bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sichelzellkrankheit unter Neugeborenen in Deutschland: Eine Studie an Routinedaten der AOK
Authors: Pattloch Dagmar 
Published: October 2018

Zusammenfassung
Hintergrund Die Sichelzellkrankheit (SCD, ICD-10:D57) ist eine autosomal rezessiv vererbte Hämoglobinkrankheit mit globaler Public-Health-Relevanz. In Deutschland kommen pro Jahr 70–150 Kinder mit SCD zur Welt (1–2 je 10 000 Neugeborene). Die Früherkennung im asymptomatischen ersten Vierteljahr wäre leitliniengerecht und sekundärpräventiv bedeutsam.
Ziel der Studie Das Ziel dieser Arbeit ist 1) die Ermittlung der Prävalenz von SCD in Routinedaten von AOK-versicherten Neugeborenen, 2) die Messung des Alters bei der Erstdiagnose D57, 3) die Zählung charakteristischer Krankenhausdiagnosen.
Methode Analysiert wurden ambulante und stationäre Routinedaten von 204 AOK-versicherten Kindern. Dies sind alle, die 2009–2010 geboren sind, mindestens einen Tag im Geburtsjahr AOK-versichert waren und innerhalb von 6 Kalenderjahren jemals einen Code D57 erhielten. Die Anzahl Neugeborener in der AOK 2009–2010 (Nennerpopulation) ist bekannt. SCD-Fälle (Zähler) gelten als validiert, wenn D57 (außer D57.3) in mindestens 2 Quartalen (Q) codiert wurde. Es wird die Prävalenzproportion mit Bootstrap-Konfidenzintervall (CI) berechnet. Pro Fall wird quartalsgenau ausgelesen, wann D57 erstmals auftaucht. Der Standardized Incidence Ratio (SIR) wird berechnet für Krankenhausfälle vom Monat 13 bis Monat 61 im Vergleich zur Bevölkerung gleichen Geschlechts und Alters (1 bis unter 5 Jahre). Die Auswertung erfolgt mit SPSS 22 und Excel.
Ergebnis Nach interner Validierung resultierten 78 Fälle von SCD. Die Prävalenz beträgt 1,96 (95% CI 1,53–2,41) pro 10 000 Neugeborene. Regionale Schwerpunkte zeigten sich in Berlin, Bremen, Hamburg (zusammengefasst) sowie in Nordrhein-Westfalen. Die Erstnennung von D57 erfolgte nur bei 15,4% der Fälle früh, d. h. in Q1–2. Der Median liegt in Q7. In 78 Fällen ereigneten sich 266 Krankenhausfälle mit einem SIR=6,8, d. h. die Hospitalisierungsrate ist 6,8fach höher als die der Bevölkerung. Unter den Entlassungsdiagnosen fanden sich gefürchtete Outcomes wie Pneumonie, Sepsis und Milzerkrankungen.
Schlussfolgerung SCD in Deutschland lässt sich mit Routinedaten der größten gesetzlichen Krankenkasse plausibel darstellen. Derzeit wird die Krankheit zu selten frühzeitig erkannt. Die Zeit bis zur Erkennung ließe sich entscheidend verkürzen durch Aufnahme von SCD in das Neugeborenenscreening. Bis eine solche Lösung erreicht ist, sollten Eltern mit Migrationshintergrund und Fachleute ihre Aufmerksamkeit für SCD erhöhen.
Übersicht über die Organisation des vertragsärztlichen Bereitschaftsdienstes in Deutschland: Auf welche Basis bauen Krankenhausstrukturgesetz und Versorgungsstärkungsgesetz auf?
Authors: Schmidt Felicitas Maria , Wildner Manfred 
Published: October 2018

