch and intensity when head position is changed to chin-down position.
Methods Thirty women aged 18 to 25 years were included in this preliminary study. Individuals having any history of voice disorder were excluded. Voice samples were collected using clinical microphone and acoustically analyzed using the Praat software. The participants were instructed to phonate and count numbers in neutral position and chin down position.
Results It was observed that there was no change in the acoustic or perceptual measure of pitch with change in the head position. However, there was a significant reduction in the intensity for phonation task in the chin-down position.
Conclusion Speech language pathologists need to provide chin down as a facilitative technique for lowering larynx along with other voice therapies which are proved to effectively lower pitch.
Does Hearing Thresholds Vary Across Different Blood Groups?
Authors: Sarve Archana Rai , K. Megha , Hem Devika 
Published: February 2020

AbstractThe current study aimed at identifying the relationship between the blood group and hearing thresholds. The objective of the study was to identify if there is a difference in the pure tone audiometric thresholds of individuals with different blood groups, and to identify if there is a difference between pure tone audiometric thresholds of males and females of the same blood group. A prospective study was performed involving 80 normal hearing individuals between the age of 18 and 40 years. All participants included in the study had normal hearing (< 25 dBHL) and were Rh+. Participants complaining or giving indications of any kind of cochlear or retrocochlear pathological conditions were excluded from the study. Participants were grouped based on their blood groups. Each group consisted of 20 participants. Thresholds were established for frequencies ranging from 125 Hz to 20 KHz. Descriptive statistical analysis was done for mean and standard deviation. Bonferroni post hoc analysis was carried out for multiple comparisons, and the results revealed that there was no statistically significant difference in thresholds observed among different blood groups.
Urogenital Sinus with Mitrofanoff Procedure: Case Review
Authors: David Jeyamoni , J. Menaka , Subramaniam Rajeswari , Gnanam Malarvizhi 
Published: February 2020

AbstractUrogenital sinus is a rare congenital anomaly. We reviewed a case of urogenital sinus anomaly in 6-year-old girl with recurrent urinary tract infection and small bladder capacity who was referred from another hospital in Coimbatore for further management. The external genitalia appeared normal, and an initial sonogram and repeat micturating cystourethrograms did not indicate any urogenital anomalies. She therefore underwent clean intermittent catheterization. Three years later the child underwent investigations like urodynamic study (UDS) and dimercaptosuccinic acid (DMSA) scan and cystoscopy, followed by ureteric implantation and Mitrofanoff procedure. The presentation of urogenital sinus anomaly with recurrent urinary tract infection is rare and the management is complex.
Health, Disease, and Social Structure in Rural India
Authors: Nanjunda Devajana Chinnappa 
Published: February 2020

AbstractHealth and disease are the two noteworthy dimensions of behavior. During the lifetime, every individual traverses through health and disease. It is not an all or none type of occurrence but a relative location that explains whether the individual is healthy or unhealthy. The individual perception of health status is largely a psychological phenomenon. In spite of the beginning of the disease process, an individual may not even perceive it at any point of time. An organic disorder may not at all involve an individual until it is perceptible. Conversely, without any organic disorder, an individual may report himself to be unhealthy. Thus, logically, disease and health may coexist in the same individual. These two are not just equally exclusive entities. This study has been performed with two objectives (1) to study the changing social, economical, cultural, political, health, and demographic profile of the studied rural population and (2) to understand the changing illness ideology of the rural people and to find out the existing perception, health-seeking behavior, and culturally bounded attitudes about the onset of certain common diseases, and use of different systems of medicines. This study has been done in the selected districts on 800 households of Karnataka, India, using both qualitative and quantitative techniques.
Diagnostic Challenges in Newborns and Infants with Coagulation Disorders
Authors: Eberl Wolfgang 
Published: February 2020

AbstractLaboratory diagnostics in children and adolescents, especially in newborns and very small children, differ considerably compared with laboratory diagnostics in adults. This applies to all individual steps of the examination (i.e., the indication, the preanalytical phase, the analysis itself, and interpretation of the findings). This is particularly true in the diagnostics of hemostasis, in which small sample volumes and relatively error prone coagulation tests are posing particular challenges to the strategy, performance, and evaluation of the tests. Differences in the individual steps are illustrated below.
Christian Bioethics: From Foundations to the Future
Authors: Iltis Ana 
Published: February 2020

