bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy
Authors: Habib Muhammad Khurram , Khan Zeeshan Ali 
Published: May 2019

Objective: To determine the radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy (HTO).Design of study: Descriptive case series.Study duration and settings: The present study was a descriptive case series carried out at the Orthopedic Departments of District Head Quarter Hospital Faisalabad affiliated with Faisalabad Medical University, Faisalabad from Jan 2014 to March 2018.Methodology: This study involved 40 patients of both genders, aged between 40 and 65 years having advanced degenerative disease of knee limited to medial compartment of joint. These patients were treated by medial open wedge high tibial osteotomy (OWHTO) and outcome was evaluated after 5 years of surgery in terms of radiological knee mechanics, functional outcome scores, and arthroscopic evidence of cartilage regeneration in the medial compartment. A signed written consent was taken from every patient.Findings:There was a female predominance with a male-to-female ratio of 1:4. The mean age of the patients was 53.2 ± 6.9 years. The values of the radiographic parameters significantly changed from pre-operative condition after HTO; mechanical tibiofemoral angle [MTFA, (−8.1 ± 1.2° vs. 2.5 ± 1.2°;p-value < 0.0001)], tibial plateau inclination [TPI, (5.3 ± 1.1° vs. 3.4 ± 1.1°;p-value < 0.0001)], knee joint line orientation relative to the ground [G-KJLO, (0.3 ± 0.1° vs. 4.6 ± 1.5°;p-value < 0.0001)], and ankle joint line orientation relative to the ground [G-AJLO (8.3 ± 3.2° vs. 2.3 ± 1.7°;p-value < 0.0001)]. There was significant improvement in patient’s functional status; KOOS-ADL score (45.5 ± 7.8 vs. 73.7 ± 8.6;p-value < 0.0001), International Knee Documentation Committee (IKDC) score (42.4 ± 6.9 vs. 68.5 ± 12.7;p-value < 0.0001), International Knee Society (IKS) score (149.4 ± 11.9 vs. 179.4 ± 10.2;p-value < 0.0001), Knee Society Score [KSS, (54.2 ± 5.6 vs. 69.7 ± 12.7;p-value < 0.0001)], and Hospital for Special Surgery [HSS, (50.8 ± 3.3 vs. 64.8 ± 10.7;p-value < 0.0001)]. 42.5% patients showed excellent regeneration of femoral and 30.0% patients showed excellent regeneration of tibial cartilage in the medial compartment.Conclusion: By significantly alternating the knee biomechanics, HTO was found to unload the medial compartment leading to regeneration of the articular cartilage and significant improvement in patient’s symptoms and quality of life. It is therefore recommended in the management of patients with arthritic changes limited to medial compartment only.
Efficacy of continuous local cryotherapy following total hip arthroplasty
Authors: Iwakiri Kentaro , Kobayashi Akio , Takeuchi Yuichi , Kimura Yusuke , Ohta Yoichi , Nakamura Hiroaki 
Published: May 2019

Background: Cryotherapy is rarely reported on the usefulness of cryotherapy applied after total hip arthroplasty (THA), and there are no reports about patient satisfaction against the cryotherapy following THA. The aim of this study was whether cryotherapy can be useful for relieving pain, reducing blood loss, and swelling, and improving patient satisfaction after THA.

Methods: Thirty patients who had undergone THA were treated by a controlled cooling device for 72 h following THA (defined as the cryotherapy group). The other 30 patients without cryotherapy were not treated with cryotherapy (defined as the control group). Blood samples (creatine kinase, and C-reactive protein), estimated blood loss, visual analog scale (VAS) of pain score, total doses of diclofenac sodium suppository used for pain relief, thigh swelling, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and adverse outcomes were compared between two groups.

Results: Thigh circumference, measured on only day 4 postoperatively, was significantly lower in the cryotherapy than in the control group. Furthermore, patient satisfaction on postoperative days 4 and 7 was significantly higher in the cryotherapy than in the control group. There were no significant differences in other outcomes between groups.

