bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stressinduzierte Veränderungen des Essverhaltens und gastrointestinaler Peptide bei adipösen und normalgewichtigen Frauen
Authors: Kiessl Gundula , Laessle Reinhold 
Published: February 2018

ZusammenfassungDer vorliegenden Arbeit liegt ein hypothetisches Modell über die Auswirkungen von Stress auf das Essverhalten zugrunde, das biologische, psychologische und verhaltensorientierte Faktoren berücksichtigt. Es wird davon ausgegangen, dass Stress zu einer Beeinträchtigung der Hunger- und Sättigungsregulation führt, indem sowohl die Art des Essverhaltens als auch die Sekretion gastrointestinaler Peptidhormone verändert wird. Basierend auf den Annahmen des Modells wurde ein kontrolliertes Laborexperiment mit 85 adipösen und normalgewichtigen Frauen durchgeführt. Vor und nach einem psychosozialen Stressor wurden Speichelkortisol sowie die gastrointestinalen Peptide PYY und Ghrelin gemessen und mit den Werten aus einer Kontrollbedingung und einer normalgewichtigen Kontrollgruppe verglichen. Außerdem wurden zentrale Kenngrößen der Mikrostruktur des Essverhaltens während des Verzehrs einer Labormahlzeit erfasst. Stress führte bei den adipösen Frauen bei der Labormahlzeit zu einer niedrigen anfänglichen Essgeschwindigkeit, die aber nicht beibehalten wurde, sondern sich zum Ende der Mahlzeit hin beschleunigte. Bei den normalgewichtigen Frauen hingegen kam es nach dem Stressor generell zu einer Stimulierung der Nahrungsaufnahme. Die Steuerung des Essverhaltens bei den Frauen mit Adipositas wurde möglicherweise durch Ghrelin beeinflusst, da der zu erwartende postprandiale Abfall der Ghrelinwerte spezifisch bei der adipösen Gruppe langsamer ausfiel und das demzufolge länger persistierende Hungersignal schneller zur erneuten Kalorienaufnahme beiträgt. Insgesamt sprechen die Ergebnisse für eine Abhängigkeit des laborexperimentellen Essverhaltens adipöser Frauen von externen Reizen wie Stress und für Defizite bei der adäquaten Wahrnehmung des momentanen Hunger- und Sättigungszustands. Eine Generalisierung auf andere Lebensmittel und Stressoren kann jedoch nur unter Vorbehalt angenommen werden. Als biologische Basis für eine veränderte Hungerwahrnehmung deutet sich eine stressspezifisch veränderte Ghrelinsekretion an.
Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony
Authors: Moleiro Maria Lúcia , Guedes-Martins Luís , Mendes Alexandrina , Marques Cláudia , Braga Jorge 
Published: February 2018

AbstractNowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture — longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies. Both women recovered, and the postpartum evaluation revealed a normal uterus with an adequate blood supply, suggesting potential fertility, as described in the literature regarding this kind of therapeutic approach.
Influence of Sexual Function on the Social Relations and Quality of Life of Women with Premature Ovarian Insufficiency
Authors: Yela Daniela Angerame , Soares Patricia Magda , Benetti-Pinto Cristina Laguna 
Published: February 2018

Objective To evaluate the impact of sexual function (SF) in the quality of life (QoL) of women with premature ovarian insufficiency (POI).
Methods Case-control study in which 80 women with POI were evaluated using estrogen plus progestogen therapy, compared with 80 women matched by age (±2 years) and presenting preserved gonadal function. Sexual function was evaluated using the Female Sexual Function Index (FSFI), and the QoL was evaluated using the World Health Organization's (WHO) QoL assessment instrument (WHOQoL-BREF).
Results The mean age of the women with POI and of the control group was 38.4 ± 7.3 years and 38.1 ± 7.3 years respectively. The QoL, was worse among the POI group, and there were significant differences in the physical (63.4 ± 17.4 and 72.7 ± 15.2 respectively, p = 0.0004) and psychological (63.2 ± 14.6 and 69.3 ± 13.9 respectively, p = 0.0075) domains among this group when compared with the control group. Women with POI presented significantly lower arousal, lubrication, orgasm and satisfaction, more dyspareunia and a worse FSFI scores when compared with the control group. All aspects of SF correlate directly with the worsening of the QoL regarding social relationships.
Conclusion Women with POI showed worse QoL and SF than the control group. The psychological aspects (desire, excitement, orgasm and sexual satisfaction) of SF had greater influence on the parameters of the QoL, while the physical aspects (pain and lubrication) had a low impact on the QoL. The poor SF in women with POI is directly correlated with a worsening across multiple domains of the QoL; however, the negative impact is particularly important in the social domain. These results suggest that the improvement in sexuality can improve the social interactions of women with POI.
Hyperglycosylated hCG and Placenta Accreta Spectrum
Authors: Straubhar Alli , Soisson Sean , Szczotka Kathryn , Dodson Mark , Silver Robert , Soisson Andrew , Einerson Brett 
Published: February 2018

