bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spielen Vitamine bei der Pathogenese und Therapie der Sepsis eine Rolle?
Authors: Häussler Ulrich , Riessen Reimer , Haap Michael 
Published: October 2018

Was ist neu?
Vitamin B1 (= Thiamin) Beim septischen Schock weisen erste Studien mit relativ kleinen Fallzahlen auf positive Effekte einer frühzeitigen Vitamin-B1-/Thiamin-Substitution in Bezug auf Laktatclearance, Nierenfunktion und Letalität, insbesondere bei Patienten mit Thiaminmangel hin. Da ein Thiaminmangel bei Intensivpatienten häufig ist, sollte eine Thiamin-Substitution in ausreichender Dosierung bei allen Sepsispatienten mit Laktatazidose erwogen werden.
Vitamin C Vitamin C besitzt multiple biologische Funktionen, die sich im Rahmen einer Sepsis günstig auswirken könnten. Die Applikation von hochdosiertem Vitamin C in Kombination mit Thiamin und Hydrokortison war in einer viel diskutierten, 2017 veröffentlichten klinischen Studie mit einer drastischen Senkung der Sepsisletalität assoziiert. In mehreren prospektiven randomisierten Studien wird die Wirksamkeit dieses Therapiekonzepts derzeit unabhängig voneinander überprüft.
Vitamin D Auch der Einsatz von Vitamin D3 bei der Sepsis ist aus pathophysiologischer Sicht insbesondere bei Mangelzuständen ein vielversprechender Ansatz, allerdings ist der Wert einer therapeutischen Substitution derzeit noch nicht gesichert.
Skelettale Effekte der Growth Guide Appliance im Vergleich zur konventionellen Headgear-Therapie – eine retrospektive kephalometrische Kohortenstudie
Authors: Herzog Guido , Herzog Claudio 
Published: October 2018

ZusammenfassungDas Ziel dieser retrospektiven Kohortenstudie war, mittels kephalometrischer Auswertungen von Fernröntgenseitenbildern zu untersuchen, ob mit einer einfachen Erweiterung eines Headgears zu einer funktionskieferorthopädischen Apparatur das Unterkiefer-Wachstum (UK-WT) positiv beeinflusst werden kann.Zu diesem Zweck wurde das UK-WT von Patienten, die mit einer Growth Guide Appliance behandelt wurden (Durchschnittsalter 10,27 Jahre, 17 Mädchen und 8 Knaben) mit Patienten verglichen, die mit einem konventionellen Headgear (HG) therapiert wurden (Durchschnittsalter 10,42 Jahre, 19 Mädchen und 8 Knaben). Es wurden alle Patienten miteinbezogen, deren Behandlungsphase in einer Privatpraxis während einem definierten Zeitraum abgeschlossen worden ist. Die Daten wurden „blind“ erfasst und ausgewertet. Die Gruppenunterschiede wurden mit dem nonparametrischen Mann-Whitney-Wilcoxon-Test berechnet und zusätzlich den Werten der Zürcher Wachstumsstudie (1982–1984) gegenübergestellt.Die GGA-Gruppe zeigte ein Unterkieferlängenwachstum gemessen an der Distanz CPg von 3,35 mm pro Jahr. Dies entspricht einer signifikanten Steigerung um zusätzliche 1,19 mm (55%) gegenüber der Headgear-Gruppe. Die Zunahme des Sekundärparameters SNB-Winkel betrug 0,69 Grad pro Jahr. Dies entspricht einer signifikanten Steigerung von 0,57 Grad gegenüber der Headgear-Gruppe.Das vorgestellte Konzept zur Korrektur einer moderaten Klasse ll-Malokklusion am wachsenden Patienten mithilfe der Growth Guide Appliance ist ein hilfreiches Behandlungsverfahren zur Erhöhung des mandibulären skelettalen Korrekturanteils.
Naturheilkunde und Komplementärmedizin bei Herz-Kreislauf-Erkrankungen Teil 2: Koronare Herzkrankheit und Herzinsuffizienz
Authors: Andreas Michalsen , Stange Rainer 
Published: October 2018