Conclusions: These results support the potential benefit of cryotherapy for the reduction of swelling, and patient satisfaction during postoperative recovery of patients undergoing THA, even in the presence of periarticular injection and tranexamic acid administration for the prevention of postoperative pain and bleeding. Postoperative cryotherapy is a potentially simple, noninvasive, and relatively inexpensive option for post-THA management.
Pulmonalklappenerkrankungen: interventionelle und operative Therapieoptionen
Authors: Karathanos Athanasios , Piayda Kerstin , Zeus Tobias 
Published: May 2019

ZusammenfassungErkrankungen der Pulmonalklappe (PK) sind selten und spielen in der Erwachsenenkardiologie eine untergeordnete Rolle. Ätiologisch dominieren angeborene PK-Vitien. Erworbene Vitien entstehen häufig durch die Degeneration einer bereits eingesetzten Bioprothese. Die Echokardiografie bildet die unverzichtbare diagnostische Basis. Um eine optimale therapeutische Entscheidung zu treffen, ist darüber hinaus die multimodale Bildgebung von entscheidender Bedeutung. Aufgrund der rechtskardialen, hämodynamischen Kompensationsmechanismen weisen betroffene Patienten häufig jahrzehntelang keine Symptome auf. Eine Entscheidung zur operativen oder interventionellen Therapie wird anhand des klinischen Verlaufs und des Schweregrades der Erkrankung gefällt. Falls technisch möglich sollte ein interventionelles Vorgehen, insbesondere bei voroperierten Patienten, einem operativen Verfahren gegenüber bevorzugt werden. Der Eingriff sowie die empfohlenen lebenslangen Nachuntersuchungen sollten in einem Schwerpunktzentrum für Erwachsene mit angeborenen Herzfehlern erfolgen. Auf eine Endokarditisprophylaxe und eine patientenadaptierte Gerinnungstherapie ist nach Klappenersatz zu achten.
Interventionelle Therapie der symptomatischen hochgradigen Trikuspidalklappeninsuffizienz
Authors: Weber Marcel , Werner Nikos 
Published: May 2019

ZusammenfassungWeltweit rücken Ärzte die Trikuspidalklappentherapie in das Zentrum ihrer Aufmerksamkeit. Sie ist nicht länger die „vergessene Klappe“, sondern erfährt durch die Möglichkeiten neuer Kathetertechniken einen breiten Zuspruch. Die zumeist an der Mitralklappe erprobten Therapiemethoden eröffnen viele neue Optionen und führen zu einer Renaissance der Trikuspidalklappenbildgebung. Die unterschiedlichen Methoden (Trialign, Cardioband, MitraClip und FORMA) zur interventionellen Therapie der Trikuspidalklappeninsuffizienz sind in klinischer Erprobung und die aktuell verfügbaren Daten zeigen, dass die interventionelle Therapie sicher ist und eine gute Reduktion der Trikuspidalklappeninsuffizienz und hiervon abhängiger Beschwerden ermöglicht. Durch Weiterentwicklung der verschiedenen Therapieansätze wird die interventionelle Behandlung der Trikuspidalklappeninsuffizienz – zumindest bei inoperablen Hochrisiko-Patienten – Eingriffe ohne große OP und ohne Einsatz einer Herz-Lungen-Maschine möglich machen. Weitere Studien zu Sicherheit, Effektivität und Haltbarkeit der interventionellen Ansätze müssen die vorliegenden sehr guten ersten Ergebnisse bestätigen.
Funktionelle Diagnostik des rechten Herzens (einschließlich dynamischer Tests)
Authors: Spieker Maximilian , Horn Patrick , Westenfeld Ralf 
Published: May 2019

