bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vermeidung von Clustering und Urge bei der chirurgischen transanalen Therapie der distalen tiefen Rektozele
Authors: Benecke Claudia , de Santo Gianluca , Strik Martin , Keck Tobias , Zimmermann Markus 
Published: August 2019

ZusammenfassungDie Behandlung obstruktiver Beschwerden des Anorektums stellt eine Herausforderung dar. Die Vorhersagewahrscheinlichkeit eines Erfolges chirurgischer Maßnahmen ist weiterhin unsicher. Aufgrund der aus dem tiefen Rektum intramural vermittelten Rückmeldesignale und konsekutiver Motilitätsmodulation des Kolorektums können morphologische Veränderungen nicht allein zur Indikationsstellung herangezogen werden. Andererseits gilt es, die Physiologie des enterischen Nervensystems in die Indikationsstellung und Verfahrenswahl mit einzubeziehen. Rektozelen können ein morphologisches Korrelat für eine Outlet-Obstruktion darstellen. Es kann hier nach der Höhenlokalisation in hohe, mittlere und distale Formen unterteilt werden, deren Erscheinungsbild sich in den oberen Dritteln eher flächig darstellt, deren Genese eng mit der Anzahl der Geburten korreliert und die Evaluation der Levatorenschenkeldistanz erforderlich macht. Die distalen tiefen verhaltbildenden Formen finden sich auch bei Nulliparae und haben ihre Ursache in einem transversen Querriss direkt oberhalb der Verankerung des Septums am Perineum. Bei diesen Patientinnen mit ventraler distaler Ventilrektozele überprüften wir die Ergebnisse der Versorgung mittels interner Vollwandraffung und Mukosaresektion im Hinblick auf die Kurz- und Langzeitergebnisse, Komplikationen, ODS-Symptomatik und insbesondere mit der Frage nach der Entstehung von De-novo-Urge oder Clustering. Im Zeitraum zwischen Januar 2009 und Januar 2014 erfolgten 35 Eingriffe bei distalen tiefen symptomatischen ventralen Rektozelen in modifizierter Technik nach Sullivan. Es fanden sich keine intraoperativen oder frühpostoperativen Komplikationen, in den Kontrollen nach 2 Wochen keine Nahtdehiszenzen oder Blutungen, 4 Wochen postoperativ keine Urge-Symptomatik, kein Clustering. In einer Langzeitbefragung (2 – 7 Jahre) postoperativ gaben über 80% an, ihr Operationsergebnis subjektiv dauerhaft positiv zu bewerten. Der mittlere obstruktive Defäkations-Score (ODS) nach Altomare et al. wurde um 9 Punkte reduziert.
Obstruktives Defäkationssyndrom: Stellenwert der sakralen Neuromodulation
Authors: Kollmann Cathérine , Kim Mia 
Published: August 2019

ZusammenfassungNach der erfolgreichen Etablierung des sakralen Nervenschrittmachers in der Therapie der fäkalen Inkontinenz zeigten erste Kohortenstudien ebenfalls vielversprechende Ergebnisse in der Therapie der konservativ refraktären chronischen Konstipation und obstruktiven Defäkation. Langzeitdaten wie auch Studien höchster Evidenz konnten diese jedoch nicht bestätigen. So zeigten randomisierte Studien keinen Vorteil einer sakralen Nervenstimulation verglichen mit nicht stimulierten Patienten. Im Langzeitverlauf erleiden viele Patienten einen Wirkverlust oder unerwünschte Ereignisse nach Implantation, die wiederum zu hohen Explantationsraten führen. Aufgrund der aktuellen Studienlage kann der sakralen Nervenstimulation momentan noch kein klarer Stellenwert im Allgemeinen Therapiealgorithmus der chronischen Konstipation und der obstruktiven Defäkation zugeordnet werden. Noch ist unklar, ob und welches Patientenkollektiv von einer sakralen Nervenstimulation (SNS) profitieren könnte. Weitere Studien zur Identifikation möglicher Selektionskriterien für die sakrale Nervenstimulation bei chronischer Konstipation und obstruktiver Defäkation sind hierfür notwendig. Ziel dieses narrativen Reviews ist es, einen Überblick über die aktuelle Datenlage in Hinblick auf den Stellenwert der SNS-Therapie bei der obstruktiven Defäkation als eine Subgruppe der chronischen Konstipation zu geben.
Female Patient with Simultaneous Occurrence of Subacute Thyroiditis and Focal Autonomy
Authors: Loberg Christina , Mallek Dirk , Mottaghy Felix M. , Beheshti Mohsen , Heinzel Alexander 
Published: August 2019

