bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internship Experience in Orthopaedics and Traumatology and its Impact on Becoming a Specialist
Authors: Kasch Richard , Abert Eva , Kolleck Nina , Ghanem Mohamed , Froehlich Susanne , Hofer André , Schulz Arndt Peter , Wassilew Georgi , Herbstreit Stephanie 
Published: September 2020

Abstract
Introduction The German practical year is the last clinical placement period during Medical School. However, it remains unclear how medical students evaluate the practical year in orthopaedics and traumatology (Orthopädie und Unfallchirurgie; O & U) and whether it has an impact on becoming an O & U specialist.
Method We analysed data of 146 medical students (46,7% female) who completed the placement in O & U. From the evaluation, 37 items were included in the analyses. Participants who could imagine becoming an O & U specialist (O & U-Ja) following graduation were statistically compared to those who could not (O & U-Nein).
Results Overall 123 (83.7%) trainees indicated that they would like to become an O & U specialist (O & U-Ja), 18 (12.8%) negated (O & U-Nein) and 6 (4.1%) were undecided. Groups did not differ for sex and age (sex: Chi² = 2.50, p = 0.114; age: F [1.93] < 1, p = 0.764). Group differences were found for practical orientation, independency, acquisition of anamnesis and diagnostics skills and problem-solving expertise with students who could imagine becoming an O & U specialist (O & U-Ja) giving the highest ratings.
Discussion Evaluations of the last medical year are essential in order to continuously improve the internship experience and to attract students towards a certain medical field and, moreover, to post-graduate specialist training. Clinics and institutions who already emphasize on the factors derived from this evaluation, or are continuously working on improvement, might be more able to attract young professionals, since personnel acquisition is starting early in the medical field.
Negative Fähigkeit nach W.R. Bion und die Balintarbeit
– Aspekte bei Leiter und Teilnehmer
Authors: Rüth Ulrich , Holch Astrid 
Published: September 2020

ZusammenfassungNegative Fähigkeit nach W.R. Bion zu verstehen als
Aufnahmefähigkeit für Ungewusstes und Unbewusstes auf Seiten
von Teilnehmern und Leitern stellt eine wichtige Voraussetzung für
eine gelungene Balintarbeit dar. Das bisher wenig rezipierte Konzept
ermöglicht ein vertieftes, tiefenpsychologisch-psychoanalytisches
Erfassen der Phänomenologie von Balintarbeit. Hierzu gehören
beobachtbare Widerstände oder Überforderungen von
Teilnehmern, aber auch spezifische Techniken, wie die der Prismatischen
Balintgruppe. Negative Fähigkeit zeigt Überschneidungen zum
ebenfalls von Bion entwickelten Containment-Begriff, geht aber in den
psychodynamischen Implikationen deutlich über diesen hinaus.
The Horn Technique for Nasal Tip Support in Rhinoplasty
Authors: Barboza Luiz Carlos de Melo , Martins Maíra Garcia , Caropreso Carlos Alberto , Rodrigues José Luiz Teixeira , Rodrigues André Baraldo 
Published: September 2020

Abstract
Introduction The predictability of nasal tip projection and rotation after aesthetic surgery is a challenge. Tongue-in-groove (TIG) is an effective technique to control tip projection and rotation, but there may be a small loss of projection and rotation of the tip lobe due to lack of support between the anterior septal angle and the domus, since this region is sustained by medial crusts suture-linked and interdomus sutures.
Objective To describe a new surgery technique in an attempt to correct the lack of support for the nasal tip after lowering the nasal dorsum.
Methods The horn technique consists in preserving a square of cartilage during the removal of the nasal dorsum and septum excess in patients with long and projected nose. This piece will give greater support to the TIG technique and greater predictability of the rotation and projection of the nasal tip.
Results Between 2016 and 2018, 50 patients with long and projected noses were submitted to the “horn technique” surgery. They were submitted to the TIG technique associated to the horn technique. A retrospective review of the preoperative and postoperative photographs (3 months to 1 year) of these patients treated with the horn technique were analyzed and showed better support of the nasal tip.
Conclusion The horn technique provides greater support to the projection and rotation of rhinoplasties in patients with long and projected nose.
Critical Appraisal of Traumatic Brain Injury and Its Management
Authors: Konar Subhas , Pavlov Orlin , Durango-Espinosa Yeider , Garcia-Ballestas Ezequiel , Joaquim Andrei Fernandes , Ghosh Amrita , Pal Ranabir , Moscote-Salazar Luis Rafael , Agrawal Amit 
Published: September 2020

