bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entwicklung eines Trainingsleitfadens für Patienten mit entzündlicher Muskelerkrankung
Authors: Baschung Pfister Pierrette , Sterkele Iris , Keller Trevisan Caroline , de Bruin Eling D. 
Published: January 2020

Zusammenfassung
Hintergrund Inflammatorische Myopathien (IM) sind eine Gruppe seltener entzündlicher Muskelerkrankungen. Verminderte Kraft und Ausdauerfähigkeit stellen die Hauptsymptome dar. Diverse Studien konnten positive Effekte einer Trainingstherapie nachweisen, es existieren jedoch keine krankheitsspezifischen Trainingsrichtlinien.
Ziel Erstellung einer Übersicht der vorhandenen Trainingsstudien mit Fokus auf erwachsene Patienten mit IM, um daraus einen evidenzbasierten, krankheitsspezifischen Trainingsleitfaden abzuleiten.
Methode In einem ersten Schritt erfolgte eine systematische Literaturübersicht. Sie diente als Basis, um den Trainingsleitfaden zu entwickeln. Die langjährige klinische Erfahrung spezialisierter Physiotherapeuten sowie die Trainingsrichtlinien des American College of Sports Medicine fanden ebenfalls Berücksichtigung.
Ergebnisse In die systematische Übersicht wurden 24 Studien mit insgesamt 151 Patienten mit IM eingeschlossen. Alle Studien zeigten positive Effekte eines Kraft- und/oder Ausdauertrainings auf. Unerwünschte Ereignisse traten nicht ein. Der Trainingsleitfaden besteht aus einem Einführungsteil zu allgemeinen Trainingsprinzipien sowie zwei weiteren Teilen über Kraft- und Ausdauertraining für jede Krankheitsaktivität (früh-aktiv, aktiv, stabil).
Schlussfolgerungen Obwohl die Trainingsprotokolle im Bereich der Myositis unterschiedlich sind, weisen alle Studien konsistent darauf hin, dass das Training sicher und effektiv ist. Der Trainingsleitfaden ermöglicht Therapeuten einen raschen Überblick über evidenzbasierte Trainingsrichtlinien. Die Richtlinien sollten in weiteren Studien angewendet, überprüft und anschließend verfeinert werden.
Arbeitsanforderungen an Ausbilder in der praktischen Physiotherapieausbildung in Deutschland – Ergebnisse einer Interviewstudie und einer quantitativen Fragebogenerhebung
Authors: Harms Jan , Dilsner Katja 
Published: January 2020

Zusammenfassung
Hintergrund Die Qualität der Ausbildung korreliert maßgeblich mit der Qualifikation der Ausbilder. Die Ordnungspapiere, welche die Ausbildung regeln, beinhalten jedoch keine Qualifikationsanforderungen an die Ausbilder. Aufgaben und Anforderungen der Ausbilder, welche als Grundlage für die Formulierung von Qualifikationsanforderungen dienen können, sind bislang nicht erforscht.
Ziel Ermittlung von Anforderungen an Ausbilder, die sich aus der Ausbildertätigkeit ergeben.
Methode Leitfadengestützte Interviews mit sechs Ausbildern in Physiotherapie, Auswertung mittels inhaltlich strukturierender qualitativer Inhaltsanalyse 1. Rekonstruierte Anforderungen wurden durch einen standardisierten Fragebogen validiert (n = 102).
Ergebnisse Insgesamt wurden 36 Anforderungen identifiziert, welche die Arbeit der Ausbilder aus deren Perspektive abbilden. Nahezu alle Anforderungen weisen in der Fragebogenvalidierung Zustimmungsraten von mehr als 50 % auf. Die einzelnen Anforderungen wurden fünf übergeordneten Anforderungskategorien zugewiesen, welche den Prozess der praktischen Ausbildung chronologisch nachzeichnen.
Schlussfolgerungen Die Arbeit der Ausbilder ist komplex und vielschichtig. Vor allem in der unmittelbaren Durchführung der praktischen Ausbildung sehen sich die Ausbilder mit Anforderungen konfrontiert, deren Bewältigung insbesondere pädagogischer Kompetenzen bedürfen. Damit liegt erstmals eine empirische Beschreibung der Arbeit von Ausbildern vor, die als Diskussionsgrundlage für die Formulierung von Qualifikationsanforderungen und Konzipierung von Qualifizierungsangeboten dienen kann.
A Hammett Study of Clostridium acetobutylicum Alcohol Dehydrogenase (CaADH): An Enzyme with Remarkable Substrate Promiscuity and Utility for Organic Synthesis
Authors: Kudalkar Gaurav P. , Tiwari Virendra K. , Lee Joshua D. , Berkowitz David B. 
Published: January 2020