ZusammenfassungAls Reaktion auf die erhöhte Inanspruchnahme der Notaufnahmen, den steigenden Kostendruck der Krankenhäuser und die zunehmende Schwierigkeit, Bereitschaftsdienste im strukturschwachen Raum zu besetzen, wurde auf Bundesebene die Einführung von sog. Portalpraxen beschlossen. Viele KVen haben bereits vor dieser Gesetzesänderung mit der Reformierung des ärztlichen Bereitschaftsdienstes begonnen und befinden sich nun in unterschiedlichen Stadien des Reformprozesses. An vielen Krankenhäusern finden sich heute schon sog. Bereitschaftsdienstpraxen (BDP). Um den aktuellen Reformstand als Basis für Krankenhausstrukturgesetz und Versorgungsstärkungsgesetz beurteilen zu können, möchte die vorliegende Arbeit eine aktuelle Übersicht über die Organisationsformen des vertragsärztlichen Bereitschaftsdienstes (ÄBD) in den einzelnen Bezirken der Kassenärztlichen Vereinigung (KV) geben.
Methodik Es wurden alle 17 KV Bezirke telefonisch und/oder schriftlich kontaktiert, um ein teilstrukturiertes Interview zu den Bereichen der allgemeinen Organisation, des Personalschlüssels (v. a. Ärzte) und des Versorgungsauftrags zu führen. Die KV Brandenburg, KV Hamburg und KV Nordrhein (Tochtergesellschaft Gesundheitsmanagementgesellschaft mbH) haben den dafür entwickelten Fragebogen schriftlich ausgefüllt.
Ergebnisse In den KVen Hessen, Schleswig-Holstein, Thüringen und Westfalen-Lippe war zum Zeitpunkt der Erhebung 2016 der ÄBD ausschließlich in Bereitschaftsdienstpraxen organisiert. Baden-Württemberg, Niedersachsen, Nordrhein, Rheinland-Pfalz und das Saarland haben größtenteils flächendeckend auf Bereitschaftsdienstpraxen umgestellt. Jedoch gibt es große Organisationsunterschiede zwischen Ballungsräumen und strukturschwachen Regionen. Diese reflektieren die unterschiedlichen Herausforderungen an die Sicherstellung. Brandenburg, Mecklenburg-Vorpommern und Bayern haben in größeren Städten Praxen aus Wirtschaftlichkeitsgründen eingerichtet.
Schlussfolgerung Bereitschaftsdienstpraxen bieten eine Möglichkeit, mit den Herausforderungen des Ärztemangels und der Patientensteuerung an die Sicherstellung umzugehen. Sie sind in ihren unterschiedlichen Organisationsformen flexibel an regionale Unterschiede anpassbar und spielen bereits eine große Rolle für die Sicherstellung.
Eckpunkte zur stationsäquivalenten Behandlung (stäB)
Authors:   Arbeitsgruppe ärztlicher und psychologischer Verbände sowie Verbände im Bereich der Pflege und Gemeindepsychiatrie
Published: October 2018

ZusammenfassungAufsuchende Angebote im Lebensumfeld durch ambulante Leistungserbringer reduzieren stationäre Behandlungen und erhöhen die Lebensqualität von psychisch erkrankten Menschen und ihren Angehörigen. Das neue Angebot der stationsäquivalenten Behandlung (stäB) erlaubt es nun auch allen Krankenhäusern mit Pflichtversorgung, Behandlung im Lebensumfeld anzubieten. Für den effektiven Einsatz der neuen Möglichkeiten haben die unterzeichnenden Fachgesellschaften und Verbände Prinzipien einer strukturierten sektorenübergreifenden Zusammenarbeit konsentiert. Dabei steht der betroffene Mensch mit seinem individuellen Behandlungsbedarf und seinem familiären und sozialen Umfeld im Mittelpunkt.
Characterization of Casearin X Metabolism by Rat and Human Liver Microsomes
Authors: Moreira da Silva Rodrigo , de Gaitani Cristiane , Marques Lucas , Fraige Baraco Karina , Cavalheiro Alberto , de Moraes Luiz , Lopes Norberto , de Oliveira Anderson 
Published: October 2018

AbstractCasearin X (CAS X) is the major clerodane diterpene isolated from the leaves of Casearia sylvestris and has been extensively studied due to its powerful cytotoxic activity at low concentrations. Promising results for in vivo antitumor action have also been described when CAS X was administered intraperitoneally in mice. Conversely, loss of activity was observed when orally administered. Since the advancement of natural products as drug candidates requires satisfactory bioavailability for their pharmacological effect, this work aimed to characterize the CAS X metabolism by employing an in vitro microsomal model for the prediction of preclinical pharmacokinetic data. Rat and human liver microsomes were used to assess species differences. A high-performance liquid chromatography with diode-array detection (HPLC-DAD) method for the quantification of CAS X in microsomes was developed and validated according to European Medicines Agency guidelines. CAS X was demonstrated to be a substrate for carboxylesterases via hydrolysis reaction, with a Michaelis-Menten kinetic profile. The enzyme kinetic parameters were determined, and the intrinsic clearance was 1.7-fold higher in humans than in rats. The hepatic clearance was estimated by in vitro-in vivo extrapolation, resulting in more than 90% of the hepatic blood flow for both species. A qualitative study was also carried out for the metabolite identification by mass spectrometry and indicated the formation of the inactive metabolite CAS X dialdehyde. These findings demonstrate that CAS X is susceptible to first-pass metabolism and is a substrate for specific carboxylesterases expressed in liver, which may contribute to a reduction in antitumor activity when administered by the oral route.
Obstetric Outcomes Associated with Fetal Cyanotic Congenital Heart Disease
Authors: Rossi Robert M. , Divanovic Allison , DeFranco Emily A. 
Published: October 2018

