bluuebunny/crossref_metadata_2025_split huggingface dataset:
Öffentliche Gesundheit in Deutschland: Eine Perspektive des Nachwuchses
Authors: Akçay Marina , Drees Simon , Geffert Karin , Havemann Mathias , Hommes Franziska , Jaehn Philipp , Krisam Mathias , Mohsenpour Amir , Sell Kerstin , Stratil Jan , von Philipsborn Peter 
Published: December 2018

ZusammenfassungDer aktuelle Reformprozess der öffentlichen Gesundheit in Deutschland hat die Möglichkeit einer Stärkung dieses Faches und des entsprechenden Praxis- und Politikfeldes in Deutschland eröffnet. Im vorliegenden Beitrag werden anstehende Herausforderungen und notwendigen Maßnahmen aus einer Nachwuchsperspektive dargestellt. Notwendig sind insbesondere eine umfassende Stärkung und Reform der Aus- und Weiterbildungsstrukturen der öffentlichen Gesundheit. Zudem gilt es, Strukturen und Prozesse zu schaffen, mittels derer die Fachgemeinschaft ihre Expertise stärker und wirkungsvoller als bislang in Politik und Gesellschaft einbringen kann. Dies schließt den Aufbau einer handlungsfähigen Fachvertretung mit ein. Die hierzu in den vergangenen Jahren u. a. im Rahmen des Zukunftsforums Public Health begonnene Diskussion sollte zeitnah strukturbildend konkretisiert und in praktische Umsetzungen überführt werden.
Morphometric Analysis of the External Aperture of the Carotid Canal in Skulls of South Indian Origin
Authors: Tewari Siddharth , Gupta Chandni , Palimar Vikram , Aithal Sanjana 
Published: December 2018

Background and Objective The carotid canal (CC) is a bent passage in the petrous temporal bone from where the internal carotid artery (ICA) goes inside the skull. The shape, location and measurements of the CC are clinically very important in cases of skull base surgery, since the ICA has to be identified and isolated throughout its petrous course. Therefore, the present study was performed to measure and locate the CC from various important anatomical landmarks.
Materials and Method The present study was conducted on 68 dry skulls of unknown gender. Various measurements and distances of the CC from various important landmarks were taken. The shape of the CC was also noted. Measurements were taken with the help of a screw-adjusted compass and of digital Vernier calipers. From the above measurements, mean and standard deviation (mean ± SD), median, range, and mode were calculated. Data analysis was done with IBM SPSS Statistics for Windows, Version 19.0 (IBM Corp, Armonk, NY, USA).
Results The mean length of the CC on the right and left sides was 7.76 and 7.89 mm, respectively. The mean breadth of the CC on the right and left sides was 5.81 and 6.32 mm, respectively. The most common shape of the CC was round both on the right and left sides in 49.20% and in 53.12% of the cases.
Conclusion The results of the present study will be useful in the performance of neurosurgical procedures, thereby preventing unpleasant complications.
Variation in Cervical Length over Time during a Single Transvaginal Ultrasound Examination
Authors: Connolly Katherine A. , Vieira Luciana , Yoselevsky Elizabeth M. , Pan Stephanie , Stone Joanne L. 
Published: December 2018

Objective To quantify the degree of change in cervical length (CL) over a 3-minute transvaginal ultrasound.
Study Design We conducted a prospective observational study of nulliparous patients who underwent routine transvaginal CL screening at the time of their second-trimester ultrasound. We recorded CL at four time points (0, 1, 2, 3 minutes) and compared these values to determine the minute-to-minute change within a single patient.
Results A total of 771 patients were included. The mean gestational age was 20.8 weeks (±0.84). We used a linear mixed effect model to assess if each minute during the ultrasound is associated with a change in CL. The intraclass correlation coefficient between minute 0 to minute 3 was 0.82 (95% confidence interval: 0.80, 0.84). This indicates that there is a relatively high within-patient correlation in CL during their ultrasound. Additionally, we stratified patients based on their starting CL; the intraclass correlation coefficient remained high for all groups. We additionally compared CL at each minute. Although there is a statistically significant difference between several time points, the actual difference is small and not clinically meaningful.
Conclusion The variation in CL over a 3-minute transvaginal ultrasound examination is not clinically significant. It may be reasonable to conduct this examination over a shorter period.
Islamic tourism and use of social media.
Authors: Rashid T. , Adwik S. 
Published: December 2018