Described is a physical organic study of the reduction of three sets of carbonyl compounds by the NADPH-dependent enzyme Clostridium acetobutylicum alcohol dehydrogenase (CaADH). Previous studies in our group have shown this enzyme to display broad substrate promiscuity, yet remarkable stereochemical fidelity, in the reduction of carbonyl compounds, including α-, β- and γ-keto esters (d-stereochemistry), as well as α,α-difluorinated-β-keto phosphonate esters (l-stereochemistry). To better mechanistically characterize this promising dehydrogenase enzyme, we report here the results of a Hammett linear free-energy relationship (LFER) study across three distinct classes of carbonyl substrates; namely aryl aldehydes, aryl β-keto esters and aryl trifluoromethyl ketones. Rates are measured by monitoring the decrease in NADPH fluorescence at 460 nm with time across a range of substrate concentrations for each member of each carbonyl compound class. The resulting v
0 versus [S] data are subjected to least-squares hyperbolic fitting to the Michaelis–Menton equation. Hammett plots of log(V
max) versus σX yield the following Hammett parameters: (i) for p-substituted aldehydes, ρ = 0.99 ± 0.10, ρ = 0.40 ± 0.09; two domains observed, (ii) for p-substituted β-keto esters ρ = 1.02 ± 0.31, and (iii) for p-substituted aryl trifluoromethyl ketones ρ = –0.97 ± 0.12. The positive sign of ρ indicated for the first two compound classes suggests that the hydride transfer from the nicotinamide cofactor is at least partially rate-limiting, whereas the negative sign of ρ for the aryl trifluoromethyl ketone class suggests that dehydration of the ketone hydrate may be rate-limiting for this compound class. Consistent with this notion, examination of the 13C NMR spectra for the set of p-substituted aryl trifluo­romethyl ketones in 2% aqueous DMSO reveals significant formation of the hydrate (gem-diol) for this compound family, with compounds bearing the more electron-withdrawing groups showing greater degrees of hydration. This work also presents the first examples of the CaADH-mediated reduction of aryl trifluoromethyl ketones, and chiral HPLC analysis indicates that the parent compound α,α,α-trifluoroacetophenone is enzymatically reduced in 99% ee and 95% yield, providing the (S)-stereoisomer, suggesting yet another compound class for which this enzyme displays high enantioselectivity.
speech understandability of repaired cleft palate patients pre and post caregiver training
Authors: jobe andrea L , d′mello Joan , Kumar Sanjay 
Published: January 2020

ABSTRACT
Background: Treating speech and language problems in repaired cleft palate patients in india is still an uphill task due to lack of facilities. this study attempted to use parents as team members for the speech management of cleft palate patients in andhra pradesh, india. objectives: to investigate whether a positive change in speech understandability for individuals with cleft palate will result froma parent-administered intervention program.Materials and methods: Twenty-eight parents had enrolled for the speech camp held in september 2004. the parent-training program at the speech camp ensured that parents were given adequate awareness. out of the 28, 18 (64.28%) reported for one follow-up, referred to in this article as group i. ten (35.72%) out of the 28 came for two consecutive follow-ups, referred to in this article as group ii.Results: Pre and post training understandability scores obtained in the known context (reciting a familiar poem in the native language, counting 1 to 10) and unknown context (peer group names, family information, describing their journey from home to hospital) for group i and group ii were evaluated. results revealed that a higher percentage of cases showed significant improvement in understandability in the unknown context after treatment. unknown context can be considered a measure to assess speech understandability after training. further, it shows that parent training without practice at home may not show the desired results.Conclusion: This study reveals that parents can effect a positive change in the speech understandability of their children following training, provided the exercises are carried out regularly at home and the parents report for the follow-up assessments and guidance.
Microsurgical free tissue transfer as avaluable reconstructive procedure in foot reconstruction
Authors: el-shazly mohamed , makboul mohamed 
Published: January 2020