SummaryDie konventionelle Therapie der KHK und Herzinsuffizienz fokussiert zumeist auf die akutmedizinische Versorgung und die medikamentöse Kontrolle von Risikofaktoren. Vernachlässigt werden dabei Lebensstilfaktoren, die oft ursächliche Bedeutung für die Erkrankung haben. Naturheilkunde und Komplementärmedizin ergänzen die konventionelle Behandlung in genau diesem Punkt sinnvoll und erfolgreich.Im Beitrag wird ein Überblick gegeben zu wissenschaftlich belegten und in der Praxis bewährten Verfahren zur komplementären Behandlung von KHK und Herzinsuffizienz.
Zum Patientenbild in der Psychiatrie
Authors: Müller T. , Borbé R. 
Published: October 2018

ZusammenfassungDie Beziehungsgestaltung zwischen Arzt und Patient wird von Bildern und Rollenzuschreibungen beeinflusst. Während es vielfältige Auslassungen zum Arztbild gibt, fehlt aber ein solches auf Patientenseite. Gerade in der Psychiatrie als „sprechendem Fach” aber auch wegen deren ordnungspolitischem Auftrag ist es für den Arzt wichtig, zu reflektieren, welches Bild er von seinem Gegenüber hat und dass dieses Bild verschiedenen Einflüssen unterworfen sein kann.Die Literatursuche zum Patientenbild ergab, anders als zum Menschenbild, nur wenige Publikationen. In diesen wird ein „philanthropes” Patientenbild dem paternalistischen gegenübergestellt. Die Entscheidungsgewalt sei dem Patienten zugewiesen, der damit aber auch die Rolle eines selbstverantwortlich-mitwirkenden erhalte. Die geringe Publikationsdichte zum Patientenbild zeigt auch, dass diese Zuschreibungen in der Versorgungsrealität bisher kaum wahrgenommen wurden.Psychiatriehistorisch ist dies gut nachvollziehbar, da erst Mitte des 20. Jahrhunderts die Interessen und der Wille des Patienten sowohl berufsständische als auch politische Resonanz erfuhren. Klassische medizinhistorische Methoden blendeten dies weitgehend aus, während neuere Ansätze, wie die Patientengeschichte, die Auswertung von Selbstzeugnissen oder Pathografien die Wirklichkeit des Patienten besser abbilden.
Assistierter Suizid oder Weiterleben
Authors: Spittler J. F. 
Published: October 2018

ZusammenfassungNach eigeninitiativer Suche nach einer Beihilfe zu einem Suizid wurden 494 Menschen eingehend psychiatrisch untersucht. Hier wird über die weiteren Verläufe berichtet. Es folgten 53,6% assistierte Suizide (“AssS”), 9,7% natürliche Todesfälle und 2,0% einsame Suizide. Bei 18,2% konnten telefonisch Katamnesen (“Lebend”) erhoben werden. Im Vergleich überwiegen bei AssS somatische Leiden (59,2:18,9%, p < 0,001), bei den Lebenden	psychische	Störungen (32,2%:11,3%, p < 0,001). Bei den Lebenden wurde das körperliche Befinden schlechter angegeben, das psychische Befinden trotz größerer Häufigkeit psychischer Störungen besser als bei AssS. Die Entscheidungskompetenz wurde in die drei Teilaspekte Einsichts-/Urteilsfähigkeit, Selbstbestimmtheit und Wohlerwogenheit differenziert. Hier finden sich im Detail Unterschiede, die sich insgesamt nicht als gewichtig interpretieren lassen. Von den Lebenden halten 50% entschieden und teilweise dringend an ihrem Lebensbeendigungswunsch fest.Die weiterhin eine Beihilfe zu einer Lebensbeendigung Suchenden haben zuallermeist keine oder nicht hilfswillige Angehörige und keinen Hausarzt, mit denen ein Gespräch möglich oder die zu einer Hilfe bereit wären.
Blutspende – Behandlungsoption bei Hypertonie?
Authors: Kamhieh-Milz Julian , Tauchmann Yvonne , Pruß Axel , Dörffel Yvonne , Michalsen Andreas 
Published: October 2018

