bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurocognitive Recovery of Sentence Processing in Aphasia
Authors: Thompson Cynthia K. 
Published: November 2019

PurposeReorganization of language networks in aphasia takes advantage of the facts that (a) the brain is an organ of plasticity, with neuronal changes occurring throughout the life span, including following brain damage; (b) plasticity is highly experience dependent; and (c) as with any learning system, language reorganization involves a synergistic interplay between organism-intrinsic (i.e., cognitive and brain) and organism-extrinsic (i.e., environmental) variables. A major goal for clinical treatment of aphasia is to be able to prescribe treatment and predict its outcome based on the neurocognitive deficit profiles of individual patients. This review article summarizes the results of research examining the neurocognitive effects of psycholinguistically based treatment (i.e., Treatment of Underlying Forms; Thompson & Shapiro,2005) for sentence processing impairments in individuals with chronic agrammatic aphasia resulting from stroke and primary progressive aphasia and addresses both behavioral and brain variables related to successful treatment outcomes. The influences of lesion volume and location, perfusion (blood flow), and resting-state neural activity on language recovery are also discussed as related to recovery of agrammatism and other language impairments. Based on these and other data, principles for promoting neuroplasticity of language networks are presented.ConclusionsSentence processing treatment results in improved comprehension and production of complex syntactic structures in chronic agrammatism and generalization to less complex, linguistically related structures in chronic agrammatism. Patients also show treatment-induced shifts toward normal-like online sentence processing routines (based on eye movement data) and changes in neural recruitment patterns (based on functional neuroimaging), with posttreatment activation of regions overlapping with those within sentence processing and dorsal attention networks engaged by neurotypical adults performing the same task. These findings provide compelling evidence that treatment focused on principles of neuroplasticity promotes neurocognitive recovery in chronic agrammatic aphasia.Presentation Videohttps://doi.org/10.23641/asha.10257587
Remarks on path factors in graphs
Authors: Zhou Sizhong 
Published: November 2019

A spanning subgraph of a graph is defined as a path factor of the graph if its component are paths. A P≥n-factor means a path factor with each component having at least n vertices. A graph G is defined as a (P≥n, m)-factor deleted graph if G–E′ has a P≥n-factor for every E′ ⊆ E(G) with |E′| = m. A graph G is defined as a (P≥n, k)-factor critical graph if after deleting any k vertices of G the remaining graph of G admits a P≥n-factor. In this paper, we demonstrate that (i) a graph G is (P≥3, m)-factor deleted if κ(G) ≥ 2m + 1 and bind(G) ≥ 2/3 - $ \frac{3}{2}-\frac{1}{4m+4}$; (ii) a graph G is (P≥3, k)-factor critical if κ(G) ≥ k + 2 and bind(G) ≥ $ \frac{5+k}{4}$.
Die unklare Leberraumforderung
Authors: Roderburg Christoph , Loosen Sven H. , Bruners Philipp , Luedde Tom 
Published: November 2019

AbstractUnknown liver lesions represent a common clinical challenge, for example in the context of routine ultrasound examinations of primary care physicians. There are different data on the prevalence of primary liver lesions in the literature. As such, a forensic autopsy series described focal liver lesions in about 50 % of all examined men between 35 and 69 years of age with an increasing incidence for older people. In the diagnostic work-up of unclear liver lesions, a careful distinction between lesions that occur in asymptomatic and healthy individuals and are benign in over 95 % of cases, and lesion found in patients with pre-existing malignant, inflammatory or cirrhotic disease must be made. The main goal in the diagnosis of unclear liver lesions is to prove the benignity of the lesion and to exclude a malignant cause as reliably as possible. In case of benign lesions, an attempt should be made to achieve an exact classification. The most common benign focal liver lesions include liver cysts, focal fatty liver deposition or sparing, haemangiomas, focal calcifications, focal nodular hyperplasia (FNH), nodular regenerative hyperplasia, biliary hamartomas (von-Meyenburg complexes) and hepatocellular adenomas. Abscesses, inflammatory infiltrations or pseudotumors as well as sites of extramedullary haematopoiesis are observed much less frequently. Among the most frequent malignant focal liver lesions are metastases of other tumor entities such as colorectal cancer or pancreatic adenocarcinoma as well as hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCA). Other entities such as hepatic lymphomas or mesenchymal malignant neoplasia are extremely rare.
Störung des Sozialverhaltens und Antisoziale Persönlichkeitsstörung - Herausforderungen in der Transition vom Jugend- zum Erwachsenenalter
Authors: Koelch Michael G. , Döpfner Manfred , Freitag Christine M. , Dulz Birger , Rösler Michael 
Published: November 2019