ZusammenfassungDie Wahrnehmung der Bedeutung der Funktion des rechten Herzens hat sich in den letzten Jahren in Forschung und Klinik grundlegend geändert. Im klinischen Alltag erlaubt die Echokardiografie eine rasche Beurteilung der RV-Anatomie und -Funktion (RV: rechter Ventrikel). Den Goldstandard der Bildgebung bildet die MRT, die neben einer anatomischen Darstellung des RV und einer exakten Quantifizierung der RV-Funktion auch die Charakterisierung des Myokards ermöglicht. Die Rechtsherzkatheteruntersuchung stellt einen wichtigen Bestandteil in der Diagnostik dar, erlaubt eine exakte Bewertung hämodynamischer Kenngrößen der Rechtsherzinsuffizienz und kann in besonderen klinischen Szenarien um eine Belastungsuntersuchung erweitert werden.
Sagittales Profil der Wirbelsäule: Was ist sinnvoll, was gefährdet den Patienten, was ist Hype? Evidenz für Korrekturoperationen bei sagittaler Dysbalance
Authors: Thomé Claudius 
Published: May 2019

ZusammenfassungIn den letzten Jahren hat das sagittale Profil der Wirbelsäule zunehmend Beachtung gefunden und es konnten je nach Beckenkonfiguration unterschiedliche Wirbelsäulentypen identifiziert werden. Kommt es durch die fortschreitende Bandscheibende-generation zu einer Entlordosierung der Lendenwirbelsäule, resultiert eine sagittale Dysbalance, oft im Sinne einer degenerativen Lumbalskoliose. Nicht selten forcieren Versteifungsoperationen diese Entwicklung iatrogen durch Fixierungen in entlordosierter Position. Fällt das C7-Lot vor die Hüftköpfe, spricht man von dekompensierter sagittaler Dysbalance, die von vielen Wirbelsäulenchirurgen als entscheidend für die Patientendisabilität angesehen wird und aufwändige Korrekturoperationen indiziert werden. Derartige Eingriffe, die häufig Osteotomien erfordern, gehen jedoch mit einem 50 %igen perioperativen Komplikationsrisiko und mit einer Versagens- bzw. Reoperationsrate von ebenfalls 50 % einher, so dass dieser Hype zunehmend kritisch gesehen wird, zumal beispielsweise in Fällen von lumbalen Spinalstenosen ungeachtet des sagittalen Profils reine Dekompressionsoperationen gute Ergebnisse erzielen. Bei insgesamt spärlicher Evidenzlage können daher aktuell umfangreiche Deformitätenkorrekturen nur bei ausgeprägter sagittaler Dysbalance und stärksten, therapierefraktären Beschwerden empfohlen werden. Eine detaillierte präoperative Evaluation und Risikoabschätzung ist in diesem Zusammenhang ebenso unerlässlich wie die Versorgung an spezialisierten Zentren. In diesem selektionierten Patientengut sind Outcome und Patientenzufriedenheit allerdings erstaunlich gut. Es ist davon auszugehen, dass sich die Datenlage in den nächsten Jahren verdichtet und auch altersspezifische Empfehlungen möglich sind. Auch wenn aktuell die routinemäßige Korrektur des sagittalen Profils bei allen Patienten nicht empfohlen werden kann, so macht das Konzept der sagittalen Balance grundsätzlich Sinn. Dementsprechend sollte bei Instrumentationen vor allem der unteren Lendenwirbelsäule eine Wiederherstellung der physiologischen lumbalen Lordose angestrebt werden.
Troponinwerte und der akute Myokardinfarkt
Authors: von Jeinsen Beatrice , Keller Till 
Published: May 2019

ZUSAMMENFASSUNGDurch die klinische Nutzung hochsensitiver Troponinbestimmungen werden erhöhte Troponinwerte auch bei Patienten ohne akuten Myokardinfarkt gemessen. Die aktuelle überarbeitete Definition des Myokardinfarktes definiert neben dem Typ 1- und Typ 2-Infarkt mit nachgewiesener Myokardischämie für diese Patienten den Begriff „Myokardschädigung“ ohne Myokardischämie.
Akutes Koronarsyndrom
Authors: Kriechbaum Steffen D. , Rolf Andreas 
Published: May 2019