ABSTRACT
Background: owing to the limited soft tissue donor sites in the foot area, the use of microsurgical tissue transfer is frequently becoming mandatory in this area, especially in cases of massive defects due to the common motor vehicle accidents in the territory of upper egypt. free flaps offer a great variety of available tissues to cover larger, multifocal or multistructural defects. they also improve the perfusion of the infected poorly perfused areas.Objectives: in this study, we tried to evaluate foot defects according to their size, shape and site and to determine the general and specific parameters of free tissue transfer to the foot area in concomitance with the patients needs.Materials and methods: eleven patients were included in this study. for each patient, complete history was taken, general and local examination, photographic documentation, laboratory investigations, imaging and other investigations were performed. free flap transfers were applied in all cases as follows: latissimus dorsi flap in five cases, rectus abdominis flap in three cases, scapular flap in one case, gracilis flap in one case and radial forearm flap in one case.Results: nine flaps survived. no infection or donor site complications were recorded. every patient had the optimum free flap as regards the defect size, site, depth, condition, shape, donor site availability and the recipient vessels′ condition.Conclusion: the study of the optimum free flap for foot reconstruction in relation to the defect present and patient conditions is crucial to have significant results.
Silicone Foley′s catheter: A useful splint in ear surgeries
Authors: Karanth Siddharth K. , Mokal Nitin J. 
Published: January 2020

ABSTRACTMaintenance of ear projection and post auricular sulcus in staged ear reconstruction in microtia is a trying problem. So also is the maintenance of the patency of the external auditory meatus following recanalization and meatoplasty. Numerous splints and dressing techniques have been described for the above situations. Some of the problems encountered include the availability of the materials, cost, expertise in fabrication and compliance.Aims: To devise a simple, reliable, inexpensive and readily available splint for the maintenance of post auricular sulcus and external auditory meatus opening. Settings and Design: A silicone catheter is made out of a soft and inert material that doesn′t cause tissue necrosis or any loss of skin graft. The basic design is that of a simple, self-retaining type of splint that doesn′t dislodge and can be prepared within minutes on the operating table.Materials and Methods: This splint has been used in four cases of microtia reconstruction and one case of congenital external auditory meatus stenosis between June 2006 and August 2007. A 14 or 16 Fr silicone Foley′s catheter was used. The proximal end of a catheter of required length was retained and the distal part was cut off. The catheter was looped into a circle around the base of the reconstructed ear and secured in position with a suture. A similar construct was used in cases of external auditory meatus reconstruction or recanalization. The funnel-shaped distal drainage end was sutured to the circular frame near the region of the tragus. This funnel was inserted into the external auditory canal.Results: The catheter was found to sit snugly in the newly created sulcus, thereby maintaining the sulcus and ear projection. It aided in maintaining the meatal opening of a satisfactory diameter in the case of external auditory canal recanalization. It was never found to slip or get dislodged in any of the cases. There was no skin graft loss or tissue necrosis due to the use of the splint.Conclusions: The silicone Foley′s catheter is found to be a simple, readily available, inexpensive and reliable self-retaining splint following ear elevation in microtia and external auditory meatus recanalization. The catheter is easily constructed and applied intraoperatively. The results following its usage have been uniformly good in all cases without causing any adverse events at the operated site or discomfort to the patient ensuring good compliance.
Intravenous injection of elemental mercury: A report of two cases
Authors: Gopalakrishna A. , Pavan Kumar T. V. 
Published: January 2020

ABSTRACTTwo cases of intravenous injection of elemental mercury are described in this report. One patient succumbed and the other remains asymptomatic two years after the surgical removal of all the injected mercury. Management of intravenous injection of elemental mercury (intended to be an aphrodisiac in these two cases) is discussed here and the need for surgical removal of all accessible mercury has been emphasized
Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity
Authors: Allberg Clara M. , Miles James 
Published: January 2020