ZusammenfassungAggressives Verhalten ist ein häufiges Phänomen in der Kindheit und Jugend. Es ist auch ein häufiger Anlass für eine Behandlung in der Kinder- und Jugendpsychiatrie und psychotherapie. Störungen des Sozialverhaltens bergen ein hohes Risiko für eine lebenslange Problematik, auch für das spätere Auftreten komorbider Suchterkrankungen oder affektiver Störungen. Die Behandlung im Übergang zum Erwachsenenalter ist schwierig, weil zum einen oft die Einsicht bei den Betroffenen in die Probleme und langfristige Konsequenzen fehlt, zum anderen verspricht hier nicht allein die psychiatrische und psychotherapeutische Behandlung Erfolg. Vielmehr sind umfassende interdisziplinäre Interventionen unter Einbezug der Jugendhilfe, der Familie und des Umfeldes notwendig. Forschungslücken bestehen sowohl in der Implementation evidenzbasierter Therapieinterventionen, wie auch der Forschung zu besonderen Risikogruppen (z. B. Mädchen oder Jugendliche mit Substanzabusus).
Antikoagulation bei Patienten mit nichtvalvulärem Vorhofflimmern (nvVHF) und eingeschränkter Nierenfunktion (NI)
Authors: Zeymer Uwe , Bonnemeier Hendrik , Wanner Christoph 
Published: November 2019

ZusammenfassungNichtvalvuläres Vorhofflimmern (nvVHF) ist wegen des assoziierten Schlaganfallrisikos eine Hauptindikation der oralen Antikoagulation. Viele dieser Patienten zeigen eine eingeschränkte Nierenfunktion, die das Schlaganfall- und Blutungsrisiko erhöht. Bei Niereninsuffizienz und nvVHF werden Vitamin-K-Antagonisten (VKA) von den Leitlinien aufgrund der heterogenen Studienlage nur zurückhaltend empfohlen – laut Fachinformation sind sie bei manifester Nierenfunktionsstörung kontraindiziert. Neue orale Antikoagulanzien (NOAK) sind bei Patienten mit Niereninsuffizienz ab einer Kreatinin-Clearance (KrCl) von 25 oder 30 ml/min klinisch untersucht und zugelassen, die Faktor-Xa-Inhibitoren können auch bei einer KrCl > 15 ml/min angewendet werden. NOAK zeigen gegenüber VKA ein günstiges Nutzen-Risiko-Profil bei der Reduktion von Schlaganfällen, sonstigen thromboembolischen Ereignissen und Todesfällen einerseits und beim Auftreten von Blutungen andererseits und werden daher von den ESC-Leitlinien empfohlen.
Intelligenzminderung
Authors: Gaese Franziska , Häßler Frank , Menzel Martin 
Published: November 2019

