bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication
Authors: Wang Kun , Ai Fangxin , Zhou Pan , Liu Zhiwei , Chen Zhenbing , Chen Jianghai 
Published: October 2019

Abstract
Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication.
Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique
Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients.
Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.
Nr. 1 und 11 für bewegliche Stabilität
Authors: Dichtl Karoline 
Published: October 2019

SummaryDas Bindegewebe wird in verschiedenen Lebenssituationen besonders beansprucht, zum Beispiel in der Schwangerschaft, im Wachstum, bei Abbauprozessen oder bei starker körperlicher Belastung. Ein Mangel der Mineralstoffe Calcium fluoratum und Silicea wirkt sich unter anderem auf die Elastizität und Stabilität des Bindegewebes aus, was verschiedene Folgen wie Dehnungsstreifen, Spreizfüße oder Gebärmutter- und Blasensenkung haben kann. Die Schüßler-Salze Nr. 1 (Calcium fluoratum) und Nr. 11 (Silicea) können bedarfsgerecht bei gleichzeitig ausreichender Aufnahme der Mineralstoffe über die Ernährung oder Supplemente prophylaktisch oder therapeutisch eingesetzt werden.
Medizinische Behandlungsmethoden: Was macht sie medizinisch notwendig? Teil II: Weitere Kriterien, Übermaßverbot, wandernde Grenzen und Grauzonen
Authors: Raspe Heiner , Friedrich Daniel R. , Harney Anke , Huster Stefan , Schoene-Seifert Bettina 
Published: October 2019

Zusammenfassung
Ziel der Studie „Medizinische Notwendigkeit“ (MedN) ist ein unscharfer Begriff. Ziel unseres Projekts ist es, ihn zwischen Medizinethik, Sozialrecht und Sozialmedizin so zu konkretisieren, dass er sich für die Versorgungssteuerung v. a. im Bereich der GKV eignet. In Teil I unseres Textes identifizierten wir Wirksamkeit, (Netto)Nutzen und die entsprechenden Evidenzlagen als obligatorische Kriterien von MedN. Hier folgt Teil II mit Überlegungen zu weiteren Kriterien.
Methodik Siehe Teil I
Ergebnisse (Teil II): Als weitere MedN-Kriterien zur Beurteilung medizinischer Methoden diskutieren wir kritisch deren Praxisbewährung, Nutznießer, theoretische Grundlagen, Alternativlosigkeit und Kosten sowie Eigenverantwortung, Mitwirkung und Präferenzen der Patienten. MedN hat Unter- und Obergrenzen und muss sich auch mit verschiedenen Fallkonstellationen der Überbehandlung (u. a. infolge schleichender Indikationsausweitung oder ökonomisch getriebener Medikalisierung) auseinandersetzen.
Schlussfolgerungen Die weiter genannten Kriterien können die MedN einer Methode weder begründen noch verändern. Ist eine Methode im Licht der 3 obligatorischen Kriterien nicht notwendig, dann wird sie es nicht durch die Erfüllung einzelner oder aller weiteren genannten. Ist sie andererseits schon medn, dann wird sie durch weitere Kriterien nicht „mehr oder weniger notwendig“. In Teil I haben wir MedN als dichotomes Konzept bestimmt. Dennoch sind wir überzeugt, dass nicht alle medn Methoden gleich wichtig sind. Wollte man innerhalb des MedN-Bereichs Methoden nach medizinischer Relevanz unterscheiden, könnte man auf Techniken zur Priorisierung in der medizinischen Versorgung zurückzugreifen.
Sozialmedizinische Beurteilung der entzündlich-rheumatischen Gelenkkrankheiten
Authors: Keysser Peter , Rahmeh Bassam , Meurer Thomas 
Published: October 2019

ZUSAMMENFASSUNGDie Gruppe der entzündlich-rheumatischen Gelenkerkrankungen bzw. der entzündlich-rheumatischen Systemerkrankungen, die die Gelenke mitbetreffen können, umfasst über 400 verschiedene Krankheitsbilder. In der sozialmedizinischen Leistungsbeurteilung spielt naturgemäß die Ausprägung der Gelenkschädigungen eine wichtige Rolle. Allerdings muss auch die sogenannte entzündliche Aktivität beachtet werden, die zu einer allgemeinen Leistungsminderung führen kann. Im Falle von sogenannter „Organbeteiligung“ (z. B. Augen, Haut, Innere Organe) kann dies zu Auswirkungen auf das Leistungsvermögen führen. Des Weiteren spielen äußere Einflüsse, wie Klimafaktoren, Schichtarbeit etc. eine Rolle in der Beurteilung. Letztlich muss bei jedem Patienten im Einzelfall die Gesamtbeurteilung des Leistungsvermögens all diese Faktoren berücksichtigen.
Die Versorgung Angehöriger von Menschen mit Suchtproblemen in
Bayern
Authors: Härtl Sabine , Sleczka Pawel , Erbas Beate , Buchner Ursula Gisela 
Published: October 2019

