bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building an endobariatric program: lessons learned
Authors: Badurdeen Dilhana , Hedjoudje Abdellah , Itani Mohamad , Fayad Lea , Farha Jad , Dunlap Margo , Cheskin Lawrence , Schweitzer Michael , Koller Kristen , Hartman Christian , Oberbach Andreas , Kashab Mouen A. , Kalloo Anthony , Kumbhari Vivek 
Published: September 2020

AbstractThe emphasis on treating obesity has never been more critical, yet the complexity of delivering care has become more intricate due to new procedures, variable insurance coverage, and inconsistent reimbursement. This is our experience building an endobariatric program and treating overweight and obese patients with endobariatric therapies (EBTs) over 3 years. The primary intention of this manuscript was to educate the reader on how to build an endobariatric program, identify barriers, and provide succinct solutions to establish a successful program. The secondary aim was weight loss outcomes of procedures offered at our institution. We compiled a list of lessons learned, based on the difficulties we experienced to make it easy for others embarking on this journey. Herein, we present a business development strategy to overcome impediments, whilst offering high quality service. The high cost and lack of insurance coverage are significant barriers. Marketing can be costly and is often a factor that is ignored particularly early on, when finances are limited. However, it is an integral component of growing the program. The percentage total body weight loss (%TBWL) at 6 and 12 months post ESG was 17.8 ± 6.48 and 20.6 ± 8.3 (P < 0.001), respectively. The %TBWL at 6 months post IGB was 14.9 ± 9.8 for the Orbera IGB and 12.6 ± 7.4 for the Reshape IGB. There was a trend of preference for ESG compared to IGB placement over the 3 years. The key to building a successful endobariatric program is a motivated physician leader, collaborative bariatric surgeons, institutional support, and marketing. Insurance coverage will likely occur in the near future and programs must be prepared to manage the massive influx of patients that will likely request these procedures.
Bedeutung der SARS-CoV-2-Pandemie für Menschen mit Adipositas
Authors: Gerlach Stefanie , Blüher Matthias , Engeli Stefan , de Zwaan Martina ,   für den Vorstand der Deutschen Adipositas-Gesellschaft (DAG)
Published: September 2020

ZusammenfassungZiel Analyse des derzeitigen Wissens zur Bedeutung der SARS-CoV-2-Pandemie für Menschen mit Adipositas. Formulierung von Gesundheitsempfehlungen der Deutschen Adipositas-Gesellschaft.Methodik Selektive Literatursuche in PubMed und Internetrecherche.Ergebnisse Derzeit gibt es keine belastbaren Hinweise, dass Menschen mit Adipositas ein erhöhtes SARS-CoV-2-Infektionsrisiko aufweisen. Adipositas ist jedoch ein wichtiger Risikofaktor für einen schweren COVID-19-Verlauf. Eine kausale Beziehung zwischen Adipositas und schwerem Krankheitsverlauf kann derzeit allerdings nicht abgeleitet werden. Jedoch zeigt die COVID-19-Situation, dass PatientInnen mit Adipositas bei Intensiv- und Beatmungspflichtigkeit klinisch in der Regel schwer zu führen sind.Schlussfolgerungen Die DAG rät Menschen mit Adipositas, die empfohlenen Hygieneregeln und Maßnahmen des Infektionsschutzgesetzes sowie der Kontaktbeschränkungen sorgfältig zu befolgen. Darüber hinaus sollten grundlegende Empfehlungen zum Gesundheitsschutz und zu einem gesunden Lebensstil beachtet werden.
Elephantiasis nostras verrucosa gigantea nach nekrotisierender Fasziitis – Erfolgreiche Therapie mit Acitretin
Authors: Saternus R. , Müller C. S. L. , Heinricy L. , Reichrath J. , Vogt T. 
Published: September 2020