Objective To characterize obstetric outcomes associated with cyanotic congenital heart disease (CCHD) in a contemporary population.
Study Design We conducted a population-based retrospective cohort study of all livebirths in Ohio (2006–2015). Obstetric characteristics of pregnancies complicated by fetal CCHD were compared with those without CCHD, excluding those with other anomalies and aneuploidy. The primary objective was to determine the risk of cesarean delivery among CCHD affected pregnancies. Multivariate logistic regression estimated the influence of CCHD on these obstetric outcomes.
Results Among 1,463,506 live births in Ohio, there were 863 (0.06%) CCHD affected births. The overall cesarean rate was 45.9 versus 31.0% (p< 0.001) in CCHD compared with non-CCHD pregnancies. After adjusting for various confounders, CCHD affected pregnancies were associated with a higher risk for cesarean delivery (adjusted relative risk [aRR]: 2.0, 95% confidence interval [CI]: 1.6–2.4), preterm birth (PTB) (aRR: 1.5, 95% CI: 1.1–2.0), induction of labor (aRR: 1.2, 95% CI: 1.04–1.4), small for gestational age (SGA) birthweight (aRR: 2.4, 95% CI: 2.0–2.9), and fetal intolerance of labor (FIOL; aRR: 2.0, 95% CI: 1.6–2.4). Women with CCHD affected pregnancies were also less likely to undergo a trial of labor (aRR: 0.4, 95% CI: 0.3–0.5) prior to cesarean delivery.
Conclusion Obstetric outcomes associated with CCHD include higher risk for cesarean delivery, PTB, SGA, and FIOL.
The Association between Intended Mode of Delivery and Maternal Morbidity in Twin Pregnancies
Authors: Zafman Kelly B. , Naqvi Mariam , Melka Stephanie , Miller James , Rebarber Andrei , Fox Nathan S. 
Published: October 2018

Objective To compare maternal morbidity between women undergoing delivery of twins who intend to labor with those women who do not intend to labor.
Study Design This was a retrospective cohort study of women undergoing delivery of twins in a single maternal–fetal medicine practice between January 2005 and February 2018. We identified women with a twin delivery at gestational age ≥24 weeks and determined if they intended or did not intend to labor. Maternal outcomes were compared between the groups.
Results A total of 788 patients were included, of whom 404 (51.3%) intended to labor and 384 (48.7%) did not intend to labor. Women who intended to labor had a high rate of vaginal delivery (VD; 79.7%). Overall, 45 (5.7%) women required blood transfusion; this was not significantly different between the groups (6.2 vs. 5.2%, p = 0.54). Women who intended to labor had a shorter hospital stay and lower blood loss. There were no significant differences for all other maternal outcomes.
Conclusion In patients undergoing twin delivery, women who intend to labor have similar maternal morbidity compared with women who do not intend to labor. This supports current guidelines recommending providers offer a trial of VD for twin pregnancies.
Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction
Authors: Rhoades Janine S. , Stout Molly J. , Macones George A. , Cahill Alison G. 
Published: October 2018

Objective To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term.
Study Design Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios. Our secondary outcome was composite neonatal morbidity. Logistic regression was used to control for confounders.
Results Of 3,787 patients who underwent IOL, 147 had a diagnosis of oligohydramnios and 3,640 were included in the no oligohydramnios group. There was no significant difference in EFM characteristics between the two groups. There was no difference in composite neonatal morbidity. In patients with oligohydramnios, EFM patterns with baseline tachycardia for 30 minutes or greater were significantly associated with composite neonatal morbidity (31.3 vs. 5.3% adjusted odds ratio 8.63, 95% confidence interval 2.18, 34.1]).
Conclusion Term patients undergoing IOL with oligohydramnios had EFM patterns that did not differ from their induced peers.
Results of Ten-Year Follow-Up of Alcohol Septal Ablation in Patients with Obstructive Hypertrophic Cardiomyopathy
Authors: Rzhannikova Anastasiya , Chernyshev Sergey , Kardapoltsev Lev , Idov Eduard , Berdnikov Sergey , Kashtanov Maksim 
Published: October 2018

