bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kosten-Erlös-Verhältnis orthopädisch-unfallchirurgischer Patienten in Abhängigkeit vom Body-Mass-Index
Authors: Schmelz Helmut , Geraedts Max 
Published: June 2018

Zusammenfassung
Hintergrund Immer mehr Patienten in der Orthopädie und Unfallchirurgie sind adipös. Damit gehen unter anderem erhöhte Operationsrisiken, aber auch höhere Kosten zum Beispiel für verlängerte Krankenhausaufenthalte oder spezielle Operationstische einher. Fraglich ist, inwiefern die im deutschen DRG-System erzielten Erlöse die individuellen Kosten in Abhängigkeit vom Body Mass Index (BMI) der Patienten decken und in welchen Bereichen der stationären Versorgung eventuell höhere Kosten anfallen.
Material und Methoden Aus dem Krankenhausinformationssystem eines maximalversorgenden Krankenhauses wurden die Daten zum BMI und den individuellen Kosten und Erlösen zu 13 833 zwischen 2007 – 2010 an den unteren oder oberen Extremitäten operierten Patienten extrahiert. Unterschiede zwischen den Kosten-Erlös-Verhältnissen in Abhängigkeit vom BMI der Patienten und den jeweiligen Operationslokalisationen sowie bei der Verteilung der Kosten auf die verschiedenen Kostenartengruppen in Abhängigkeit vom BMI der Patienten wurden mithilfe von T- und U-Tests statistisch abgesichert.
Ergebnisse Die in orthopädisch-unfallchirurgischen Kliniken anfallenden individuellen Kosten der Versorgung von Patienten mit einem Adipositasgrad III (BMI ≥ 40) sowie von Patienten mit Untergewicht (BMI < 18,5) übersteigen oftmals signifikant (p < 0,05) die individuellen Erlöse aus dem DRG-System. Signifikant höhere Kosten ließen sich bei allen Eingriffen an den unteren bzw. oberen Extremitäten außer bei Eingriffen am Sprunggelenk nachweisen, bei denen arthroskopische Eingriffe überwiegen. Der Großteil dieser Mehrkosten resultiert aus einem erhöhten Ressourcenverbrauch im Bereich des pflegerischen Personals, bei Arzneimitteln und bei Sachkosten für übrigen medizinischen Bedarf. Beim ärztlichen- und Funktionsdienst waren keine Kostensteigerungen in Abhängigkeit vom BMI erkennbar.
Schlussfolgerung Um eine gewichtsabhängige Diskriminierung von Patienten zu vermeiden, sollten die Erlöse für die nicht gedeckten Kosten bei stark über- und untergewichtigen Patienten, die an der unteren oder oberen Extremität operiert werden, über eine Vergütungsanpassung nachgebessert werden. Zudem sollten sich Kliniken auf diese Patienten organisatorisch vorbereiten.
Effect of Physical Exercise on Platelet Reactivity in Patients with Dual Antiplatelet Therapy
Authors: Brunner Stefan , Rizas Konstantinos , Hamm Wolfgang , Mehr Michael , Lackermair Korbinian 
Published: June 2018

AbstractIt is known that physical exercise may increase platelet activity. However, the effect of exercise on platelet reactivity in patients on dual antiplatelet therapy has not been investigated yet. In our study, 21 patients with coronary artery disease on dual antiplatelet therapy and 10 controls were enrolled. We performed an exercise test using a cycle ergometer and determined the adenosine diphosphate-induced platelet reactivity before and immediately after exercise testing. Additionally, we analysed maximal exercise capacity and an electrocardiogram. Further, we assessed chromogranin A and P-selectin levels and platelet counts.
Degree of Myelination (g-ratio) of the Human Hypoglossal Nerve
Authors: Campos D. , Páfaro J.N. , Goulart G.R. , Silveira C.H. , Cella P.A.M. , Malysz T. , Jotz G.P. 
Published: June 2018