SummaryDer Aderlass zählt zu den wichtigsten traditionellen Behandlungsverfahren der traditionellen Medizin in den unterschiedlichsten Kulturen. Das zwischenzeitlich durch missbräuchliche Anwendung in Ungnade gefallene Verfahren hat sich heute z.B. zur Behandlung von Patienten mit Hämochromatose und Polycythaemiaverawieder etabliert.In den letzten Jahren konnten positive Ergebnisse bei therapierefraktärem Hypertonus gezeigt werden. So konnte im Rahmen von Studien bei Patienten nach Nierentransplantation und bei Patienten mit metabolischem Syndrom der Blutdruck durch Aderlass erfolgreich gesenkt werden. Weitere Forschungsarbeit zu den vielversprechenden Ergebnissen ist allerdings notwendig, um die Ergebnisse zu untermauern.Perspektiven ergeben sich zudem in Anbetracht der zunehmenden Blutknappheit. Allerdings steht die Klärung ethischer Fragestellungen noch aus.
The effect of increasing toroidal magnetic field in the Globus-M spherical tokamak
Authors: Bakharev N.N. , Bulanin V.V. , Chernyshev F.V. , Gusev V.K. , Khromov N.A. , Kiselev E.O. , Kurskiev G.S. , Melnik A.D. , Minaev V.B. , Mironov M.I. , Miroshnikov I.V. , Patrov M.I. , Petrov A.V. , Petrov Yu.V. , Sakharov N.V. , Shchegolev P.B. , Sladkomedova A.D. , Solokha V.V. , Telnova A.Yu. , Tokarev V.A. , Tolstyakov S.Yu. , Yashin A.Yu. 
Published: October 2018

Abstract
In the final Globus-M experimental campaign B
tor and I
p were raised by 25% up to 0.5 T and 250 kA, respectively, expanding available range of experimental parameters. In these experiments an overall improvement in plasma performance was observed, plasma total stored energy and neutron rate increased significantly. The energy confinement time dependence on B
tor and n
e was close to linear. L-H transition threshold was 5–10 times higher than threshold predicted by the scaling. Despite the small plasma-wall distance, the level of radiation losses in the main plasma volume was relatively small and decreased as B
tor rised. An increase in B
tor and I
p led to a decrease in the sawtooth-induced losses. While a rise in the plasma current led to a decrease of fast ion losses per TAE burst at the same amplitude; frequency of bursts and their amplitude increased. Doppler backscattering, applied to study TAE localization for the first time, revealed that TAE fluctuations are localized in the region of normalized minor radii ρ  =  0.5–0.75. A new movable 9-pin head probe provided data, necessary for power decay length scaling investigation. Significant power decay length contraction, stronger than predicted by Eich’s scaling, was observed.
Dispute Settlement on the Belt and Road: Ideas on System, Spirit and Style
Authors: Yee Sienho 
Published: October 2018

Abstract
This comment offers some brief observations on ideas that may promote the settlement of disputes that may arise from the Belt and Road Initiative, such as a possible standing investment court, a unified appellate mechanism or a legal aid mechanism as system components, a “lawyer for the situation” spirit for lawyering, an emphasis on a friendly style of dispute settlement, and a style of directly providing for rules of interpretation as part of the applicable law.
History Education for Transitional Justice? Challenges, Limitations and Possibilities for Settler Colonial Australia
Authors: Keynes Mati 
Published: October 2018

