bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSR J1618−3921: a recycled pulsar in an eccentric orbit
Authors: Octau F. , Cognard I. , Guillemot L. , Tauris T. M. , Freire P. C. C. , Desvignes G. , Theureau G. 
Published: April 2018

Context.The 11.99 ms pulsar PSR J1618−3921 orbits a He white dwarf companion of probably low mass with a period of 22.7 d. The pulsar was discovered in a survey of the intermediate Galactic latitudes at 1400 MHz that was conducted with the Parkes radio telescope in the late 1990s. Although PSR J1618−3921 was discovered more than 15 years ago, only limited information has been published about this pulsar, which has a surprisingly high orbital eccentricity (e≃ 0.027) considering its high spin frequency and the likely low mass of the companion.Aims.The focus of this work is a precise measurement of the spin and the astrometric and orbital characteristics of PSR J1618−3921. This was done with timing observations made at the Nançay Radio Telescope from 2009 to 2017.Methods.We analyzed the timing data recorded at the Nançay Radio Telescope over several years to characterize the properties of PSR J1618−3921. A rotation ephemeris for this pulsar was obtained by analyzing the arrival times of the radio pulses at the telescope.Results.We confirm the unusual eccentricity of PSR J1618−3921 and discuss several hypotheses regarding its formation in the context of other discoveries of recycled pulsars in eccentric orbits.
Robotics in Total Hip Arthroplasty—A Current Review
Authors: Allen Mark , Myerthall Steven , Jacofsky David 
Published: April 2018

AbstractRobotic-assisted total hip arthroplasty (THA) is gaining popularity among surgeons and patients alike. This technology has been available clinically in some form for over two decades. This technology claims to improve component positioning, decrease complications, and improve clinical outcomes. Historical and modern systems have shown both advantages and disadvantages while assisting THA procedures. Robotic arms and milling systems have been utilized with both fully active and semi active technology platforms designed to perform or assist the surgeon with various portions of the procedure. The future design objectives include precise planning and even further improved consistent intraoperative execution. Robotics has proven to be beneficial, reliable, and cost effective in numerus other industries and is likely to continue to expand in the field of orthopaedic surgery. This article will review the historical and current technology being utilized for robotic-assisted THA.
New Technologies for Diagnosis of Periprosthetic Hip Infection
Authors: Shohat Noam , Parvizi Javad , Tarabichi Majd 
Published: April 2018

AbstractPeriprosthetic joint infection (PJI) is a devastating mode of failure following total joint arthroplasty, imposing a serious burden on the healthcare system and society at large. Increasing demand for elective arthroplasty, as well as independent predictions demonstrating future rise in the prevalence of PJI, will lead to an increasing financial burden imposed by this dreadful complication. This challenge is further compounded by disturbing trends, such as drug-resistant organisms among others as a cause of PJI. The aim of this review is to provide the latest updates in the diagnosis of PJI, with a view to identifying areas in need of further research.
Indikation und Besonderheiten der Knochendichtemessungen im Kindes- und Jugendalter
Authors: Semler O. , Hoyer-Kuhn H.-K. , Stark C. , Schönau E. , Rehberg M. 
Published: April 2018

ZusammenfassungPrimäre Erkrankungen des Skelettsystems (z. B. Osteogenesis imperfecta, idiopathische, juvenile Osteoporose) sind im Kindesalter selten. Frakturen dagegen treten häfig auf. Zunehmend sind Erkrankungen, welche sekundär mit einer erhöhten Frakturneigung einhergehen, wie zum Beispiel chronische, entzündliche und immobilisierende Erkrankungen. Die Aufgabe des Kinderarztes ist es, Kinder mit primären Knochenerkrankungen zu erkennen, sowie gegebenenfalls ein sekundär erhöhtes Frakturrisiko bei schweren und chronischen Grunderkrankungen nachzuweisen, um es adäquat therapieren zu können.Die Knochendichte beziehungsweise die Knochenmasse sind Surrogatparameter für die Knochengesundheit in diesen Situationen. Wir stellen im vorliegenden Text Begrifflichkeiten und physikalische Grundlagen der Knochendichtemessung vor, sowie die verschiedenen, in der Pädiatrie gebräuchlichen technischen Methoden zur Messung. Die Goldstandardmethode ist die Dual-energy X-ray absorptiometry (DXA)-Untersuchung. Für diese Methode stellen wir die Besonderheiten bei der Indikationsstellung und der Interpretation der Ergebnisse vor. Abschließend fassen wir die konkreten Empfehlungen der internationalen Gesellschaft für klinische Densitometrie zusammen.
Neue therapeutische Ansätze bei seltenen Skeletterkrankungen im Kindesalter
Authors: Rehberg M. , Stark C. , Semler O. , Hoyer-Kuhn H. 
Published: April 2018