Zusammenfassung
Ziel Angehörige von Menschen mit Suchtproblemen sind mit
gesundheitlichen, sozialen und emotionalen Belastungen konfrontiert. Jedoch
liegen für Bayern keine Daten zu ihrer Versorgung im ambulanten
Suchthilfesystem vor, weshalb die vorliegende Studie Anhaltspunkte zum Status
quo der Angehörigenversorgung in Bayern erhebt. Zudem werden Ressourcen
in der Angehörigenarbeit identifiziert und Optimierungspotenziale
abgeleitet.
Methodik Onlinegestützte Befragung von Mitarbeitenden der
bayerischen Suchtberatungsstellen im September und Oktober 2016
(n=158)
Ergebnisse Primär nahmen Sozialpädagoginnen und
Sozialpädagogen an der Befragung teil (78%). Die
Angehörigenberatung umfasste in den meisten Einrichtungen (58%)
maximal ein Fünftel an allen Beratungen. Am häufigsten wurden
die (Ehe-)Partnerinnen und (Ehe-)Partner sowie Eltern von Menschen mit
Suchtproblemen beraten. Die beratenen Angehörigen waren meist zwischen
41 und 50 Jahre alt (54%). In den Bereichen Glücksspiel,
Computer/Internet und Alkohol wird mehr Angehörigenarbeit
relativ zu allen Beratungen geleistet als bei illegalen Drogen/NPS und
Medikamenten. Die Belastung der Angehörigen wurde mit einem Mittelwert
von 86% auf einer Skala von 0–100% eingeschätzt.
Systemische und psychoedukative Konzepte, Ansätze der
Co-Abhängigkeit sowie Angehörigengruppen wurden am
häufigsten in der Praxis umgesetzt.
Schlussfolgerungen Es besteht Bedarf in Forschung und Versorgung
hinsichtlich bisher wenig oder nicht erreichter Gruppen von Angehörigen,
bspw. Kindern. Die Definition von Angehörigen als eigene Zielgruppe, die
Vernetzung mit anderen Institutionen sowie die Bereitstellung eines
praxisrelevanten, evidenzbasierten sowie themen- und zielgruppenspezifischen
Fortbildungsangebotes sind hierfür zielführend.
Begutachtung der Osteoporose und osteoporotischer Frakturen
Authors: Maus Uwe , Maier Gerrit Steffen , Schultz Katharina , Peters Klaus M. , Niedhart Christopher 
Published: October 2019

ZUSAMMENFASSUNGOsteoporose ist eine Erkrankung mit einer verminderten Knochenmasse und Knochenstruktur. Das Frakturrisiko für atraumatische Frakturen ist in Abhängigkeit der Schwere der Erkrankung erhöht. Für den ärztlichen Gutachter stellt die Beurteilung einer osteoporotischen Fraktur eine Herausforderung dar, da in den verschiedenen Versicherungssystemen unterschiedliche Bewertungen hinsichtlich Mitwirkung, Vorinvalidität und Kausalität bestehen. Neben der Klärung der Begrifflichkeiten in der gesetzlichen und privaten Unfallversicherung spielt die Beurteilung der Erkrankung mit klinischen, radiologischen und osteodensitometrischen Parametern eine Rolle. In dem vorliegenden Beitrag werden die Begutachtung der Osteoporose in der gesetzlichen und privaten Unfallversicherung dargestellt und Möglichkeiten zu deren gutachterlichen Beurteilung aufgezeigt.
Should We Use Contrast-Enhanced Ultrasound (CEUS) for the Characterization of Nonpalpable Testicular Lesions? An Analysis from a Cost-Effectiveness Perspective
Authors: Rübenthaler Johannes , Kim Su Hwan , Kunz Wolfgang G. , Sommer Wieland H. , Trottmann Matthias , Clevert Dirk-André , Froelich Matthias Frank 
Published: October 2019