ZusammenfassungWir berichten über einen 54-jährigen männlichen Patienten mit einer posttraumatischen und postinflammatorischen Elephantiasis nostras verrucosa (ENV) des linken Beines. 5 Jahre zuvor war ein Arbeitsunfall vorausgegangen (Bagatellverletzung der linken Patella) mit nachfolgendem komplikationsreichen Verlauf (u. a. Entwicklung einer nekrotisierenden Fasziitis). Die dadurch entstandenen Hautdefekte wurden mittels Spalthauttransplantation versorgt. Nach initialer Einheilungstendenz kam es bei Verbandswechseln jedoch zu erheblichem Spalthautverlust mit begleitender infizierter Wundheilungsstörung. In den darauffolgenden Jahren bildeten sich eine massive Umfangsvermehrung des linken Beins sowie übel riechende, vegetierende, flächige Hyperkeratosen mit scharfer zirkulärer Demarkationslinie ca. 10 cm proximal des Kniegelenkes. Wir begannen eine Therapie mit Acitretin 40 mg/d p. o., eine intensivierte externe Therapie (stadienadaptiert antiseptisch, aggressiv keratolytisch) sowie mechanische Débridements (Skalpell, Kürette) zur Massenabtragung. Im Verlauf wurde die Acitretindosis auf 10 mg alle 2 Tage reduziert. Hierunter zeigt sich ein langfristig stabiler Befund. Pathogenetisch kann eine ENV bei einer wie im vorgestellten Fall insuffizienten Wiederherstellung des lymphatischen Abflusses nach z. B. Operationen oder Traumen mit Sistieren des Clearings relevanter Zytokine und Wachstumsfaktoren entstehen. Aufgrund der Seltenheit der ENV mit nur wenigen Fallberichten in der Literatur existiert keine standardisierte Therapie. Im hier dargestellten Fall wird über eine erfolgreiche Therapie der ENV mit Acitretin berichtet.
Vertauschung von Hautbiopsien als voll beherrschbares Risiko
Authors: Elsner P. 
Published: September 2020

ZusammenfassungEin Hautarzt führte bei einem Patienten wegen suspekter Hautveränderungen an der rechten Schulter und im Bereich des Nackens Biopsien durch. Der Pathologie-Befund ergab für die Hautveränderung an der rechten Schulter ein fortgeschrittenes und ulzeriertes invasives superfiziell spreitendes malignes Melanom (SSM) und für die im Bereich des Nackens vorgefundene Hautveränderung ein fortgeschrittenes solid-adenoides Basalzellkarzinom. Der Patient unterzog sich daraufhin einem unter Vollnarkose durchgeführten operativen Eingriff zur Entfernung der Hautveränderung an der Schulter (Nachexzision mit Sicherheitsabstand von 2 cm und Sentinel-Lymphonodektomie axillär). Da der Patient bereits zu diesem Zeitpunkt eine Vertauschung der zuvor entnommenen Gewebeproben vermutete, erfolgte im Rahmen dieses Eingriffs auf seinen ausdrücklichen Wunsch zugleich eine Re-Biopsie der Hautveränderung im Bereich des Nackens. Während die Exzision im Bereich der Schulter einen tumorfreien Befund ergab, bestätigte die Re-Biopsie am Nacken den Nachweis von Tumorzellverbänden im Sinne eines malignen Melanoms und damit den Verdacht auf Verwechslung der Präparate. Das zuständige Landgericht gab seiner Klage auf Schmerzensgeld statt und hielt fest, dass die verwechslungssichere Aufbewahrung, Etikettierung und Versendung von Patienten entnommenen Gewebeproben ein sog. vollbeherrschbares Risiko ist. Für voll beherrschbare Risiken gilt eine Beweislastumkehr, d. h. der Arzt muss beweisen, dass kein Behandlungsfehler vorlag. Zur Vermeidung von Vertauschungen dermatopathologischer Proben sollten alle Prozessschritte der Biopsieentnahme, des Versandes und der Verarbeitung analysiert und in einem Qualitätsmanagement-Dokument festgehalten werden.
Injuries and Rapid Weight Loss in Elite Adolescent Taekwondo
Athletes: A Korean Prospective Cohort Study
Authors: Kim ChanWoo , Park Ki Jun 
Published: September 2020