Abstract

This chapter discusses the use of social media and its impact on consumer behaviour in the context of Islamic/Muslim-friendly tourism. The chapter begins by discussing the development of social media and the application of Web 2.0 technology, and then provides a definition of social media and some related terms. Furthermore, an understanding of the importance of Halal and Islamic (Shari'ah) law leads to conclusions on why Muslims are interested in Muslim-friendly tourism rather than the traditional form of tourism.
An opportunity unexploited: a pilgrim's observations on the potential of Muslim pilgrimage (Hajj).
Authors: Acar M. 
Published: December 2018

Abstract

This chapter discusses why the Muslim pilgrimage to Makkah (Hajj) is a disturbingly underutilized or unexploited business opportunity for the Islamic tourism industry, and puts forward suggestions to improve the utilization of its potential. The chapter assesses the potential benefits of Hajj from the economic and sociocultural point of view and evaluates the problems faced by pilgrims during the Hajj period.
A review of the studies on food-derived factors which regulate energy metabolism via the modulation of lipid-sensing nuclear receptors
Authors: Goto Tsuyoshi 
Published: December 2018

ABSTRACT
Obesity is one of the most important risk factors for chronic metabolic disorders. Molecular mechanisms underlying obesity-related metabolic disorders have not been completely elucidated. Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptor superfamily and are key metabolic regulators of the whole-body energy metabolism. Certain enzymes involved in carbohydrate and lipid metabolism are directly regulated by PPARs via their interaction with specific response elements in their gene promoters. Many food factors act as ligands of PPARs and regulate carbohydrate and lipid metabolism by regulating the activities of these nuclear receptors, leading to the attenuation of obesity-related metabolic disorders. In this review, we describe our current knowledge of the role of PPARs in the regulation of whole-body energy metabolism and several examples of food factors that act as ligands of PPARs, which may be useful in the management of obesity and the accompanying energy metabolism abnormalities.
Abbreviations: WAT: white adipose tissue; PPAR: Peroxisome proliferators-activated receptor; RXR: retinoid X receptors; mTORC1: mechanistic target of rapamycin complex 1; PPRE: PPAR-responsive regulatory elements; NAFLD: nonalcoholic fatty liver disease; LPL: lipoprotein lipase; FGF21: fibroblast growth factor 21; BAT: brown adipose tissue; UCP1: uncoupling protein 1; LPC(16:0): 1-palmitoyl lysophosphatidylcholine; C/EBP: CCAAT-enhancer binding proteins; STAT5A: signal transduction and activator of transcription 5A; APO apolipoptotein; CBP: cAMP response element-binding protein-binding protein; PGC1A: PPARγ coactivator protein 1a; HFD: high-fat diet; TG: triglyceride; VLDL: very low density lipoprotein; HDL: high density lipoprotein
A Step Forward Toward the Understanding of the Long-Term Pathogenesis of Double Capsule Formation in Macrotextured Implants: A Prospective Histological Analysis
Authors: Glicksman Caroline A , Danino Michel A , Efanov Johnny I , El Khatib Arij , Nelea Monica 
Published: December 2018

Abstract

Background
Although increasingly reported in the literature, most plastic surgeons cannot define the etiology of double capsules. Often an incidental finding at implant exchange, double capsules are frequently associated with macrotextured devices. Several mechanisms have been proposed, including at the forefront that shearing causes a delamination of the periprosthetic capsule into a double capsule.

Objectives
This study was designed to confirm the hypothesis that mechanical forces are involved in formation of double capsules by histological analysis.

Methods
A prospective analysis of consecutive implants with double capsules removed over 2 years was performed. Data collected at the time of surgery included Baker classification, reason for explant, implant manufacturer and style, and any presence of a seroma associated with the capsule. Specimens were sent for analysis by histology utilizing hematoxylin and eosin and alpha-smooth muscle actin staining techniques.

Results
Eight double capsules were collected for specimen analysis. All capsules demonstrated evidence of granulation tissue, alpha-smooth muscle actin positive myofibroblasts, and folds with embedded texture. Fibrosis surrounded weak areas with presence of layering and splitting, creating a potential space that is prone to separation. Tears and folds from granulomatous reaction are also present within the outer layer of the double capsule, which can only be explained by a mechanical shearing force as a pathogenic mechanism.