ZusammenfassungDie Diagnose und Therapie seltener Erkrankungen im Kindes- und Jugendalter nimmt zunehmend einen großen Stellenwert in der pädiatrischen Praxis ein. Die hohe Anzahl seltener Erkrankungen mit jeweils nur einzelnen Betroffenen stellt eine besondere Herausforderung an die alltäglichen Versorgungsstrukturen dar. Durch die detaillierte Entschlüsselung der jeweiligen genetischen und pathophysiologischen Grundlage vieler der monogenetisch bedingten seltenen Erkrankungen ist es jedoch in den letzten Jahren gelungen, gezielte Therapieansätze zu entwickeln, welche derzeit in der klinischen Erprobung sind. Aktuell werden Studien im Kindes- und Jugendalter bei Patienten mit Achondroplasie, Osteogenesis imperfecta, Hypophosphatasie, hypophosphatämischer Rachitis und Fibrodysplasia ossificans progressiva durchgeführt. Die zugrunde liegenden genetischen Veränderungen, deren pathophysiologische Auswirkungen bis hin zum translationalen Therapieansatz werden in dieser Übersichtsarbeit schematisch dargestellt.
Seltene Ursache für sekundäres Fanconi-Syndrom
Authors: Terliesner N. , Beblo S. , Arélin M. , Abou Jamra R. , Dittrich K. , Schitke J. 
Published: April 2018

ZusammenfassungDer Sohn konsanguiner syrischer Eltern war ab Säuglingsalter mit einem großem Bauch und einer Gedeihstörung aufgefallen. Es bestanden Polydipsie, primäre Harninkontinenz sowie eine ausgeprägte Obstipation mit Enkopresis. Auf der Flucht nach Deutschland erlitt er nach geringen Traumata Frakturen beider Oberschenkel. Bei der Erstvorstellung mit sieben Jahren zeigte sich ein stark kleinwüchsiger, blonder Junge mit fehlenden oberen Schneidezähnen, massiven Rachitiszeichen und ausgeprägter Hepatomegalie. Laborchemisch bestanden eine metabolische Azidose und Hypophosphatämie bei Hyperphosphaturie, Hyperkalziurie, Ketonurie, Glukosurie, Mischproteinurie und Aminoazidurie. Klinisch bestand der Eindruck einer „Speichererkrankung“ mit gestörter Tubulusfunktion. Eine ausführliche Stoffwechseldiagnostik sowie Biopsien von Niere und Leber führten nicht zur Diagnosestellung. Eine molekulargenetische Untersuchung sicherte schließlich ein Fanconi-Bickel-Syndrom durch den Nachweis einer homozygoten, pathogenen Variante im SLC2A2-Gen.
Neonatal Outcomes Based on Duration of Exposure to Antenatal Corticosteroids in Indicated Preterm Deliveries
Authors: Kuper Spencer , Dimperio Lisa , Tita Alan , Biggio Joseph , Harper Lorie , Cawyer Chase 
Published: April 2018