Abstract
Objective Patellar luxation can be associated with abnormal proximodistal positioning of the patella. The current gold standard index (Insall–Salvati) for referencing this position is poorly suited to postoperative use, if the tibial tuberosity is moved surgically, but has the advantage of changing minimally with altered joint angles. The aim of this study was to identify an alternative index, which was simple to use, joint-angle insensitive and suitable for postoperative use.
Study Design Candidate indices based on the angle between stifle joint landmarks were screened across a wide range of joint angles for insensitivity to joint angle changes using vulpine and canine stifle radiographs. Intraobserver and interobserver agreements were assessed for a single candidate index using canine radiographs.
Results An angular index based on the caudal aspect of the femoral and tibial condyles and the apex of the patella was largely insensitive to joint angle variation. Intra- and interobserver agreements appeared suitable for clinical use, with low within-subject standard deviations (<1.3°) and coefficients of variations (<2.2%), and high intraclass correlation coefficients (>0.89).
Conclusion Patellar proximodistal position can be acceptably assessed at a variety of caudal joint angles using the described angular index. Further work is required to define reference intervals across a range of canine breeds.
Lower versus Standard INR Targets in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Pandey Arjun K. , Xu Ke , Zhang Li , Gupta Saurabh , Eikelboom John , Cook Olivia , McIntyre William F. , Lopes Renato D. , Crowther Mark , Belley-Côté Emilie P. , Whitlock Richard P. 
Published: January 2020

Abstract
Background Western guidelines recommend an international normalized ratio (INR) range of 2 to 3 when using warfarin for stroke prevention in atrial fibrillation (AF), but lower INR ranges are frequently used in East Asia. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) in AF patients comparing the effect of lower versus standard INR targets on thromboembolism, major bleeding, and mortality.
Methods We searched Western databases including Cochrane CENTRAL, Medline, and Embase as well as Chinese databases including SinoMed, CNKI, and Wanfang Data. We pooled risk ratios (RRs) using random-effects model. We grouped INR targets in two ways: (1) any study-specific lower versus standard targets and (2) INR ranges of approximately 1.5 to 2 versus 2 to 3.
Results Seventy-nine RCTs (n = 12,928) met eligibility criteria: 74 (n = 11,322) from East Asia and 5 (n = 1,606) from Western countries. Compared with standard targets, lower INR ranges were associated with higher rates of thromboembolism (76 RCTs, n = 12,577: 7.1% vs. 4.4%, RR 1.50, 95% confidence interval [CI] 1.29–1.74, I
2 = 0%), lower rates of major bleeding (61 RCTs, n = 10,815: 2.2% vs. 4.4%, RR 0.54, 95% CI 0.44–0.67, I
2 = 0%), and similar mortality (32 RCTs, n = 7,327: 4.8% vs. 5.2%, RR 1.00, 95% CI 0.85–1.19, I
2 = 0%). Results were similar when comparing target ranges of approximately 1.5 to 2 versus 2 to 3.
Conclusion Moderate quality evidence suggests lower INR targets reduce bleeding but increase thromboembolism in AF. The data are dominated by East-Asian studies, limiting generalizability to Western populations. Until higher quality data demonstrate otherwise, an INR range of 2 to 3 should remain standard for thromboembolic prophylaxis in AF.
Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR
Authors: Bersani Kerrin , Fuller Theresa E. , Garabedian Pamela , Espares Jenzel , Mlaver Eli , Businger Alexandra , Chang Frank , Boxer Robert B. , Schnock Kumiko O. , Rozenblum Ronen , Dykes Patricia C. , Dalal Anuj K. , Benneyan James C. , Lehmann Lisa S. , Gershanik Esteban F. , Bates David W. , Schnipper Jeffrey L. 
Published: January 2020

Abstract
Background Preventable adverse events continue to be a threat to hospitalized patients. Clinical decision support in the form of dashboards may improve compliance with evidence-based safety practices. However, limited research describes providers' experiences with dashboards integrated into vendor electronic health record (EHR) systems.
Objective This study was aimed to describe providers' use and perceived usability of the Patient Safety Dashboard and discuss barriers and facilitators to implementation.
Methods The Patient Safety Dashboard was implemented in a cluster-randomized stepped wedge trial on 12 units in neurology, oncology, and general medicine services over an 18-month period. Use of the Dashboard was tracked during the implementation period and analyzed in-depth for two 1-week periods to gather a detailed representation of use. Providers' perceptions of tool usability were measured using the Health Information Technology Usability Evaluation Scale (rated 1–5). Research assistants conducted field observations throughout the duration of the study to describe use and provide insight into tool adoption.
Results The Dashboard was used 70% of days the tool was available, with use varying by role, service, and time of day. On general medicine units, nurses logged in throughout the day, with many logins occurring during morning rounds, when not rounding with the care team. Prescribers logged in typically before and after morning rounds. On neurology units, physician assistants accounted for most logins, accessing the Dashboard during daily brief interdisciplinary rounding sessions. Use on oncology units was rare. Satisfaction with the tool was highest for perceived ease of use, with attendings giving the highest rating (4.23). The overall lowest rating was for quality of work life, with nurses rating the tool lowest (2.88).
Conclusion This mixed methods analysis provides insight into the use and usability of a dashboard tool integrated within a vendor EHR and can guide future improvements and more successful implementation of these types of tools.
Multiple sclerosis and bilingualism
Authors: Aveledo Fraibet , Higueras Yolanda , Marinis Theodoros , Bose Arpita , Pliatsikas Christos , Meldaña-Rivera Ariana , Martínez-Ginés María Luisa , García-Domínguez José Manuel , Lozano-Ros Alberto , Cuello Juan Pablo , Goicochea-Briceño Haydee 
Published: January 2020