Conclusions
Understanding the pathogenesis of double capsules may allow plastic surgeons to refine their indications for macrotextured implants while providing guidance to patients on avoidance of activities that produce shear-forces. The findings support the hypothesis that shearing forces delaminate the capsule into 2 separate distinct capsules.

Level of Evidence: 5
Switching From a Protease Inhibitor–based Regimen to a Dolutegravir-based Regimen: A Randomized Clinical Trial to Determine the Effect on Peripheral Blood and Ileum Biopsies From Antiretroviral Therapy–suppressed Human Immunodeficiency Virus–infected Individuals
Authors: Morón-López Sara , Navarro Jordi , Jimenez Montse , Rutsaert Sofie , Urrea Víctor , Puertas Maria C , Torrella Ariadna , De Clercq Laura , Ribas Bibiana Planas , Gálvez Cristina , Salgado Maria , Vandekerckhove Linos , Blanco Julià , Crespo Manel , Martinez-Picado Javier 
Published: December 2018

AbstractBackgroundOptimization of combination antiretroviral therapy (cART) can impact the human immunodeficiency virus (HIV) reservoir. We evaluated the effect on the HIV reservoir in peripheral blood and ileum biopsies in patients switching from boosted protease inhibitor (PI/r)–based therapy to dolutegravir (DTG)–based therapy.MethodsImpact of Integrase-inhibitor DOlutegravir On the viral Reservoir (INDOOR) is a phase 4 open-label clinical trial that randomly included 42 HIV type 1–infected individuals on effective cART: 20 who switched from PI/r-based to DTG-based cART (switch group), and 22 who remained in PI/r-based regimens (control group). We analyzed blood and ileum biopsies to quantify episomal, total, and integrated HIV DNA, cell-associated HIV RNA, residual plasma viremia, T-cell subsets, cell activation, and inflammation markers.ResultsThere were no related adverse events or treatment discontinuations due to drug intolerance. The HIV reservoir was consistently larger in ileal than in peripheral CD4+ T cells in both groups (P < .01). Residual viremia in plasma decreased in the switch group (P = .03). However, we did not observe significant longitudinal changes in low-level viral replication, total and integrated HIV reservoir, HIV transcription, T-cell maturation subsets, immunoactivation markers, inflammatory soluble proteins, or cellular markers of latently infected cells.ConclusionsThe INDOOR study is the first evaluation of changes in HIV reservoir size in ileum biopsies and in peripheral blood in individuals switched from PI/r- to DTG-based cART. Although this switch was safe and well tolerated, it had no impact on a large array of immunological and inflammatory markers or on HIV reservoir markers in peripheral or in ileal CD4+ T cells.Clinical Trials RegistrationEudraCT 2014-004331-39.
One-stage aortic replacement for type A aortic dissection: using a Vasoring and a conventional elephant trunk graft
Authors: Wei Jeng , Lee Yung-Tsai , Wu Ching-Wen 
Published: December 2018

AbstractOBJECTIVESWe used a vascular ring connector (Vasoring) and a conventional elephant trunk graft for complete repair in open surgery for type A aortic dissection. This report described the immediate and mid-term results of this new technique.METHODSWe used a rigid titanic ring as a stent in the vascular graft for rapid sutureless anastomosis in the reconstruction of type A aortic dissection.RESULTSA total of 65 consecutive patients with Stanford type A aortic dissection underwent open surgery performed by a single surgeon from November 2007 to February 2017. All patients underwent aortic reconstruction with vascular grafts and Vasorings (21 patients in the ascending aorta and 44 patients in the total aortic arch). For total aortic arch replacement, we implanted the conventional vascular graft in the proximal descending thoracic aorta as an elephant trunk graft. Concomitant procedures included the Bentall procedure (9 patients), the David operation (6 patients), coronary artery bypass grafting (9 patients), heart transplantation (1 patient), mitral valve replacement (2 patients) and endovascular aortic repair (1 patient). The mean duration of postoperative endotracheal intubation was 17.0 ± 11.8 h. The average blood loss was 520 ± 743 ml, and 25% of patients required no blood transfusion. The in-hospital mortality rate was 6%.CONCLUSIONSThe combined use of the vascular ring connector and the conventional elephant trunk graft may reduce bleeding and pump time, stop the blood flow in the false lumen and allow the 1-stage total arch replacement to be performed safely. The conventional elephant trunk graft is free from stent graft-induced new entry.
Cold Turkey and Hot Vapes? A National Study of Young Adult Cigarette Cessation Strategies
Authors: Watkins Shannon Lea , Thrul Johannes , Max Wendy , Ling Pamela M 
Published: December 2018