Objective We aimed to evaluate the relationship between hyperglycosylated human chorionic gonadotropin (hCG-H) and placenta accreta spectrum (PAS) in the second and third trimesters of pregnancy.
Study Design This was a case–control study of PAS and controls. hCG-H was measured in the second and third trimesters of pregnancy in women with pathologically confirmed cases of PAS and in gestational age-matched controls without PAS. We compared serum hCG-H levels in cases and controls, calculated summary statistics for diagnostic accuracy, and used receiver operating characteristic (ROC) curves to define an optimal cut-point for diagnosis of PAS using hCG-H.
Results Thirty case samples and 30 control samples were evaluated for hCG-H. Mean hCG-H was lower in the case compared with control group (7.8 ± 5.9 μg/L vs. 11.8 ± 8.8 μg/L, p = 0.03). At an optimal cut-point for hCG-H of ≤7.6 μg/L, the sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and area under the ROC curve were 66.7%, 69.7%, 2.20%, 0.48%, and 0.68%, respectively.
Conclusion Hyperglycosylated hCG levels in the second and third trimesters of pregnancy were lower in patients with PAS than in controls, but hCG-H showed only modest capability as a diagnostic test for PAS.
Kleinzelliges Lungenkarzinom
Authors: Reinmuth Niels , Hoffmann Hans 
Published: February 2018

ZusammenfassungDas kleinzellige Lungenkarzinom stellt eine besonders aggressive Tumorentität dar und ist durch schnellen Progress, sehr frühe Metastasierung und schlechte Prognose charakterisiert. Nur wenige Patienten werden in einem frühen Erkrankungsstadium diagnostiziert, bei dem in ausgewählten Fällen eine chirurgische Resektion diskutiert werden kann. Chemotherapie und Strahlentherapie sind initial häufig effektiv. Allerdings erleiden die meisten Patienten im metastasierten Stadium nach zunächst gutem Ansprechen auf eine platinhaltige Chemotherapie einen Progress mit dann nur limitierten Therapieoptionen.
Korrelation der quantitativen Metamorphopsiemessung und der zentralen Netzhautdicke bei diabetischem Makulaödem und altersassoziierter exsudativer Makuladegeneration
Authors: Claessens Daniela , Schuster Alexander K. 
Published: February 2018

Zusammenfassung
Hintergrund Zur Erfassung von Metamorphopsien steht im klinischen Alltag der Amsler-Test zur Verfügung. Dieser erfasst qualitativ Metamorphopsien, zur Quantifizierung von Metamorphopsien und als Verlaufskontrolle wurde der computerbasierte Test „AMD – A Metamorphopsia Detector®“ entwickelt. Das Ziel dieser Studie ist zu untersuchen, ob eine Korrelation zwischen zentraler Netzhautdicke (CRT, gemessen mittels Spectral Domain OCT) und quantifizierter Metamorphopsiemessung bei Patienten mit exsudativer altersassoziierter Makuladegeneration (AMD) und diabetischem Makulaödem (DMÖ) besteht.
Material und Methoden 66 Augen von 66 Patienten (DMÖ: 19 [11 Männer, 8 Frauen; Alter 42 – 76 Jahre]; AMD: 47 [13 Männer, 34 Frauen; Alter 56 – 93 Jahre]) wurden in dieser explorativen Pilotstudie untersucht und in Hinblick auf das Vorliegen eines Makulaödems (zentrale 500-µm-Zone, Cirrus HD-OCT) klassifiziert. Bestkorrigierter monokularer Fernvisus (BCVA), Amsler-Test, Metamorphopsiemessung (AMD – A Metamorphopsia Detector) mit Angabe des Metamorphopsie-Index (MI), binokulare Ophthalmoskopie, SD-OCT mit Messung der zentralen Netzhautdicke (CRT) und ggf. Fluoreszenzangiografie wurden durchgeführt. Die Korrelation von CRT und MI wurde mittels Spearman-Korrelation geprüft.
Ergebnisse BCVA bei DMÖ bzw. AMD betrug (logMAR) 0,27 (SD 0,3) bzw. 0,29 (SD 0,2). Bei Augen mit DMÖ zeigte sich eine Korrelation von MI und CRT mit rho = 0,88 (p < 0,001) und bei Augen mit AMD betrug rho = 0,56 (p < 0,001).
Schlussfolgerung Die Korrelation von CRT und MI war bei DMÖ hoch und bei AMD moderat. Künftige Studien sollen untersuchen, ob sich die Metamorphopsiemessung zur Detektion einer Konversion in eine exsudative AMD eignet und ob dies eine Messung zur Verlaufskontrolle, ggf. als Selbsttest ermöglicht.
Multicenter experience from the UK and Ireland of use of lumen-apposing metal stent for transluminal drainage of pancreatic fluid collections
Authors: Venkatachalapathy Suresh , Bekkali Noor , Pereira Stephen , Johnson Gavin , Oppong Kofi , Nayar Manu , Leeds John , Paranandi Bharat , Penman Ian , Carroll Nicholas , Godfrey Edmund , James Martin , Aithal Guruprasad , McKay Colin , Devlin John , Wong Terry , Makin Alistair , Ryan Barbara , Huggett Matthew 
Published: February 2018