AbstractCritical appraisal of traumatic brain injury (TBI) management has always been marred with a conflict of differential approaches, with claims and counterclaims of outcomes among the research groups. We performed this study to review the management of TBI from risk factors to outcomes including the comorbidities and final clinical status. In conjunction with the aforesaid stabilization of TBI cases, prophylactic and definitive surgical approaches and other supporting interventions will ultimately decide the final outcomes in the long run. Improvements in the quality of care for patients with severe TBI, with the reduction in mortality, have been demonstrated in high-income areas due to improvements in the health care system and not just in one isolated intervention. In the management of TBI, a fast and high index of suspicion is the key to success, from the initial assessment to the final rehabilitation of the cases, from the victim of risk factors to the victims of situation. The research groups feel that TBI prophylactic measures and primary care mitigation models are as important as definitive care, starting from prehospital care to dedicated care.
Debunking the Myth: Do Maternal-Fetal Medicine Fellows Negatively Impact Resident Obstetrical Skills?
Authors: Dotters-Katz Sarah K. , Grace Matthew , Heine R Phillips , Propst Katie 
Published: September 2020

Abstract
Objective Residency applicants often express concern that fellows negatively impact surgical opportunities, especially with less common procedures. We sought to describe the impact of maternal-fetal medicine (MFM) fellows on resident surgical opportunities.
Study Design Anonymous 27-question e-survey sent to obstetrics and gynecology (OBGYN) residents in the United States and Puerto Rico in March 2018. Questions included experience as primary surgeon, for fourth year residents only, comfort performing procedures postresidency, and demographics. Residents from programs with MFM fellows (pMFM) were compared with those without (nMFM). Descriptive statistics used as appropriate. Regression was performed, controlling for significant variables.
Results A total of 417 residents completed the survey; 275 (66%) from nMFM and 142 (33%) from pMFM. PMFM residents were more likely to have >7 residents/year, be from an academic residency, and less likely to be planning to practice obstetrics postresidency (all, p < 0.01). Plan to pursue MFM fellowship did not differ. NMFM residents were more likely to have been primary surgeon on a vacuum assisted delivery (77 vs. 63%, p < 0.01). No difference in primary surgeon experience was seen for forceps delivery, breech deliveries, third- or fourth-degree repairs, cerclage, or cesarean hysterectomy. With regard to comfort performing procedures postresidency, vacuum-assisted vaginal delivery (VAVD) was more likely among nMFM trainees, no other differences seen. In regression models, no differences in likelihood of comfort performing procedures postresidency for any procedures based on the presence of MFM fellows were seen. Among pMFM residents, 94% stated fellows positively impacted their learning.
Conclusion MFM fellows do not appear to impact residents' perceived competency in obstetric procedures and the majority of trainees report that fellows positively impact their education.
Empowering Caseworkers to Better Serve the Most Vulnerable with a Cloud-Based Care Management Solution
Authors: Snowdon Jane L. , Robinson Barbie , Staats Carolyn , Wolsey Kenneth , Sands-Lincoln Megan , Strasheim Thomas , Brotman David , Keating Katie , Schnitter Elizabeth , Jackson Gretchen , Kassler William 
Published: September 2020

Abstract
Background Care-management tools are typically utilized for chronic disease management. Sonoma County government agencies employed advanced health information technologies, artificial intelligence (AI), and interagency process improvements to help transform health and health care for socially disadvantaged groups and other displaced individuals.
Objectives The objective of this case report is to describe how an integrated data hub and care-management solution streamlined care coordination of government services during a time of community-wide crisis.
Methods This innovative application of care-management tools created a bridge between social and clinical determinants of health and used a three-step approach—access, collaboration, and innovation. The program Accessing Coordinated Care to Empower Self Sufficiency Sonoma was established to identify and match the most vulnerable residents with services to improve their well-being. Sonoma County created an Interdepartmental Multidisciplinary Team to deploy coordinated cross-departmental services (e.g., health and human services, housing services, probation) to support individuals experiencing housing insecurity. Implementation of a data integration hub (DIH) and care management and coordination system (CMCS) enabled integration of siloed data and services into a unified view of citizen status, identification of clinical and social determinants of health from structured and unstructured sources, and algorithms to match clients across systems.
Results The integrated toolset helped 77 at-risk individuals in crisis through coordinated care plans and access to services in a time of need. Two case examples illustrate the specific care and services provided individuals with complex needs after the 2017 Sonoma County wildfires.
Conclusion Unique application of a care-management solution transformed health and health care for individuals fleeing from their homes and socially disadvantaged groups displaced by the Sonoma County wildfires. Future directions include expanding the DIH and CMCS to neighboring counties to coordinate care regionally. Such solutions might enable innovative care-management solutions across a variety of public, private, and nonprofit services.
Mobile Health (mHealth) and Advances in Noninvasive Diagnosis of Anemia: An Overview
Authors: Mazzu-Nascimento Thiago , Evangelista Danilo Nogueira , Abubakar Obeedu , Carrilho Emanuel , Silva Diego Furtado , Chachá Silvana Gama Florencio , Luporini Rafael Luis , Luca Andréia Andreozi Alcântara Moura de , Estevão Isabeth Fonseca , Nogueira-de-Almeida Carlos Alberto 
Published: September 2020