Abstract

Introduction
Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. We investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18–24) and compared patterns with those of older adults (age 25–64).

Methods
We used a population-based sample from the Population Assessment of Tobacco and Health (PATH) study of young adult (n = 1,881) and older adult (n = 6,366) established smokers of conventional cigarettes at Wave 1 (2013–2014), who were surveyed at Wave 2 (2014–2015). Simple regression analysis compared intentions to quit between age groups. Among Wave 1 smokers who reported a Wave 2 quit attempt (young adults [YA] n = 748; older adults [OA] n = 2,068), bivariate and multinomial logistic regression estimated differences in use of behavioral support, pharmacotherapy, product substitution, and unassisted quit attempts. Interaction terms estimated age-group differences in relationships between predictors and cessation strategy use.

Results
Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared with older adults. Young adults were significantly less likely to use pharmacotherapy (adjusted odds ratio: 0.15; confidence interval: 0.09, 0.24; reference: quitting unassisted). Both groups reported using product substitution (YA: 31.6%; OA: 28.5%), primarily with e-cigarettes, more than any evidence-based cessation strategy. Socioeconomic predictors of cessation strategy use did not differ between age groups.

Conclusions
More research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance.

Implications
Young adulthood is a key transition time for tobacco use, and early cessation substantially reduces the risk of morbidity and mortality from smoking. In the context of high e-cigarette and polytobacco use, this study finds young adults have significantly less intention to quit than older adults and are less likely to use evidence-based cessation strategies to help quit. Innovative methods are needed to increase young adult intentions to quit and use of evidence-based cessation assistance.
Interprofessional Development of a Livestream Simulation Activity to Enhance an Undergraduate Nursing Research Course
Authors: Lanier Yzette , Bryant Kellie , Budin Wendy C. , Marsaglia Matthew , Resto David , Genee Jordan , Birk Kevin , Sultana Nadia , Carumba Ralph , Jaravata Jo Anne 
Published: December 2018

Abstract
The article describes the development, implementation, and evaluation of an interactive simulation activity to enhance student engagement and comprehension of evidence-based practice principles. An interprofessional team of nurse educators, simulation experts, information technology specialists, and nursing informatics graduate students collaborated on the simulation design. The results of this project support the need to develop innovative learning strategies to facilitate nursing students’ understanding of the relevance of evidence-based practice research to improve patient outcomes.
ReActivate—A Goal-Orientated Rehabilitation Program for Adolescent and Young Adult Cancer Survivors
Authors: Smith Andrew , Murnane Andrew , Thompson Kate , Mancuso Sam 
Published: December 2018

Background:
Adolescent and young adult (AYA) cancer survivors tend to have poorer physical and mental health outcomes than their healthy peers or survivors of childhood cancer. This study evaluated the feasibility and acceptability of ReActivate, an 8-week, group-based, goal-orientated rehabilitation program for AYA cancer survivors.

Methods:
A prospective, single-site cohort study was conducted of all AYA cancer survivors who self-referred to the ReActivate program. Participants were 21 (60%) males and 14 (40%) females, who ranged in age from 16 to 25 years (M = 21.05, SD = 2.62). Weekly group sessions comprised 1 hour of physical activity, followed by 1 hour of education or self-management sessions. The AYAs completed measures assessing physical functioning (ie, cardiovascular fitness, and muscular endurance and strength), psychosocial outcomes (ie, health-related quality of life), and occupational performance.

Results:
The ReActivate program was found to be feasible and acceptable, with an 87% completion rate and a median attendance rate of 7 sessions (range = 3-8). There were statistically significant increases across most of the physical functioning, health-related quality of life, and perceived occupational performance and satisfaction outcomes, with Cohen's d effect sizes ranging from small to large.