ABSTRACT∞
In recent times, a conception of history education as facilitating truth, remembrance and critical thinking has been positioned as useful for transitional justice in divided societies, but this analysis has not been extended to settler states which are also characterized by prolonged division and state-administered violence. To explore this, the article draws on examples from Australia where scholars have been extending the framework of transitional justice in order to better address the structural nature of injustice in settler states. By investigating the uses of temporality and historicization in history education, it concludes that while disciplinary models might contribute to the popular theses of transitional justice by encouraging students to emulate the skills of the historian, these models would likely work to strengthen rather than challenge the legitimacy of the Australian settler state. Therefore, any attempts to align history education with reconciliation in Australia will require a rethinking of current disciplinary models.
Stable Rationality of del Pezzo Fibrations of Low Degree Over Projective Spaces
Authors: Krylov Igor , Okada Takuzo 
Published: October 2018

Abstract
The main aim of this article is to show that a very general three-dimensional del Pezzo fibration of degrees 1, 2, and 3 is not stably rational except for a del Pezzo fibration of degree 3 belonging to explicitly described two families. Higher-dimensional generalizations are also discussed and we prove that a very general del Pezzo fibration of degrees 1, 2, and 3 defined over the projective space is not stably rational provided that the anti-canonical divisor is not ample.
Recruiting for a pragmatic trial using the electronic health record and patient portal: successes and lessons learned
Authors: Pfaff Emily , Lee Adam , Bradford Robert , Pae Jinhee , Potter Clarence , Blue Paul , Knoepp Patricia , Thompson Kristie , Roumie Christianne L , Crenshaw David , Servis Remy , DeWalt Darren A 
Published: October 2018

Abstract

Objective
Querying electronic health records (EHRs) to find patients meeting study criteria is an efficient method of identifying potential study participants. We aimed to measure the effectiveness of EHR-driven recruitment in the context of ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness)—a pragmatic trial aiming to recruit 15 000 patients.

Materials and Methods
We compared the participant yield of 4 recruitment methods: in-clinic recruitment by a research coordinator, letters, direct email, and patient portal messages. Taken together, the latter 2 methods comprised our EHR-driven electronic recruitment workflow.

Results
The electronic recruitment workflow sent electronic messages to 12 254 recipients; 13.5% of these recipients visited the study website, and 4.2% enrolled in the study. Letters were sent to 427 recipients; 5.6% visited the study website, and 3.3% enrolled in the study. Coordinators recruited 339 participants in clinic; 23.6% visited the study website, and 16.8% enrolled in the study. Five-hundred-nine of the 580 UNC enrollees (87.8%) were recruited using an electronic method.

Discussion
Electronic recruitment reached a wide net of patients, recruited many participants to the study, and resulted in a workflow that can be reused for future studies. In-clinic recruitment saw the highest yield, suggesting that a combination of recruitment methods may be the best approach. Future work should account for demographic skew that may result by recruiting from a pool of patient portal users.

Conclusion
The success of electronic recruitment for ADAPTABLE makes this workflow well worth incorporating into an overall recruitment strategy, particularly for a pragmatic trial.
DDT and Breast Cancer: Prospective Study of Induction Time and Susceptibility Windows
Authors: Cohn Barbara A , Cirillo Piera M , Terry Mary Beth 
Published: October 2018

