bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinanten der Niederlassung als Allgemeinmediziner – eine
qualitative Studie
Authors: Zwierlein Ruben , Portenhauser Frank , Flägel Kristina , Steinhäuser Jost 
Published: April 2020

Zusammenfassung
Ziel der Studie In den letzten Jahren kann beobachtet werden, dass die
Motivation der nachrückenden Fachärzte für
Allgemeinmedizin sich in einer eigenen Praxis niederzulassen
rückläufig ist. Mit der Kenntnis der hier fördernden und
hemmenden Faktoren, können Strategien zur Förderung der
Niederlassung abgeleitet werden. Ziel dieser Studie war es daher diese
Determinanten zu erheben.
Methodik Es wurden niedergelassene Fachärzte für
Allgemeinmedizin aus Baden-Württemberg (BW) im Zeitraum von April bis
Oktober 2016 eingeladen, an einer qualitativen Interviewstudie teilzunehmen. Die
Stratifikation der Ärzte aus einer Gruppe von insgesamt 553, die
zwischen 2008 und 2011 am Förderprogramm Allgemeinmedizin in BW
teilnahmen und sich in den Jahren 2008 bis 2014 niederließen, erfolgte
anhand der Verdichtungsräume im ländlichen Raum, der Randzonen
um Verdichtungsräume und der Verdichtungsräume selbst. Die
Transkripte der Interviews wurden von zwei Autoren inhaltsanalytisch nach
Mayring ausgewertet, zusammengefasst und im zweiten Schritt in eine
Konsensversion überführt.
Ergebnisse Es konnten 23 Allgemeinmediziner rekrutiert werden, die zu
57% weiblich und im Durchschnitt 42 Jahre alt waren sowie mehrheitlich
in Kooperation arbeiteten. Hauptmotivation sich niederzulassen lag in dem Wunsch
die Situation gegenüber dem Klinikalltag zu verbessern. Hierzu
zählten insbesondere eine geringere Dienstbelastung und
familienfreundlichere Arbeitszeiten. Relevante, unterstützende Faktoren
während des Niederlassungsprozesses waren der familiäre
Rückhalt, die (Verbund-)Weiterbildung und professionelle Beratung.
Hemmende Faktoren waren Ängste vor Regressen und Verschuldung, das als
kompliziert erlebte Abrechnungssystem und der als bürokratisch erlebte
Zulassungsprozess.
Schlussfolgerungen Die Studie zeigt zum einen, dass die vielen Vorteile
als niedergelassener Allgemeinmediziner, wie z. B. die gute
Familienkompatibilität, besser kommuniziert und die finanziellen
Bedenken entschärft werden müssen. Zum anderen zeigt sich der
Bedarf nach Lehrangeboten in der Ausbildung zum Praxismanagement. Ein
standardisierter und optimierter Niederlassungsprozess mit verbesserter
Übersicht und einem kollegialen Ansprechpartner kann die Entscheidung
für die Niederlassung und die Durchführung erleichtern.
Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19
Authors: Lütje Susanne , Marinova Milka , Kütting Daniel , Attenberger Ulrike , Essler Markus , Bundschuh Ralph Alexander 
Published: April 2020

AbstractThe current outbreak of coronavirus SARS-CoV-2 has reached multiple countries worldwide. While the number of newly diagnosed cases and fatalities is rising quickly, far-reaching measures were enacted to prevent further spread. Diagnosis relies on clinical presentation, exposure history, PCR using specimens from the respiratory tract together with computed tomography (CT) imaging. One of the hallmarks of a critical course of COVID-19 is the development of severe acute respiratory distress syndrome (ARDS). As management of COVID-19 can be considered a multi-disciplinary approach involving various medical specialties, we here review the first 18F-FDG-PET/CT scans of COVID-19 to discuss how Nuclear Medicine could contribute to management of this disease.
Thrombocytopenia in Surgery and Neuraxial Anesthesia
Authors: Estcourt Lise J. 
Published: April 2020

