bluuebunny/crossref_metadata_2025_split huggingface dataset:
„Crystal“ und Schwangerschaft – erste Ergebnisse einer retrospektiven Studie zum Schwangerschafts- und Geburtsverlauf Methamphetamin-konsumierender Frauen in Sachsen
Authors: Schmidt Uwe , Capek Claudia , Birdir Cahit , Erfurt Christine , Nitzsche Katharina 
Published: February 2019

Zusammenfassung
Einleitung Im Freistaat Sachsen ist seit Jahren ein zunehmender Methamphetamin-(MA-)Konsum zu beobachten. Untersuchungen zum Risiko des MA-Konsums für Schwangerschaft und Geburt liegen aus dem deutschsprachigen Raum bislang nicht vor.
Methoden Es wurden die Behandlungsakten aller betreuten Schwangerschaften und Geburten der Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Jahre 2010–2015 mit dokumentiertem MA-Konsum retrospektiv untersucht. 119 Schwangerschaften mit 113 Geburten von 115 Frauen mit MA-Konsum konnten ausgewertet werden. 88 Frauen räumten den Konsum anamnestisch ein, 28 Frauen bestritten ihn, in 3 Fällen lag keine Information in der Akte vor. In 113 Fällen erfolgte ein immunochemischer Drogentest auf MA mit Zustimmung der Frauen, der in 93 Fällen positiv war. Als Vergleichsgruppe dienten die Daten des jährlich erscheinenden Qualitätssicherungsberichts Geburtshilfe des Jahres 2015.
Ergebnisse MA-Konsumentinnen sind signifikant jünger, ohne festen Partner, ohne Berufstätigkeit und mit geringer beruflicher Qualifikation. Die Erstfeststellung der Schwangerschaft erfolgt später und die Zahl der Vorsorgeuntersuchungen einschließlich Ultraschall ist geringer im Vergleich zur Referenzgruppe. 7 Frauen nahmen gar keine Vorsorgeuntersuchung wahr. Signifikant häufiger bestanden vorzeitige Wehen, eine Zervixinsuffizienz sowie ein Gestationsdiabetes. Während der Schwangerschaft benötigten die MA-Patientinnen signifikant häufiger eine Tokolyse, eine ANS Prophylaxe bzw. einen präpartalen stationären Aufenthalt. Unter der Geburt kam es häufiger einem vorzeitigen Blasensprung sowie zu einem Amnioninfektionssyndrom. Die Rate der intrauterinen Fruchttodesfälle lag mit 3,5% weit über dem Wert der Referenzgruppe (0,35%).
Diskussion Der Konsum von MA führte zu einem signifikant erhöhten Risiko für Mutter und Kind während Schwangerschaft und Geburt im Vergleich zur Normalpopulation (Schwangerschaftskomplikationen, Frühgeburtlichkeit, erhöhte Abortrate, Totgeburt). Ein besonderes Augenmerk ist auf jüngere Schwangere mit verspäteter und unregelmäßiger Inanspruchnahme von Vorsorgeuntersuchungen, ohne festen Partner und ohne berufliche Tätigkeit zu richten.
Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study
Authors: İyidir Özlem Turhan , Rahatlı Feride Kural , Bozkuş Yusuf , Ramazanova Lala , Turnaoğlu Hale , Nar Aslı , Tütüncü Neslihan Başçıl 
Published: February 2019

Abstract
Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy.
Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness.
Results Achilles tendon thicknesses were similar between groups (p=0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p=0.01; group II vs control p=0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p=0.993). Shear Wave Velocity was significantly lower in group I than group IIand control group (p<0.001).
Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.
Digital cholangioscopy-guided laser versus mechanical lithotripsy for large bile duct stone removal after failed papillary large-balloon dilation: a randomized study
Authors: Angsuwatcharakon Phonthep , Kulpatcharapong Santi , Ridtitid Wiriyaporn , Boonmee Chaloemphon , Piyachaturawat Panida , Kongkam Pradermchai , Pareesri Wattana , Rerknimitr Rungsun 
Published: February 2019