AbstractAnemia is a public health problem that can have different causes, such as iron deficiency, vitamin deficiency, inflammation, hemolytic anemias, and anemias associated with bone marrow disease. Anemia shows a decrease in the concentration of hemoglobin, a pigmented molecule in the erythrocytes. The objectives of this review were to highlight the impact of nutritional factors on morbidity and mortality caused by anemia and to present different non-invasive approaches that use a smartphone to analyze hemoglobin levels to detect anemia. According to the records of the Brazilian Unified Health System (SUS, in the Portuguese acronym), ∼ 440,000 people checked in hospitals due to anemia between January 2015 and April 2020, with 215,000 deaths. The government spent ∼ 294 million Brazilian Reais (more than 50 million US dollars) on anemia hospitalization cases during this period. There is a worldwide search to provide noninvasive diagnostics and mobile health (mHealth) tools to help diagnosing anemia. The smartphone appears to be a viable device to detect anemia by a camera with colorimetric analysis of images providing a quantitative, instantaneous, and noninvasive result. These images can be obtained as a photograph or extracted from video frames. The review presents three different methods of detecting anemia using a smartphone: i) photoplethysmograph from video obtained from the tip of the index finger, ii) photo of the palpebral conjunctiva, and iii) fingernail photo app. Therefore, it seems urgent that these approaches may be applied in routine clinical diagnosis to allow remote, needy, low-tech locations to have access to anemia screening.
Effect of Direct Oral Anticoagulant, Patient, and Surgery Characteristics on Clinical Outcomes in the Perioperative Anticoagulation Use for Surgery Evaluation Study
Authors: MacDougall Kira , Douketis James D. , Li Na , Clark Nathan P. , Tafur Alfonso , D'Astous Julien , Duncan Joanne , Schulman Sam , Spyropoulos Alex C. 
Published: September 2020

Abstract
Introduction The Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE) Study assessed a standardized perioperative management strategy in patients with atrial fibrillation who were taking a direct oral anticoagulant (DOAC) and required an elective surgery or procedure. The aim of this substudy is to analyze the safety of this management strategy across different patient subgroups, according to four presurgical variables: (1) DOAC type and dose, (2) surgery/procedure bleed risk, (3) patient renal function, and (4) age.
Methods Clinical outcomes analyzed included major bleeding (MB), arterial thromboembolism, any bleeding, and any thromboembolism. We used descriptive statistics to summarize clinical outcomes, where the frequency, proportion, and 95% confidence interval were reported. Fisher's exact tests were used for testing the null hypothesis of independence between the clinical outcome and patient characteristic, where the test p-values were reported.
Results There were 3,007 patients with atrial fibrillation requiring perioperative DOAC management. There was no significant difference in bleeding or thromboembolic outcomes according to DOAC type/dose regimen, renal function, or patient age. The rate of MB was significantly higher with high bleed risk procedures than low bleed risk procedures in apixaban-treated patients (2.9 vs. 0.59%; p < 0.01), but not in dabigatran-treated patients (0.88 vs. 0.91%; p = 1.0) or rivaroxaban-treated patients (2.9 vs. 1.3%; p = 0.06). The risk for thromboembolism did not differ according to surgery/procedure-related bleed risk.
Conclusion Our results suggest that in DOAC-treated patients who received standardized perioperative management, surgical bleed risk is an important determinant of bleeding but not thromboembolic outcomes, although this finding was not consistent across all DOACs. There were no differences in bleeding and thromboembolism according to DOAC type and dose, renal function, or age.
Cerebral Responses to Stationary Emotional Stimuli Measured by fMRI in Women with Persistent Postural-Perceptual Dizziness
Authors: von Söhsten Lins Eliane Maria Dias , Bittar Roseli Saraiva Moreira , Bazán Paulo Rodrigo , Amaro Júnior Edson , Staab Jeffrey Paul 
Published: September 2020

Abstract
Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception.
Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects.
Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires.
Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex).
Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.
Triploidy in a Live-Born Extremely Low Birth Weight Twin: Clinical Aspects
Authors: Vakrilova Liliya , Hitrova-Nikolova Stanislava , Bradinova Irena 
Published: September 2020