Abstract
Purpose Accurate characterization of testicular lesions is crucial to allow for correct treatment of malignant tumors and to avoid unnecessary procedures in benign ones. In recent years, contrast-enhanced ultrasound (CEUS) proved to be superior in specifying the dignity of small, nonpalpable testicular lesions (< 1.5 cm) compared to native B-mode and color Doppler ultrasound which were previously regarded as the primary imaging method. However, the cost-effectiveness of CEUS has not been evaluated yet. The aim of this study was to analyze the cost-effectiveness of CEUS as compared to unenhanced ultrasound for the characterization of nonpalpable testicular lesions.
Methods A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with unenhanced ultrasound and CEUS. Model input parameters were obtained from recent literature. Deterministic sensitivity analysis of diagnostic parameters and costs was performed. Also, probabilistic sensitivity analysis using Monte-Carlo Modelling was applied. The willingness-to-pay (WTP) was set to $100 000/QALY.
Results In the base-case scenario, unenhanced ultrasound resulted in total costs of $5113.14 and an expected effectiveness of 8.29 QALYs, whereas CEUS resulted in total costs of $4397.77 with 8.35 QALYs. Therefore, the unenhanced ultrasound strategy was dominated by CEUS in the base-case scenario. Sensitivity analysis showed CEUS to be the cost-effective alternative along a broad range of costs.
Conclusion Contrast-enhanced ultrasound is a cost-effective imaging method for the characterization of nonpalpable testicular lesions.
Terminalia ferdinandiana Fruit and Leaf Extracts Inhibit Methicillin-Resistant Staphylococcus aureus Growth
Authors: Cheesman Matthew J. , White Alan , Matthews Ben , Cock Ian E. 
Published: October 2019

AbstractThe development of multiple antibiotic–resistant bacteria has vastly depleted our repertoire of effective antibiotic chemotherapies. The development of multi-β-lactam-resistant strains are particularly concerning due to our previous reliance on this class of antibiotics because of their initial efficacy and broad-spectrum activity. With increases in extended-spectrum β-lactam-resistance and an expanded resistance to other classes of antibiotics, there is an urgent need for the development of effective new antibiotic therapies. Terminalia ferdinandiana is an endemic Australian plant known for its high antioxidant and tannin contents. T. ferdinandiana fruit and leaf extracts have strong antibacterial activity against a wide variety of bacterial pathogens. However, T. ferdinandiana extracts have not been tested against ESBL and MRSA antibiotic-resistant pathogens. An objective of this study was to screen T. ferdinandiana fruit and leaf extracts for bacterial growth inhibitory activity by disc diffusion assay against β-lactam-sensitive and -resistant E. coli strains and against methicillin-sensitive and -resistant S. aureus. The minimum inhibitory concentration (MIC) was quantified by liquid dilution techniques. The fruit methanolic extract, as well as the methanolic, aqueous, and ethyl acetate leaf extracts strongly inhibited the growth of the MRSA, with MICs as low as 223 µg/mL. In contrast, the extracts were ineffective inhibitors of ESBL growth. Metabolomic fingerprint analysis identified a diversity and relative abundance of tannins, flavonoids, and terpenoids, several of which have been reported to inhibit MRSA growth in isolation. All extracts were nontoxic in the Artemia nauplii and HDF toxicity assays, further indicating their potential for medicinal use.
Subacute Arsenic Neuropathy: Clinical and Electrophysiological Observations
Authors: Valappil Ashraf V. , Mammen Abraham 
Published: October 2019

AbstractWe report a patient who developed subacute peripheral neuropathy following ingestion of a traditional medicine for obesity. A 9-year-old girl who had a residual equinus varus deformity and sphincter disturbance due to pelvic ganglioneuroma presented with subacute sensorimotor peripheral neuropathy of 2 weeks duration. Her symptoms started 3 weeks after she started taking a locally made traditional medicine for obesity. She had no other systemic features of arsenic toxicity. She had Mee's lines on her nails and high serum arsenic levels and 24-hour urine levels confirmed the diagnosis of arsenic neuropathy. Nerve conduction study on admission demonstrated axonal sensorimotor neuropathy with slowed conduction velocity. She was not given any specific treatment and recovery was slow. At 18 months, she showed complete recovery and electrodiagnostic parameters returned to normal values. Arsenic is a known ingredient of many Indian ethnic remedies and possibility of arsenic neuropathy should be thought of in patients presenting with acute or sub-acute peripheral neuropathy of unknown etiology.
Avaliação da concordância interobservador no diagnóstico de lesões do anel pélvico posterior usando radiografia simples
Authors: Comerlatto Leonardo , Batista Alberto Braun , Concatto Natália Henz , Ungaretti Neto Ary da Silva , Gonçalves Ramiro Zilles 
Published: October 2019