ZUSAMMENFASSUNGBei Verdacht auf ein ACS kommt nicht-invasive Bildgebung bei der Initialdiagnostik und der (sub-)akuten Risikostratifizierung zum Einsatz. Während die Ruhe-TTE (transthorakale Echokardiografie) zügig die kardiale Funktion und Differenzialdiagnosen des ACS evaluiert, ermöglichen Stress-TTE, Kardio-CT, Kardio-MRT und Szintigrafie die Detektion struktureller Koronarpathologien bzw. deren funktionelle Auswirkungen. Zudem liefert die Kardio-CT differenzialdiagnostische Informationen.
Thrombozytenaggregation und Antikoagulation beim akuten Koronarsyndrom
Authors: Weferling Maren , Hamm Christian , Liebetrau Christoph 
Published: May 2019

ZUSAMMENFASSUNGNach einem akuten Koronarsyndrom (ACS) ist die Gefahr des Auftretens erneuter ischämischer Ereignisse im Sinne von rekurrierenden Myokardinfarkten und Stentthrombosen erhöht. Gleichzeitig steigt mit der antiaggregatorischen und ggf. antikoagulatorischen Therapie vor allem bei gleichzeitiger Indikation zur oralen Antikoagulation das Risiko für Blutungsereignisse deutlich an. Der folgende Artikel soll auf Grundlage der aktualisierten ESC-Leitlinien zur myokardialen Revaskularisation, STEMI und NSTE-ACS sowie des im Jahre 2017 erschienenen fokussierten Updates der dualen Plättchenhemmung eine Übersicht über die derzeitigen Empfehlungen zur Plättchenhemmung und Antikoagulation beim ACS geben.
Enlargement of Dorello's Canal as a Novel Radiographic Marker of Idiopathic Intracranial Hypertension
Authors: Eggerstedt Michael , Dua Sumeet G. , Varelas Antonios N. , Bhabad Sudeep H. , Batra Pete S. , Tajudeen Bobby A. 
Published: May 2019

Objectives The objective of this study is to compare the visibility and size of Dorello's canal (DC) on magnetic resonance imaging between patients with idiopathic intracranial hypertension (IIH) and control patients, for its evaluation as a potential novel marker for chronic increased intracranial pressure (ICP).
Design Retrospective blinded case–control study.
Setting Tertiary care academic center.
Participants Fourteen patients with spontaneous cerebrospinal fluid (CSF) rhinorrhea and diagnosed IIH, as well as an equal number of age and gender-matched controls.
Main Outcome Measures Radiographic presence or absence of visible CSF sleeve within DC as well as CSF sleeve width when present.
Results Following review of 28 IIH canals and 28 control canals, IIH patients were significantly more likely to have a visible CSF sleeve within DC and to have a wider measured medial entrance to DC (p < 0.001).
Conclusion Identification of CSF evagination into DC may serve as a reliable marker for increased ICP in the IIH population. This finding should be considered in the future as paradigms for diagnosis of IIH continue to evolve.
Quantum parity Hall effect in Bernal-stacked trilayer graphene
Authors: Stepanov Petr , Barlas Yafis , Che Shi , Myhro Kevin , Voigt Greyson , Pi Ziqi , Watanabe Kenji , Taniguchi Takashi , Smirnov Dmitry , Zhang Fan , Lake Roger K. , MacDonald Allan H. , Lau Chun Ning 
Published: May 2019

