bluuebunny/crossref_metadata_2025_split huggingface dataset:
Messinstrumente zur Erfassung von Geburtserwartungen und des Geburtserlebens (Teil 2 einer Serie zur psychologischen Diagnostik im Peripartalzeitraum)
Authors: Weigl Tobias , Garthus-Niegel Susan 
Published: May 2021

ZusammenfassungDer Geburtsvorgang ist ein tiefgreifendes Erlebnis und geht zumeist mit starken Schmerzen einher. Neben medizinischen Komplikationen können aber auch subjektive Faktoren das Geburtserleben beeinflussen. Dazu zählen unter anderem bisherige Erfahrungen mit Schwangerschaft und Geburt, frühere traumatische Erlebnisse und Geburtserwartungen. Verschiedene Fragebögen ermöglichen derzeit eine standardisierte Erfassung der Geburtserwartungen und des Geburtserlebens. Allerdings steht in deutscher Sprache bisher kein Fragebogen zur Verfügung, der sich an den diagnostischen Symptomen der geburtsbezogenen posttraumatischen Belastungsstörung orientiert. Darüber hinaus wurden die bestehenden Instrumente für Frauen entwickelt und das subjektive Geburtserleben von Männern wurde nur wenig untersucht. Fragebögen scheinen allerdings gut geeignet, das Geburtserleben von sowohl Müttern als auch Vätern zu erheben. So könnten Unterstützungsangebote ausgebaut werden, da mitunter auch bei medizinisch unkomplizierten Geburten von den Eltern ein negatives Geburtserlebnis geschildert wird. Neben dem Ziel den Eltern ein positives Geburtserlebnis zu ermöglichen, spielt auch die Verhinderung der Entwicklung einer subklinischen oder gar einer ausgeprägten posttraumatischen Belastungsstörung nach der Geburt eine wesentliche Rolle.
Serum Melatonin as a Biomarker for Assessment of Late-term and Postterm Pregnancies in Women without Spontaneous Onset of Labor
Authors: Yurtcu Nazan , Çalışkan Canan , Çelik Samettin 
Published: May 2021

AbstractWe conducted a prospective study to assess serum melatonin as a biomarker to predict the development of late-term and postterm pregnancies and spontaneous beginning of labor in women with term pregnancies. Population of this prospective study included pregnant women with late-term and postterm pregnancies and term pregnancies as controls. In these study groups, serum melatonin concentrations were measured in women with or without labor and their perinatal data were collected. In the postterm pregnancies without labor, the lowest median melatonin concentrations were measured (p<0.05). In the late-term and postterm pregnancies with and without labor, the median serum melatonin concentrations were significantly lower than term ones (p<0.05). In the term pregnancies with labor, the highest median melatonin concentration was measured (p<0.05). A serum melatonin concentration≤34 pg/mL as a cut-off value determines late-term and postterm pregnancy with a sensitivity of 80.4% and a specificity of 81.4%. A serum melatonin concentration>29.35 pg/mL as a cut-off value determines presence of labor with a sensitivity of 82.1% and a specificity of 55.0%. In women with term pregnancies, with the measurement of serum melatonin, it is possible to predict the development of late-term and postterm pregnancies and whether these pregnancies undergo spontaneous labor. With further studies, these findings need to be supported before their routine clinical use.
Erweiterte medizinische Eingangsuntersuchungen als sinnvolle Instrumentarien zur Verletzungsprävention im Hochleistungssport am Beispiel eines Basketball-Bundesligisten
Authors: Fehske Kai , Lukas Christoph , Bischoff Andreas , Krutsch Werner , Hoos Olaf , Latzel Richard 
Published: May 2021