This study looks at 10-year follow-up outcomes of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy.Between 2000 and 2008, 40 patients with obstructive hypertrophic cardiomyopathy (27 males, 13 females) underwent alcohol septal ablation. The median follow-up period was 123 (2–179) months. The mean age ran to 43.8 + 13.9 years. The initial dose of ethanol (3 mL) was chosen for ablation in all cases.The hospital mortality was 0%. Permanent pacemakers were implanted in 3 of 40 (7.5%) cases in the hospital period. The median clinical follow-up was 123 (2–179) months. Survival rates at 1, 5, 10, and 15 years after the procedure were as follows: 97.5% (95% confidence interval [CI], 95.1–99.9%), 92.5% (95% CI, 94.8–90.2%), 85.0% (95% CI, 82.9–87.1%), and 81.3% (95% CI, 79.3–83.3%), respectively. Seven patients died during follow-up. Sudden death was observed in two cases. Permanent pacemakers were implanted in 2 of 40 (5%) cases in the follow-up. The log-rank test revealed no statistically significant difference between the 15-year survival rate in our cohort and age- and sex-matched general Russian population (p = 0.11113).Alcohol septal ablation provides long-term survival rates that look comparable with age- and sex-matched general population in the 15-year follow-up period.
Conceptualizing work-related mental distress in the British coalfields (c.1900–1950)
Authors: Long Vicky , Brown Victoria 
Published: October 2018

AbstractThe history of occupational health is now an established and growing field of study, yet to date comparatively little research has been undertaken on the history of work-related mental health issues, which currently account for 40% of all work-related illnesses in the UK. Work-related stress is usually seen as a post-war and post-industrial phenomenon, largely confined to white collar and service sectors, which developed as a consequence of changing working cultures. However, through a close reading of diverse source sets generated by, or pertaining to, the coal industry, this article unearths another history of work-related mental health issues; a history focussing on a heavy industry in the early years of the twentieth century. Through this analysis, we argue that the heavy industries more typically associated with physical illnesses and disabilities also generated mental distress amongst their workers, which reflected the distinctive pressures of these working environments. The article explores how understandings of the mental distress experienced by miners were shaped by medical, political, economic, occupational and industrial factors, and generated debates between different organizations as to the cause of these disorders and appropriate responses. Further analysis of work-related mental disorders in different occupational sectors may allow researchers to tease out the nuanced role played by workplace environments and working practices on mental health, and to examine the relationship between physical and mental health at work.
Functional structures of US state governments
Authors: Kosack Stephen , Coscia Michele , Smith Evann , Albrecht Kim , Barabási Albert-László , Hausmann Ricardo 
Published: October 2018

SignificanceUnderstanding of modern government is limited by a lack of comprehensive, reliable, comparable data on what governments do and how they are organized to execute their diverse responsibilities. We demonstrate that such data can be collected from the extensive footprint that governments leave on the Internet, opening a range of unresolved puzzles and questions about modern government to closer empirical inquiry. The online footprint of the 50 US state governments reflects their close embeddedness with state economies and suggests that other factors widely hypothesized to influence government play more limited roles, including location and income. It also casts doubt on the degree to which state government functional structures systematically reflect voters’ recent ideological preferences.
Current CaCO3dissolution at the seafloor caused by anthropogenic CO2
Authors: Sulpis Olivier , Boudreau Bernard P. , Mucci Alfonso , Jenkins Chris , Trossman David S. , Arbic Brian K. , Key Robert M. 
Published: October 2018

SignificanceThe geological record contains numerous examples of “greenhouse periods” and ocean acidification episodes, where the spreading of corrosive (CO2-enriched) bottom waters enhances the dissolution of CaCO3minerals delivered to the seafloor or contained within deep-sea sediments. The dissolution of sedimentary CaCO3neutralizes excess CO2, thus preventing runaway acidification, and acts as a negative-feedback mechanism in regulating atmospheric CO2levels over timescales of centuries to millennia. We report an observation-based indication and quantification of significant CaCO3dissolution at the seafloor caused by man-made CO2. This dissolution is already occurring at various locations in the deep ocean, particularly in the northern Atlantic and near the Southern Ocean, where the bottom waters are young and rich in anthropogenic CO2.
Diverse segments of the US public underestimate the environmental concerns of minority and low-income Americans
Authors: Pearson Adam R. , Schuldt Jonathon P. , Romero-Canyas Rainer , Ballew Matthew T. , Larson-Konar Dylan 
Published: October 2018