Introduction The degree of myelination (g-ratio) can be useful to the evaluation of the fiber morphology during peripheral nerve regeneration and in studies in the area of microsurgery. Therefore, the aim of this analyze was to investigate the g-ratio of the human hypoglossal nerve.
Materials and Methods The hypoglossal nerve was bilaterally analyzed in human specimens obtained from necropsies (6 subjects). The nerves were analyzed using histology, and the morphometric parameters (axon diameter and myelinated fiber diameter) were measured using Image Pro-Plus Software 6.0.
Results Quantitative comparison of the g-ratio demonstrated no statistically significant difference between the left and right human hypoglossal nerves. In addition, the values of the g-ratio of both hypoglossal nerves were considerably higher than the normal values for the peripheral nerve fibers. This demonstrates a low degree of myelination of the hypoglossal nerve, bilaterally.
Conclusion Knowledge of the variations of the human hypoglossal nerve, are clinically important especially in the area of microsurgery (techniques used for reinnervation).
Description of Morphological Abnormalities in Rhinella arenarum (ANURA: BUFONIDAE)
Authors: Chilote P.D. , Bozzolo L.E. , Gutierrez F.R. , Moreno L.E. 
Published: June 2018

AbstractThe rise of anatomical abnormalities in anurans over recent years has increased the interest in producing more and better information about the abnormalities observed in specimens within natural environments that are currently being altered. The aim of this work was to identify and describe la osseous abnormalities found in Rhinella arenarum. Four samplings were conducted between March 2009 and February 2010 in the Claro river, located in San Francisco in the Ayacucho Department in the province of San Luis. Specimens of R. arenarum with visible abnormalities were observed and collected manually. They were euthanized in the laboratory, preserved in 10% formaldehyde, and stored in the Herpetological Collection Unit of the National University of San Luis (CH-UNSL). The Alizarin-Alzian technique was also applied to the specimens. Photographs of the abnormalities were taken, and observations were made with a stereoscopic microscope. The following abnormalities were identified and described: femur ectromelia, tibial and fibular ectromelia, ectrodactylia and brachydactyly. Further work could focus on determining the causes of the abnormalities observed in this species, conducting an integrated study, and attempting to link this with the worldwide phenomenon of amphibious declination.
Resistance of the Collateral Ligaments of the Femorotibial Joint in Domestic Dogs (Canis lupus familiaris LINNAEUS, 1758)
Authors: Faria M. , Regis L. , Gradela A. , Constantino A. , Olivier N. , Pereira Neto J. 
Published: June 2018

Introduction This work aimed to demonstrate the resistance of the femoral-tibial joint collaterals of 60 dogs of undefned breed, euthanized at the Zoonoses Control Centre of the city of Petrolina (PE), North-Eastern Brazil.
Materials and Methods The femur-tibial articulation was dissected to expose the collateral ligaments. Bones were cut on the distal third of the femur and the proximal third of tibia and fibula. The knee joint was kept bound only by the collateral ligaments and then submitted to destructive mechanical tests, evaluating the deformation of the ligaments (mm) per unit of time, (seconds), and the joint resistance.
Results We could observe no side effects of contralateral joints. In a destructive mechanical assay, we detected that the medial collateral ligaments ruptured earlier than the lateral ones. The resistance of the lateral and medial ligament of the right limb of females was respectively 537.1N ± 413.6 and 360.1N ± 228.6; while in males, were of 632.4N ± 333.4 e 440.4N ± 227.1. About the left antimere, the females presented 442.4N ± 288 resistance on the lateral ligament and 417.4N ± 190.6. In males, the resistance was 605.8N ± 316.1 e 548.6N ± 2,333.7, respectively.
Conclusion The results of our research will allow the development of synthetic tissues to replace the natural ligament of dogs in cases of rupture or degeneration.
Re-irradiation for recurrent high-grade gliomas: a systematic review and analysis of treatment technique with respect to survival and risk of radionecrosis
Authors: Shanker Mihir , Chua Benjamin , Bettington Catherine , Foote Matthew C , Pinkham Mark B 
Published: June 2018

Abstract

Background
Re-irradiation may be considered for select patients with recurrent high-grade glioma. Treatment techniques include conformal radiotherapy employing conventional fractionation, hypofractionated stereotactic radiotherapy (FSRT), and single-fraction stereotactic radiosurgery (SRS).