Clinical presentationA 57-year-old female patient presented at the emergency department with fatigue, increased sweating, flushing symptoms, loss of appetite, drowsiness and severe diarrhea. Besides she also mentioned painful left-sided sore throat radiating to the temples, beginning two weeks after a flu and subfebrile temperatures.
Paraneoplastische Livedovaskulopathie bei einem jungen Mann mit Embryonalzellkarzinom des Hodens – ein Fallbericht
Authors: Angeletti Flavia , Meissner Markus , Kaufmann Roland , Valesky Eva 
Published: August 2019

ZusammenfassungDie Livedovaskulopathie (LV) ist eine Erkrankung der kleinen Gefäße der Haut, bei der es durch Thromben zu Gefäßverschlüssen kommt. Klinisch präsentieren die Patienten eine Livedo racemosa und schmerzhafte Ulzerationen, die narbig als Atrophie blanche abheilen. Mit der Erkrankung vergesellschaftet sind häufig Störungen der Gerinnung mit Hyperkoagulabilität, aber auch Autoimmunerkrankungen und Neoplasien. Eine gründliche Diagnostik sollte daher bei bestehendem Verdacht auf eine LV durchgeführt werden. Wir präsentieren hier den Fall eines jungen Mannes mit LV, der neben einer Faktor V Leiden-Mutation, ein Antiphospholipid-Syndrom und einen Embryonalzelltumor des Hodens aufwies.
The Impact of Patient Interactive Systems on the Management of Pain in an Inpatient Hospital Setting: A Systematic Review
Authors: Aldekhyyel Raniah N. , Bakker Caitlin J. , Pitt Michael B. , Melton Genevieve B. 
Published: August 2019

Background While some published literature exists on the use of interactive patient care systems, the effectiveness of these systems on the management of pain is unclear. To fill this gap in knowledge, we aimed to understand the impact and outcomes of pain management patient interactive systems in an inpatient setting.
Methods A systematic literature review was conducted across seven databases, and results were independently screened by two researchers. To extract relevant data, critical appraisal forms were developed and each paper was examined by two experts. Information included patient interactive system category, patient population and number of participants/samples, experiment type, and specific outcome measures.
Results Out of 58 full-text articles assessed for eligibility, 18 were eligible and included in the final qualitative synthesis. Overall, there were two main types of pain management interactive systems within the inpatient setting (standalone systems and integrated platform systems). While systems were diverse especially for integrated platforms, most reported systems were entertainment distraction systems. Reports examined a variety of outcome measures, including changes in patient-reported pain levels, patient engagement, user satisfaction, changes in clinical workflow, and changes in documentation. In the 13 systems measuring pain scores, 12 demonstrated a positive impact on pain level scores.
Conclusion Pain management systems appear to be effective in lowering patient level scores, but research comparing the effectiveness and efficacy of one type of interactive system versus another in the management of pain is needed. While not conclusive, pain management systems integrated with other technology platforms show potentially promising effects with improving patient communication, education, and self-reporting.
Pregnancy Outcomes in Women with Incidentally Detected Unicornuate Uteri
Authors: Matthews Kathy C. , Chasen Stephen T. 
Published: August 2019