AbstractBackgroundIn a previous Child Health and Development Studies report, p, p’-DDT was associated with a fivefold increased risk of premenopausal (before age 50 years) breast cancer for women first exposed before puberty. Here we extend our observation to breast cancer diagnosed during early postmenopause (ages 50–54 years) to determine whether age at diagnosis modifies the interaction of DDT with age at exposure.MethodsWe conducted a second prospective, nested case-control study in the Child Health and Development Studies (153 incident breast cancer cases diagnosed at ages 50–54 years and 432 controls matched to cases on birth year). These were analyzed separately and pooled with our previous study (129 breast cancer cases diagnosed at ages 31–49 years and 129 controls matched on birth year). Blood samples were obtained during pregnancy (median age, 26 years), 1–3 days after delivery from 1959 to 1967 in Oakland, California. Serum was assayed for p, p’-DDT, o, p’-DDT, and p, p’-DDE. Odds ratios (ORs) below are given for doubling of serum p, p’-DDT. All statistical tests were two-sided.ResultsFor early postmenopausal breast cancer, p, p’-DDT was associated with risk for all women (ORDDT 50–54 = 1.99, 95% CI = 1.48 to 2.67). This association was accounted for by women first exposed to DDT after infancy (ORDDT 50–54 for first exposure after infancy = 2.83, 95% CI = 1.96 to 4.10 vs ORDDT 50–54 for first exposure during infancy = 0.56, 95% CI = 0.26 to 1.19; Pinteraction DDT x age at first exposure = .01). In contrast, for premenopausal breast cancer, p, p’-DDT was associated with risk among women first exposed during infancy through puberty, but not after (ORDDT<50 for first exposure during infancy = 3.70, 95% CI = 1.22 to 11.26, Pinteraction DDT x age at first exposure x age at diagnosis = .03).Conclusionsp, p’-DDT was associated with breast cancer through age 54 years. Risk depended on timing of first exposure and diagnosis age, suggesting susceptibility windows and an induction period beginning in early life. DDT appears to be an endocrine disruptor with responsive breast targets from in utero to menopause.
Yoga as a Complementary Therapy for Smoking Cessation: Results From BreathEasy, a Randomized Clinical Trial
Authors: Bock Beth C , Dunsiger Shira I , Rosen Rochelle K , Thind Herpreet , Jennings Ernestine , Fava Joseph L , Becker Bruce M , Carmody James , Marcus Bess H 
Published: October 2018

Abstract

Introduction
There is evidence that Yoga may be helpful as an aid for smoking cessation. Yoga has been shown to reduce stress and negative mood and may aid weight control, all of which have proven to be barriers to quitting smoking. This study is the first rigorous, randomized clinical trial of Yoga as a complementary therapy for smokers attempting to quit.

Methods
Adult smokers (N = 227; 55.5% women) were randomized to an 8-week program of cognitive-behavioral smoking cessation and either twice-weekly Iyengar Yoga or general Wellness classes (control). Assessments included cotinine-verified 7-day point prevalence abstinence at week 8, 3-month, and 6-month follow-ups.

Results
At baseline, participants’ mean age was 46.2 (SD = 12.0) years and smoking rate was 17.3 (SD = 7.6) cigarettes/day. Longitudinally adjusted models of abstinence outcomes demonstrated significant group effects favoring Yoga. Yoga participants had 37% greater odds of achieving abstinence than Wellness participants at the end of treatment (EOT). Lower baseline smoking rates (≤10 cigarettes/day) were also associated with higher likelihood of quitting if given Yoga versus Wellness (OR = 2.43, 95% CI = 1.09% to 6.30%) classes at EOT. A significant dose effect was observed for Yoga (OR = 1.12, 95% CI = 1.09% to 1.26%), but not Wellness, such that each Yoga class attended increased quitting odds at EOT by 12%. Latent Class Modeling revealed a 4-class model of distinct quitting patterns among participants.

Conclusions
Yoga appears to increase the odds of successful smoking abstinence, particularly among light smokers. Additional work is needed to identify predictors of quitting patterns and inform adjustments to therapy needed to achieve cessation and prevent relapse.

Implications
This study adds to our knowledge of the types of physical activity that aid smoking cessation. Yoga increases the odds of successful smoking abstinence, and does so in a dose-response manner. This study also revealed four distinct patterns of smoking behavior among participants relevant to quitting smoking. Additional work is needed to determine whether variables that are predictive of these quitting patterns can be identified, which might suggest modifications to therapy for those who are unable to quit.
‘If You’re Gonna Make a Decision, You Should Understand the Rationale’: Are Police Leadership Programs Preparing Canadian Police Leaders for Evidence-Based Policing?
Authors: Huey Laura , Kalyal Hina , Peladeau Hillary , Lindsay Felisha 
Published: October 2018