Resumo
Objetivo Avaliar a concordância interobservador de radiologista, dois ortopedistas especialistas em quadril com experiência no tratamento de fraturas da pelve e acetábulo, dois ortopedistas gerais, dois residentes de ortopedia, e dois residentes de radiologia no diagnóstico de lesões do anel pélvico posterior usando radiografia simples.
Método Estudo transversal, realizado em setembro de 2017. Foram selecionados retrospectivamente e de modo aleatório exames de 20 pacientes atendidos previamente com lesões traumáticas do anel pélvico posterior. Nove examinadores de diferentes áreas médicas avaliaram as radiografias simples de bacia, que foram comparadas com a tomografia computadorizada, considerada critério confirmatório de diagnóstico. A concordância interobservador foi analisada pelo teste de Kappa (κ), e com intervalos de confiança de 95% (IC95%).
Resultados Foram encontradas pela tomografia computadorizada 28 lesões (23%; IC95%: 16–32%) em todos os casos avaliados. A concordância interobservador entre a radiografia simples e a tomografia computadorizada foi moderada nos médicos com mais experiência: o radiologista (κ  = 0,461; IC95%: 0,270–0,652), os especialistas em quadril 1 e 2 (κ  = 0,534; IC95%: 0,348–0,721; e κ  = 0,431; IC95%: 0,235–0,627, respectivamente), e os ortopedistas gerais 1 e 2 (κ  = 0,497; IC95%: 0,307–0,686; e κ  = 0,449; IC95%: 0,254–0,645, respectivamente). Já com relação aos residentes de ortopedia e radiologia, a concordância interobservador foi considerada fraca. Nos diagnósticos de todos os examinadores, foram encontrados altos valores falso-negativos, principalmente nas fraturas da região posterior do ilíaco e nas fraturas do sacro.
Conclusão Profissionais com mais experiência na área apresentam melhor capacidade de identificação de lesões do anel pélvico posterior por radiografia simples; porém, salienta-se que a radiografia simples de pelve esteve suscetível a avaliações falso-negativas da parte de todos os profissionais estudados.
Diabetes and the Vestibular System
Authors: Piker Erin G. , Romero Daniel J. 
Published: October 2019

AbstractFalls are among the most injurious, costly, and feared conditions affecting older adults. Patients with diabetes have a significantly greater risk for falling due to complications affecting the sensory systems required for balance: vision, proprioception, and vestibular. The effects of diabetes mellitus on the vestibular system are perhaps the least understood of these systems. The vestibular system is complex, includes multiple structures, and is difficult and expensive to thoroughly assess. There is pathophysiologic evidence suggesting a direct effect of diabetes mellitus complications on the vestibular system, but there is limited clinical evidence regarding which specific vestibular structures are most adversely affected. Nevertheless, large population-based studies show that patients with diabetes are more likely to have vestibular loss, have a high prevalence of a specific vestibular disorder called benign paroxysmal positional vertigo, and are at a greater risk for falling. Based on the available evidence, a balance screening and an evaluation of benign paroxysmal positional vertigo, a common but easy to treat pathology, in patients with diabetes is recommended as well as counseling on falls risk and home modifications.
Epidemiology of Diabetes and Hearing Loss
Authors: Baiduc Rachael R. , Helzner Elizabeth P. 
Published: October 2019

AbstractHearing loss is a highly prevalent chronic condition. In addition to age, sex, noise exposure, and genetic predisposition, cardiovascular disease and its antecedents may precipitate hearing loss. Of emerging interest is the connection between diabetes and auditory dysfunction. Cross-sectional studies consistently suggest that prevalence of hearing loss is higher in persons with diabetes compared with those without diabetes, especially among younger persons. Furthermore, longitudinal studies have demonstrated higher incidence of hearing loss in persons with diabetes compared to those without diabetes. These findings seem to hold for both type 1 and type 2 diabetes, although considerably more population-based evidence is available for type 2 diabetes. Data on gestational diabetes and hearing outcomes are limited, as are data relating diabetes to otologic sequelae such as fungal infection. Here, we examine evidence from epidemiologic studies of diabetes and hearing loss and consider clinical and laboratory data where population-based data are lacking.
Lattice matched Volmer–Weber growth of Fe3Si on GaAs(001)—the influence of the growth rate
Authors: Jenichen B , Cheng Z , Hanke M , Herfort J , Trampert A 
Published: October 2019