Abstract
Background and study aims Pancreatic fluid collection (PFC) is a common complication of pancreatitis for which endoscopic ultrasound-guided drainage is first-line treatment. A new single-device, lumen-apposing, covered self-expanding metal stent (LAMS) has been licensed for PFC drainage. We therefore present our multicenter experience with the LAMS for PFC drainage in a multicenter prospective case series to assess success and complication rates.
Patients and methods All adult patients from 11 tertiary centers who had LAMS placement for PFC from July 2015 to July 2016 were included. Data including indications, technical success, clinical success, collection resolution, stent removal, early and late adverse events (AEs), mortality and recurrence at 6 months were collected.
Results 116 patients, median age 52.5 years (range 16 – 80) and 67 % male, were treated with a single LAMS in each case. The indication was walled off necrosis (WON) in 70 and pseudocyst in 46. Median size of the PFC was 11 cm (5 – 21 cm) and the estimated median necrotic volume in WON was 30 % (5 % – 90 %). Stent insertion was technically successful in 115 (99.1 %) and clinically successful in 109 (94 %). Early serious AEs (SAEs): n = 7 sepsis, n = 1 stent blockage with food, n = 1 stent migration requiring laparotomy, n = 1 stent dislodgement and n = 1 bleeding requiring emboliZation. Late AEs: n = 1 buried stent and n = 1 esophageal fistula. Non-procedure-related deaths: n = 3 (2.5 %).
Conclusion This multicenter case series demonstrates that use of the new LAMS is feasible, effective and relatively safe in draining PFC with a technical success rate of 99 % and cumulative SAE rate of 11.2 %.
Die neue EACTS/ESC-Leitlinie im Spannungsfeld Operation versus Katheterintervention – Perspektive des Herzchirurgen
Authors: Sündermann Simon , Unbehaun Axel , Kempfert Jörg , Falk Volkmar 
Published: February 2018

ZusammenfassungDie neuen Guidelines geben Empfehlungen zur Behandlung aller Herzklappenvitien außer der Pulmonalklappe ab. Insbesondere im Bereich der Aortenklappenstenose und der Mitralklappeninsuffizienz spielen zunehmend katheterbasierte Therapieformen eine Rolle. Das TAVI-Verfahren wird in den neuen Guidelines bei Patienten mit intermediärem Risiko empfohlen. Zur Behandlung der Mitralinsuffizienz ist die Studienlage nicht so umfangreich. Das MitraClip-Verfahren ist die einzige katheterbasierte Therapie, die empfohlen wird – jedoch nur bei Patienten mit hohem Operationsrisiko und nur nach genauer Evaluation inklusive Diskussion im Heart-Team, um eine unverhältnismäßige Anwendung zu vermeiden. Im Bereich der Therapie der strukturellen Herzerkrankung gibt es rasante Entwicklungen. Chirurgen müssen sich mit den katheterbasierten Therapien und Techniken beschäftigen und nicht nur passiv an den Prozeduren teilnehmen, um den gesetzlichen Vorschriften zu genügen.
Die neue ESC-Leitlinie im Spannungsfeld Operation versus Katheterintervention – Perspektive des interventionellen Kardiologen
Authors: Husser Oliver , Blumenstein Johannes , Gaede Luise , Möllmann Helge 
Published: February 2018