Abstract
Background Endoscopic papillary large-balloon dilation (EPLBD) allows for the complete removal of large common bile duct (CBD) stones without fragmentation; however, a significant proportion of very large stones and stones floating above a tapering CBD require lithotripsy. Mechanical lithotripsy and cholangioscopy-guided laser lithotripsy are both effective for stone fragmentation. This study aimed to directly compare, for the first time, the efficacy of these two techniques in terms of stone clearance rate, procedure duration, patient radiation exposure, and safety.
Methods 32 patients with very large CBD stones or with stones floating above a tapering CBD, and in whom extraction after standard sphincterotomy and/or EPLBD had failed, were randomly assigned to mechanical lithotripsy or cholangioscopy-guided laser lithotripsy at two tertiary referral centers. Crossover was allowed as a rescue treatment if the assigned technique failed.
Results Patients’ demographic data were not different between the two groups. Mechanical lithotripsy had a significantly lower stone clearance rate in the first session compared with laser lithotripsy (63% vs. 100%; P < 0.01). Laser lithotripsy rescued 60% of patients with failed mechanical lithotripsy by achieving complete stone clearance within the same session. Radiation exposure of patients was significantly higher in the mechanical lithotripsy group than in the laser lithotripsy group (40 745 vs. 20 989 mGycm2; P  = 0.04). Adverse events (13% vs. 6%; P  = 0.76) and length of hospital stay (1 vs. 1 day; P  = 0.27) were not different.
Conclusions Although mechanical lithotripsy is the standard of care for a very large CBD stone after failed EPLBD, where available, cholangioscopy-guided laser lithotripsy is considered the better option for the treatment of this entity as it provides a higher success rate and lower radiation exposure.
Using Electronic Health Records to Identify Adverse Drug Events in Ambulatory Care: A Systematic Review
Authors: Feng Chenchen , Le David , McCoy Allison 
Published: February 2019

Objective We identified the methods used and determined the roles of electronic health records (EHRs) in detecting and assessing adverse drug events (ADEs) in the ambulatory setting.
Methods We performed a systematic literature review by searching PubMed and Google Scholar for studies on ADEs detected in the ambulatory setting involving any EHR use published before June 2017. We extracted study characteristics from included studies related to ADE detection methods for analysis.
Results We identified 30 studies that evaluated ADEs in an ambulatory setting with an EHR. In 27 studies, EHRs were used only as the data source for ADE identification. In two studies, the EHR was used as both a data source and to deliver decision support to providers during order entry. In one study, the EHR was a source of data and generated patient safety reports that researchers used in the process of identifying ADEs. Methods of identification included manual chart review by trained nurses, pharmacists, and/or physicians; prescription review; computer monitors; electronic triggers; International Classification of Diseases codes; natural language processing of clinical notes; and patient phone calls and surveys. Seven studies provided examples of search phrases, laboratory values, and rules used to identify ADEs.
Conclusion The majority of studies examined used EHRs as sources of data for ADE detection. This retrospective approach is appropriate to measure incidence rates of ADEs but not adequate to detect preventable ADEs before patient harm occurs. New methods involving computer monitors and electronic triggers will enable researchers to catch preventable ADEs and take corrective action.
Beating the reaction limits of biosensor sensitivity with dynamic tracking of single binding events
Authors: Sevenler Derin , Trueb Jacob , Ünlü M. Selim 
Published: February 2019

Significance
Low-abundance molecular biomarkers are a promising reservoir of diagnostic information for the early detection and precise treatment of a range of diseases. Yet, most leading assay technologies are currently limited by the affinity and specificity of the molecular-recognition agents they use. This binding “reaction limit” could be beaten by measuring the duration of individual molecular-binding events as they happen in real time. We developed a technology to measure the duration of thousands of individual binding events across a large sensor area. These duration measurements allowed specific analyte binding to be distinguished from nonspecific background binding. The sensor is large enough to accommodate 12 ultrasensitive tests at once.
Safety and efficacy of adzuki bean extract in subjects with moderate to high LDL-C: a randomized trial
Authors: Kitano-Okada Tomoko , Nagata Ryuji , Han Kyu-Ho , Mikami Nana , Satoh Koji , Nishihira Jun , Sasaki Keiko , Ohba Kiyoshi , Fukusima Michihiro 
Published: February 2019