AbstractThis is a review of the evidence for the use of different platelet count thresholds prior to invasive procedures and surgery. This review will focus on three procedures that are common in patients with thrombocytopenia—central venous catheter insertion, liver biopsy, and lumbar punctures and epidural catheters—as well as highlighting the lack of evidence for more major surgery. Tunneled or untunneled central venous catheters are low-risk procedures and can be safely performed without any intervention when the platelet count is 20 × 109/L or above. Evidence for their safety is more limited below this threshold, but as bleeding is easily treated, interventions should focus on treating any bleeding that occurs rather than preventative strategies. The available evidence for neuraxial anesthesia is based on very low-quality evidence from observational studies. Based on this evidence, the risk of an epidural hematoma is less than 0.19% (upper limit of 95% confidence interval) for pregnant women undergoing an epidural anesthetic when the platelet count is between 70 and 99 × 109/L. No randomized trials have been performed in children, nor have any randomized trials been performed in major or emergency surgeries.
Inconsistent allocations of harms versus benefits may exacerbate environmental inequality
Authors: Makov Tamar , Newman George E. , Zauberman Gal 
Published: April 2020

SignificanceLocal environmental conditions, such as air and water quality, are shaped, in part, by how societies allocate environmental harms and benefits. Since environmental conditions have long-lasting impacts on people’s lives, understanding the psychology behind such allocation decisions is critical. Across studies, we demonstrate that people are less likely to support decisions that increase environmental equality when considering the allocation of environmental harms (vs. benefits). Our findings suggest that careful attention to the way that the allocation of environmental harms is presented to the public could change the support for decisions that address environmental inequality.
Activity in grafted human iPS cell–derived cortical neurons integrated in stroke-injured rat brain regulates motor behavior
Authors: Palma-Tortosa Sara , Tornero Daniel , Grønning Hansen Marita , Monni Emanuela , Hajy Mazin , Kartsivadze Sopiko , Aktay Sibel , Tsupykov Oleg , Parmar Malin , Deisseroth Karl , Skibo Galyna , Lindvall Olle , Kokaia Zaal 
Published: April 2020

Significance
Many stroke patients exhibit long-term disability. Transplantation of stem cells has been proposed as a novel therapeutic strategy to promote recovery. However, little is known about whether these cells can form functionally integrated connections with neurons in the stroke-injured recipient’s brain. Here we show extensive morphological and functional integration of axonal projections from intracortically transplanted human iPS cell–derived cortical neurons in brains of rats with ischemic lesions in the cerebral cortex. We also demonstrate that neuronal activity in these grafts is involved in the regulation of the stroke-affected animals’ motor behavior. Our findings raise the possibility that injured neural circuitry might be restored by stem cells also in humans affected by stroke, which would have major clinical implications.
Venous Thromboembolism Prophylaxis in Aesthetic Surgery: A Survey of Plastic Surgeons’ Practices
Authors: Aimé Victoria L , Neville Matthew R , Thornburg Danielle A , Noland Shelley S , Mahabir Raman C , Bernard Robert W 
Published: April 2020

Abstract

Background
Deep venous thrombosis and pulmonary embolism, collectively known as venous thromboembolism (VTE), are among the most feared yet preventable surgical complications. Although many recommendations exist to reduce the risk of VTE, the actual VTE prophylaxis practices of aesthetic plastic surgeons remain unknown.

Objectives
The primary aim of this study was to elucidate plastic surgeons’ experiences with VTE, preferred VTE prophylaxis practices, and areas in which VTE prevention may be improved.

Methods
Members of The Aesthetic Society were queried via a 55-question electronic survey regarding their experience with VTE as well as their VTE prophylaxis practices. Anonymous responses were collected and analyzed by the Mayo Clinic Survey Research Center.

Results
The survey was sent to 1729 of The Aesthetic Society members, of whom 286 responded. Fifty percent, 38%, and 6% of respondents reported having had a patient develop a deep venous thrombosis, pulmonary embolism, or death secondary to VTE, respectively. Procedures performed on the back or trunk were associated with the highest rate of VTE. Lower extremity procedures were associated with a significantly higher rate of VTE than expected. Over 90% of respondents reported utilizing a patient risk stratification assessment tool. Although at least one-half of respondents reported that the surgical facility in which they operate maintains some form of VTE prophylaxis protocol, 39% self-reported nonadherence with these protocols.

Conclusions
Considerable variability exists in VTE prophylaxis practices among The Aesthetic Society responders. Future efforts should simplify guidelines and tailor prophylaxis recommendations to the aesthetic surgery population. Furthermore, education of plastic surgeons performing aesthetic surgery and more diligent surgical venue supervision is needed to narrow the gap between current recommendations and actual practices.
Community-Based Antibiotic Prescribing Attributable to Respiratory Syncytial Virus and Other Common Respiratory Viruses in Young Children: A Population-Based Time-series Study of Scottish Children
Authors: Fitzpatrick Tiffany , Malcolm William , McMenamin Jim , Reynolds Arlene , Guttmann Astrid , Hardelid Pia 
Published: April 2020

Abstract

Background
Inappropriate antibiotic prescribing, such as for viral illness, remains common in primary care. The objective of this study was to estimate the proportion of community-prescribed antibiotics to children aged less than 5 years attributable to common respiratory viruses.