Objective To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries.
Study Design This is a retrospective cohort of all indicated singleton preterm deliveries (23–34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death. Analyses were stratified by delivering gestational age (230/7–276/7, 280/7–316/7, and 320/7–336/7 weeks). Multivariate logistic regression refined point estimates and adjusted for confounders.
Results In total, 301 women delivered >48 hours after initial ACS dose, 230 delivered within 2 to 7 days, and 71 delivered >7 days. Infants with an interval of >7 days had no significant increase in the unadjusted composite neonatal outcome (p = 0.42), but when adjusted, the composite neonatal outcome (adjusted odds ratio [AOR]: 2.7; 95% confidence interval [CI]: 1.18–6.31) and neonatal death (AOR: 4.20; 95% CI: 1.39–12.69) were significantly increased with an ACS interval of >7 day.
Conclusion In this cohort, the benefit of ACS diminished >7 days after administration, particularly when delivery occurred at <32 weeks.
Sarkopenie
Authors: Jakob F. , Sieber C. , Kemmler W. 
Published: April 2018

ZusammenfassungSarkopenie ist eine altersassoziierte Erkrankung, deren Prävalenz mit der zunehmenden Lebenserwartung ansteigt. Der Verlust an Muskelmasse und Funktion geht mit einer erhöhten Mortalität und mit einem hohen Risiko der Behinderung und der Hospitalisierung einher. Die Angaben über die Häufigkeit in selbstständig lebenden Populationen sind sehr inkonsistent. Wichtige Risikofaktoren sind genetische/epigenetische Faktoren, Immobilisation, Fehlund Mangelernährung, Hormonmangelzustände, chronische Entzündung und ein Anstieg der inhibitorischen Faktoren der Geweberegeneration. Trotz hoher Forschungsintensität und intensiver Diskussion in Konsensus-Konferenzen über die diagnostischen Kriterien besteht noch keine einheitliche Definition der Sarkopenie. Eine ganze Reihe von Interventionsstrategien werden klinisch getestet. Trainings-Regimes, Ernährungsprogramme, Hormonersatztherapien und pharmakologische Ansätze mit anabolen Prinzipien wie SARMs, Ghrelin/Wachstumshormon und Myostatin-Antagonisten sind in der klinischen Evaluationsphase. Aus den wenigen bereits publizierten Studienergebnissen wird deutlich, dass Trainingsprogramme und Medikamente ein hohes Potenzial haben. Nicht wenige Studien zeigen aber über die Verbesserungen der Surrogatparameter hinaus keine eindrucksvollen Funktionsverbesserungen. Zukünftige Strategien müssen multimodale Interventionen zum Inhalt haben und im Design verbessert werden.
Das Problem der Osteitis bei der periprothetischen Gelenkinfektion
Authors: Schmolders J. , Zillekens A. , Strauss A. , Hischebeth G. , Randau T. , Gravius S. , Wirtz D.C. , Koob S. 
Published: April 2018

ZusammenfassungDie Therapie der periprothetischen Osteitis im Rahmen einer Endoprotheseninfektion ist nicht nur ein Determinant der vollständigen Sanierung des Situs, sondern auch ein entscheidender Faktor für die Auswahl und Stabilität des Revisionsimplantats. Nach einer nur eingeschränkt möglichen präoperativen bildmorphologischen Detektion von osteitischen Arealen im periimplantären Gewebe ist die gründliche und vor allem radikale Resektion von avitalen, biofilmtragenden Knochensequestern die Grundlage für eine nachhaltige Keimfreiheit des Prothesenlagers. Des weiteren zählen ein adäquates Totraummanagement, z. B. durch antibiotikatragende Spacer, und die hochkonzentrierte systemische Antibiose zu den Grundpfeilern der Osteitistherapie. Der vorliegende Artikel beschreibt die zugrundeliegende Pathophysiologie, bildgebende Diagnostika im Osteitisnachweis und gibt einen Einblick in die zuvor genannten Therapiegrundsätze.
Maternal Cardiac Arrest: Where is Our Data Coming From? [4A]
Authors: Shields Andrea D. , Battistelli Jacqueline , Thomson Brook , Hutchison Brian , Nielsen Peter 
Published: April 2018

INTRODUCTION:
Maternal Cardiac Arrest (MCA) is a rare event that is estimated to affect 1 in 12,000 admissions in the United States. We surveyed national databases and registries in the United States for in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA), defined by pregnancy or postpartum status.