ABSTRACT
The safety and efficacy of polyphenol-containing adzuki bean extract on lipid metabolism were evaluated in human subjects in an 8-week, randomized, double-blind, placebo-controlled, parallel intervention study. No adverse effects were observed in the participants receiving adzuki bean extract. The adzuki bean group showed a significant increase in the ΔHDL-C concentration compared with the placebo group after 4 weeks of intervention (3.76 ± 7.79 mg/dL vs. −0.08 ± 6.03 mg/dL), respectively, and both groups showed reduced ∆HDL-C concentrations, with the adzuki bean extract group showing a return to the baseline levels (0.36 ± 5.36 mg/dL) and the placebo group showing a decrease to below the baseline levels (−3.17 ± 7.79 mg/dL) at week 8. This short-term study represents the first step in establishing the practicality, safety, and plausibility of HDL-C maintaining effects of adzuki bean extract in human subjects.
Association Between Community-Level Social Participation and Self-reported Hypertension in Older Japanese: A JAGES Multilevel Cross-sectional Study
Authors: Nakagomi Atsushi , Tsuji Taishi , Hanazato Masamichi , Kobayashi Yoshio , Kondo Katsunori 
Published: February 2019

Abstract

BACKGROUND
Many factors are associated with hypertension development. We focused on social participation as an aspect of social capital and investigated the contextual relationship between community-level social participation and hypertension using multilevel regression analyses.

METHODS
We used cross-sectional data from the 2016 Japan Gerontological Evaluation Study—a population-based study of functionally independent adults aged 65 years or older. The sample comprised 116,013 participants nested in 818 communities. Hypertension and social capital were defined by questionnaires. Social capital was assessed at both the individual and the community levels in 3 dimensions: civic participation (as an index of social participation), social cohesion, and reciprocity.

RESULTS
The prevalence rate of hypertension was 43.7%, and 44.1% of the respondents were involved in civic participation. Community-level civic participation, but not social cohesion or reciprocity, was negatively associated with hypertension in the total population (prevalence ratio (95% confidence interval): 0.98 (0.96–0.99), P = 0.004) and female group (0.97 (0.95–0.99), P = 0.015), and the association neared significance in the male group (0.98 (0.96–1.005), P = 0.13) after adjustment for individual-level social capital dimensions including civic participation, individual-level covariates, and population density as a community-level covariate. The interaction between community-level civic participation and sex in relation to hypertension was significant (P = 0.012).

CONCLUSIONS
We found a contextual preventive relationship between community-level civic participation and hypertension. The design of the contextual characteristics of communities by the promotion of social participation may help reduce the prevalence of hypertension in older people.
A Moxifloxacin-based Regimen for the Treatment of Recurrent, Drug-sensitive Pulmonary Tuberculosis: An Open-label, Randomized, Controlled Trial
Authors: Perumal Rubeshan , Padayatchi Nesri , Yende-Zuma Nonhlanhla , Naidoo Anushka , Govender Dhineshree , Naidoo Kogieleum 
Published: February 2019

Abstract

Background
The substitution of moxifloxacin for ethambutol produced promising results for improved tuberculosis treatment outcomes.

Methods
We conducted an open-label, randomized trial to test whether a moxifloxacin-containing treatment regimen was superior to the standard regimen for the treatment of recurrent tuberculosis. The primary and secondary outcomes were the sputum culture conversion rate at the end of 8 weeks and the proportion of participants with a favorable outcome, respectively.

Results
We enrolled 196 participants; 69.9% were male and 70.4% were co-infected with human immunodeficiency virus (HIV). There was no significant difference between the study groups in the proportion of patients achieving culture conversion at the end of 8 weeks (83.0% [moxifloxacin] vs 78.5% [control]; P = .463); however, the median time to culture conversion was significantly shorter (6.0 weeks, interquartile range [IQR] 4.0–8.3) in the moxifloxacin group than the control group (7.9 weeks, IQR 4.0– 11.4; P = .018). A favorable end-of-treatment outcome was reported in 86 participants (87.8%) in the moxifloxacin group and 93 participants (94.9%) in the control group, for an adjusted absolute risk difference of −5.5 (95% confidence interval −13.8 to 2.8; P = .193) percentage points. There were significantly higher proportions of participants with Grade 3 or 4 adverse events (43.9% [43/98] vs 25.5% [25/98]; P = .01) and serious adverse events (27.6% [27/98] vs 12.2% [12/98]; P = .012) in the moxifloxacin group.