ZusammenfassungHintergrund Eingangsuntersuchungen sind wichtig, um Aussagen über die Gesundheit treffen zu können. Diese Untersuchungen beinhalten etablierte internistisch-kardiologische Testverfahren sowie eine orthopädische Beurteilung des Bewegungsapparats. In den großen Mannschaftsportarten ist die Lizensierung der Spieler eng an die medizinischen Eingangsuntersuchungen geknüpft. Die vorgeschriebenen Eingangsuntersuchungen bilden jedoch lediglich den aktuellen Gesundheitszustand ab und lassen nur indirekte Aussagen über die Funktions- und Leistungsfähigkeit des Athleten zu. Somit wurde in den letzten Jahren versucht, diese Lücke durch eine Erweiterung in Richtung sportartspezifische Leistungsdiagnostik zu schließen. Sollte sich der Athlet verletzen, können die erhobenen Baseline-Werte als Maßstab genutzt werden, um das Monitoring des Sportlers im Rehabilitationsprozess zu unterstützen und einen sicheren Übergang zurück zum Wettkampf zu begleiten. Dies ist ein entscheidender Vorteil in der Return-to-Play-Diagnostik.Material und Methoden Aufgrund der Annahme, dass nur ein gesunder Spieler seine volle Leistungsfähigkeit abrufen kann, wurde von der Saison 2012/2013 für 5 aufeinanderfolgende Spielzeiten im Rahmen der medizinischen Eingangsuntersuchungen zusätzlich die Basketball-spezifische, konditionelle Leistungsfähigkeit der Spieler eines Basketball-Bundesligisten überprüft. Diese Werte wurden prospektiv mit den stattgehabten Verletzungen korreliert.Ergebnisse Insgesamt wurden 71 Spieler in jeweils 5 verschiedenen Kategorien (u. a. Sprungkraft, Agilität, Sprintfähigkeit) getestet. Im Untersuchungszeitraum ereigneten sich 142 Verletzungen, die im Mittel zu einer Ausfallzeit von 23 Tagen (Range 1–347 Tage) führten. Die Verletzungen betrafen zumeist die untere Extremität, wobei Sprunggelenk, Oberschenkel und Kniegelenk am häufigsten betroffen waren. Es zeigte sich ein deutlicher Trend dahingehend, dass Spieler mit einer schwächer ausgeprägten Richtungsänderungsschnelligkeit häufiger Verletzungen erlitten (r = 0,34; p = 0,029) und Spieler, die im YoYo-Test signifikant schlechter abschnitten, häufiger von Oberschenkelverletzungen betroffen waren (r = 0,266; p = 0,012).Schlussfolgerung Als Instrument zur Prävention sind medizinische Eingangsuntersuchungen nicht nur im Profisport essenziell, um Sportverletzungen oder Sportschäden aufzeigen bzw. ausschließen zu können. Die Erweiterung in Richtung sportartspezifische Leistungsdiagnostik liefert Informationen über Defizite bezogen auf Agilität und Ausdauer, die die Entstehung einer Verletzung begünstigen können. Darüber hinaus bieten die Untersuchungen auch die Möglichkeit, die erhobenen Werte als Baseline zu nutzen, die im Falle einer Verletzung den Fortschritt der Rehabilitation objektiv erfassbar machen und eine sichere Rückkehr zum Wettkampf ermöglichen.
Alternatives for Vitamin K Antagonists as Thromboprophylaxis for Mechanical Heart Valves and Mechanical Circulatory Support Devices: A Systematic Review
Authors: Liesdek Omayra C.D. , Urbanus Rolf T. , de Heer Linda M. , Fischer Kathelijn , Suyker Willem J.L. , Schutgens Roger E.G. 
Published: May 2021

AbstractThe holy grail of anticoagulation in patients with intracardiac devices, such as mechanical heart valves (MHVs) and left ventricular assist devices (LVADs), comprises safe prevention of thrombosis without interrupting normal hemostasis. Device-induced thrombosis and anticoagulant-related bleeding problems are dreaded complications that may cause a significantly reduced quality of life and increased morbidity and mortality. Vitamin K antagonists are the current standard for oral anticoagulation therapy in patients with MHVs and LVADs. Even within the therapeutic range, hemorrhage is the primary complication of these drugs, which emphasizes the need for safer anticoagulants for the prevention of device-induced thrombosis. Device-induced thrombosis is a complex multifactorial phenomenon that likely requires anticoagulant therapy targeting multiple pathways. Here, we review the preclinical and clinical data describing the efficacy of a variety of anticoagulants as thromboprophylaxis after implantation of intracardiac devices.
Study of Short Latency Somatosensory and Brain Stem Auditory Evoked Potentials Patients with Acute Ischemic Stroke Involving Middle Cerebral Artery Territory
Authors: Miryala Abhishek , Javali Mahendra , Mehta Anish , Pradeep R. , Acharya Purushottam , Srinivasa Rangasetty 
Published: May 2021

Abstract

Background The precise timings of evoked potentials in evaluating the functional outcome of stroke have remained indistinct. Few studies in the Indian context have studied the outcome of early prognosis of stroke utilizing evoked potentials.