Zusammenfassung
Einleitung Für junge Menschen mit Intelligenzminderung (IM) besteht ein spezifischer Unterstützungsbedarf für die Sicherstellung einer ausreichenden medizinischen Versorgung im Übergang in das Erwachsenenleben.
Methode Beschrieben werden die Kernsymptomatik bei Intelligenzminderung, Verlauf und typische Komorbidität, die epidemiologische Relevanz, die spezifische Transitionslücke und sich hieraus ergebende Empfehlungen.
Ergebnisse Strukturierungsbedarf besteht anlässlich kognitiver, sozialer und kommunikativer Einschränkungen. Atypische Verläufe und ein erhöhtes Risiko für Verhaltens-, psychische und somatische Störungen sowie Gewalt- und Missbrauchserfahrungen bedingen komplexe Vorgehensweisen.
Schlussfolgerung Zur Sicherstellung einer ausreichenden gesundheitlichen Versorgung bedarf es der Wissensvermittlung und der Vorhaltung geeigneter und erreichbarer Strukturen einer multimodalen, interdisziplinären und vernetzten Versorgung zur Überleitung und Weiterversorgung, einschließlich deren Finanzierung.
Antibiotic Stewardship im Krankenhaus
Authors: Friedrichs Anette , Kramme Evelyn 
Published: November 2019

ZUSAMMENFASSUNGIm Jahr 2015 waren gemäß dem European Center for Disease Control (ECDC) ca. 33 000 Todesfälle in der Europäischen Union (EU) und Staaten des Europäischen Wirtschaftsraumes durch Antibiotika-resistente Erreger ausgelöst. In Deutschland gab es ca. 5500 Infektionen und ca. 2400 Todesfälle 1. In einem aktuellen Bericht warnen die Vereinten Nationen (UN) davor, dass bei weiterer Resistenzentwicklung auch gängige Infektionen wie Pneumonien, Harnwegsinfektionen und Geschlechtserkrankungen zunehmend unbehandelbar würden. Diesem Verlauf seien zügig Maßnahmenpakete entgegenzusetzen, die aktuell in den Industrienationen noch nahezu kostenneutral umsetzbar seien 2. Diese Berichte verdeutlichen die Dringlichkeit, Maßnahmen im Krankenhaus umzusetzen, die der bakteriellen Resistenzentwicklung entgegenwirken. Dies ist das Ziel von Antibiotic Stewardship (ABS) im Krankenhaus. Die aktualisierte Leitlinie stellt Voraussetzungen und sinnvolle Strategien sowie deren Evidenz dar und wird im folgenden Artikel zusammengefasst.
Früherkennung und Frühintervention bei psychotischen Störungen in der Transitionsphase
Authors: Karow Anne , Holtmann Martin , Koutsouleris Nikolaus , Pfennig Andrea , Resch Franz 
Published: November 2019

ZusammenfassungDie Adoleszenz ist aufgrund des Hirnreifungsprozesses und vor allem bei zusätzlichen Belastungsfaktoren ein besonders vulnerables Alter für die Erstmanifestation von Psychosen mit negativen psychosozialen Konsequenzen für die Betroffenen und ihre Angehörigen. Die Nachteile eines frühen Erkrankungsalters können teilweise durch eine hochqualitative Früherkennung und Frühbehandlung unter einer Berücksichtigung transitionsmedizinischer Versorgungsansätze ausgeglichen werden. Für die Förderung einer erfolgreichen Transition heranwachsender PatientInnen mit Psychosen bestehen praxisbezogene Empfehlungen zum Aufbau populationsbezogener, flexibler und nachgehender Früherkennungs- und Behandlungsnetzwerke, in denen MitarbeiterInnen diagnose-, alters- und fachübergreifend settingübergreifend zusammenarbeiten und eine erfolgreiche Transition strukturiert, flächendeckend, patientenorientiert und flexibel ermöglichen.
Antimikrobielle Therapie der Harnwegsinfektionen
Authors: Konik Margarethe , Bartonickova Lucia , Witzke Oliver 
Published: November 2019