Conclusions
The replacement of ethambutol with moxifloxacin did not significantly improve either culture conversion rates at the end of 8 weeks or treatment success, and was associated with a higher incidence of adverse events.

Clinical Trials Registration
NCT02114684.
Evaluating Movement of Patients With Carbapenem-resistant Enterobacteriaceae Infections in the Greater Atlanta Metropolitan Area Using Social Network Analysis
Authors: Bower Chris W , Fridkin Cass , Wolford Hannah M , Slayton Rachel B , Kubes Julianne N , Jacob Jesse T , Ray Susan M , Fridkin Scott K 
Published: February 2019

Abstract

Background
Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent threat with potential for rapid spread. We evaluated the role of Medicare patient movement between facilities to model the spread of CRE within a region.

Methods
Through population-based CRE surveillance in the 8-county Atlanta (GA) metropolitan area, all Escherichia coli, Enterobacter spp., or Klebsiella spp. resistant to ≥1 carbapenem were reported from residents. CRE was attributed to a facility based on timing of culture and facility exposures. Centrality metrics were calculated from 2016 Medicare data and compared to CRE-transfer derived centrality metrics by Spearman correlation.

Results
During 2016, 283 incident CRE cases with concurrent or prior year facility stays were identified; cases were attributed mostly to acute care hospitals (ACHs; 141, 50%) and skilled nursing facilities (SNFs; 113, 40%), and less frequently to long-term acute care hospitals (LTACHs; 29, 10%). Attribution was widespread, originating at 17 of 20 ACHs (85%), 7 of 8 (88%) LTACHs, but only 35 of 65 (54%) SNFs. Betweenness of Medicare patient transfers strongly correlated with betweenness of CRE case-transfer data in ACHs (r = 0.75; P &lt; .01) and LTACHs (r = 0.77; P = .03), but not in SNFs (r = 0.02; P = 0.85). We noted 6 SNFs with high CRE-derived betweenness but low Medicare-derived betweenness.

Conclusions
CRE infections originate from almost all ACHs and half of SNFs. We identified a subset of SNFs central to the CRE transfer network but not the Medicare transfer network; other factors may explain CRE patient movement in these facilities.
Haemadsorption improves intraoperative haemodynamics and metabolic changes during aortic surgery with hypothermic circulatory arrest
Authors: Saller Thomas , Hagl Christian , Woitsch Stefan , Li Yupeng , Niedermayer Sebastian , Born Frank , Luehr Maximilian , Kammerer Tobias , Pichlmaier Maximilian , Scheiermann Patrick , Peterss Sven 
Published: February 2019

Abstract

OBJECTIVES:
Aortic surgery involving hypothermic circulatory arrest (HCA) results in a systemic inflammatory response that may negatively influence outcome. An extracorporeal haemadsorption (HA) device (CytoSorb®) that removes inflammatory triggers may improve haemodynamic and metabolic reactions due to excessive inflammation and, ultimately, outcome.

METHODS:
As a single-centre experience, the data of 336 patients who had undergone aortic surgery with HCA between 2013 and 2017 were retrospectively analysed. Patients with HA were matched to patients receiving standard therapy without HA (Control) by propensity score matching and compared subsequently.

RESULTS:
During aortic surgery with HCA, HA significantly reduced the requirement of norepinephrine (HA: 0.102 µg/kg/min; Control: 0.113; P = 0.043). Severe disturbances of acid–base balance as reflected by a pH lower than 7.19 (HA: 7.1%; Control: 11.6%; P = 0.139), maximum lactate concentrations (HA: 3.75 mmol/l; Control: 4.23 P = 0.078) and the need for tris-hydroxymethylaminomethane buffer (HA: 6.5%; Control: 13.7%; P = 0.045) were less frequent with HA. Compared to standard therapy, HA decreased the need for transfusion of packed red blood cells (1 unit; P = 0.021) and fresh frozen plasma (3 units; P = 0.001), but increased the requirement of prothrombin complex concentrate (800 IE, P = 0.0036). HA did not affect inflammatory laboratory markers on the first postoperative day. Differences in operative mortality (HA: 4.8%; Control: 8.8%) and the length of hospital stay (HA: 13.5 days; Control: 14) were not statistically significant.