METHODS:
We reviewed data dictionaries of 8 separate national registries for IHCA, OHCA and maternal deaths, searching for maternal indicators (pregnancy, pregnancy within 42 days, pregnancy within 1 year).

RESULTS:
The largest databases for OHCA in the United States, Cardiac Arrest Registry to Enhance Survival (CARES) and The Resuscitation Outcomes Consortium (ROC) Epistry, do not track pregnant/postpartum data. The National Emergency Services Medical Information System (NEMSIS) database, the largest EMS database in the country on OHCA, tracks pregnancy/childbirth but not postpartum status. Get With the Guidelines ® -Resuscitation, formerly the National Registry for Cardiopulmonary Resuscitation (NRCPR), is the largest database on IHCA and only tracks pregnancy data in relation to neonatal outcome and contraindication for hypothermia. The National Inpatient Sample of the Agency for Healthcare Research and Quality (NIS) includes both pregnancy/postpartum status, although collection of data varies by state. The pregnancy morality surveillance system (PMSS), and the National Vital Statistics both include pregnancy/postpartum data, although data collection is limited deaths during pregnancy.

CONCLUSION:
Current national surveillance of IHCA and OHCA do not consistently account for pregnancy and postpartum status. Standardization of all databases to include pregnancy and postpartum status up to 1 year will allow policymakers better access to performance, trends and outcomes in MCA.
Impact of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on Preterm Birth [6A]
Authors: Chavan Niraj R. , McDaniel Honour , Williams Corrine M. 
Published: April 2018

INTRODUCTION:
This study was undertaken to evaluate the differential impact of pre-pregnancy body mass index (PPBMI) and gestational weight gain (GWG) on preterm birth (PTB).

METHODS:
Vital statistics (birth) data collected by the National Center for Health Statistics (NCHS) was utilized. Using the 2015 data for singleton gestations, GWG was calculated and PPBMI was categorized as per WHO guidelines. Each PPBMI category was further stratified based on the adequacy of GWG - into inadequate, adequate and excess GWG subgroups using the 2009 IOM guidelines. Multivariate logistic regression analyses were used to predict the risk for preterm birth (<37 weeks) in each PPBMI and GWG group while adjusting for age, race, education, marital status, insurance and smoking status.

RESULTS:
The rate of preterm birth was noted to be 7.65% (276,820/3,619,295 deliveries). In comparison to women with adequate GWG, those with inadequate GWG [OR = 1.637 (95% CI 1.621 – 1.653)] had an overall increased risk for PTB across all PPBMI categories. Specifically, inadequate GWG was noted to increase the risk for PTB in normal weight [OR = 1.976 (95% CI 1.948 – 2.004)], underweight [OR = 2.384 (95% CI 2.286 – 2.486)], overweight [OR = 1.435 (95% CI 1.404 – 1.468)] and obese women [OR = 1.161 (95% CI 1.138 – 1.185)] as compared to women in the matched PPBMI categories with adequate GWG in the adjusted regression analyses.

CONCLUSION:
In this cohort, weight gain outside of the IOM recommendations was noted to significantly impact the risk for PTB across all PPBMI categories.
Prediction of Spontaneous Vaginal Delivery in Women with Prolonged Second Stage of Labor Undergoing TOLAC [11A]
Authors: Gimovsky Alexis , Amdur Richard , Macri Charles , Ahmadzia Homa 
Published: April 2018

INTRODUCTION:
To develop a prediction model for spontaneous vaginal delivery (SVD) in women with prolonged second stage (PSS) of labor undergoing a trial of labor after cesarean (TOLAC).

METHODS:
Secondary analysis of the MFMU Cesarean Registry. Inclusion criteria: term, singleton gestation, TOLAC, no prior vaginal delivery, who reached 10 cm cervical dilation. Women with PSS (≥3 hours with epidural or ≥2 hours without epidural) were compared to women with a normal second stage. Primary outcome: development of a model for predicting SVD. Univariate analysis, multivariable logistic regression were used to examine independent association of PSS with outcomes. A simple risk score was created using the regression model to calculate maximum likelihood estimates of probabilities for each subject. The association of probability quintile with incidence of SVD was examined.