Conclusion:
The ReActivate program was feasible and acceptable and may have a positive effect on AYA cancer survivors' physical, psychosocial, and occupational functioning. While the findings require replication in a randomized controlled trial, the program has the capacity to optimize delivery of patient care and health resources by bridging the gap that currently exists between the acute and primary care settings.
A Laboratory Evaluation of Contextual Factors Affecting Ratings of Speech in Noise: Implications for Ecological Momentary Assessment
Authors: Jenstad Lorienne M. , Gillen Lise , Singh Gurjit , DeLongis Anita , Pang Flora 
Published: December 2018

Objectives:
As hearing aid outcome measures move from retrospective to momentary assessments, it is important to understand how contextual factors influence subjective ratings. Under laboratory-controlled conditions, we examined whether subjective ratings changed as a function of acoustics, response timing, and task variables.

Design:
Eighteen adults (age 21 to 85 years; M = 51.4) with sensorineural hearing loss were fitted with hearing aids. Sentences in noise were presented at 3 overall levels (50, 65, and 80 dB SPL) and 3 signal to noise ratios (0, +5, and +10 dB signal to noise ratio [SNR]). Listeners rated three sound quality dimensions (intelligibility, noisiness, and loudness) under four experimental conditions that manipulated timing and task focus.

Results:
The quality ratings changed as the acoustics changed: intelligibility ratings increased with input level (p < 0.05); noisiness ratings increased at poorer SNRs (p < 0.05); and loudness ratings increased as input level increased (p < 0.05). Timing of rating was significant at the highest presentation level (80 dB SPL): Participants gave higher noise ratings while listening to the signal than afterward (p < 0.05). Presence of a secondary task had no significant effect on ratings (p > 0.1).

Conclusions:
The findings of this laboratory study provide evidence to support the conclusion that group-mean listener ratings of loudness, noisiness, and intelligibility change in predictable ways as level and SNR of the speech in noise stimulus are altered. They also provide weak evidence to support the conclusion that timing of the ratings (during or immediately after sound exposure) can affect noisiness ratings under certain conditions, but no evidence to support the conclusion that timing affects other quality ratings. There is also no evidence to support the conclusion that quality ratings are influenced by the presence of, or focus on, a secondary nonauditory task of the type used here.
Pharmacokinetic and Pharmacodynamic Drug Monitoring of Direct-Acting Oral Anticoagulants: Where Do We Stand?
Authors: Wieland Eberhard , Shipkova Maria 
Published: December 2018

Abstract:
For decades, oral anticoagulation has been based on vitamin K antagonist such as warfarin, which requires pharmacodynamic (PD) drug monitoring to guide the therapy. The drug effect is measured by the clotting test prothrombin time and expressed as international normalized ratio. New direct oral anticoagulants are increasingly used in fixed-dose regimens but are licensed without any therapy monitoring. However, extensive clinical experiences have demonstrated that interindividual variations in the response to the therapy with direct oral anticoagulants do exist. In situations such as bleeding or thrombosis, therapeutic drug monitoring could be useful. Unfortunately, global coagulation assays such as the prothrombin time or the activated partial thrombin time are not suitable for this purpose. To measure drug concentrations, more specific coagulation test can be used if they are externally calibrated with the respective drugs. For the direct thrombin inhibitor dabigatran etexilate, a calibrated diluted thrombin time or ecarin clotting time can be used, whereas for anti–factor Xa drugs such as rivaroxaban, apixaban, edoxaban, and betrixaban, calibrated anti–factor Xa assays are appropriate. However, the gold standard to measure drug concentrations is LC-MS/MS. The variation in bleeding and thrombotic events noted with both drug classes under fixed-dose conditions suggests additional interindividual PD differences. Therefore, PD monitoring to individualize the therapy may be an option. For dabigatran, this is the inhibition of thrombin formation and for anti–factor Xa drugs, the inhibition of factor Xa activity, which can be followed using the functional assays mentioned above but without calibration. Alternatively, thrombin generation assays have been proposed for both drug classes. So far, not many clinical data have been published about the potentially beneficial effects of PD monitoring for dose individualization. The assay platforms for PD monitoring are present in many clinical laboratories, but efforts are needed to validate and standardize available assays to perform appropriate clinical trials.