ZUSAMMENFASSUNGHarnwegsinfektionen gehören zu den häufigsten Infektionen im ambulanten Bereich und stellen auch die häufigsten nosokomialen Infektionen dar. Die typischen Symptome sind Schmerzen beim Wasserlassen (Algurie), häufiges Wasserlassen (Pollakisurie), imperativer Harndrang (Strangurie) und ggf. Hämaturie. Es wird eine unkomplizierte von einer komplizierten Harnwegsinfektion unterschieden, die sich im Keimspektrum und dadurch in der therapeutischen Strategie unterscheiden. Harnwegsinfekte bei Männern sollten in der Regel als komplizierte Infektionen eingeschätzt werden, da die Prostata mitbetroffen sein kann. Als Diagnostik stehen die Anamnese, die körperliche Untersuchung, die Urinuntersuchung durch Schnellstreifentest, die Mikroskopie und die Urinkultur zur Verfügung. Der häufigste Erreger von unkomplizierten Harnwegsinfektionen ist Escherichia coli, gefolgt mit Abstand von Staphylococcus saprophyticus, Proteus mirabilis und Klebsiella pneumoniae. Bei komplizierten Harnwegsinfektionen sollte der vorherige Erregernachweis berücksichtigt werden, wenn dieser bekannt ist. Bei einer akuten unkomplizierten Harnwegsinfektion ist eine orale kurzzeitige antimikrobielle Therapie empfohlen, um die klinischen Symptome rasch zu beenden. Die Dauer der Therapie orientiert sich am klinischen Verlauf.
A Large Ascending Aortic Aneurysm Secondary to Idiopathic Necrotizing Aortitis—A Rare but Important Cause of Thoracic Aortic Disease
Authors: Smeeton Benjamin , Mustaev Muslim , Sabetai Michael 
Published: November 2019

AbstractIdiopathic necrotizing aortitis is characterized by lymphoplasmacytic or giant cell-associated inflammation of the aorta, with no specific identifiable cause. We present the case of a 79-year-old man who sought medical attention from his primary care physician because of worsening shortness of breath. The patient underwent an elective ascending aorta, hemiarch, and aortic valve replacement. Histological examination of the aortic specimen demonstrated an unusually thin aorta with features consistent with necrotizing aortitis with giant cell infiltration.
Efficacy and Safety of Glycoprotein IIb/IIIa Inhibitors on Top of Ticagrelor in STEMI: A Subanalysis of the ATLANTIC Trial
Authors: Tavenier Anne H. , Hermanides Renicus S. , Fabris Enrico , Lapostolle Frédéric , Silvain Johanne , ten Berg Jurrien M. , Lassen Jens F. , Bolognese Leonardo , Cantor Warren J. , Cequier Ángel , Chettibi Mohamed , Goodman Shaun G. , Hammett Christopher J. , Huber Kurt , Janzon Magnus , Merkely Béla , Storey Robert F. , Zeymer Uwe , Ecollan Patrick , Collet Jean-Phillipe , Willems Frank F. , Diallo Abdourahmane , Vicaut Eric , Hamm Christian W. , Montalescot Gilles , van 't Hof Arnoud W. J. ,   ATLANTIC investigators
Published: November 2019

Abstract
Background Glycoprotein IIb/IIIa inhibitors (GPIs) in combination with clopidogrel improve clinical outcome in ST-elevation myocardial infarction (STEMI); however, finding a balance that minimizes both thrombotic and bleeding risk remains fundamental. The efficacy and safety of GPI in addition to ticagrelor, a more potent P2Y12-inhibitor, have not been fully investigated.
Methods 1,630 STEMI patients who underwent primary percutaneous coronary intervention (PCI) were analyzed in this subanalysis of the ATLANTIC trial. Patients were divided in three groups: no GPI, GPI administration routinely before primary PCI, and GPI administration in bailout situations. The primary efficacy outcome was a composite of death, myocardial infarction, urgent target revascularization, and definite stent thrombosis at 30 days. The safety outcome was non-coronary artery bypass graft (CABG)-related PLATO major bleeding at 30 days.
Results Compared with no GPI (n = 930), routine GPI (n = 525) or bailout GPI (n = 175) was not associated with an improved primary efficacy outcome (4.2% no GPI vs. 4.0% routine GPI vs. 6.9% bailout GPI; p = 0.58). After multivariate analysis, the use of GPI in bailout situations was associated with a higher incidence of non-CABG-related bleeding compared with no GPI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.32–6.64; p = 0.03). However, routine GPI use compared with no GPI was not associated with a significant increase in bleeding (OR 1.78, 95% CI 0.88–3.61; p = 0.92).
Conclusion Use of GPIs in addition to ticagrelor in STEMI patients was not associated with an improvement in 30-day ischemic outcome. A significant increase in 30-day non-CABG-related PLATO major bleeding was seen in patients who received GPIs in a bailout situation.
Use of a Modified Tibial Plateau Levelling Osteotomy with Double Cut and Medial Crescentic Closing Wedge Osteotomy to Treat Dogs with Cranial Cruciate Ligament Rupture and Tibial Valgus Deformity
Authors: Vezzoni Luca , Bazzo Sara , Boiocchi Silvia , Vezzoni Aldo 
Published: November 2019