Objective The aim of this study was to determine somatosensory evoked potentials (SSEPs) and brain stem auditory evoked potentials (BAEPs), their timing and abnormalities in acute ischemic stroke involving the middle cerebral artery (MCA) territory and to correlate SSEP and BAEP with the functional outcome (National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS) and Barthel’s index) at 3 months.

Methods MCA territory involved acute ischemic stroke patients (n = 30) presenting consecutively to the hospital within 3 days of symptoms onset were included. Details about clinical symptoms, neurological examination, treatment, NIHSS score, mRS scores were collected at the time of admission. All patients underwent imaging of the brain and were subjected to SSEP and BAEP on two occasions, first at 1 to 3 days and second at 4 to 7 days from the onset of stroke. At 3 months of follow-up, NIHSS, mRS, and Barthel’s index were recorded.

Results P37 and N20 amplitude had a strong negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a significant positive correlation with Barthel’s index (p < 0.0001). BAEP wave V had a negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a positive correlation with Barthel’s index (p < 0.0001).

Conclusion SSEP abnormalities recorded on days 4 to 7 from onset of stroke are more significant than those recorded within 1 to 3 days of onset of stroke; hence, the timing of 4 to 7 days after stroke onset can be considered as better for predicting functional outcome.
Stress, Burnout, and Coping among First-Year Medical Undergraduates
Authors: Nebhinani Naresh , Kuppili Pooja Patnaik , Mamta  
Published: May 2021

Abstract

Background and Objectives Stress, burnout, and coping have been found to be interlinked with each other. Several adverse psychological outcomes have been associated with stress and burnout. Improving coping can decrease the stress and burnout. There is limited literature on perceived stress, coping, and burnout among first-year medical undergraduates from India. With this background, the study aimed to assess perceived stress, coping, and burnout among first-year medical undergraduates.

Methods It was a cross-sectional study assessing 100 undergraduates studying in the first year of medical school. Medical Students Stressor Questionnaire, Brief COPE questionnaire, and Maslach burnout inventory–student survey were applied for assessment of perceived stress, burnout, and coping, respectively. Socio-demographic profile was assessed by a semi-structured proforma.

Results Majority of students reported facing moderate level of stress in most of the domains, with stress being the highest for the academic aspects and least for social-related and drive- and desire-related areas. The stress was significantly greater in female students. Burnout was identified in 62% students by two-dimensional criteria and 30% by three-dimensional criteria. Among the coping strategies, active coping was most commonly used and substance use was less commonly used. No differences were found in coping between males and females except for active coping, which was significantly better in females.

Conclusion The stress was of moderate degree in majority of students and academic stress was the most common stress. Burnout was present in at least one-third of the students. However, majority of the students practiced active coping.
Mosaic Pattern of H3 K27M-Mutant Protein Expression in a Diffuse Midline Glioma—A Diagnostic Dilemma for the Pathologist
Authors: Narasimhaiah Deepti , Thomas Bejoy , Abraham Mathew , Poyuran Rajalakshmi 
Published: May 2021

Abstract
Diffuse midline glioma, H3 K27M-mutant, is a World Health Organization (WHO) grade IV glioma arising in pons, thalamus, and spinal cord. They show mutations resulting in replacement of lysine at position 27 by methionine (K27M) of histone genes, H3F3A, HIST1H3B, and HIST1H3C. The H3 K27M mutant protein is identified in tumor tissue by immunohistochemistry. As these mutations are clonal and homogeneous, the mutant protein is normally identified in all tumor cells. Here we report a case of diffuse midline glioma with mosaic pattern of expression of H3 K27M mutant protein and discuss the diagnostic and therapeutic implications of this unusual pattern.
Morphological Assessment of TMJ Spaces, Mandibular Condyle, and Glenoid Fossa Using Cone Beam Computed Tomography (CBCT): A Retrospective Analysis
Authors: Ahmed Junaid , Sujir Nanditha , Shenoy Nandita , Binnal Almas , Ongole Ravikiran ,   Nithin
Published: May 2021