Methods
A pooled, population-weighted, multiple linear regression analysis of publications from 1992 to 2016 was performed to evaluate the relationships between re-irradiation technique and median overall survival (OS) and radionecrosis outcomes.

Results
Seventy published articles were analyzed, yielding a total of 3302 patients. Across all studies, initial treatment was external beam radiotherapy to a median dose of 60 Gy in 30 fractions, with or without concurrent chemotherapy. On multivariate analysis, there was a significant correlation between OS and radiotherapy technique after adjusting for age, re-irradiation biologically equivalent dose (EQD2), interval between initial and repeat radiotherapy, and treatment volume (P < .0001). Adjusted mean OS was 12.2 months (95% CI, 11.8–12.5) after SRS, 10.1 months (95% CI, 9.7–10.5) after FSRT, and 8.9 months (95% CI, 8.4–9.4) after conventional fractionation. There was also a significant association between radionecrosis and treatment technique after adjusting for age, re-irradiation EQD2, interval, and volume (P < .0001). Radionecrosis rate was 7.1% (95% CI, 6.6–7.7) after FSRT, 6.1% (95% CI, 5.6–6.6) after SRS, and 1.1% (95% CI, 0.5–1.7) after conventional fractionation.

Conclusions
The published literature suggests that OS is highest after re-irradiation using SRS, followed by FSRT and conventionally fractionated radiotherapy. Whether this represents superiority of the treatment technique or an uncontrolled selection bias is uncertain. The risk of radionecrosis was low for all modalities overall. Re-irradiation is a feasible option in appropriately selected patients.
Goal importance, use of performance measures, and knowledge exchange: An empirical study on general practitioners’ performance
Authors: Cifalinò Antonella , Mascia Daniele , Vendramini Emanuele Antonio 
Published: June 2018

Background:
In many health systems, general practitioners (GPs) exhibit high levels of isolation and, at the same time, low levels of organizational identification, which can hinder their individual performance. The extant health care literature suggests that the physicians’ belief that organizational goals are important, the adoption of performance measurement systems, and knowledge-sharing practices affect their individual performance. Most research has investigated these constructs in isolation, however, rather than explored their collective impact on GPs’ individual performance.

Purpose:
The aim of this study was to explore how GPs’ belief in goal importance, use of performance measures, and knowledge exchange affect their individual performance, here defined as their individual achievement of organizational goals.

Methodology:
We developed five hypotheses regarding how GPs’ belief in goal importance and use of performance measures may affect individual performance, as well as how knowledge exchange may moderate these relationships. We tested our theoretical conjectures using data collected in a community of GPs in the Italian National Health Service. A survey questionnaire was administered to gather information about the GPs’ level of belief in goal importance, use of performance measures, and perception about knowledge exchange in their primary care units. We considered two measures of GPs’ individual performance: efficiency and appropriateness of drug prescription. We tested our hypotheses using probit regressions.

Results:
Our findings show that perceived importance of organizational goals and use of performance measures have a positive effect on GPs’ individual performance. Meanwhile, GPs’ use of performance measures moderates the relationship between their belief in goal importance and individual performance. Finally, perceived knowledge exchange moderates the relationships between belief in goal importance/use of performance measures and individual performance.

Practice Implications:
Executives could improve GPs’ individual performance through interventions that reinforce their belief that organizational goals are important, facilitate a more intensive use of performance measures, and encourage knowledge exchange practices.
Dynamic sodium imaging at ultra-high field reveals progression in a preclinical migraine model
Authors: Abad Nastaren , Rosenberg Jens T. , Hike David C. , Harrington Michael G. , Grant Samuel C. 
Published: June 2018

