bluuebunny/crossref_metadata_2025_split huggingface dataset:
Berufssituation der Hebammen in Einrichtungen mit und ohne hebammengeleitete Geburtshilfe in einem Schweizer Kanton
Authors: Grylka-Baeschlin Susanne , Borner Barbara , Pehlke-Milde Jessica 
Published: February 2020

Zusammenfassung
Einleitung Verglichen mit herkömmlichen Betreuungsmodellen bietet die hebammengeleitete Geburtshilfe den Hebammen mehr Möglichkeiten ihre Kompetenzen einzusetzen. Dies wirkt sich positiv auf ihre Berufszufriedenheit aus. Ziel dieser Erhebung war eine Übersicht über die Berufssituation der Hebammen in den Geburtenabteilungen eines Schweizer Kantons zu erlangen und die Situation in Einrichtungen mit und ohne hebammengeleitete Geburtshilfe zu vergleichen.
Methodik Ein Online-Fragebogen wurde literaturbasiert entwickelt. Alle 17 Institutionen des Kantons Zürich, die über eine Geburtenabteilung verfügten, waren teilnahmeberechtigt. Die Daten wurden mit Stata 15 deskriptiv ausgewertet.
Ergebnisse 16 Geburtenabteilungen (94,1%) nahmen an der Umfrage teil: 12 öffentliche Kliniken, 2 Privatkliniken und 2 Geburtshäuser. Insgesamt 5 Einrichtungen (31,3%) boten hebammengeleitete Geburten an oder waren Geburtshäuser. In Institutionen mit hebammengeleiteter Geburtshilfe kannten sich die Frauen und die Hebamme häufiger schon vor Aufnahme zur Geburt als in solchen ohne (60,0 vs. 9.1%, p=0,063), es wurden weniger routinemässige Massnahmen durchgeführt (z. B. venöser Zugang: 20,0 vs. 81,8%, p=0,036), die Hebammen hatten mehr Entscheidungskompetenzen sowie Verantwortung (z. B. selbständige Austrittsuntersuchung: 60,0 vs. 9,1%, p=0,063) und nahmen häufiger Supervisionen in Anspruch (60,0 vs. 9,1%, p=0,013).
Fazit Das Fördern von hebammengeleiteten Betreuungsmodellen erhöht die Kontinuität in der Betreuung, senkt das Einsetzen von routinemässigen Massnahmen und fördert die eigenverantwortliche Übernahme von Aufgaben.
Arbeitsunfähigkeitsbescheinigung auf Basis der Blockchain-Technologie und Smart-Contracts
Authors: Nürnberg Volker , Widmaier Stephanie 
Published: February 2020

Zusammenfassung
Zielsetzung Welche Potenziale bietet die Blockchain-Technologie zur Verbesserung des Gesundheitswesens? Anhand eines konkreten Anwendungskonzepts zur Arbeitsunfähigkeitsbescheinigung auf Basis von Blockchain und Smart-Contracts wird diese Fragestellung beleuchtet.
Methodik Ausgangspunkt stellt der bisherige papierbasierte AU-Prozess inklusive der gesetzlichen Grundlagen dar, um daraufhin die Lösung auf Blockchain-Basis vorzustellen und dabei die Besonderheiten sowie den Mehrwert gegenüber herkömmlichen technologischen Ansätzen herauszuarbeiten.
Ergebnisse Eine Umsetzung der AU auf Blockchain-Basis besitzt das Potenzial und gleichzeitig die Herausforderung insgesamt über 43 Millionen Ärzte, Arbeitgeber, Krankenkassen und Versicherte in Echtzeit miteinander zu vernetzten. Dies eliminiert nicht nur sämtliche Medienbrüche und bietet enorme Einsparpotenziale durch reduzierte Transaktionskosten. Der digitale Prozess kann zudem der hohen Papier- und Ressourcenverschwendung entgegenwirken und verhindert durch dezentrale Datenhaltung den Streit um die Datenhoheit. Zudem stellen Smart-Contracts die Authentizität und AU-Echtheit automatisch sicher, sodass Manipulationen praktisch ausgeschlossen werden.
Schlussfolgerung Das vorgestellte Anwendungskonzept bietet enorme Potenziale zur Digitalisierung des Gesundheitswesens als auch zur Schonung der Umwelt und sollte daher vorangetrieben werden. Die Umsetzung des Blockchain-Konzepts und die damit verbundene Integration der Prozessbeteiligten ermöglicht darüber hinaus die Anknüpfung analoger papierbasierter Prozesse und trägt somit wesentlich zum Bürokratieabbau im Gesundheitswesen bei.
Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug
Reactions Leading to Unplanned Emergency Visits in General
Hospitals
Authors: Stingl Julia C. , Just Katja S. , Schurig Marlen , Böhme Miriam , Steffens Michael , Schwab Matthias , Seufferlein Thomas , Dormann Harald 
Published: February 2020