Abstract
It has been suggested that bilingualism is beneficial for executive control and could have positive long-term effects by
delaying the onset of symptoms of degenerative diseases. This research investigates, for the first time, the impact of bilingualism on
executive control (monitoring and inhibitory control) in individuals with Multiple Sclerosis (MS), a neurodegenerative disease which
commonly causes deficiencies in the cognitive system. Bilingual and monolingual adults, with and without an MS diagnosis, performed a
flanker task with two degrees of monitoring demands (high monitoring vs. low monitoring). Results showed that bilingual MS patients had
inhibitory control and monitoring abilities that were similar to healthy bilingual controls. In contrast, monolingual MS patients showed
similar inhibitory control but significantly worse monitoring abilities compared to monolingual healthy controls. We propose that the
similar behaviour between bilingual groups suggests that bilingualism might counteract cognitive deficits related to MS, especially with
respect to monitoring. The high monitoring cost observed in monolingual patients seems related to underlying deficits in monitoring and
possibly switching, executive control abilities commonly impaired in MS patients from early stages. Our findings provide some preliminary
evidence for the cognitive reserve hypothesis in bilingual MS patients.
Understanding CMB physics through the exploration of exotic cosmological models: a classroom study using CLASS
Authors: Rindler-Daller T 
Published: January 2020

Abstract
Every cosmology lecturer these days is confronted with teaching the modern cosmological standard model ΛCDM, and there are many approaches to do this. However, the danger is imminent that it is presented to students as something set into stone, merely to be accepted as a fact based on the plenty of evidences we have. This is even more critical, given that the standard model of cosmology confronts us with entities not yet fully understood, namely a cosmological constant Λ and cold dark matter. In this article, we report on an advanced cosmology course exercise, conducted in computer lab, which was conceived as a means to have students experience first-hand why the ΛCDM model has become so prevalent in the interpretation of modern cosmological data. To this end, we focused on the cosmic microwave background radiation (CMB) and calculated theoretical temperature and matter power spectra, using the modern Boltzmann code CLASS. By comparing and analyzing the outcome for ΛCDM, as well as for three other exotic cosmological models, the students were able to grasp the impact of cosmological parameters on CMB observables, and also to understand some of the complicated CMB physics in a direct way. Our chosen examples are not exhaustive and can be easily modified or expanded, so we express the hope that this article will serve as a valuable resource for interested students and lecturers.
Achromatic reflected metalens for highly directional and long-distance acoustic probing
Authors: Wang Peifeng , Yu Gaokun , Li Yong , Wang Xinlong , Wang Ning 
Published: January 2020

Abstract
Simultaneous temporal and spatial focusing of a pulse is of significance for detection and imaging. Here, an achromatic reflected metalens is designed using hybrid resonance and anti-resonance. The theoretical result demonstrates that the anti-resonance provides an extra degree of freedom to control local phases of reflected waves, yielding an achromatic lens of thickness equal to one half of central wavelength. To overcome the shortcoming of traditional approach to design lenses (neglecting the intercell coupling), a boundary integral method is proposed to alleviate the focus deviation over a broadband. The achromatic feature of designed lens is then verified in the frequency range from 2800 to 5600 Hz by an experiment. Owing to a very weak frequency dependence of focal point and a high reflected focusing efficiency over a broadband, a highly directional and long-distance acoustic probing scheme (the mainlobe width about 80) is proposed with the aid of achromatic reflected metalens and being confirmed by another experiment, where a signal processing method using triple sensors separated by a subwavelength interval is adopted to eliminate the interferences between incident waves and reflected waves. Our result may find its application in a long-distance underwater acoustic probing.