Abstract
Under the hypothesis that increased extracellular sodium induces sustained neuronal excitability with the onset and progression of migraine, this study evaluates dynamic in vivo 23Na fluxes in the brain of a preclinical rodent analogue of migraine. Ultra-high field 23Na magnetic resonance imaging (MRI) at 21.1 T has demonstrated potential to quantify sodium concentrations with good spatial and temporal resolution after the onset of central sensitization. Sprague-Dawley male rats with implanted intraperitoneal lines were studied by MRI before and after an in situ injection of 10 mg/kg of nitroglycerin (NTG) vs vehicle and saline controls. Slice-selective 23Na images were acquired using a multislice free induction decay–based chemical shift imaging sequence with resolution of 1.1 × 1.1 × 3 mm for a 9-minute acquisition. A total of 27 repeated scans were acquired over 1 hour of baseline scanning and longitudinally up to 3 hours after injection. Increases of 23Na MRI signal in the brainstem, extracerebral cerebrospinal fluid, and cisterna magna were evident almost immediately after NTG injection, gaining significance from controls in 36 minutes. The cerebellum and third ventricle also showed sustained trends of increased 23Na, with the former gaining significance at over 2 hours after NTG injection. The data provide evidence of an early change in sodium concentration, markedly in posterior fossa cerebrospinal fluid and brainstem regions. Further study of fluctuations of sodium concentration and their modulation with treatments could help understand the dynamic features of migraine, locate a putative migraine generator, and guide development of therapeutic measures to correct the disturbance of sodium homeostasis.
Muscle Stem Cell Niche Dysregulation in Volumetric Muscle Loss Injury
Authors: Anderson Shannon E. , Han Woojin M. , Srinivasa Vunya , Mohiuddin Mahir , Ruehle Marissa A. , Moon Austin , Shin Eunjung , San Emeterio Cheryl L. , Ogle Molly E. , Botchwey Edward A. , Willett Nick J. , Jang Young C. 
Published: June 2018

AbstractSkeletal muscle has a remarkable regenerative capacity; however, after volumetric muscle loss (VML) due to traumatic injury or surgery this regenerative response is significantly diminished, causing chronic functional deficits. The critical defect size at which the muscle will not functionally recover has not yet been established and subsequently, the relative contribution of crucial muscle components, including muscle stem cells and the muscle stem cell niche, are unknown. In this study, we created VML injuries of 2, 3, or 4 mm diameter, full-thickness defects in the mouse quadriceps. The 2, 3, and 4 mm injuries resulted in a defect of 5, 15, or 30% of the quadriceps mass, respectively. At 14 and 28 days after injury, histological analyses revealed injury size-dependent differences in myofiber morphology and fibrosis; the number of small myofibers increased with increasing injury size. The results showed that the 3 mm injury was at a threshold point, as myofibers were unable to bridge the defect, there was persistent fibrosis and inflammation, and significantly increased number of myofibers with centrally located nuclei. We then further investigated the 3 mm VML for nerve and vascular regeneration. These injured muscles were accompanied by a drastic increase in denervated neuromuscular junctions (NMJ), while assessment of angiogenesis via micro-CT analysis revealed a significant increase in vascular volume primarily from small diameter vessels after VML injury. Collectively, these data indicate that the spatial and temporal control of the fibrotic and neuromotor response are critical to regeneration and could be potential therapeutic targets, as they are the most dysregulated components of the muscle stem cell niche after VML.
Coevolution of structural variation and optimization in sound systems of human language
Authors: Zhang Meng-Han , Gong Tao 
Published: June 2018

AbstractEvolution of sound systems of human language is an optimization process to improve communicative effectiveness: The intrinsic structures of sound systems are constantly organized with respect to constraints in speech production and perception. However, there lack sufficient quantitative descriptions of this process, large-scale investigations on universal tendencies in sound systems, and explicit evidence on whether demographic and/or geographic factors can influence linguistic typology of sound systems. Here, we proposed two composite parameters, namely structural variation and optimization, to capture linguistic typology of sound systems, vowel systems in particular. Synchronic comparisons based on a large-scale vowel corpus of world languages revealed a universal negative correlation between the two parameters. Phylogenetic comparative analyses identified a correlated evolution of the two, but with distinct evolutionary modes: a gradual evolution of the structural variation and a punctuated equilibrium of the optimization. Mixed-effect models also reported significant effects of speaker population size and longitude on shaping vowel systems of world languages. All these findings elaborate the intrinsic evolutionary mechanism of sound systems, clarify the extrinsic, non-linguistic effects on shaping human sound systems, and quantitatively describe and interpret the evolution and typology of sound systems.
Field relationships and data collecting: dilemmas encountered in a construction organization
Authors: Nycyk Michael 
Published: June 2018

Purpose
This paper is an autoethnographic account of field dilemmas encountered while undertaking research in a construction organization. The purpose of this paper is to provide a reflexive account for those who undertake organizational field studies and focusses on the issue of field relationships and data collection.