Abstract
Introduction The prevalence of psychotropic drug use in our society
is increasing especially in older adults, thereby provoking severe adverse
drug reactions (ADR). To identify specific patient risk profiles associated
with psychotropic drug use in the situation of polymedication.
Methods Cases of ADRs in general emergency departments (ED) collected
within the multi-center prospective observational study (ADRED) were
analyzed (n=2215). We compared cases with use of psychotropic drugs
and without concerning their clinical presentation at the ED.
Results A third of patients (n=731, 33%) presenting
to the ED with an ADR took at least 1 psychotropic drug. Patients with
psychotropic drug use tended to be older, more often female, and took a
higher number of drugs (all p<0.001). The frequency of falls was
almost 3 times higher than compared to the non-psychotropic drug group (10.5
vs. 3.9%, p<0.001), and similar syncope was also more often
seen in the psychotropic drug users (8.8 vs. 5.5%, p=0.004).
The use of psychotropic drugs increased the risk for falls by a factor of
2.82 (OR, 95% CI (1.90–4.18)), when adjusting for gender,
age, numbers of pre-existing diseases, and drugs, respectively.
Discussion The association of psychotropic drug use with fall and
syncope in combination with polymedication and older age leads to the
suspicion that psychotropic drugs might be potentially harmful in specific
risk populations such as older adults. It may lead us to thoroughly weigh
the benefit against risk in a patient-oriented way, leading to an
integrative personalized therapy approach.
Postsustained Virological Response Management in Hepatitis C Patients
Authors: Masetti Chiara , Lleo Ana , Colombo Matteo , Colombo Massimo , Aghemo Alessio 
Published: February 2020

AbstractThe introduction of direct-acting antiviral agents (DAA) has revolutionized management and care of patients with chronic hepatitis C virus (HCV) infection, leading to cure rates higher than 90% in patients with advanced liver disease as well. Viral eradication has been associated with longer survival, reduced mortality from both hepatic and extrahepatic causes, improvement in liver function, and reduced incidence of HCV-related extrahepatic diseases. While patients with mild fibrosis can safely be discharged after achievement of a sustained virological response, patients with advanced fibrosis and cirrhosis remain at risk of developing complications of liver disease, thus requiring regular and life-long surveillance. Major complications of cirrhosis that need to be monitored are hepatocellular carcinoma onset and development or progression of clinically significant portal hypertension.
Socio‐demographic factors associated with physical activity and sitting time patterns in adults: An analysis based on the Portuguese Food, Nutrition and Physical Activity Survey
Authors: Martins João , Marques Adilson , Teixeira Pedro J. , Mota Jorge , Lopes Carla , Nicola Paulo J. 
Published: February 2020