Abstract
Objective The aim of this study was to report efficacy of a modified tibial plateau levelling osteotomy (TPLO) with double cut and medial crescentic closing wedge osteotomy (TPLO/MCCWO) to treat dogs with cranial cruciate ligament rupture and concurrent tibial valgus.
Study Design This study was a cases series.
Materials and Methods Medical records of dogs that had TPLO with medial crescentic closing wedge osteotomy were reviewed. Data collected included signalment, body weight, pre- and postoperative tibial valgus angle, tibial plateau angle (TPA), surgical planning, corrective osteotomy technique, method of fixation, complications, and length of time to radiographic healing.
Results Fifty-two surgical procedures performed in 45 dogs (7 bilateral) were included in the study. Mean age at surgery was 54 months, and body weight ranged from 5 to 63 kg (mean: 36.5 kg). Mean pre- and postoperative mechanical medial proximal tibial angle were 101° (98°–107°) and 92.80° (88°–97°) respectively. The mean pre- and postoperative TPA were 27.80° (16–35°) and 6.50° (3–11°) respectively. Intraoperative complications occurred in two stifles: in one stifle over-rotation of the proximal tibial segment resulted in a TPA of –8°, with immediate revision to a 5° TPA; in the second stifle a fissure of the lateral tibial cortex developed during insertion of a screw and required adjunctive fixation. No postoperative complications were recorded and all osteotomies healed uneventfully.
Conclusions Tibial plateau levelling osteotomy/medial crescentic closing wedge osteotomy is an effective treatment for dogs with cranial cruciate ligament rupture and tibial valgus allowing accurate correction of the tibial deformity with a low complication rate.
Neonatal Abstinence Syndrome among Infants Born to Mothers with Sickle Cell Hemoglobinopathies
Authors: Brown Jewel A. , Sinkey Rachel G. , Steffensen Thora S. , Louis-Jacques Adetola F. , Louis Judette M. 
Published: November 2019

Abstract
Objective The objective of this study is to examine risk factors for neonatal abstinence syndrome (NAS) among infants born to mothers with sickle cell hemoglobinopathies (SCH).
Study Design Retrospective cohort study of nonanomalous, singleton infants born to mothers with laboratory confirmed SCH. Infants were included if they were diagnosed with NAS prior to hospital discharge. The outcome of interest was the association of maternal variables with NAS.
Results Of 131 infants born to mothers with SCH, 4% (n = 5) were diagnosed with NAS. Mothers of infants with NAS were more likely to have SC disease (80%) compared with other SCH (20%), p = 0.001. Fifteen women had antepartum (AP) admissions for pain and/or sickle crisis. Of these patients, four infants (29%) were diagnosed with NAS. The median (5th and 95th percentile) maternal AP length of stay for women with infants diagnosed with NAS to mothers with sickle cell disease was 132 (5, 180) days (p = 0.02).
Conclusion Incidence of NAS among mothers with SCH is low; severe disease characterized by AP sickle cell crisis requiring prolonged AP admission for pain control significantly increases the risk of NAS. Further studies are needed to investigate the association of maternal opioid dose and NAS.
Improved Computed Tomography Accuracy with a 1-mm versus 2- or 3-mm Slice Thickness for the Detection of Medial Coronoid Disease in Dogs
Authors: Zweifel Raffaela T. , DiDonato Pamela , Hartmann Antje , Kramer Martin , von Pückler Kerstin H. 
Published: November 2019