Abstract
Objective To estimate the incidence of adverse pregnancy outcomes in women with incidentally detected unicornuate uteri.
Study Design This is a descriptive study. Database review identified patients with unicornuate uteri and singleton pregnancies at ≥12 weeks' gestation. Patients were excluded if the diagnosis of unicornuate uterus was made after a midtrimester loss or preterm delivery. Records were reviewed to obtain clinical outcomes. Chi-square test, Fisher's exact test, and Mann–Whitney U-test were used for statistical analysis.
Results Forty patients with 67 pregnancies were included. Most diagnoses were made during infertility work-up (76.2%). There was one midtrimester loss (1.5%). In the remaining 66 pregnancies, median gestational age at delivery was 38 weeks. There were 20 (30.3%) preterm births, 9 (13.6%) spontaneous preterm births, and 11 (16.7%) indicated preterm births. Women with indicated preterm births were more likely to have placental abnormalities. Of the available placental pathology, 45.2% had histological lesions of malperfusion. Cesarean delivery was performed in 77.3% of cases.
Conclusion Most women with incidentally detected unicornuate uteri gave birth at term. More than half the preterm births were indicated, with relatively high rates of placental abnormalities. In patients without a poor obstetrical history, rates of midtrimester loss and spontaneous preterm birth were lower than previously described.
Risk of Severe Maternal Morbidity or Death in Relation to Prenatal Biochemical Screening: Population-Based Cohort Study
Authors: Lentz Eric J.M. , Park Alison L. , Langlois Alec W.R. , Huang Tianhua , Meschino Wendy S. , Ray Joel G. 
Published: August 2019

Abstract
Objective This study aimed to examine whether prenatal biochemical screening analytes are associated with an increased risk of severe maternal morbidity (SMM) or maternal mortality.
Study Design This population-based cohort study includes all women in Ontario, Canada, who underwent prenatal screening from 2001 to 2011. Increasing fifth percentiles of the multiple of the median (MoM) for alphafetoprotein (AFP), total human chorionic gonadotropin, unconjugated estriol (uE3), dimeric inhibin-A (DIA), and pregnancy-associated plasma protein A were evaluated. An abnormally high concentration (>95th percentile MoM) for each analyte, individually and combined, was also evaluated. The main outcome assessed was the adjusted relative risk (aRR) of SMM or maternal mortality from 20 weeks' gestation up to 26 weeks thereafter.
Results Among 748,972 pregnancies, 11,177 resulted in SMM or maternal mortality (1.5%). Except for uE3, the aRR of SMM or maternal mortality increased in association with increasing fifth percentiles of the MoM for all analytes. AFP (aRR: 2.10; 95% confidence interval [CI]: 1.97–2.25) and DIA (aRR: 2.33; 95% CI: 1.98–2.74) > 95th versus ≤ 5th percentile of the MoM were especially associated with SMM or death.
Conclusion Women with abnormally high concentrations of certain prenatal biochemical analytes may be at a higher risk of SMM or death in pregnancy or postpartum.
Risk Factors for Inpatient Mortality in Patients Born with Gastroschisis in the United States
Authors: Lamoshi Abdulraouf , Rothstein David H. 
Published: August 2019

AbstractObjective This study aimed to characterize risk factors for inpatient mortality in patients born with gastroschisis in a contemporary cohort.Study Design This was a retrospective cohort study of infants born with gastroschisis using the Kids' Inpatient Database 2016. Simple descriptive statistics were used to characterize the patients by demographics, and illness severity was estimated using the All-Patient Refined Diagnosis-Related Groups classification. Variables associated with an increased risk of mortality on univariate analysis were incorporated into a multivariable logistic regression model to generate adjusted odds ratios (aORs) for mortality.Results An estimated 1,990 patient with gastroschisis were born in 2016, with a 3.7% mortality rate during the initial hospitalization. Multivariable logistic regression demonstrated the following variables to be associated with an increased risk of inpatient mortality: black or Asian race compared with white (aOR: 2.6, 95% confidence interval [CI]: 1.1–6.1, p = 0.03 and aOR: 4.1, 95% CI: 1.3–13.3, p = 0.02, respectively), whereas private health insurance compared with government (aOR: 0.2; 95% CI: 0.2–0.8; p = 0.007) and exurban domicile compared with urban (aOR: 0.5; 95% CI: 0.2–0.9; p = 0.04) appeared to be associated with a decreased risk of inpatient mortality.Conclusion Inpatient mortality for neonates with gastroschisis is relatively low. Even after correcting for illness severity, race, health insurance status, and domicile appear to play a role in mortality disparities. Opportunities may exist to further decrease mortality in at-risk populations.
Smallness at Birth and Neonatal Death: Reexamining the Current Indicator Using Sibling Data
Authors: Tabet Maya , Flick Louise H. , Xian Hong , Jen Jen Chang 
Published: August 2019