Abstract
Objectives To report injury patterns associated with training activities
of elite adolescent Taekwondo athletes who are expected to represent South Korea
in the future.
Methods Beginning in 2019, we prospectively collected data on elite
adolescent Taekwondo athletes at the Korean Training Center. The athletes were
assessed by sports medicine doctors, and data were stratified according to sex,
weight class, injury location, injuries during the weight loss period, and
weight loss method. We used χ2 tests were used to compare
groups. Injury rates were expressed as Poisson rates with 95% confidence
intervals.
Results There were 117 male and 102 female elite adolescent Taekwondo
athletes. The mean weight loss among athletes was 3.37
(±1.23) kg, and the mean duration of weight loss was 7.53
(±3.40) days. In general, all athletes used similar weight loss methods.
We recorded 846 injuries (annual average, 3.98 injuries/athlete). In
general, female athletes had higher injury rates than their male counterparts.
Additionally, the athletes had significantly higher injury rates during weight
loss periods than during other periods of training. When all athletes were
considered, most injuries occurred in the lower extremities (63.2%),
followed by the trunk (14.2%), upper extremities (16.3%), and
the head and neck area (6.3%). The injury severity significantly
influenced the body regions in weight categories.
Conclusion Rapid weight loss is related to the incidence of sports damage
in athletes. Most injuries occur during weight loss periods in South Korean
elite adolescent Taekwondo athletes. Moreover, the injury rate and injury
severity depends on weight class.
Efficacy of an internal anchoring plastic stent to prevent migration of a fully covered metal stent in malignant distal biliary strictures: a randomized controlled study
Authors: Paik Woo Hyun , Woo Sang Myung , Chun Jung Won , Song Byeong Jun , Lee Woo Jin , Ahn Dong-Won , Lee Yoon Suk , Choi Young Hoon , Ryu Ji Kon , Kim Yong-Tae , Lee Sang Hyub 
Published: September 2020

Background Two types of self-expandable metal stents (SEMS) are available for malignant distal biliary obstruction: fully covered SEMS (FCSEMS) and uncovered SEMS. FCSEMS can prevent stent ingrowth, but a major concern is spontaneous migration. This study aimed to determine whether the additional insertion of a double-pigtail plastic stent to anchor the FCSEMS can prevent migration.
Methods 68 patients with unresectable, malignant, distal, biliary obstruction were included in this multicenter, randomized, superiority trial. The patients were randomly assigned to receive either the FCSEMS plus an anchoring plastic stent (n = 33) or an FCSEMS alone (n = 35). After placement of the FCSEMS, the anchoring stent was inserted inside the FCSEMS. The primary outcome was the rate of stent migration during the 6-month follow-up. The secondary outcomes were stent-related adverse events, stent patency, and survival rates.
Results The baseline characteristics were similar between the two groups. The rate of stent migration at 6 months was significantly lower in patients with the FCSEMS plus anchoring stent (15 % vs. 40 %; P = 0.02). The mean stent patency was significantly longer in the FCSEMS plus anchoring group (237 days [95 % confidence interval [CI] 199 to 275] vs. 173 days [95 %CI 130 to 217]; P = 0.048). There were no significant differences in stent-related adverse events and overall survival rates at 6 months between the two groups.
Conclusions Our data suggest that the additional double-pigtail plastic stent anchored the FCSEMS to prevent migration and prolonged patency without any serious adverse events.
Combined Surgical Approaches In and Around the Orbit
Authors: Stefko S. Tonya 
Published: September 2020

AbstractOrbital pathology requiring surgery can be planned based on the nature of the disease and the position of this relative to the globe and optic nerve complex. Multidisciplinary treatment is now common, and this sometimes includes multiple surgical corridors employed for approach. The orbit is also now frequently used as a corridor to intracranial pathology, and these same processes may be applied. Combined surgical approaches, whether at the same time or staged, allow for minimization of manipulation of critical neurovascular structures in complex skull base pathology.
ESD and Pit Pattern Diagnosis: Lessons from a Japanese Endoscopist Working in the United States
Authors: Nishimura Makoto 
Published: September 2020

AbstractEndoscopic submucosal dissection (ESD) was developed in 2000s to overcome the limitations of endoscopic mucosal resection (EMR), especially to accomplish en-bloc resection, and it has been accepted worldwide in the past decades. Many ESD devices and diagnosis modalities are currently available, which include pit pattern and narrow band imaging (NBI) diagnoses to evaluate the depth of the tumor preoperatively with sensitivities of 70 to 90%. Depending on the Japanese colorectal guideline, the intramucosal cancer and shallow invasion of the submucosal layer are the main good indications of ESD; however, the ESD practices between Japan and Western countries still vary, including pathologic definition of cancer, tumor/node/metastasis classification, and handling of ESD specimen. In the United States, despite the large demand for treatment of colorectal neoplasm, pit pattern and magnified NBI diagnoses are not widely accepted yet, and piecemeal EMR is still the major method in most of the institutions. Moreover, the specific guideline of ESD is also not available yet. More new technologies are being developed other than conventional ESD methods in Eastern and Western countries, and ESD is now expected to change in the next generation. It is recommended that not only gastroenterologists but also colorectal surgeons have appropriate knowledge of colorectal lesions and their management to ensure current treatments is applied to patients.
The Segmental Preservation Rhinoplasty: The Split Tetris Concept
Authors: Neves José Carlos , Arancibia-Tagle Diego , Dewes Wilson , Ferraz Mario 
Published: September 2020