ZusammenfassungDie Aktualisierung der ESC-Leitlinien für Herzklappenerkrankungen spiegelt weitgehend den Stand der Forschung wider – insbesondere hinsichtlich der Indikationsausweitung auf Intermediärrisiko-Patienten. Die Empfehlung für spezialisierte Herzklappenzentren ist wissenschaftlich nachvollziehbar und wird zukünftig die guten Ergebnisse konsolidieren und weiter verbessern. Nicht Bestandteil der Aktualisierung sind eine visionäre Ausgestaltung der Indikation sowie eine dezidierte Einstufung bei asymptomatischen und Niedrigrisiko-Patienten. Dies wäre bei zunehmend soliderer wissenschaftlicher Basis möglich gewesen. Die Empfehlung zur interventionellen Mitralklappentherapie beschränkt sich aufgrund der Datenlage auf eine schwache Empfehlung zu perkutanen Edge-to-Edge-Verfahren nur bei inoperablen bzw. Hochrisiko-Patienten. Anstehende Neuerungen in diesem Bereich lassen eine zukünftige Ausweitung der Indikation erwarten.
Parallelization of MAFFT for large-scale multiple sequence alignments
Authors: Nakamura Tsukasa , Yamada Kazunori D , Tomii Kentaro , Katoh Kazutaka 
Published: February 2018

AbstractSummaryWe report an update for the MAFFT multiple sequence alignment program to enable parallel calculation of large numbers of sequences. The G-INS-1 option of MAFFT was recently reported to have higher accuracy than other methods for large data, but this method has been impractical for most large-scale analyses, due to the requirement of large computational resources. We introduce a scalable variant, G-large-INS-1, which has equivalent accuracy to G-INS-1 and is applicable to 50 000 or more sequences.Availability and implementationThis feature is available in MAFFT versions 7.355 or later at https://mafft.cbrc.jp/alignment/software/mpi.html.Supplementary informationSupplementary data are available at Bioinformatics online.
Open science initiatives: challenges for public health promotion
Authors: Holzmeyer Cheryl 
Published: February 2018

SummaryWhile academic open access, open data and open science initiatives have proliferated in recent years, facilitating new research resources for health promotion, open initiatives are not one-size-fits-all. Health research particularly illustrates how open initiatives may serve various interests and ends. Open initiatives not only foster new pathways of research access; they also discipline research in new ways, especially when associated with new regimes of research use and peer review, while participating in innovation ecosystems that often perpetuate existing systemic biases toward commercial biomedicine. Currently, many open initiatives are more oriented toward biomedical research paradigms than paradigms associated with public health promotion, such as social determinants of health research. Moreover, open initiatives too often dovetail with, rather than challenge, neoliberal policy paradigms. Such initiatives are unlikely to transform existing health research landscapes and redress health inequities. In this context, attunement to social determinants of health research and community-based local knowledge is vital to orient open initiatives toward public health promotion and health equity. Such an approach calls for discourses, norms and innovation ecosystems that contest neoliberal policy frameworks and foster upstream interventions to promote health, beyond biomedical paradigms. This analysis highlights challenges and possibilities for leveraging open initiatives on behalf of a wider range of health research stakeholders, while emphasizing public health promotion, health equity and social justice as benchmarks of transformation.
The History of Medical Education in Europe and the United States, With Respect to Time and Proficiency
Authors: Custers Eugène J.F.M. , Cate Olle ten 
Published: February 2018