Abstract
Objective The similarity in size among siblings has implications for neonatal death, but research in this area is lacking in the United States. We examined the association between small-for-gestational age (SGA), defined as a birthweight <10th percentile for gestational age, and neonatal death, defined as death within the first 28 days of life, among second births who had an elder sibling with SGA (“repeaters”) versus those whose elder sibling did not have SGA (“nonrepeaters”).
Study Design We conducted a population-based retrospective cohort study including 179,436 women who had their first two nonanomalous singleton live births in Missouri (1989–2005). Logistic regression was used to evaluate the association between SGA and neonatal death among second births, stratified by whether the elder sibling was SGA.
Results Out of 179,436 second births, 297 died in the neonatal period. There was a significant interaction between birthweight-for-gestational age of first and second births in relation to neonatal death (p = 0.001). Second births with SGA had increased odds of neonatal death by 2.15-fold if they were “repeaters,” and 4.44-fold if they were “nonrepeaters,” as compared with non-SGA second births.
Conclusion Our findings suggest that referencing sibling birthweight may be warranted when evaluating infant size in relation to neonatal death.
Motility-limited aggregation of mammary epithelial cells into fractal-like clusters
Authors: Leggett Susan E. , Neronha Zachary J. , Bhaskar Dhananjay , Sim Jea Yun , Perdikari Theodora Myrto , Wong Ian Y. 
Published: August 2019

Significance
Individually migrating cells cluster into multicellular tissues during tissue formation, inflammation, and cancer. The corresponding increase in cell density can result in arrested motion, analogous to the “jamming” of soft materials such as glasses and gels. Here, we show that cells with reduced motility and proliferation organize into branching clusters, reminiscent of aggregation in nonliving colloidal particles. Subsequently, “leader cells” guide collective migration to link clusters together into spanning networks. These arrested dynamics occur at unusually low density and are reminiscent of gelation. Furthermore, increased motility and proliferation recover a glass-like transition at higher density. Overall, arrested motion in living cells has striking similarities with nonliving colloidal particles, suggesting physical signatures of clustering and branching morphogenesis in development and disease.
Yet another paradigm change? Narratives and competing policy paradigms in Brazilian labour market policies
Authors: Vogeler Colette S 
Published: August 2019

ABSTRACT
When policy paradigms compete for sovereignty, a well thought-out narrative story is essential to arguing why one paradigm is superior to another. Narrative stories can be applied to underline the imperative for paradigmatic policy change. Combining Hall’s work on policy paradigms with Stone’s conceptualisation of narrative stories, this article explores how narrative stories are applied to support or oppose competing policy paradigms and proposes that the systematic analysis of narrative stories fosters a better understanding of policy paradigms. The case of labour market policy in Brazil is used to exemplify the argument: 13 years of Workers’ Party rule induced far-reaching changes in Brazilian social and labour market policy based on demand-orientation. Following the impeachment of President Rousseff, interim-President Temer initiated major labour reforms, reviving liberal narratives. This article explores how these policy changes are representative of the competition between policy paradigms, which are reflected in party-political competition, and how recent paradigm change is supported by the construction of narrative stories.
Opto-electromechanically induced transparency in a hybrid opto-electromechanical system*
Authors: Liu Hui , Qin Li-Guo , Tian Li-Jun , Ma Hong-Yang 
Published: August 2019

Abstract
We study opto-electromechanically induced transparency in a hybrid opto-electromechanical system made up of an optical cavity tunneling-coupled to an opto-mechanical cavity, which is capacitively coupled to a charged mechanical oscillator by a charged and moveable mechanical cavity mirror as an interface. By studying the effects of the different parameters on the output field, we propose a scheme to modulate the opto-electromechanically induced transparency (OEMIT). Our results show that the OEMIT with the transparency windows from single to double to triple can be modulated by changing the tunneling, opto-mechanical and electrical couplings. In addition, the explanation of the OEMIT with multi-windows is given by the energy level diagram based on quantum interference. Our investigation will provide an optimal platform to manipulate the transmission of optical field via microfabricated opto-electromechanical device.
Nondeterministic Model Updating of Laser Spot Welded Structure via Response Surface Methodology
Authors: Shah M A S Aziz , Yunus M A , Rani M N Abdul , Salleh N , Iskandar Mirza W I I Wan , Peter C 
Published: August 2019