AbstractDorsal preservation rhinoplasty has seen considerable advances in the recent years as many doctors have improved and developed new ideas on the subject. In the era of minimal trauma surgery, it is important to achieve a beautiful nasal aesthetic result with minimum injury to the nose. Preserving the main structures of the nasal pyramid has been pursued for more than a century, and some different approaches have been described and developed since then. Their strengths and weakness have been shown. The present society's demand for perfection is an added reason for improving the stability and predictability of preservation rhinoplasty. We describe a brand-new philosophy of approaching the nasal dorsum hump that combines both safety and delicacy in dealing with the anatomical structures with elegancy and accuracy and achieving the aesthetic goal required.
Surgical and Transcatheter Treatments in Children with Congenital Aortic Stenosis
Authors: Zhu Yifan , Hu Renjie , Zhang Wen , Yu Xiafeng , Dong Wei , Sun Yanjun , Zhang Haibo 
Published: September 2020

AbstractBackground For patients with congenital aortic valve stenosis (AVS), comprehensive analysis of surgical aortic valvuloplasty (SAV) or balloon dilation (BD) is scarce and remains controversial.Methods This study reviewed AVS data (aortic peak gradient, aortic insufficiency, and survival and reoperation) for patients who were suitable for biventricular repair at our center in 2008 to 2018. Patients were categorized into two subgroups based on age (≤3 or >3 months).Results A total of 194 patients were treated, including 124 with SAV and 70 with BD. Resulting data revealed that residual aortic gradient at discharge was worse for BD (p = 0.001). While for patients younger than 3 months, the relief of AVS was comparable between the two groups (p = 0.624). There was no significant difference in time-related survival between the two groups (log-rank p = 0.644). Multivariate analysis demonstrated that preoperative left ventricular end-diastolic dimension predicted early death (p = 0.045). Survival in the two groups after 10 years was 96.8% in SAV and 95.7% in BD (p = 0.644). Freedom from reoperation after 10 years was 58.1% in SAV and 41.8% in BD patients (p = 0.01). There was no significant difference in freedom from reoperation between SAV and BD in patients younger than 3 months (p = 0.84). Multivariate analysis indicated that residual aortic peak gradient was predictive of reoperation (p = 0.038).Conclusion Both methods achieved excellent survival outcomes at our center. SAV achieved superior gradient reduction and minimized the necessity for reoperation. For patients younger than 3 months, BD rivaled SAV both in aortic stenosis relief and freedom from reoperation.
Insight View on Pandemic COVID-19: Worldwide Perspective with Homoeopathic Management through Repertorial Analysis
Authors: Ram Hanuman , Sharma Rashmi , Dewan Deepti , Singh Anuradha 
Published: September 2020

AbstractThe current outbreak of novel corona virus that began in China, created massive disaster worldwide resulting in thousands of deaths and enormous impact on health system and economic. This viral infection facilitates damage of alveolar macrophages and epithelial cells of lung caused by cytokine storm and deregulated immune responses and transmitted rapidly through the droplet infection via cough, sneeze and through contact. The reporting spectrum ranges from asymptomatic cases to symptomatic manifestations, fever, cough and shortness of breath with high-risk potential in systemic associated diseases of cardiovascular, diabetes and hypertension. The global impact of COVID-19 has been profound and the public health threat, it represents, is the most serious picture seen in a respiratory virus since the 1918 H1N1 influenza pandemic. As of now there are no vaccines or medicines approved for the SARS-CoV-2 infection; it is the time to look for other possible measures which can be possibly undertaken to combat the crisis. Keeping in mind this current scenario, there is a need to adopt an integrative approach in public health-care system and include complementary and alternative medicines in designing roadmap in battle against this malady. One of peculiar aspect of homoeopathy is individualisation. There is an inter-individual variation in reaction to a stimulus. Clinical presentation in a disease is significantly determined by the host immunogenetic mechanisms. Homoeopathy treatment is done on the basis of symptoms of the patient; this concept is relevant when we deal with the new diseases. As homoeopathic medicines stimulate the body's own defence mechanism rather than directly attacking specific pathogens, they have much to offer in the treatment of viral diseases. In this review, authors have collected symptoms from previous studies done in conventional medicine and homoeopathy. These symptoms are repertorised from two general and two clinical repertories. Frequently appearing medicines are examined with their symptoms in context of influenza-like illness. The review concludes with the key learning points about epidemiology, clinical features, prevention and homoeopathic management of COVID-19.
Aspectual particles and event types in TSM
Authors: Lien Chinfa 
Published: September 2020