AbstractBackground The temporomandibular joint (TMJ) is included in the category of ginglymoarthrodial synovial joints. The mandibular condyle plays a vital part in the development of the craniofacial complex. Hence, the evaluation and assessment of the condylar volume and its morphology are of utmost importance.Aim The aim of this research was to use cone beam computed tomography (CBCT) imaging modality to evaluate the morphology of the mandibular condyle and glenoid fossa in a selected population and document any morphometric changes.Setting and Design It is an observational study.Materials and Methods A retrospective CBCT analysis was performed on 119 patients. The length, width, height, linear measurements of the joint spaces (anterior, posterior, and superior), volume of the condyle, and roof of glenoid fossa thickness were evaluated on both the left and right sides in both males and females.Results The height, width, and length of mandibular condyle were significantly increased in males on both sides. Except for the left anterior space, all other spaces were significantly larger in males. Overall, the volume of the condyles in males was significantly increased on both sides.Conclusion CBCT can be a valuable diagnostic aid in the evaluation of various dimensions, joint spaces, and condylar volume in different planes and thus, can be a useful predictor in the assessment of treatment outcomes of disorders affecting the TMJ.
Diagnostic Role of Cardiovascular Magnetic Resonance Imaging in Dilated Cardiomyopathy
Authors: Singla Nehal , Mehra Shibani , Garga Umesh C. 
Published: May 2021

Abstract
Aims The purpose of the study was to compare the accuracy of cardiac magnetic resonance (CMR) with echocardiography for the evaluation of ventricular dysfunction in patients of dilated cardiomyopathy (DCM). Further, we evaluated the potential of CMR for myocardial tissue characterization.
Design Prospective observational.
Materials and Methods A total of 30 patients with suspected DCM prospectively underwent cardiac magnetic resonance (MR) using a 1.5 Tesla MR scanner, with appropriate phased-array body coils. Dynamic sequences after injection of 0.1 mmol/kg of body weight of gadolinium-based intravenous contrast (Magnevist) were acquired for each patient, after which delayed images were obtained at an interval of 12 to 15 minutes. Myocardial tagging was performed in all patients for assessment of wall motion abnormalities. Each MR examination was interpreted with two radiologists for chamber dimensions and ventricular dysfunction as well as morphologic characteristics with disagreement resolved by consensus. All patients included in the study were taken up for MR evaluation after cardiological evaluation through echocardiography and the results for both the studies were compared. Data were analyzed through standard statistical methods.
Conclusion CMR is a comprehensive diagnostic tool, which can estimate the ventricular function more precisely than echocardiography. CMR reliably differentiates between ischemic and nonischemic etiologies of DCM based on patterns of late gadolinium enhancement (LGE) and based on the presence or absence of LGE, which helps to estimate the degree of myocardial fibrosis. Thereby it can be a useful tool in establishing risk stratification, predicting prognosis, and thus instituting appropriate therapy in DCM patients.
Factors That Impact the Timing and Removal of Gastrostomy Placement/Nissen Fundoplication in Children with Bronchopulmonary Dysplasia
Authors: Ng Kenneth , Lefton-Greif Maureen A. , McGrath-Morrow Sharon A. , Collaco Joseph M. 
Published: May 2021

Objective The study aimed to identify factors that impact timing of gastrostomy placement/removal and Nissen fundoplication (NF) in infants with bronchopulmonary dysplasia (BPD).
Study Design Clinical data were reviewed retrospectively from patients recruited from the Johns Hopkins Bronchopulmonary Dysplasia Clinic (January 1, 2014–December 31, 2018).
Results Patients with gastrostomy tubes (GTs) placed in the neonatal intensive care unit (NICU) were older at discharge (p < 0.001) and less likely to have abnormal upper gastrointestinal series findings (p = 0.005) than those with GTs placed after NICU discharge. Patients with NF had lower mean gestational ages (p = 0.011), longer NICU stays (p = 0.019), more frequent home ventilation requirements (p = 0.005), and greater likelihood of pulmonary hypertension (p = 0.032) compared with those without. Median age of GT removal was 61.6 months. Patients with GTs were weaned from supplemental oxygen and/or home ventilation before GT removal (p < 0.001).
Conclusion Patients with GT/NF were more medically complex than those with GT alone. Patients were more likely to be weaned from home respiratory support before GT removal.
Key Points
Cost-Effectiveness of Routine Type and Screens in Select Endonasal Skull Base Surgeries
Authors: Spillinger Aviv , Allen Meredith , Karabon Patrick , Hojjat Houmehr , Shenouda Kerolos , Hussein Inaya Hajj , Jacob Jeffrey T. , Svider Peter F. , Folbe Adam J. 
Published: May 2021