Significance
Perceived norms (e.g., beliefs about the consensus views of others) have been shown to predict a broad range of proenvironmental behaviors. We document widespread underestimation of the environmental concerns of a broad range of sociodemographic groups among the US public. This underestimation was largest for judgments of minorities’ and low-income Americans’ concerns—groups that indicate high levels of environmental concern in public opinion surveys—and tracked with stereotypes of environmentalists as white and highly educated, similarly widely shared across demographic groups. These findings point to false beliefs about the environmental concerns of vulnerable populations as a potential impediment to addressing environmental inequities and broadening public participation in environmental decision making.
Temporal variability largely explains top-down/bottom-up difference in methane emission estimates from a natural gas production region
Authors: Vaughn Timothy L. , Bell Clay S. , Pickering Cody K. , Schwietzke Stefan , Heath Garvin A. , Pétron Gabrielle , Zimmerle Daniel J. , Schnell Russell C. , Nummedal Dag 
Published: October 2018

Significance
Our results demonstrate that access to high-resolution spatiotemporal activity data and multiscale, contemporaneous measurements is critical to understanding oil- and gas-related methane emissions. Careful consideration of all factors influencing methane emissions—including temporal variation—is necessary in scientific and policy discussions to develop effective strategies for mitigating greenhouse gas emissions from natural gas infrastructure.
IL-15 enhanced antibody-dependent cellular cytotoxicity mediated by NK cells and macrophages
Authors: Zhang Meili , Wen Bernard , Anton Olga M. , Yao Zhengsheng , Dubois Sigrid , Ju Wei , Sato Noriko , DiLillo David J. , Bamford Richard N. , Ravetch Jeffrey V. , Waldmann Thomas A. 
Published: October 2018

SignificancePreviously we demonstrated that IL-15 by continuous infusion at 2 μg/kg/d for 10 days induced a 38-fold increase in circulating natural killer (NK) cells and a 358-fold increase in CD56brightNK cells. In the present study we demonstrated that IL-15 enhanced antibody-dependent cellular cytotoxicity (ADCC) of tumor-directed monoclonal antibodies in two systems. Both NK cells and macrophages were required for optimal therapeutic responses. These studies support clinical trials of IL-15 combined with tumor-directed monoclonal antibodies. In translation of this study, a phase I trial of IL-15 combined with alemtuzumab has been opened for patients with adult T cell leukemia (ATL) NCT02689453.
Estimating species distribution and abundance in river networks using environmental DNA
Authors: Carraro Luca , Hartikainen Hanna , Jokela Jukka , Bertuzzo Enrico , Rinaldo Andrea 
Published: October 2018

Significance
Organisms leave traces of DNA in their environment [environmental DNA (eDNA)], such as cells in mucus or feces. When extracted from water or soil, eDNA can be used to track the presence of a target species or the composition of entire communities. In rivers, eDNA dynamics are modulated by transport and decay. Here, we use hydrologically based models to reconstruct the upstream distribution and abundance of target species throughout a river network from eDNA measurements. We validate our method by estimating the catchment-wide biomass distribution of a sessile invertebrate and its parasite, causing disease in salmonids. This work unlocks the power of eDNA for monitoring biodiversity across broad geographies in a way hitherto unfeasible with traditional survey approaches.
Preferred end coordinates and somatic variants as signatures of circulating tumor DNA associated with hepatocellular carcinoma
Authors: Jiang Peiyong , Sun Kun , Tong Yu K. , Cheng Suk Hang , Cheng Timothy H. T. , Heung Macy M. S. , Wong John , Wong Vincent W. S. , Chan Henry L. Y. , Chan K. C. Allen , Lo Y. M. Dennis , Chiu Rossa W. K. 
Published: October 2018

Significance
Cell-free DNA fragmentation is a nonrandom process. We showed that cell-free DNA fragments with ends at certain genomic coordinates had higher likelihoods of being derived from hepatocellular carcinoma. Other coordinates were associated with cell-free DNA molecules originating from the liver. Quantitative assessment of cell-free DNA molecules bearing these respective groups of end signatures correlated with the amounts of tumor-derived or liver-derived DNA in plasma. There were millions of tumor-associated plasma DNA end coordinates across the genome. Due to their high prevalence, they were more readily detectable than somatic mutations as a cancer signature in plasma. Hence, detection of tumor-associated plasma DNA ends may offer a cost-effective means of capturing evidence for the presence of cancer through liquid biopsy assessment.
Trump's tariff impact on Africa and the ambiguous role of African agency
Authors: Kohnert Dirk 
Published: October 2018

SUMMARY
The current debate on Trump’s tariffs focuses on the big global players and competitors of the USA. Africa plays virtually no role in international scholarly perceptions of the impact of US protective tariffs on imported steel, aluminium and cars. Nevertheless, there are such effects and these are more than peanuts, as will be shown in this Briefing.