ABSTRACTPhysical activity (PA) and sedentary behaviours (SB) influence health. Since most people engage in different combinations of both behaviours every day, understanding the socio‐demographic characteristics of adults with distinct PA and sitting time (ST) patterns is important to contribute to evidence‐based planning of public health strategies. Data from a national survey on diet and activity behaviours (IAN‐AF, 2015/16) including 1724 adults (50.5% women, 18–64 years) from a representative sample of Portuguese adults was used in this study. Participants were interviewed face‐to‐face, and the International Physical Activity Questionnaire (IPAQ) was used. Logistic regression examined the associations between socio‐demographic factors each of the four‐low/high PA‐ST groups. PA low/high categories were defined as in IPAQ, while ST low/high categories were defined according to ST tertiles (≤180 min/day, ≥360 min/day). A ‘higher risk’ behaviour pattern (low PA/high ST) was present in 37.3% of the adults and was likely associated with a middle household income, and with having 12 or more years of education. The ‘lower risk’ (high PA/low ST) represented 26.6% of the sample and was likely associated with middle‐aged adults and with having a lower educational level. Being male, young and highly educated was related to being physically active and spending large amounts of time in ST. Besides adding to the body of mixed evidence on this theme, the identification of the socio‐demographic factors associated with each PA/ST pattern will permit national public health authorities to define policies and tailored actions to promote PA and reduce ST.
Model-based design for seizure control by stimulation
Authors: Ashourvan Arian , Pequito Sérgio , Khambhati Ankit N , Mikhail Fadi , Baldassano Steven N , Davis Kathryn A , Lucas Timothy H , Vettel Jean M , Litt Brian , Pappas George J , Bassett Danielle S 
Published: February 2020

Abstract

Objective. Current brain stimulation paradigms are largely empirical rather than theoretical. An opportunity exists to improve upon their modest effectiveness in closed-loop control strategies with the development of theoretically grounded, model-based designs. Approach. Inspired by this need, here we couple experimental data and mathematical modeling with a control-theoretic strategy for seizure termination. We begin by exercising a dynamical systems approach to model seizures (n = 94) recorded using intracranial EEG (iEEG) from 21 patients with medication-resistant, localization-related epilepsy. Main results. Although each patient’s seizures displayed unique spatial and temporal patterns, their evolution can be parsimoniously characterized by the same model form. Idiosyncracies of the model can inform individualized intervention strategies, specifically in iEEG samples with well-localized seizure onset zones. Temporal fluctuations in the spatial profiles of the oscillatory modes show that seizure onset marks a transition into a regime in which the underlying system supports prolonged rhythmic and focal activity. Based on these observations, we propose a control-theoretic strategy that aims to stabilize ictal activity using static output feedback for linear time-invariant switching systems. Finally, we demonstrate in silico that our proposed strategy allows us to dampen the emerging focal oscillatory sources using only a small set of electrodes. Significance. Our integrative study informs the development of modulation and control algorithms for neurostimulation that could improve the effectiveness of implantable, closed-loop anti-epileptic devices.
Are Established Embedded Performance Validity Test Cut-Offs Generalizable to Patients With Multiple Sclerosis?
Authors: Domen Christopher H , Greher Michael R , Hosokawa Patrick W , Barnes Sierra L , Hoyt Brian D , Wodushek Thomas R 
Published: February 2020

Abstract

Objective
Data for the use of embedded performance validity tests (ePVTs) with multiple sclerosis (MS) patients are limited. The purpose of the current study was to determine whether ePVTs previously validated in other neurological samples perform similarly in an MS sample.

Methods
In this retrospective study, the prevalence of below-criterion responding at different cut-off scores was calculated for each ePVT of interest among patients with MS who passed a stand-alone PVT.

Results
Previously established PVT cut-offs generally demonstrated acceptable specificity when applied to our sample. However, the overall cognitive burden of the sample was limited relative to that observed in prior large-scale MS studies.

Conclusion
The current study provides initial data regarding the performance of select ePVTs among an MS sample. Results indicate most previously validated cut-offs avoid excessive false positive errors in a predominantly relapsing remitting MS sample. Further validation among MS patients with more advanced disease is warranted.
Beyond Stewardship: Reordering the Economic Imagination of Catholic Health Care
Authors: Lysaught M Therese 
Published: February 2020

AbstractThe principle of stewardship has come to play a significant role in the consciousness of Catholic health care. This is a recent development correlative with changes in the economic configurations of Catholic health care in the latter two decades of the twentieth century, as well as with the striking ascendance of the principle within US Catholic culture during the same period. Yet while the concept of stewardship seems to be an unobjectionable given central to Catholic practice, I argue that in its contemporary configuration, it embodies a deeply problematic set of theological assumptions drawn from a particular historical trajectory that is—from a Catholic perspective—quite troubling. This history is concurrent with an equally problematic deformation of the concept of charity. Taken together, these malformed concepts often shackle and misdirect the ability of those who work within Catholic health care to creatively discern transformative solutions and faithful modes of practice.
Prevalence and outcome of dual aortic stenosis and cardiac amyloid pathology in patients referred for transcatheter aortic valve implantation
Authors: Scully Paul R , Patel Kush P , Treibel Thomas A , Thornton George D , Hughes Rebecca K , Chadalavada Sucharitha , Katsoulis Michail , Hartman Neil , Fontana Marianna , Pugliese Francesca , Sabharwal Nikant , Newton James D , Kelion Andrew , Ozkor Muhiddin , Kennon Simon , Mullen Michael , Lloyd Guy , Menezes Leon J , Hawkins Philip N , Moon James C 
Published: February 2020