Methods
We fitted time-series negative binomial models to predict weekly antibiotic prescribing rates from positive viral pathogen tests for the period 1 April 2009 through 27 December 2017 using comprehensive, population-based administrative data for all children (&lt;5 years) living in Scotland. Multiple respiratory viral pathogens were considered, including respiratory syncytial virus (RSV), influenza, human metapneumovirus (HMPV), rhinovirus, and human parainfluenza (HPIV) types 1–4. We estimated the proportion of antibiotic prescriptions explained by virus circulation according to type of virus, by age group, presence of high-risk chronic conditions, and antibiotic class.

Results
We included data on 6 066 492 antibiotic prescriptions among 452 877 children. The antibiotic-prescribing rate among all Scottish children (&lt;5 years) was 609.7 per 1000 child-years. Our final model included RSV, influenza, HMPV, HPIV-1, and HPIV-3. An estimated 6.9% (95% confidence interval, 5.6–8.3%), 2.4% (1.7–3.1%), and 2.3% (.8–3.9%) of antibiotics were attributable to RSV, influenza, and HMPV, respectively. RSV was consistently associated with the highest proportion of prescribed antibiotics, particularly among children without chronic conditions and for amoxicillin and macrolide prescriptions.

Conclusions
Nearly 14% of antibiotics prescribed to children in this study were estimated to be attributable to common viruses for which antibiotics are not recommended. A future RSV vaccine could substantially reduce unnecessary antibiotic prescribing among children.
Blinding multiprobe cosmological experiments
Authors: Muir J , Bernstein G M , Huterer D , Elsner F , Krause E , Roodman A , Allam S , Annis J , Avila S , Bechtol K , Bertin E , Brooks D , Buckley-Geer E , Burke D L , Carnero Rosell A , Carrasco Kind M , Carretero J , Cawthon R , Costanzi M , da Costa L N , De Vicente J , Desai S , Dietrich J P , Doel P , Eifler T F , Everett S , Fosalba P , Frieman J , García-Bellido J , Gerdes D W , Gruen D , Gruendl R A , Gschwend J , Hartley W G , Hollowood D L , James D J , Jarvis M , Kuehn K , Kuropatkin N , Lahav O , March M , Marshall J L , Melchior P , Menanteau F , Miquel R , Ogando R L C , Palmese A , Paz-Chinchón F , Plazas A A , Romer A K , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Suchyta E , Tarle G , Thomas D , Troxel M A , Walker A R , Weller J , Wester W , Zuntz J ,   (DES Collaboration)
Published: April 2020

ABSTRACT
The goal of blinding is to hide an experiment’s critical results – here the inferred cosmological parameters – until all decisions affecting its analysis have been finalized. This is especially important in the current era of precision cosmology, when the results of any new experiment are closely scrutinized for consistency or tension with previous results. In analyses that combine multiple observational probes, like the combination of galaxy clustering and weak lensing in the Dark Energy Survey (DES), it is challenging to blind the results while retaining the ability to check for (in)consistency between different parts of the data. We propose a simple new blinding transformation, which works by modifying the summary statistics that are input to parameter estimation, such as two-point correlation functions. The transformation shifts the measured statistics to new values that are consistent with (blindly) shifted cosmological parameters while preserving internal (in)consistency. We apply the blinding transformation to simulated data for the projected DES Year 3 galaxy clustering and weak lensing analysis, demonstrating that practical blinding is achieved without significant perturbation of internal-consistency checks, as measured here by degradation of the χ2 between the data and best-fitting model. Our blinding method’s performance is expected to improve as experiments evolve to higher precision and accuracy.
An asymmetric explosion mechanism may explain the diversity of Si ii linewidths in Type Ia supernovae
Authors: Livneh Ran , Katz Boaz 
Published: April 2020