Abstract
We investigate the formation of lattice matched single-crystalline Fe3Si/GaAs(001) ferromagnet/semiconductor hybrid structures by Volmer–Weber island growth, starting from the epitaxial growth of isolated Fe3Si islands up to the formation of continuous films as a result of island coalescence. We find coherent defect-free layers exhibiting compositional disorder near the Fe3Si/GaAs—interface for higher growth rates, whereas they are fully ordered for lower growth rates.
New life for old wires: electrochemical sensor method for neural implants
Authors: Weltin Andreas , Ganatra Dev , König Kathrin , Joseph Kevin , Hofmann Ulrich G , Urban Gerald A , Kieninger Jochen 
Published: October 2019

Abstract

Objective. Electrochemical microsensors based on noble metals can give essential information on their microenvironment with high spatio-temporal resolution. However, most advanced chemo- and biosensors lack the long-term stability for physiological monitoring of brain tissue beyond an acute application. Noble metal electrodes are widely used as neural interfaces, particularly for stimulating in the central nervous system. Our goal was to recruit already deployed, unmodified noble metal electrodes (Pt, Pt/Ir) as in situ chemical sensors. Approach. With advanced electrochemical sensor methods, we investigated electrode surface processes, oxidizable species and oxygen as an indicator for tissue mass transport. We developed a unique, multi-step, amperometric/potentiometric sensing procedure derived from the investigation of Pt surface processes by chronocoulometry providing fundamental characterization of the electrode itself. Main results. The resulting electrochemical protocol preconditions the electrode, measures oxidizable and reducible species, and the open circuit potential (OCP). A linear, stable sensor performance was demonstrated, also in the presence of proteins, validating signal stability of our cyclic protocol in complex environments. We investigated our sensor protocol with microelectrodes on custom Pt/Ir-wire tetrodes by in vivo measurements in the rat brain for up to four weeks. Results showed that catalytic activity of the electrode is lost over time, but our protocol is repeatedly able to both quantify and restore electrode sensitivity in vivo. Significance. Our approach is highly relevant because it can be applied to any existing Pt electrode. Current methods to assess the brain/electrode microenvironment mainly rely on imaging techniques, histology and analysis of explanted devices, which are often end-point methods. Our procedure delivers online and time-transient information on the chemical microenvironment directly at the electrode/tissue interface of neural implants, gives new insight into the charge transfer processes, and delivers information on the state of the electrode itself addressing long-term electrode degradation.
Integrated plasma scenario analysis for the HL-2M tokamak
Authors: Xue L. , Garcia J. , Zheng G.Y. , Hoang G.T. , Artaud J.F. , Duan X.R. , Li J.X. , Giruzzi G. , Zou X.L. , Pan W. , Zhang J.H. , Huang M. , Wei H.L. , Bai X.Y. , Ji X.Q. , Song X.M. , Wang S. , Song X. , Xue M. , Huang W.Y. 
Published: October 2019

Abstract
HL-2M is a new medium-sized tokamak under construction at the Southwestern Institute of Physics, dedicated to supporting the critical physics and engineering issues of ITER and CFETR. Analyzing integrated plasma scenarios is essential for assessing performance metrics and foreseeing physics as well as the envisaged experiments of HL-2M. This paper comprehensively presents the kind of expected discharge regimes (conventional inductive (baseline), hybrid and steady-state) of HL-2M based on the integrated suite of codes METIS. The simulation results show that the central electron temperature of the baseline regime can achieve more than 10 keV by injecting 27 MW of heating power with a plasma current of I
p  =  3 MA and Greenwald fraction f
G  =  0.65, with the thermal energy and β
N reaching 5 MJ and 2.5, respectively. The hybrid regime with f
ni  =  80%–90% can be realized at I
p  =  1–1.4 MA with f
G around 0.5, where β
N is 2.3–2.5 with H
98(y ,2)  =  1.1. Because of the effect of the on-axis NBCD, the hybrid steady state, at I
p  =  1.0 and 1.2, can be achieved more easily than the steady state regimes with reversed shear, corresponding to β
N  =  2.6 and 3.4. Such studies show that HL-2M is a flexible tokamak with a significant capacity for generating a broad variety of plasmas as a consequence of the different heating and current drive systems installed.