Abstract

Aims
Cardiac amyloidosis is common in elderly patients with aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI). We hypothesized that patients with dual aortic stenosis and cardiac amyloid pathology (AS-amyloid) would have different baseline characteristics, periprocedural and mortality outcomes.

Methods and results
Patients aged ≥75 with severe AS referred for TAVI at two sites underwent blinded bone scintigraphy prior to intervention (Perugini Grade 0 negative, 1–3 increasingly positive). Baseline assessment included echocardiography, electrocardiogram (ECG), blood tests, 6-min walk test, and health questionnaire, with periprocedural complications and mortality follow-up. Two hundred patients were recruited (aged 85 ± 5 years, 50% male). AS-amyloid was found in 26 (13%): 8 Grade 1, 18 Grade 2. AS-amyloid patients were older (88 ± 5 vs. 85 ± 5 years, P = 0.001), with reduced quality of life (EQ-5D-5L 50 vs. 65, P = 0.04). Left ventricular wall thickness was higher (14 mm vs. 13 mm, P = 0.02), ECG voltages lower (Sokolow–Lyon 1.9 ± 0.7 vs. 2.5 ± 0.9 mV, P = 0.03) with lower voltage/mass ratio (0.017 vs. 0.025 mV/g/m2, P = 0.03). High-sensitivity troponin T and N-terminal pro-brain natriuretic peptide were higher (41 vs. 21 ng/L, P &lt; 0.001; 3702 vs. 1254 ng/L, P = 0.001). Gender, comorbidities, 6-min walk distance, AS severity, prevalence of disproportionate hypertrophy, and post-TAVI complication rates (38% vs. 35%, P = 0.82) were the same. At a median follow-up of 19 (10–27) months, there was no mortality difference (P = 0.71). Transcatheter aortic valve implantation significantly improved outcome in the overall population (P &lt; 0.001) and in those with AS-amyloid (P = 0.03).

Conclusions
AS-amyloid is common and differs from lone AS. Transcatheter aortic valve implantation significantly improved outcome in AS-amyloid, while periprocedural complications and mortality were similar to lone AS, suggesting that TAVI should not be denied to patients with AS-amyloid.
Seroprevalence of Nipah Virus Infection in Peninsular Malaysia
Authors: Yong Ming-Yen , Lee Soo-Ching , Ngui Romano , Lim Yvonne Ai-Lian , Phipps Maude E , Chang Li-Yen 
Published: February 2020

Abstract
Nipah virus (NiV) outbreak occurred in Malaysia in 1998. The natural host reservoir for NiV is Pteropus bats, which are commonly found throughout Malaysia. Humans become infected when NiV spills over from the reservoir species. In this study, NiV serosurveillance in Peninsular Malaysia, particularly among the indigenous population, was performed. The collected samples were tested for presence of NiV antibodies using a comparative indirect enzyme-linked immunosorbent assay based on the recombinant NiV nucleocapsid (rNiV-N) protein. We found that 10.73% of the participants recruited in this study had antibodies against rNiV-N, suggesting possible exposure to NiV.
A Dual Role for the Plasminogen Activator Protease During the Preinflammatory Phase of Primary Pneumonic Plague
Authors: Banerjee Srijon K , Crane Samantha D , Pechous Roger D 
Published: February 2020