Abstract
Objective Computed tomography (CT) is used complementarily to radiography for the evaluation of medial coronoid disease (MCD). We hypothesized that a slice thickness > 2 mm would significantly affect the image quality and detection of fragmentation of the medial coronoid process. This study aimed to assess CT features indicating direct and indirect evidence of MCD in 168 CT studies with slice thicknesses of 1-, 2- and 3 mm.
Materials and Methods The CT studies were blinded in terms of CT slice thickness and patient data and randomly assessed by two independent observers. All dogs underwent arthroscopic evaluation of the elbow joints. Both observers were unaware of the arthroscopic findings.
Results Notably, blurring of the bone contour (p = 0.0001) was significantly influenced by slice thickness; here, a 1-mm thickness yielded a predominantly sharp and well-defined bone contour (observer 1, 91%; observer 2, 79%), whereas 2- (observer 1, 39.3%; observer 2, 56.3%) and especially 3-mm slice thicknesses yielded blurred margins with significantly reduced sharpness (observer 1, 0%; observer 2, 12.5%). The 1-mm slice thickness also yielded the highest fragment detection rate (observer 1, 55.4%; observer 2, 60.4%). Furthermore, the detection of fragment positions and of single fragments and fissures differed substantially with slice thickness.
Clinical Relevance The findings of this study support the hypothesis that a CT slice thickness of ≥ 2 mm significantly affects fragment detection. In conclusion, a CT slice thickness of at least 1 mm is recommended for the assessment of MCD of the canine elbow.
Recurrent Demyelinating Episodes as Sole Manifestation of Inherited CD59 Deficiency
Authors: Solmaz Ismail , Aytekin Elif Soyak , Çağdaş Deniz , Tan Cagman , Tezcan Ilhan , Gocmen Rahsan , Haliloglu Goknur , Anlar Banu 
Published: November 2019

AbstractDefects in the regulatory components of the complement system can lead to inflammatory diseases. We present a patient who had four episodes of demyelination in the central nervous system as the only manifestation of inherited CD59 deficiency. Relapsing encephalopathy partially responsive to intravenous immunoglobulin and steroid treatments on the background of parental consanguinity suggested an inherited immune dysregulation. Next generation sequencing revealed homozygous mutation in the CD59 gene, confirmed by lack of CD59 expression on flow cytometry. Inherited CD59 deficiency is a rare autosomal recessive condition characterized by chronic hemolysis, recurrent strokes, and relapsing peripheral demyelinating neuropathy mimicking Guillain–Barré syndrome or chronic inflammatory demyelinating polyneuropathy. Recurrent central nervous system demyelinating episodes as the only manifestation has not been reported to date in inherited CD59 deficiency. This entity should be considered in the differential diagnosis of patients with early-onset recurrent neurological diseases with central or peripheral origin.
Differentiation of leukemic blasts is not completely blocked in acute myeloid leukemia
Authors: Agarwal Anupriya , Bolosky William J. , Wilson David B. , Eide Christopher A. , Olson Susan B. , Fan Guang , Druker Brian J. 
Published: November 2019

Significance
A long-held tenet in acute myeloid leukemia (AML) is that multiple genetic events produce a block in the differentiation of primitive myeloblast cells. Using mathematical modeling, we show that, rather than a complete block, even a slight reduction or skewing of the differentiation rate in these cells produces an AML phenotype. We experimentally validated that mature myeloid cells have the same genotype as leukemic blasts, demonstrating that there is not a complete block in differentiation. While targeted differentiation therapies have shown success in isolated subtypes of AML, our findings suggest that maximizing the potential impact of these agents will require discernment of the specific actionable mechanisms underlying reduced or skewed differentiation in genetic subtypes of the disease.