ABSTRACT
Near maximum brightness, the spectra of Type Ia supernovae (SNe Ia) present typical absorption features of Silicon II observed at roughly $6100$ and $5750\, \mathring{\rm A}$. The two-dimensional distribution of the pseudo-equivalent widths (pEWs) of these features is a useful tool for classifying SNe Ia spectra (Branch plot). Comparing the observed distribution of SNe on the Branch plot to results of simulated explosion models, we find that one-dimensional models fail to cover most of the distribution. In contrast, we find that tardis radiative transfer simulations of the white dwarf head-on collision models along different lines of sight almost fully cover the distribution. We use several simplified approaches to explain this result. We perform order-of-magnitude analysis and model the opacity of the Si ii lines using local thermodynamic equilibrium and non-local thermodynamic equilibrium approximations. Introducing a simple toy model of spectral feature formation, we show that the pEW is a good tracer for the extent of the absorption region in the ejecta. Using radiative transfer simulations of synthetic SN ejecta, we reproduce the observed Branch plot distribution by varying the luminosity of the SN and the Si density profile of the ejecta. We deduce that the success of the collision model in covering the Branch plot is a result of its asymmetry, which allows for a significant range of Si density profiles along different viewing angles, uncorrelated with a range of 56Ni yields that cover the observed range of SN Ia luminosity. We use our results to explain the shape and boundaries of the Branch plot distribution.
Nonmelanoma Skin Cancers: Embryologically Relevant Sites and UV Exposure
Authors: Nicoletti Giovanni , Tresoldi Marco Mario , Malovini Alberto , Francesco Borelli , Faga Angela 
Published: April 2020

Background:
Traditionally, nonmelanoma skin cancers (NMSCs) are considered mainly UV-related malignancies. Nevertheless, a strong correlation between the embryologically relevant sites (ERS) of the head and neck and the preferential sites of onset of basal cell carcinomas (BCCs) has long been supposed and demonstrated. The aim of this research was the investigation of the potential correlation between the ERS of the head and neck and the sites of tumor onset in all of the NMSCs.

Methods:
The distribution of 1165 NMSC was correlated with the ERS of the head and neck using the universally accepted anatomical diagrams featuring the congenital head and neck clefts and an original anatomical diagram showing the most credited sites of the embryonic fusion planes of the auricle.

Results:
In our sample, both BCC and SSC display an increased likelihood of onset in the ERS of the head and neck. A proportion of 93.10% BCCs was distributed within ERS, while 6.90% derived from non-embryologically relevant sites (P < 0.001). A proportion of 69.70% SCCs was distributed within ERS, while 30.30% derived from non-embryologically relevant sites (P < 0.001). The probability of tumors within ERS was significantly higher for BCC versus SCC (P < 0.001), with BCCs having a 5-fold increase in the probability of occurring in ERS compared to SCCs (P < 0.001).

Conclusions:
The ERS might host areas of cellular instability yielding to the development of an NMSC. The environmental UV exposure plays a relatively main role versus dysontogenic factors in the pathogenesis of SCC.
Bleeding Events in Patients 75 Years of Age and Older Under Long-term Anticoagulant Therapy: A Real-life Study
Authors: Conti Alberto , Renzi Noemi , Catarzi Stefania , Mazzucchelli Mariuccia , Covelli Antonella , Pampana Alessandro , Bongini Giada , Bini Giacomo , Leorin Marco , Ghiadoni Lorenzo 
Published: April 2020

Objective:
To investigate the risk of bleeding events in older patients under oral anticoagulant with a 4-year survey of a catchment area with 197,722 inhabitants of whom 15,267 were on warfarin and 10,397 on direct oral anticoagulants (DOACs).

Methods:
Patients presented to the Emergency Department with major bleeding were enrolled and stratified according to age ≥75 years and ongoing warfarin or DOACs. Primary endpoint was 1-month death.

Results:
Out of 1919 major bleeding, those of patients ≥75 years of age were 1127 (59%) versus 792 (41%) <75 years of age, P < 0.0001. In patients ≥75 years of age, brain hemorrhage accounted for 612 (54%) patients, gastrointestinal hemorrhage for 301 (27%), hematuria for 104 (9%), and other hemorrhage for 108 (10%). In patients ≥75 years of age, those on warfarin accounted for 175 versus 53 on DOACs, without difference of Charlson Comorbidity Index (5.25 ± 1.92 versus 5.09 ± 1.61; P = 0.5824). One-month death in patients ≥75 of age versus <75 years of age accounted for 77 (4.0%) versus 20 (1.0%); P < 0.0001. One-month death in patients ≥75 of age on DOACs was very low, without difference versus <75 years and within DOACs. Among DOACs, absolute bleeding events showed differences as follows: 3 bleeding events for edoxaban versus 21 for dabigatran; P < 0.001; versus 16 for rivaroxaban, P = 0.006; and versus 13 for apixaban, P = 0.02.