AbstractThis paper presents the application of response surface method in finite element model updating, as an approach for improving the accuracy and efficiency of the finite element model of a laser spot welded structure, to reflect the physical responses of the structure. The procedures of implementation for response surface in model updating such as sampling method, selecting the significant updating parameters and constructing a quadratic polynomial response surface are discussed. Initially, the finite element model of the structure was developed using CQUAD4 shell element alongside CWELD element connectors to represent laser spot weld joints. Then, NASTRAN SOL 103 was used to calculate the dynamic behaviour of the model (natural frequencies and mode shapes). The experimental modal analysis was then conducted under free-free boundary conditions via LMS SCADAS to obtain experimental data. The minimisation of the discrepancies of the finite element model was based on objective function that was formed by the residuals between finite element and experimental natural frequencies. Results show that response surface method was efficient to be used in finite element model updating since it is capable to improve the accuracy of the finite element model.
Identification dynamic behaviour of disc brake based on finite element model updating approach
Authors: Fouzi M. S. M. , Sani M. S. M. , Ishak M. F. R. 
Published: August 2019

Abstract
Braking system is an essential mechanism that designed to provide a good handling in order to slow down or to stop a vehicle depends on situation and driver’s capability. In order to slow down or to stop the vehicle, brake pad will be pushed and make contact with the disc/rotor to form the friction. Resultant from braking event, it will produce vibration on disc/rotor structure. Thus, this study presents numerical prediction approach to identify the dynamic behaviour of disc brake structure using normal mode analysis in FEA software. Since the result of FEA is a prediction, the fidelity of FE model might be questioned. Therefore, measured data from EMA used to validate the predicted result of FEA through correlation process. As FE model used in this study made from assumption and simplification apart of real structure, it drive to discrepancy between FEA result and EMA data during correlation process. Hence, FE model updating approach implemented in order to reduce the discrepancy and increase the trustworthiness of FE model and it is become the main goal in the present study. The updating process has successfully reduced the discrepancy between FEA and EMA from 9.00 % of error to 4.05 % of error from its original value. As conclusion, the use of model updating process is important in preparing a reliable FE model of test structure no matters how simple or complex it is before being used for further analysis.
Vibration Analysis on Palm Oil Methyl Ester Biodiesel as a Fuel with The Additional of Butanol
Authors: Zikri J.M. , Sani M.S.M. , Erdiwansyah  , Yusop A.F. , Izzudin I. , Sapee S. 
Published: August 2019

Abstract
Along with the development of alternative fuel to replace the usage of petroleum-derivatives, the vibration in the diesel engine has become one of the main focus by researchers recently. The biodiesel has been investigated numerously since the application does not need any modification of the engine and with the different fuel properties, the biodiesel can enhance or deteriorates the engine. Hence, this study will be carried out to investigate the effect adding butanol in two different biodiesel blends by using vibration analysis. The vibration level will be determined in velocity term in RMS by using uniaxial accelerometer. The results indicated that the B10Bu10 blend shows a better reduction in vibration level with the decrement more than 30% for both speed in 25% load while in the 50% load, the decrement was observed to be 13.46% for 1800 RPM and 22.9% for the 2100 RPM. Finally, it can be conclude that the usage of biodiesel with the additional of butanol can improve the vibration level in the diesel engine, however, with an additional volume of biodiesel in the blend tends to increase the vibration level in certain condition.
Correlation of numerical and experimental analysis for dynamic behaviour of a 3 blade propeller structure
Authors: Brapakaran P , Abdullah N A Z , Fouzi M S M , Sani M S M 
Published: August 2019

Abstract
In pursuance of deciding the dependability of data gathered by testing a finite element modal in the software version, experimental data is frequently used for validation. On account of finite element analysis, it can sometimes be considered as inaccurate particularly when applied to the complex structure, for example, a propeller blade. This is because of challenges that may happen in the modelling of joints, boundary conditions, and damping of the structure. In this research, a procedure of correlation and validation of the model-based test plan with modal testing results was conducted. Modal properties (normal frequencies, mode shapes, and damping ratio) of a propeller blade structure were resolved by using both test experimental modal analysis (EMA) and finite element analysis (FEA). Correlation of both sets of data was performed for validation. It created the impression that there was a noticeable estimation of error between those two sets of data. Small discrepancies of percentage error of obtained natural frequency for FEA and EMA makes both of the methods can be applied to determine the dynamic characteristic of the propeller structure.