Abstract
Objective The study aimed to evaluate the cost-effectiveness of obtaining preoperative type and screens (T/S) for common endonasal skull base procedures, and determine patient and hospital factors associated with receiving blood transfusions.
Study Design Retrospective database analysis of the 2006 to 2015 National (nationwide) Inpatient Sample and cost-effectiveness analysis.
Main Outcome Measures Multivariate regression analysis was used to identify factors associated with transfusions. A cost-effectiveness analysis was then performed to determine the incremental cost-effectiveness ratio (ICER) of obtaining preoperative T/S to prevent an emergency-release transfusion (ERT), with a willingness-to-pay threshold of $1,500.
Results A total of 93,105 cases were identified with an overall transfusion rate of 1.89%. On multivariate modeling, statistically significant factors associated with transfusion included nonelective admission (odds ratio [OR]: 2.32; 95% confidence interval [CI]: 1.78–3.02), anemia (OR: 4.42; 95% CI: 3.35–5.83), coagulopathy (OR: 4.72; 95% CI: 2.94–7.57), diabetes (OR: 1.45; 95% CI: 1.14–1.84), liver disease (OR: 2.37; 95% CI: 1.27–4.43), pulmonary circulation disorders (OR: 3.28; 95% CI: 1.71–6.29), and metastatic cancer (OR: 5.85; 95% CI: 2.63–13.0; p < 0.01 for all). The ICER of preoperative T/S was $3,576 per ERT prevented. One-way sensitivity analysis demonstrated that the risk of transfusion should exceed 4.12% to justify preoperative T/S.
Conclusion Routine preoperative T/S does not represent a cost-effective practice for these surgeries using nationally representative data. A selective T/S policy for high-risk patients may reduce costs.
A balance for fairness: fair distribution utilising physics
Authors: Kim Song-Ju , Takahashi Taiki , Sano Kazuo 
Published: May 2021

AbstractThe problem of ‘uneven distribution of wealth’ accelerated during the COVID-19 pandemic. In the chaotic modern society, there is an increasing demand for the realisation of true ‘fairness’. In this study, we propose a fair distribution method ‘using physics’, which imitates the Greek mythology, Themis, having a ‘balance of judgement’ in her left hand, for the profit in games of characteristic function form. Specifically, we show that the linear programming problem for calculating ‘nucleolus (a solution for the fair distribution)’ can be efficiently solved by considering it as a physical system in which gravity works. In addition to significantly reducing the computational complexity, the proposed scheme provides a new perspective to open up a physics-based policymaker that is adaptable to real-time changes. We will be able to implement it not only in liquid systems but also in many other physical systems, including semiconductor chips. The fair distribution problem can be solved immediately using physical systems, which should reduce disputes and conflicts based on inaccurate information and misunderstandings, eliminating fraud and injustice.
Freud and the algorithm: neuropsychoanalysis as a framework to understand artificial general intelligence
Authors: Possati Luca M. 
Published: May 2021

AbstractThe core hypothesis of this paper is that neuropsychoanalysis provides a new paradigm for artificial general intelligence (AGI). The AGI agenda could be greatly advanced if it were grounded in affective neuroscience and neuropsychoanalysis rather than cognitive science. Research in AGI has so far remained too cortical-centric; that is, it has privileged the activities of the cerebral cortex, the outermost part of our brain, and the main cognitive functions. Neuropsychoanalysis and affective neuroscience, on the other hand, affirm the centrality of emotions and affects—i.e., the subcortical area that represents the deepest and most ancient part of the brain in psychic life. The aim of this paper is to define some general design principles of an AGI system based on the brain/mind relationship model formulated in the works of Mark Solms and Jaak Panksepp. In particular, the paper analyzes Panksepp’s seven effective systems and how they can be embedded into an AGI system through Judea Pearl’s causal analysis. In the conclusions, the author explains why building a sub-cortical AGI is the best way to solve the problem of AI control. This paper is intended to be an original contribution to the discussion on AGI by elaborating positive arguments in favor of it.