RESULTS:
There were 364 women with PSS with epidural and no women with PSS without epidural anesthesia; therefore analysis was conducted only for women with epidurals. SVD occurred in 96 cases (26.4%). In univariate analyses, SVD was associated with birth weight, insurance, indication for previous cesarean and male sex. The multivariate model predicting SVD, showed no independent predictors. The simple risk score was calculated. Incidence of SVD was 13.9% in the lowest risk quintile and 42.5% in the highest risk quintile. Risk quintile based on the prediction model was significantly associated with SVD (p = 0.006).

CONCLUSION:
A prediction model for SVD in women with singleton gestation undergoing TOLAC with PSS and epidural may be useful to clinicians facing decisions regarding delivery.
Pelvic Floor Dysfunction after Prolonged Second Stage of Labor [12A]
Authors: Gimovsky Alexis , Amero Molly , Phillips Jaclyn , Levine Jordan , Berghella Vincenzo 
Published: April 2018

INTRODUCTION:
To evaluate whether extending the length of labor in nulliparas with prolonged second stage (PSS) affects the incidence of self-reported pelvic floor dysfunction.

METHODS:
Planned follow up survey to our randomized controlled trial of PSS using the Pelvic Floor Distress Inventory- 20 (PFDI-20): composed of the Pelvic Organ Prolapse Distress Inventory (POPDI-6), Colorectal-Anal Distress Inventory (CRADI-8) and Urinary Distress Inventory (UDI-6). Primary outcome: PFDI-20 summary score. Secondary outcomes: POPDI-6, CRADI-8, UDI-6 scores. Inclusion criteria: nulliparas, singleton gestation, 36.0 - 41.6 weeks, PSS. Women surveyed were previously enrolled in a study that assigned them randomly to extended labor (EL)- at least 1 additional hour in the 2nd stage, or to usual labor (UL)- expedited delivery via cesarean/operative vaginal delivery at the diagnosis of PSS. Women were surveyed at 12 - 36 months postpartum.

RESULTS:
Survey response rate was 43.6% (34/78). Maternal demographics were similar between groups. PFDI-20 summary score was 13.8 ± 23.3 in the EL and 13.1 ± 20.9 in the UL group (p = 0.9). POPDI-6 was 1.2 ± 2.9 in the EL group and 2.7 ± 6.4 in the UL group (p = 0.4). CRADI- 8 was 0.8 ± 2.8 in the EL group and 2.1 ± 4.0 in the UL group (p = 0.6). UDI- 6 was 11.8 ± 21.1 in the EL group and 8.3 ± 14.5 in the UL group (p = 0.6).

CONCLUSION:
Extending the length of labor in nulliparas with singleton gestation and PSS did not have an impact on PFDI-20 scores at 12-36 months postpartum.
Placental Pathology: Useful for Undiagnosed Small for Gestational Age Neonates? [14A]
Authors: Leftwich Heidi , Novak Brittany , Masiero Jessica , Nicasio Erica , Leung Katherine , Vanguri Vijay 
Published: April 2018

INTRODUCTION:
Up to 75% of babies born growth restricted were undiagnosed prior to delivery. Certain placental changes have associated with growth restriction. Our objective is to determine if these changes are increased in cases with ultrasound estimated fetal weight (EFW) 10-20%.

METHODS:
Retrospective analysis on singleton placentas from 2011 to 2016. Exclusion criteria were less than 24 weeks’ gestation or EFW <10%, multiple anomalies, known aneuploidy. Primary outcome was decreased placental weight. Secondary outcomes were infarcts, villitis, fibrin deposition, calcium deposition and a composite of outcomes. Pathology reports, ultrasound reports, and the electronic medical records were reviewed. Chi square was used for categorical variables and logistic regression for adjusted analyses.