AbstractThe papers in this issue of Christian Bioethics explore and challenge taken-for-granted ideas that inform judgments about the nature of Christian bioethics, the nature of Christian clinicians’ and healthcare organizations’ obligations, and the nature of who we are. In doing so, these leading scholars in the field address some of the most fundamental questions in Christian bioethics scholarship today.
Coordinate Graph Grammar for the Specification of Spatial Graphs
Authors: Liu Yufeng , Zeng Xiaoqin , Zhang Kang , Zou Yang 
Published: February 2020

Abstract
As a two-dimensional formal method, graph grammar is widely used in defining various visual programming languages. This paper presents a new graph grammar formalism called coordinate graph grammar (CGG). CGG is extended from the edge-based graph grammar (EGG) by introducing the spatial mechanism into the theoretical framework, which consists of continuous coordinate graph grammar (cCGG) and discrete coordinate graph grammar (dCGG). By combining quantitative and qualitative spatial semantics in one framework, CGG provides strong expressiveness and flexibility for specifying various spatial graphs. This paper focuses on several important issues on the new formalism. First, the theoretical framework of CGG is given. Second, two matching algorithms for cCGG and dCGG are proposed, which use the spatial relationships between nodes to narrow down the search space during parsing. Finally, an application of CGG is demonstrated, which generates parsable flowcharts in a uniform layout.
Adenosine kinase is critical for neointima formation after vascular injury by inducing aberrant DNA hypermethylation
Authors: Wang Yong , Xu Yiming , Yan Siyuan , Cao Kaixiang , Zeng Xianqiu , Zhou Yaqi , Liu Zhiping , Yang Qiuhua , Pan Yue , Wang Xiaoling , Boison Detlev , Su Yunchao , Jiang Xuejun , Patel Vijay S , Fulton David , Weintraub Neal L , Huo Yuqing 
Published: February 2020

AbstractAimsAdenosine receptors and extracellular adenosine have been demonstrated to modulate vascular smooth muscle cell (VSMC) proliferation and neointima formation. Adenosine kinase (ADK) is a major enzyme regulating intracellular adenosine levels but is function in VSMC remains unclear. Here, we investigated the role of ADK in vascular injury-induced smooth muscle proliferation and delineated the mechanisms underlying its action.Methods and resultsWe found that ADK expression was higher in the neointima of injured vessels and in platelet-derived growth factor-treated VSMCs. Genetic and pharmacological inhibition of ADK was enough to attenuate arterial injury-induced neointima formation due to inhibition of VSMC proliferation. Mechanistically, using infinium methylation assays and bisulfite sequencing, we showed that ADK metabolized the intracellular adenosine and potentiated the transmethylation pathway, then induced the aberrant DNA hypermethylation. Pharmacological inhibition of aberrant DNA hypermethylation increased KLF4 expression and suppressed VSMC proliferation as well as the neointima formation. Importantly, in human femoral arteries, we observed increased ADK expression and DNA hypermethylation as well as decreased KLF4 expression in neointimal VSMCs of stenotic vessels suggesting that our findings in mice are relevant for human disease and may hold translational significance.ConclusionOur study unravels a novel mechanism by which ADK promotes VSMC proliferation via inducing aberrant DNA hypermethylation, thereby down-regulating KLF4 expression and promoting neointima formation. These findings advance the possibility of targeting ADK as an epigenetic modulator to combat vascular injury.
Long-term implications of left atrial appendage thrombus identified incidentally by pre-procedural cardiac computed tomography angiography in patients undergoing transcatheter aortic valve replacement
Authors: Szekely Yishay , Shmilovich Haim , Hochstadt Aviram , Ghantous Eihab , Topilsky Yan , Aviram Galit , Hadad Yitzhak , Arbel Yaron , Konigstein Maayan , Banai Shmuel , Finkelstein Ariel , Halkin Amir 
Published: February 2020

Abstract

Aims
The prevalence and prognostic implications of left atrial appendage (LAA) thrombus (LAAT) in patients considered for transcatheter aortic valve replacement (TAVR) are incompletely defined. We, therefore, studied pre-procedural cardiac computed tomography angiography (CCTA) scans of TAVR candidates to determine the prevalence of LAAT and its association with late outcomes.