Significance
The quantum Hall effect, which is characterized by an insulating bulk and chiral edge states, has recently been generalized from transport of charges to transport of other degrees of freedom, leading to quantum spin Hall and quantum valley Hall effects. Here, we report a class of quantum Hall effect, the quantum parity Hall (QPH) effect, in which boundary channels are distinguished by even or odd parity under the system’s mirror reflection symmetry. The QPH is realized in charge neutral Bernal- or ABA-stacked trilayer graphene, which displays a striking phase diagram with four different phases, arising from an interplay between topologically protected crystalline symmetry and Coulomb interactions. Our results motivate a search for classes of topological states in van der Waals materials.
Factors constraining agriculture and livestock technology adoption in Southern Africa.
Authors: Hargreaves M. M. J. , Riveros F. J. L. 
Published: May 2019

Abstract
Southern Africa is comprised of 15 members linked by economical and development reasons. The area has a high potential for agriculture but there are factors (climatic, economic, extension, social and soil) constraining production. Climate change is occurring fast, which has led to the current water crisis in the region. Sugarcane and maize are the major crops produced in the region, and South Africa is the major producer with 43.5% (sugarcane) and 44.8% (maize) of the production in 2016. South Africa, Mauritius and Tanzania are the major producers of raw sugar. Data show that they processed 12% (South Africa), 11% (Mauritius) and 10% (Tanzania) of their sugarcane, respectively, which could reflect a lack of technology or a high level of informal processing. South Africa and Tanzania are the biggest producers of cattle, goats and sheep. South Africa slaughters 11.8% of their cattle, 20.3% of goat and 29.7% of sheep; Tanzania slaughters 27.2% of their cattle, 15.1% of goat and 24.9% of sheep, which leads to a large informal market. Factors affecting technology adoption are mainly geographic (water crisis, climate, soil and land use), social (the poor community's wishes and considerations within a top-down delivery of technology, to gender issues in chieftaincies and to language barriers), financial (unequal access and distribution) and extension (communication between the donors, the community and extension institutions such as the government, NGOs and foundations).
Benchmarking irrigation water use in producer fields in the US central Great Plains
Authors: Gibson Katherine E B , Gibson Justin P , Grassini Patricio 
Published: May 2019

Abstract
Efficient use of freshwater resources is necessary to balance food production and long-term sustainability of irrigated agricultural systems. Here we developed a framework to benchmark irrigation water use relative to crop yield for individual fields based on site-specific weather and soil. Subsequently, we used the framework to diagnose on-farm irrigation management, in relation to crop production, in maize and soybean producer fields in Nebraska (USA). We found actual irrigation to be similar to estimated irrigation water requirement in about half of the fields (i.e. small water surplus). Remarkably, these fields attained yields similar to fields where actual irrigation exceeded water requirements (i.e. large water surplus). Underlying causes for water surplus included producer risk aversion in soils with low water storage capacity, use of coarse methods for scheduling irrigation, and tillage. Scenario assessment indicated that total irrigation volume could potentially be reduced up to 25%–40%, without hurting crop yields, by reducing current irrigation surplus in years with above- or near-average seasonal precipitation. About a third of the producer fields already achieved high yields with little water surplus, supporting the contention that achieving high productivity with less irrigation by better matching irrigation amounts in relation with crop water requirements are compatible goals. The proposed framework can be applied to other crops and regions provided there are well-validated models, local soil and weather datasets, and reliable field-level irrigation, yield, and management records.
Caring for a frail older person: the association between informal caregiver burden and being unsatisfied with support from family and friends
Authors: Lopez Hartmann Maja , De Almeida Mello Johanna , Anthierens Sibyl , Declercq Anja , Van Durme Thérèse , Cès Sophie , Verhoeven Véronique , Wens Johan , Macq Jean , Remmen Roy 
Published: May 2019

Abstract

Background/objective
although informal caregivers (ICG) find caring for a relative mainly satisfying, it can be difficult at times and it can lead to a state of subjective burden characterised by -among others- fatigue and stress. The objective of this study is to analyse the relationship between perceived social support and subjective burden in providing informal care to frail older people.