RESULTS:
1748 ultrasounds had with EFW >10th%. Pregnancies with EFW 10-20% were more likely in women who were younger, nulliparous, had lower BMI, less gestational weight gain, and delivered less than a week earlier (p<0.05). Rates of SGA at birth were also increased (69.2% vs 8.7%, p<0.001). Placental pathology was sent in 35 (37%) of EFW 10-20% pregnancies and 281 (17%) those with EFW>20%. There were more placentas with decreased placental weight in the EFW 10-20% group (p<0.005). There was a trend toward increase in the incidence of infarcts, villitis, no differences in any of the other secondary outcomes, except decreased placental weight and one other placental finding (p=0.005).

CONCLUSION:
Placentas from pregnancies with EFW 10-20% had higher rates of decreased placental weight. No difference found in secondary outcomes, but with small numbers, further research is needed to assess these outcomes.
Genomic Alterations Found in Recurrent Uterine Sarcomas of African-American Women [18A]
Authors: Geisler John , Manahan Kelly , Webb Kathryn , Bryant Allison , Moore Crystal 
Published: April 2018

INTRODUCTION:
To describe the frequency of genomic alterations found in tumors from a population of African-American women with recurrent uterine sarcomas

METHODS:
Medical records were analyzed for all African American women with recurrent uterine sarcomas who underwent next generation sequencing of their tumors. Demographics were collected as well as all tumor genomic alterations. Data was evaluated by SPSS to see if any consistent genomic alterations were found.

RESULTS:
Twenty-four African-American women had next-generation sequencing on their recurrent uterine sarcomas with 12 having high-grade leiomyosarcomas (LMS), 11 having carcinosarcomas (MMMT), and one having an undifferentiated uterine sarcoma. The mean age of the patients was 54 years (median 52 years, 95%CI 51.2-57.7). The mean mutation burden/Mb was 6.4 mutations/Mb (median 4.5, 95%CI 1.7-11.1). Nineteen tumors had 1-5 mutations/Mb, 4 had 6-10 mutations/Mb and 1 had >10 mutations/Mb. p53 mutations occurred in the majority of tumors (LMS 66.7%, MMMT 63.6%; respectively). The gene with the second most alterations was PIK3CA (LMS 8.3%, MMMT 45.5%). BRCA2 mutations were the only other genomic alterations to occur in >10% of recurrent uterine sarcomas (LMS 16.7%, MMMT 27.3%).

CONCLUSION:
In this population of African-American women with recurrent uterine sarcomas, the 3 genes found to most commonly harbor genomic alterations were p53, PIK3CA, and BRCA2.
Correlation of Preoperative HgbA1c in Diabetic Patients and Postoperative Outcomes [23A]
Authors: Gelhaus Kelsey 
Published: April 2018

INTRODUCTION:
The surgical literature has demonstrated an association between high perioperative HgbA1c and increased surgical morbidity in cardiac surgical procedures. However, there is a lack of information for abdominopelvic surgical procedures. The objective of this study was to determine if there is an association between HgbA1c levels and postoperative complications in diabetic gynecologic oncology patients undergoing laparotomy, and to determine if there is a HgbA1c cut-off at which the postoperative complications increases.

METHODS:
A retrospective cohort study was performed. Preoperative HgbA1c level within 3 months of surgery, as well as other key preoperative, intraoperative and postoperative variables were abstracted. Descriptive statistics were performed on demographic and baseline data. A Student’s t-test was used to determine if there was a difference in HgbA1c between patients who did and did not experience a postoperative complication. Regression analysis was performed to determine if there was a HgbA1c cut-off at which the rate of complications significantly increased.

RESULTS:
113 diabetic gynecologic oncology patients with HgbA1c levels available were identified between 1/1/2009 to 12/30/2013. There was no statistically significant difference in HgbA1c between those who experienced any complication (6.99 vs 6.95; p=0.86), any serious complication (6.90 vs. 7.14; p=0.44) or wound complication (7.0 vs 6.96; p=0.05). A HgbA1c cut-off where the risk of complications increased could not be determined (AUC 0.51, 0.53, 0.49 for any complication, serious complication, wound complication, respectively).

CONCLUSION:
A mildly elevated HgbA1c is not associated with increased postoperative or wound complications, and surgery should not be delayed for patients with a suspected or confirmed malignancy.