In this article, the authors present a historic overview of the development of medical education in the United States and Europe (in particular the Netherlands), as it relates to the issues of time (duration of the course) and proficiency (performance requirements and examinations). This overview is necessarily limited and based largely on post hoc interpretation, as historic data on time frames are not well documented and the issue of competence has only recently been addressed.
During times when there were few, if any, formal regulations, physicians were primarily “learned gentlemen” in command of few effective practical skills, and the duration of education and the competencies acquired by the end of a course simply did not appear to be issues of any interest to universities or state authorities. Though uniform criteria gradually developed for undergraduate medical education, postgraduate specialty training remained, before accreditation organizations set regulations, at the discretion of individual institutions and medical societies. This resulted in large variability in training time and acquired competencies between residency programs, which were often judged on the basis of opaque or questionable criteria. Considering the high costs of health care today and the increasing demand for patient safety and educational efficiency, continuing historic models of nonstandardized practices will no longer be feasible. Efforts to constrain, restructure, and individualize training time and licensing tracks to optimize training for safe care, both in the United States and Europe, are needed.
Biologic Impact of Mechanical Power at High and Low Tidal Volumes in Experimental Mild Acute Respiratory Distress Syndrome
Authors: Santos Raquel S. , Maia Ligia de A. , Oliveira Milena V. , Santos Cíntia L. , Moraes Lillian , Pinto Eliete F. , Samary Cynthia dos S. , Machado Joana A. , Carvalho Anna Carolinna , Fernandes Marcos Vinícius de S. , Martins Vanessa , Capelozzi Vera L. , Morales Marcelo M. , Koch Thea , Gama de Abreu Marcelo , Pelosi Paolo , Silva Pedro L. , Rocco Patricia R. M. 
Published: February 2018

Abstract

Background
The authors hypothesized that low tidal volume (VT) would minimize ventilator-induced lung injury regardless of the degree of mechanical power. The authors investigated the impact of power, obtained by different combinations of VT and respiratory rate (RR), on ventilator-induced lung injury in experimental mild acute respiratory distress syndrome (ARDS).

Methods
Forty Wistar rats received Escherichia coli lipopolysaccharide intratracheally. After 24 h, 32 rats were randomly assigned to be mechanically ventilated (2 h) with a combination of different VT (6 ml/kg and 11 ml/kg) and RR that resulted in low and high power. Power was calculated as energy (ΔP,L
2/E,L) × RR (ΔP,L = transpulmonary driving pressure; E,L = lung elastance), and was threefold higher in high than in low power groups. Eight rats were not mechanically ventilated and used for molecular biology analysis.

Results
Diffuse alveolar damage score, which represents the severity of edema, atelectasis, and overdistension, was increased in high VT compared to low VT, in both low (low VT: 11 [9 to 14], high VT: 18 [15 to 20]) and high (low VT: 19 [16 to 25], high VT: 29 [27 to 30]) power groups. At high VT, interleukin-6 and amphiregulin expressions were higher in high-power than in low-power groups. At high power, amphiregulin and club cell protein 16 expressions were higher in high VT than in low VT. Mechanical energy and power correlated well with diffuse alveolar damage score and interleukin-6, amphiregulin, and club cell protein 16 expression.

Conclusions
In experimental mild ARDS, even at low VT, high mechanical power promoted ventilator-induced lung injury. To minimize ventilator-induced lung injury, low VT should be combined with low power.
Pharmacokinetic/Pharmacodynamic Model of CW002, an Investigational Intermediate Neuromuscular Blocking Agent, in Healthy Volunteers
Authors: Kaullen Josh D. , Owen Joel S. , Brouwer Kim L. R. , Heerdt Paul M. , Lien Cynthia A. , Savarese John J. , Schmith Virginia D. 
Published: February 2018

Abstract

Background
CW002 is an investigational nondepolarizing, neuromuscular blocking agent with a rapid onset and intermediate duration of action in animals. This is a single ascending dose, healthy subject study exploring tolerability, pharmacokinetics, and potency.

Methods
Population pharmacokinetic and pharmacokinetic/pharmacodynamic models were developed using plasma drug concentration data from a previously published dose–response study in 28 healthy subjects receiving single doses of CW002 during sevoflurane anesthesia. Subjects included in the models were from five different dose cohorts (cohorts 3, 4, 5, 6, and 8 receiving 0.04, 0.06, 0.08, 0.10, and 0.14 mg/kg, respectively). Serial arterial plasma concentrations and muscle twitch heights were monitored.

Results
A four-compartment model was fit to the concentration–time data, whereas a transit compartment with a sigmoid Emax model was fit to the pharmacokinetic/pharmacodynamic data. The population pharmacokinetics of CW002 was linear with very low interindividual variability in clearance (10.8%). Simulations were conducted to predict the onset and offset of effect at 2×, 3×, and 4× ED95. The time to 80% block was predicted to be 1.5, 0.8, and 0.7 min for 2×, 3×, and 4× ED95 doses, respectively. The simulated 25 to 75% recovery index was independent of dose.

Conclusions
CW002 has predictable pharmacokinetics and is likely to have a rapid onset with an intermediate duration of action at 3× ED95. This model provides information to inform critical decisions (e.g., dose, study design) for continued development of CW002.