Abstract
Early after inhalation, Yersinia pestis replicates to high numbers in the airways in the absence of disease symptoms or notable inflammatory responses to cause primary pneumonic plague. The plasminogen activator protease (Pla) is a critical Y. pestis virulence factor that is important for early bacterial growth in the lung via an unknown mechanism. In this article, we define a dual role for Pla in the initial stages of pulmonary infection. We show that Pla functions as an adhesin independent of its proteolytic function to suppress early neutrophil influx into the lungs, and that Pla enzymatic activity contributes to bacterial resistance to neutrophil-mediated bacterial killing. Our results suggest that the fate of Y. pestis infection of the lung is decided extremely early during infection and that Pla plays a dual role to tilt the balance in favor of the pathogen.
Breast Imaging in Transgender Patients
Authors: Chowdhry Divya N , O’Connell Avice M 
Published: February 2020

AbstractIn the United States, at least 1.4 million adults identify as transgender. Despite growing national awareness, the transgender population experiences disparities in breast care access and breast health outcomes. One of the challenges of breast care delivery to transgender patients is the lack of evidence-based screening guidelines, which is likely partly due to the infrequency of transgender breast cancer cases. Several gender-affirming hormonal and surgical interventions are available that impact the imaging appearance of the breasts and the risk of breast cancer. Breast imaging radiologists should be familiar with the imaging appearance of expected findings and potential complications following gender-affirming interventions. It has been shown that the incidence of breast cancer in transgender women is higher than in natal males but still lower than in natal females, implying that estrogen supplementation confers an increased breast cancer risk. It is proposed that transgender women follow the screening guidelines for natal females if they have risk factors for breast cancer and received hormone therapy for &gt; 5 years. However, further research is necessary, especially in transgender women who have no risk factors or received hormone therapy for ≤ 5 years. The breast cancer risk of presurgical transgender men is considered equivalent to that of natal females, but the risk markedly decreases following bilateral mastectomy. It is proposed that transgender men follow the screening guidelines for natal females if they have any preserved breast tissue, or that they undergo annual chest wall and axillary physical exam if they are status post bilateral mastectomy.
Guided ultrasonic wavefield cross-correlation with a curved array for high-resolution plate inspection
Authors: Nguyen Luan T , Saenger Erik H 
Published: February 2020

Abstract
We present in this work an ultrasonic imaging technique based on wavefield cross-correlation that has potential for high-resolution inspecting of plates and plate-like structures. A curved transmit/receive array setup is used for acquiring wide-aperture waveform data beneficial for applying the presented imaging condition. An additional dispersion analysis using waveform data received by a linear array allows one to reveal the excited guided wave modes and possibly determine the shear wave velocity as an input parameter in the 3D wavefield simulation. Using synthetic but realistic data generated by realistic 3D simulations, we demonstrate the invariance of the time reversal process and the capability of the presented imaging approach for ultrasonic testing based on Lamb waves. In addition to the ability to localise and size multiple defects simultaneously, this imaging approach does not require baseline data and involves only minimal waveform data pre-processing.
Estimating broad trend of acoustic impedance profile from observed seismic reflection data using first principles only
Authors: Mandal Animesh , Ghosh Santi Kumar 
Published: February 2020

Abstract
Estimation of broad features or the low-frequency part of acoustic impedance from conventional reflection data is an essential yet challenging step for quantitative interpretation of seismic data due to its band-limited nature. A missing low-frequency part leads to non-uniqueness in the solution as well as placing restrictions in recovering the absolute impedance values. The current industry practice fills this gap by assuming either an initial impedance model or statistical restrictions on such a model. Doing away with such assumptions but using only first principles (Zoeppritz's equations) and homogeneous layered earth model, we have formulated a set of linear equations that are then solved for an unknown reflection co-efficient using singular value decomposition (SVD) approach with time sampled seismic trace as the input data. The present work demonstrates the effectiveness of reconstructing a broad and smooth impedance profile from first principles and even from acquired seismic reflection data. It also illustrates the method's success with real data, while determining in one go the unknown scale factor linking the true and the relative seismic amplitudes, and the smallest singular value to be retained in the solution from only the knowledge of the average value of the acoustic impedance over the depth range in question. Thus, the salient feature of this work is the ability to reconstruct an approximate impedance profile from field data without the aid of an initial model or statistical assumption on the reflectivity series. This approximate impedance profile can serve as a reliable initial input for more refined inversion or geologic interpretation.