Abstract
The paper investigates the syntactic behavior and semantic constraints of four types of aspectual particles (1)
夭

iau2
/
夭故

iau2koh4
‘still’, (2) 已經

i2king1
‘already’,
(3) 夭未

iau2be7
‘not…yet’, and (4) 毋

m7
/無

bo5
/勿

mai3
/免

bien2

故

koh4
‘not…any more’ in
Taiwanese Southern Min (TSM). In line with Löbner (1989) it examines the interaction
between aspectual particles and event types. The four types of aspectual particles can be better captured in terms of the notion
of two consecutive event types: event 1 (Ev1) and event 2 (Ev2) coupled with the value of existence and non-existence of a
situation symbolized by [+] and [−]. Type 1 and 3 share the common element 夭

iau2
and Type 1 and 4, the common element 故
koh4
. Whereas not…yet and still in English show no lexical
relationship, such a relationship is tangible in TSM and German, as in 夭未

iau2be7
still not ‘not…yet’ and 夭

iau2
‘still’, on the one hand,
and noch nicht still not ‘not…yet’ and noch ‘still’, on the other. Parametric variation matters
in dealing with language universal. Like still in English, 夭

iau2
or its compound kin 夭故

iau2koh4
‘still’
develops the non-aspectual additive and even concessive sense.
Requests for stories
Authors: Norrick Neal R. 
Published: September 2020

AbstractMy contribution traces the evolving notion of tellability in the study of narrative over the last thirty-odd years: Tellability was initially seen as an objective property of textual content, but research on narrative in real contexts of talk has increasingly recognized the various ways interactional factors can override content as grounds for relating a story. I advance a set of research strategies based on investigation of the discourse structures that accompany the negotiation of tellability in context and the syntactic markers of tellability, specifically requests for stories like “tell me” and “tell her,” correlating with features of recipient design in narration. This will reveal distinctions in presuppositions about who knows a story already, who else should be included, and who may conarrate, demonstrating how tellability varies from one participant to another even in the same context.
Clinical translation of a new flat-panel detector for beam’s-eye-view imaging
Authors: Harris TC , Seco J , Ferguson D , Lehmann M , Huber P , Shi M , Jacobson M , Valencia Lozano I , Myronakis M , Baturin P , Fueglistaller R , Morf D , Berbeco R 
Published: September 2020

Abstract
Electronic portal imaging devices (EPIDs) lend themselves to beams-eye view clinical applications, such as tumor tracking, but are limited by low contrast and detective quantum efficiency (DQE). We characterize a novel EPID prototype consisting of multiple layers and investigate its suitability for use under clinical conditions. A prototype multi-layer imager (MLI) was constructed utilizing four conventional EPID layers, each consisting of a copper plate, a Gd2O2S:Tb phosphor scintillator, and an amorphous silicon flat panel array detector. We measured the detector’s response to a 6 MV photon beam with regards to modulation transfer function, noise power spectrum, DQE, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and the linearity of the detector’s response to dose. Additionally, we compared MLI performance to the single top layer of the MLI and the standard Varian AS-1200 detector. Pre-clinical imaging was done on an anthropomorphic phantom, and the detector’s CNR, SNR and spatial resolution were assessed in a clinical environment. Images obtained from spine and liver patient treatment deliveries were analyzed to verify CNR and SNR improvements. The MLI has a DQE(0) of 9.7%, about 5.7 times the reference AS-1200 detector. Improved noise performance largely drives the increase. CNR and SNR of clinical images improved three-fold compared to reference. A novel MLI was characterized and prepared for clinical translation. The MLI substantially improved DQE and CNR performance while maintaining the same resolution. Pre-clinical tests on an anthropomorphic phantom demonstrated improved performance as predicted theoretically. Preliminary patient data were analyzed, confirming improved CNR and SNR. Clinical applications are anticipated to include more accurate soft tissue tracking.