Abstract
Recently, we have seen a steady growth in the number of police practitioners and agencies adopting evidence-based policing (EBP). At its core, EBP rests on a central tenet: police decision-making should be ‘based on scientific evidence about what works best’ (Sherman, L. W. (1998). Evidence Based Policing. Washington, DC: Police Foundation). While this proposition seems straightforward, it places a responsibility on police leaders for which they may be unprepared. Understanding how best to commission, resource, appreciate the strengths and limitations of and/or make actionable the products of research, requires senior officers to have some level of familiarity with the research process. One potential source of that knowledge is police leader training and education. However, no one has yet explored the question of whether police leadership programs are adequately preparing senior officers for the world of EBP. To examine this issue, the authors present the results of an analysis of 29 in-depth qualitative interviews with senior Canadian police officers.
Psychometric Properties of the Early Feeding Skills Assessment Tool
Authors: Thoyre Suzanne M. , Pados Britt Frisk , Shaker Catherine S. , Fuller Kristy , Park Jinhee 
Published: October 2018

Background:
Supporting infants as they develop feeding skills is an essential component of neonatal and pediatric care. Selecting appropriate and supportive interventions begins with a thorough assessment of the infant's skills. The Early Feeding Skills (EFS) tool is a clinician-reported instrument developed to assess the emergence of early feeding skills and identify domains in need of intervention.

Purpose:
The purpose of this study was to identify the factor structure of the EFS and test its psychometric properties, including internal consistency reliability and construct validity.

Methods:
EFS-trained interprofessional clinicians in 3 settings scored 142 feeding observations of infants 33 to 50 weeks' postmenstrual age. Redundant and rarely endorsed items were removed. Factor analysis methods clustered items into subscales. Construct validity was examined through the association of the EFS with (1) concurrently scored Infant-Driven Feeding Scale-Quality (IDFS-Q), (2) infant birth risk (gestational age), and (3) maturity (postmenstrual age).

Results:
Principal components analysis with varimax rotation supported a 5-factor structure. The total EFS demonstrated good internal consistency reliability (Cronbach α= 0.81). The total EFS score had construct validity with the IDFS-Q (r =−0.73; P < .01), and with gestational age of a subsample of premature infants (r = 0.22; P < .05).

Implications for Practice:
As a valid and reliable tool, the EFS can assist the interprofessional feeding team to organize feeding assessment and plan care.

Implications for Research:
The strong psychometric properties of the EFS support its use in future research.
Golden Hour Protocol for Preterm Infants
Authors: Harriman Tiffany L. , Carter Brigit , Dail Robin B. , Stowell Katherine E. , Zukowsky Ksenia 
Published: October 2018

Background:
Preterm infants are a vulnerable patient population, especially during the first hours of life. Hypothermia, hypoglycemia, and early-onset sepsis are common problems related to prematurity. Implementation of a Golden Hour protocol has been shown to improve outcomes for preterm infants.

Purpose:
To evaluate the effectiveness of a Golden Hour protocol for infants born at less than 32 weeks' gestation on improving the admission process in a military care facility. Specific aims focused on temperature, time to initiation of intravenous (IV) fluids, time to administration of antibiotics, and time to close of the incubator top.

Methods:
A pre-/postdesign was used to compare outcomes from preimplementation to postimplementation. Predata were collected using electronic health record chart review and postdata were collected from the Neonatal Intensive Care Unit admission worksheet.

Results:
Although we did not find statistical significance, we found that more infants had a temperature greater than 36.5°C within 1 hour of birth and decrease in time to initiation of IV fluids and antibiotics from preimplementation to postimplementation, which is clinically significant. Time to close of the incubator top remained greater than 1 hour.

Implications for Practice:
Implementation of a Golden Hour protocol provides a guide to caring for preterm infants during the first hour of life to improve patient outcomes. Involvement of key stakeholders and staff education are key to successful implementation.

Implications for Research:
Researchers should examine long-term outcomes related to implementation of a Golden Hour protocol in future studies. Future quality improvement projects should include the effectiveness of similar protocols and address possible barriers.