CONCLUSIONS:
HA significantly reduces the need for vasopressors, the amount of transfusion and improves acid–base balance in aortic surgery with HCA. Multicentre prospective trials are required to confirm these results.
Patching Up a Diplomatic Fissure: Reassessing Richard Wunsch, a German Physician to the Korean Court, 1901–1905*
Authors: Kim Hoi-Eun 
Published: February 2019

Abstract
In 1901 the Korean imperial court invited Greifswald-educated medical doctor Richard Wunsch to be personal physician to Emperor Kojong, only to abandon him upon his arrival in Seoul. Previous scholarship has understood Wunsch’s wasteful four-year engagement as a typical example from an incompetent regime on the cusp of its forceful transformation into Japan’s protectorate in 1905. Based upon careful analysis of hitherto unexplored diplomatic documents from both German and Korean sides, I argue that the appointment of Wunsch needs be understood in the whirlwind of diplomatic tension between Germany and Korea that arose over the issue of a disputed mining concession in 1898. The mutually agreed arrangement to install a German doctor in the Korean court in 1901 was a symbol of the patched-up relationship, with each side harbouring a different agenda—the German government wanted to put a powerful person in the court to gain an edge in imperial politics in Korea, and Koreans wished to have a German doctor who would function as a counterweight to the more dominant presence of American and British doctors in the court. By reconstructing the impact of convoluted factors, both local and global, in the invitation of a German doctor to Korea, this article provides a detailed case study of the use of medical science by the German imperial government as a chip in the global game of influence. It also functions as an overdue corrective to a commercially inspired and prevalent image of Wunsch that has capitalized upon a self-orientalizing tendency in contemporary Korea.
Risk of oil contamination of fish eggs and larvae under different oceanic and weather conditions
Authors: Samuelsen Annette , Daewel Ute , Wettre Cecilie 
Published: February 2019

Abstract
An oil drift model is applied to determine the spread of oil spills from different locations along ship lanes off southern Norway every month for 20 years. These results are combined with results from an egg- and larvae drift model for Atlantic cod (Gadus morhua) to determine their risk of being impacted by oil. The number of eggs and larvae exposed to oil contamination is connected to environmental conditions. The highest risk of overlap between an oil spill and cod in early life stages occurs during March and April when the eggs and larvae concentrations are highest. Spills off the west coast pose a greater risk because of the ship lanes’ proximity to the spawning grounds, but there is large interannual variability. For some spill locations the interannual variability can be explained by variability in wind and ocean currents. Simultaneously occurring onshore transports lead to a high-risk situation because both oil and larvae are concentrated towards the coast. This study demonstrates how results from oil drift and biological models can be combined to estimate the risks of oil contamination for marine organisms, based on the location and timing of the oil spill, weather/ocean conditions, and knowledge of the organisms’ life cycle.
Immigrants’ Support for Welfare Spending and the Role of Perceived and Preferred Group’s Access to Welfare: A Comparative Study Among 10 Immigrant Groups in the Netherlands
Authors: Renema Jeanette A J , Meuleman Roza , Lubbers Marcel 
Published: February 2019

AbstractImmigrants’ opinions on welfare spending are often ignored, but an examination of these perspectives provides further insights into the formation of welfare attitudes. We developed a framework proposing that support for welfare spending is not only driven by self-interest and group-interest, but also by the preferences and perceptions of immigrants regarding their group’s access to welfare. We discuss how these two aspects affect immigrants’ support for spending on unemployment benefits and social assistance in the Netherlands. Immigrants were found to be more supportive of spending on welfare to which they perceived they had greater access, particularly when they preferred a more generous access for their group. Their support for welfare spending was weaker if they preferred less generous access.
Regulatory T cells in inflammatory skin disease: from mice to humans
Authors: Kalekar Lokesh A , Rosenblum Michael D 
Published: February 2019

AbstractThe skin is the largest organ in the body and one of the primary barriers to the environment. In order to optimally protect the host, the skin is home to numerous immune cell subsets that interact with each other and other non-immune cells to maintain organ integrity and function. Regulatory T cells (Tregs) are one of the largest immune cell subsets in skin. They play a critical role in regulating inflammation and facilitating organ repair. In doing so, they adopt unique and specialized tissue-specific functions. In this review, we compare and contrast the role of Tregs in cutaneous immune disorders from mice and humans, with a specific focus on scleroderma, alopecia areata, atopic dermatitis, cutaneous lupus erythematosus and psoriasis.