AbstractTriploidy is a rare chromosomal aberration characterized by a karyotype with 69 chromosomes. Triploid fetuses usually are miscarried in early pregnancy. We present a case of a triploid twin and a genetically unaffected co-twin, conceived through in vitro fertilization. A discordant growth was registered at 20 weeks of gestation. Cesarean section was performed at 355/7 gestational week. The second twin was extremely growth restricted female (780 g) with oligohydramnios and severe respiratory distress, and died at 20 hours of age. The autopsy revealed unilobar left lung, bilobar right lung, and cysts of the terminal bronchioles. Quantitative fluorescent polymerase chain reaction detected triploidy compatible pattern. So, early intrauterine growth restriction may be a sign of triploidy, which must be proven by pre or postnatal genetic testing.
Nerve Block Options for Pain Control during Hepatic and Upper Abdominal Minimally Invasive Procedures
Authors: Boucher Louis-Martin , Benz Robyn Melanie , Pierotty Mathieu , de Melo Rafael Cardoso , Valenti David 
Published: September 2020

AbstractAvailability of minimally invasive abdominal procedures can be restricted in cases of painful procedures, due to limited access to anesthesia support or the more recent avoidance of aerosol generating medical procedures such as intubation. Intravenous sedation, in many cases is insufficient to effectively control the pain, leaving patients to suffer undue discomfort and a medical team stressed by the situation. Regional nerve blocks can offer a solution but are underutilized, likely in large part due to a lack of knowledge of available options.This manuscript describes four different nerve blocks that can be useful for analgesia related to upper abdominal procedures. Available data are reviewed regarding their effectiveness and the technique used to perform them is described. Information provided aims to help decide which is likely to provide the best analgesia depending on the procedure being done. Increase use of these blocks has the potential to improve patient's accessibility to minimally invasive upper abdominal procedures.
The Shapley value of coalitions to other coalitions
Authors: Hausken Kjell 
Published: September 2020

AbstractThe Shapley value for an n-person game is decomposed into a 2n × 2n value matrix giving the value of every coalition to every other coalition. The cell ϕIJ(v, N) in the symmetric matrix is positive, zero, or negative, dependent on whether row coalition I is beneficial, neutral, or unbeneficial to column coalition J. This enables viewing the values of coalitions from multiple perspectives. The n × 1 Shapley vector, replicated in the bottom row and right column of the 2n × 2n matrix, follows from summing the elements in all columns or all rows in the n × n player value matrix replicated in the upper left part of the 2n × 2n matrix. A proposition is developed, illustrated with an example, revealing desirable matrix properties, and applicable for weighted Shapley values. For example, the Shapley value of a coalition to another coalition equals the sum of the Shapley values of each player in the first coalition to each player in the second coalition.
Tribological performance of hardfaced and heat treated EN-47 steel used for tillage applications
Authors: Singh Jagseer , Chatha Sukhpal Singh , Sidhu Buta Singh 
Published: September 2020

AbstractIn the present work, two different hardfacings, namely SZ (Super-Zed alloy; C3.83Cr33.37) and ZK (Zedalloy-K; C0.65Cr4.5Mo8.18) were deposited on EN-47 ploughshare steel by manual metal arc welding process to enhance the abrasive wear resistance. In addition, the influence of heat-treatment of steel by two different methods, i.e., carburizing (C) and through-hardening (Q&T), on the abrasive wear behaviour has also been investigated. Abrasive wear studies were conducted on bare, hardfaced, and heat-treated steel in a laboratory by using a three-body dry sand rubber wheel test rig as per the ASTM G-65 standard. The bare steel suffered a high wear rate, which may be attributed to its soft ferritic-pearlitic microstructure. The abrasive wear rate of tested specimens was found to be 1.7651 × 10−3g m−1, 0.7439 × 10−3g m−1, 0.961 × 10−3g m−1, 0.992 × 10−3g m−1and 1.21 × 10−3g m−1for bare, SZ, ZK, C and Q&T steel specimens respectively. The SZ hardfacing provided better abrasive wear protection than the other treatments due to high chromium and carbon concentration in the hardfacings electrodes, which presented a higher area fraction of primary M7C3carbides in the matrix. The wear resistance indices (WRI) for SZ hardfacing, ZK hardfacing, carburized, and through-hardened steel specimens were found to be 2.37, 1.84, 1.78, and 1.46, respectively.
Topology optimization of embedded and co-cured damping composite structure
Authors: Wang Shaoqing , Li Qiang , Liang Sen 
Published: September 2020

Abstract
The purpose of this work is to reduce the weight of the structure and conclude the most appropriate topology configuration proper for the embedded and co-cured damping composite structure. A topological optimization model for the embedded co-cured damping composite structure is established. For maximizing modal loss factor under the constraint of total amount of experimental substance, the work investigates the damping performance of the fiber-reinforced layer and deduces the sensitivity of modal loss factor by Modal Strain Energy (MSE) method. The best distribution of viscoelastic materials is obtained via the evolution structural optimization (ESO) method. The deleted elements in the structure correspond to the lower sensitivity elements in the sensitivity cloud published in existing document. Considerable related studies have been presented to demonstrate the relationship of structural topological configuration accompanied by the changes of structural parameters.