Conclusions:
Major bleeding and 1-month death accounted for higher percentage in patients ≥75 years of age and in patients receiving warfarin. Among DOACs, edoxaban presented the lowest absolute rate of hemorrhage among the 4 available DOACs, without difference in mortality.
Practice Patterns of Family Physicians With and Without Sports Medicine Certification
Authors: Cox Rachel , Morgan Zachary J. , Nithyanandam Srikanth , Puffer James C. , Peterson Lars E. 
Published: April 2020

Objective:
To update information regarding practice patterns of family physicians with a certificate of added qualifications (CAQ) in Sports Medicine (SM), because it has been over 10 years since the last comprehensive study.

Design:
Cross-sectional analysis of 2017 and 2018 American Board of Family Medicine (ABFM) Family Medicine Certification and SM CAQ examination registration practice demographic questionnaire data.

Setting:
N/A.

Participants:
Family physicians with a CAQ in SM [sports medicine family physicians (SM-FPs)] and family physicians without a CAQ registering for the ABFM Family Medicine Certification or SM CAQ examinations.

Intervention:
N/A.

Main Outcomes:
Self-reported time spent practicing SM, activities in SM, scope of practice, and practice setting.

Results:
Sports medicine family physicians are predominately men (78.7%) and below 49 years (65.8%). Most SM-FPs spend 60% of their time or less practicing SM and the scope of practice of SM-FPs is only slightly narrower than that of their family physician counterparts without a CAQ. In addition, 92.8% of SM-FPs are practicing in an urban setting.

Conclusions:
The similarity of scope of practice for SM-FPs and family physicians without a CAQ and the time spent practicing SM by SM-FPs suggests that most SM-FPs are spending a significant amount of time continuing to practice their primary specialty. Sports medicine family physicians are largely attracted to urban practice settings, most likely because of the higher likelihood of employment opportunities. Finally, factors that may be dissuading women from entering the field of SM deserve further investigation.
Comparison of transmissibility of coronavirus between symptomatic and asymptomatic patients: Reanalysis of the Ningbo Covid-19 data
Authors: Yin Guosheng , Jin Huaqing 
Published: April 2020

AbstractWe investigate the transmissibility of coronavirus for symptomatic and asymptomatic patients using the Ningbo Covid-19 data1. Through more in-depth and comprehensive statistical analysis, we conclude that there is no difference in the transmission rates of coronavirus between the symptomatic and asymptomatic patients, which is consistent with the original findings in Chen et al.1
Longitudinal analysis of laboratory findings during the process of recovery for patients with COVID-19
Authors: Tian Suyan , Zhu Xuetong , Sun Xuejuan , Wang Jinmei , Zhou Qi , Wang Chi , Chen Li , Xu Jiancheng 
Published: April 2020

AbstractObjectiveTo explore longitudinal change patterns of key laboratory tests in patients with COVID-19, and to identify independent prognostic factors by examining the associations between laboratory findings and outcomes of patients.MethodsThe multicenter study prospectively included 59 patients with COVID-19 treated at Jilin province from January 21, 2020 to May 5, 2020. Laboratory tests were included haematological, biochemical, and immunological tests.ResultsLaboratory findings, the characteristics of epidemiological and demographic data were extracted from electronic medical records. Eosinopenia was shown in 52.6% cases at onset, and the average value of eosinophil continued to significantly increase thereafter. Lymphopenia was found in 40.4% cases at onset, and the average value of lymphocyte was slowly elevated after day 5. Thrombocytopenia was shown in 12.3% cases at onset, and the average value of mean platelet volume was decreased sharply after day 7. The values of aspartate aminotransferase, lactate dehydrogenase, creatine kinase, creatinine kinase-muscle/brain activity, and cardiac troponin I, serum cardiac markers, were beyond the upper limit of RI from 6.1% to 30.6% at onset. The abnormity of liver function tests, kidney function tests, electrolytes was 2.0%∼59.2%, 2.0%∼4.1%, 6.0%∼30.0%, respectively. Eosinophil, platelet and carbondioxide combining power were selected as the prognostic factors.ConclusionsThe haematological, biochemical, and immunological tests were found significant abnormity at onset and longitudinal change patterns in the patients with COVID-19. Age, Eosinophil, PLT and CO2 may used to predict the recovery probability. Risk stratification and management could be improved for the patients with COVID-19 according to temporal trajectories of laboratory tests.Article SummaryThe longitudinal change patterns of the laboratory characteristics of affected patients were important to identify prognosis. Eosinophil, platelet and carbondioxide combining power may be independent predictors of recovery in patients with COVID-19.