Methods and results
Baseline clinical variables and CCTA findings from a prospective TAVR registry were analysed for the prevalence of pre-procedural LAAT and its impact on in-hospital outcomes and late mortality. LAAT was differentiated from LAA filling defects (LAAFD) reflecting stasis without clot. Patients (n = 561) with complete in-hospital and late mortality data were included in the study (median follow-up 31.6 months). LAAT and LAAFD were evidenced on pre-procedural CCTA in 24 (4.3%) and 26 (4.6%) patients, respectively. One hundred fourteen (20.3%) patients died during the study period. Though in-hospital adverse event rates (including stroke) did not differ among groups, mortality at long-term follow-up was higher among LAAT patients compared with those with or without LAAFD (58.3% vs. 11.5% vs. 19.0%, respectively; P &lt; 0.003). By multivariable analysis, LAAT (but not LAAFD) was independently associated with all-cause mortality [hazard ratio (HR) = 3.33 (1.83–6.00), P &lt; 0.001]. In patients with LAAT, oral anticoagulation at discharge was associated with lower mortality risk, independently of atrial fibrillation status.

Conclusions
LAAT visualized by pre-procedural CCTA is an independent predictor of late mortality following TAVR, but not peri-procedural stroke. When reporting TAVR-CCTA, particular note should be made of LAA features and presence of LAAT which may have prognostic and management implications.
Service utilization patterns for childbirth and neonatal mortality in the occupied Palestinian territory during conflict
Authors: Siam Zeina Ali , Leone Tiziana 
Published: February 2020

Abstract

Background
The global incidence of man-made crises has increased in the last decade. Evidence on deviations in service uptake during conflict is needed to better understand the link between conflict and adverse neonatal outcomes. We assessed the association between conflict intensity in the occupied Palestinian territory (oPt) at time of birth and (i) utilization patterns for childbirth across different providers; and (ii) neonatal mortality.

Methods
We combined data on conflict intensity with four demographic and health surveys (2004, 2006, 2010 and 2014) that included nationally representative samples of women of childbearing age. Our exposure variable was casualties per 100 000 population in defined sub-regions of the oPt. Our outcome specifications were a binary variable for neonatal deaths and a categorical variable for childbirth location. We used multivariate logistic and multinomial regressions to assess the associations.

Results
High conflict intensity was associated with fewer childbirths in the private sector (RR=0.97, P=0.04), and non-governmental organizations (RR=0.95, P=0.03) compared to public facilities. Conflict intensity was not associated with higher neonatal mortality beyond 2004.

Conclusions
Policy implications include better preparedness in the public sector for childbirth during conflict and exploring reasons for the slow decline in neonatal mortality in the territory beyond conflict at time of birth.
Chitin binding protein as a possible RNA binding protein inLeishmaniaparasites
Authors: Rashidi Sajad , Kalantar Kurosh , Fernandez-Rubio Celia , Anvari Enayat , Nguewa Paul , Hatam Gholamreza 
Published: February 2020

ABSTRACTLeishmaniasis includes a broad spectrum of pathological outcomes in humans caused by protozoan parasites from the genus Leishmania. In recent years, proteomic techniques have introduced novel proteins with critical functions in Leishmania parasites. Based on our report of a Chitin binding protein (CBP) in our previous immunoproteomic study, this article suggests that CBP might be an RNA binding protein (RBP) in Leishmania parasites. RBPs, as key regulatory factors, have a role in post-transcriptional gene regulation. The presence of RBPs in Leishmania parasites has not been considered so far; however, this study aims to open a new venue regarding RBPs in Leishmania parasites. Confirming CBP as an RBP in Leishmania parasites, exploring other RBPs and their functions might lead to interesting issues in leishmaniasis. In fact, due to the regulatory role of RBPs in different diseases including cancers and their further classification as therapeutic targets, the emerging evaluation of CBP and RBPs from Leishmania parasites may allow the discovery of novel and effective drugs against leishmaniasis.