Design/methodology/approach
Vignettes are used providing vivid accounts of field interactions between author, informants and research team members, followed by a reflection on the consequences of these. Field notes and reflective journaling were used in the construction of the vignettes.

Findings
Data collection in organizations where informants have limited time for researchers involves building relationships that need much attention, compromise and addressing of dilemmas which arise. This autoethnography highlights this and reflects on lessons learnt of how to manage dilemmas in field relationships that require attention when they hinder data collection and prove detrimental to the research project’s progress.

Practical implications
This study informs those undertaking research in commercial organizations about the importance of managing relationships and solving potential field dilemmas.

Originality/value
This autoethnography adds to the discussion about how researchers negotiate complex relationships and the dilemmas that constrain data collection. The value of being reflective of dilemmas lies in understanding that challenging organizational field studies involves careful tending to informants’ and research stakeholders’ needs whilst remaining focused on one’s own research goals.
Formation, morphology and classification of colluvial soils: a review
Authors: Zádorová T. , Pení žek V. 
Published: June 2018

SummaryColluvial soils have received increased attention in different fields of environmental and geoarchaeological research over the past two decades. However, their pedological functions and status as specific soil units have seldom been discussed. The concepts and general understanding of the term ‘colluvial soil’ often vary; the definition of this term is vague and thus requires standardization. In this paper we define colluvial soils as soil units that underwent a specific profile development and record characteristics formed by specific processes. We also review and summarize concepts and definitions of colluvial soils in the geosciences, describe their morphology and properties, assess a typical colluvial profile and propose a new definition and inclusion of colluvial soils in soil classification systems. We suggest that colluvial soils should be defined as either (i) colluvisols, which are recent undeveloped soils formed by the periodic rejuvenation of a soil profile because of the accumulation of eroded topsoil or (ii) colluvium‐derived soils, which are soils that developed from colluvia that underwent various pedogenetic processes. The proposed criteria for the classification of colluvisols highlight (i) the accumulation of eroded soil material as the primary process in the formation of colluvisols, (ii) their specific terrain positions and (iii) the different types of development of colluvisol profiles.HighlightsConcepts and general understanding of the term ‘colluvial soil’ vary and need standardization.
We distinguish two types of colluvial soil: colluvisols and colluvium‐derived soils.
We define three types of colluvisols reflecting variation in stratigraphy of their profiles.
We propose internationally applicable criteria for identification and classification of colluvisols.
Sampling at high spatial and temporal resolutions with an experimental chamber
Authors: Ouaknin H. , Weisbrod N. , Furman A. 
Published: June 2018

SummaryLaboratory‐scale studies of the dynamics of soil biogeochemical processes often require destructive sampling for chemical, biological and genetic analyses. The consequences are either ‘end‐of‐experiment’ sampling or a set‐up with multiple experiments in parallel, of which some are sacrificed over time. We propose an alternative experimental set‐up to enable matrix sampling and monitoring at high spatiotemporal resolution of chemical, biological and physical properties. A customized experimental chamber was constructed, including an array of sensors on one side and hundreds of sampling ports on the other. A vertical unidirectional flow regime was maintained in the chamber, and soil samples were collected through ports that were not adjacent laterally to ones used in an earlier sampling campaign. We give an example of an experiment with such a chamber in which the environmental conditions (matric head and redox) were kept almost uniform in the horizontal dimension. Under these conditions nitrogen cycling was also almost the same in the lateral dimension. This system offers a unique combination of high spatial and temporal resolution sensors in the same system that is destructively sampled.Highlights

A new experimental chamber allows high‐resolution sampling
In unidirectional flow, sacrificial sampling can be avoided