Methods
a descriptive cross-sectional study was conducted using data from a large nationwide longitudinal effectiveness study. Pearson correlations were calculated between the variables for support and burden. Logistic regression models were applied to determine the association between being unsatisfied with support and burden, taking into account multiple confounding variables.

Results
of the 13,229 frail older people included in this study, 85.9% (N = 11,363) had at least one informal caregiver. Almost 60% of the primary informal caregivers manifested subjective burden, measured with the 12-item Zarit-Burden-Interview (ZBI-12). The percentage of informal caregivers that were unsatisfied with support from family and friends was on average 11.5%. Logistic regression analysis showed that being unsatisfied with support is associated with burden (OR1.85; 95%CI1.53–2.23). These results were consistent for the three groups of impairment level of the frail older persons analysed.

Conclusions
the association between perceived social support and subjective caregiver burden was explored in the context of caring for frail older people. ICGs who were unsatisfied with support were more likely to experience burden. Our findings underline the importance of perceived social support in relation to caregiver burden reduction. Therefore efforts to improve perceived social support are worth evaluating.
Expression Pattern of Aquaporin 1 and Aquaporin 3 in Melanocytic and Nonmelanocytic Skin Tumors
Authors: Osorio Giovana , Zulueta-Dorado Teresa , González-Rodríguez Patricia , Bernabéu-Wittel José , Conejo-Mir Julian , Ramírez-Lorca Reposo , Echevarría Miriam 
Published: May 2019

Abstract

Objectives
Study of aquaporin 1 (AQP1) and aquaporin 3 (AQP3) expression to understand its potential role in the pathophysiology of skin cancer.

Methods
Analysis of AQP1 and AQP3 expression by immunohistochemistry of 72 skin biopsy specimens from melanocytic skin tumors, nonmelanocytic tumors, or healthy samples.

Results
AQP1 showed strong labeling in 100% of benign common melanocytic nevi. Small blood vessels, stroma, and melanophages surrounding different types of melanomas tumors also were positive. Tumoral melanocytes in atypical nevi and melanomas were negative for AQP1. AQP3 showed strong labeling in 100% of melanocytic nevi, 100% of atypical melanocytic nevi, and 100% of melanomas. In all basal cell carcinomas and squamous cell carcinomas, staining for AQP3 was positive.

Conclusions
To our knowledge, this work represents the first demonstration of AQP1/AQP3 expression in human melanocytic skin tumors. More studies are needed to understand the underlying molecular mechanisms of expression of both AQPs in melanocytic tumors and their potential as molecular therapeutic targets.
Inter-assessor Agreement for TREXMO and Its Models Outside the Translation Framework
Authors: Savic Nenad , Lee Eun Gyung , Gasic Bojan , Vernez David 
Published: May 2019

Abstract
Within the framework of Registration, Evaluation, Authorization, and restriction of CHemicals (REACH), occupational exposure models are often used to predict the levels of exposure at a workplace. Poor inter-assessor agreement with their use poses a concern that may lead to different and dangerous risk conclusions. TREXMO (v1, 2016), a web tool providing parameter translations between six exposure models under REACH, is expected to improve the inter-assessor agreement. In this study, 18 assessors performed exposure assessment for six exposure situations within and outside the framework of this translation tool. In more than half of the evaluated cases, the results showed better agreement between assessors selecting the exposure parameters within the framework of TREXMO than when manually coding. The most affected were the parameters related to activity (such as “handling types” of Stoffenmanager) and exposure control (such as local controls). Furthermore, the agreement between the estimates calculated by different assessors was also improved when performing the translations between the models. For Stoffenmanager, for example, the relative standard deviation of 70–121%, obtained for vapors without applying the translation system, was 29–94% with the translations from ART. These findings showed a potential of TREXMO to impact the inter-assessor agreement. Because the study was limited to 18 assessors and only six exposure situations were assessed, further investigations are suggested.