bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining multiple structural inversions to constrain the solar modelling problem
Authors: Buldgen G. , Salmon S. J. A. J. , Noels A. , Scuflaire R. , Montalban J. , Baturin V. A. , Eggenberger P. , Gryaznov V. K. , Iosilevskiy I. L. , Meynet G. , Chaplin W. J. , Miglio A. , Oreshina A. V. , Richard O. , Starostin A. N. 
Published: November 2018

Context. The Sun is the most studied of all stars, which serves as a reference for all other observed stars in the Universe. Furthermore, it also serves the role of a privileged laboratory of fundamental physics and can help us better understand processes occuring in conditions irreproducible on Earth. However, our understanding of our star is currently lessened by the so-called solar modelling problem, resulting from comparisons of theoretical solar models to helioseismic constraints. These discrepancies can stem from various causes, such as the radiative opacities, the equation of state as well as the mixing of the chemical elements.
Aims. By analysing the potential of combining information from multiple seismic inversions, our aim is to help disentangle the origins of the solar modelling problem.
Methods. We combined inversions of the adiabatic sound speed, an entropy proxy and the Ledoux discriminant with other constraints such as the position of the base of the convective zone and the photospheric helium abundance. First, we tested various combinations of standard ingredients available for solar modelling such as abundance tables, equation of state, formalism for convection and diffusion and opacity tables. Second, we studied the diagnostic potential of the inversions on models including ad hoc modifications of the opacity profile and additional mixing below the convective envelope.
Results. We show that combining inversions provides stringent constraints on the required modifications to the solar ingredients, far beyond what can be achieved from sound speed inversions alone. We constrain the form and amplitude of the opacity increase required in solar models and show that a 15% increase at log T = 6.35 provides a significant improvement, but is insufficient on its own. A more global increase in the opacity, within the uncertainties of the current tables, coupled with a localized additional mixing at the bottom of the convective zone provides the best agreement for low-metallicity models. We show that high-metallicity models do not satisfy all the inversion results. We conclude that the solar modelling problem likely occurs from multiple small contributors, as other ingredients such as the equation of state or the formalism of convection can induce small but significant changes in the models and that using phase shift analyses combined with our approach is the next step for a better understanding of the inaccuracies of solar models just below the convective envelope.
Analysis of the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head
Authors: Zhao Pengfei , Hao Jing 
Published: November 2018

Objective: to investigate the safety and long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head.
Method: a total of 76 patients with non-traumatic osteonecrosis of the femoral head were admitted to our hospital from February 2012 to November 2014 and included in the study. All the patients were treated by core decompression with synthetic calcium-sulfate bone grafting. After treatment, the patients were followed-up for 12 months. The operation time, intraoperative blood loss, and perioperative complications were also recorded intraoperatively to evaluate the clinical efficacy and safety. The preoperative and postoperative pain scores measured by visual analogy score (VAS) were also recorded and compared.
Results: all of the 76 patients were successfully operated and included in the study. The mean operation time was 34.6±14.2 min, and the intraoperative blood loss was 23.6±8.9 mL. The patients hip functions were assessed on the basis of the Harris hip score, 3 and 12 months after operation. The excellent rates 3 and 12 months after operation were significantly higher than those before operation (P<0.05). The imaging stabilities of the hip joints 3 and 12 months after operation were significantly higher than those before operation (P<0.05). The patient postoperative pain scores (VAS score) gradually decreased. The VAS scores 12 months after operation were significantly lower than those before operation (P<0.05).
Conclusion: the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head is good and accompanied with significantly improved postoperative joint functions.
Laparoscopic combined with hysteroscopic repair or operative hysteroscopy in the treatment of symptomatic cesarean-induced diverticulum
Authors: Lv Bingqing , Xie Xi , Liu Chaobin , Lin Yuan 
Published: November 2018

Objective: The postmenstrual bleeding with cesarean-induced diverticulum is a bothersome symptom and can be confused with other abnormal-uterine bleeding disease. The aim of the present study was to evaluate the efficacy and safety of laparoscopic combined with hysteroscopic repair vs operative hysteroscopy in treatment of symptomatic cesarean-induced diverticulum.
Methods: Eighty-two women with cesarean-induced diverticulum who underwent either laparoscopic combined with hysteroscopic repair or operative hysteroscopy between January 2012 and September 2015 were retrospectively included in the study. We evaluated the menstrual duration before and after the surgery, the width, length and depth of the niche, operating time, blood loss, complications, and postoperative pregnancy status.
Results: 62.2% (51/82) patients started to have postmenstrual bleeding immediately when they gained regular menstruation after their cesarean section. The laparoscopic group has longer operative time and greater blood loss (p<0.001). Both groups have a significant improvement in their menstruation duration ( p< 0.001). The patients in the laparoscopic repair group had a greater improvement in bringing the uterine bleeding into normal menstruation duration (P=0.046) and the same in pregnancy rate (P=0.505). The interval between operation and pregnancy in laparoscopic combined with hysteroscopic group was much longer than the hysteroscopic group (27 vs 10 months, p<0.001).
Conclusion: the laparoscopic repair exhibited a better efficiency in bringing the uterine bleeding into normal menstruation duration and in improving the pregnancy rate However, there was not a clear absolute advantage for one of the two type of surgeries. Thus, patients with post-cesarean section diverticulum (PCSD) should choose with caution the type of surgery, considering the residual myometrial thickness (RMT), the age, the desire for further fertility and ovarian reserve capacity.
Effects of continuous positive airway pressure on elderly patients with obstructive sleep apnea: a meta-analysis
Authors: Yan Binhong , Jin Yongmei , Hu Yi , Li Shu 
Published: November 2018

Objective: the aim of the study was to evaluate the efficacy of continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea in the elderly.
Method: a comprehensive search for qualified clinical trials was performed on April, 2016. Basic demographic information of enrolled subjects, study design, survival rate, cardiovascular events, quality of life scores, and neurocognitive data were extracted for analysis.
Results: A total of seven clinical trials were included in this meta-analysis, in which untreated elderly patients exhibited worse survival rate than those with CPAP (OR=2.22, 95% CI=1.64 to 3.01, P< 0.00001). Treated elderly patients exhibited less cardiovascular risk than those without CPAP (RR=0.49, 95% CI=0.36 to 0.66, P<0.00001) and a statistically significant improvement on all the domains of Quebec Sleepiness Questionnaire, supported by pooled weighted mean difference. Furthermore, CPAP treatment partially improved the cognitive functions.
Conclusion: CPAP treatment achieves improvements in decreasing mortality and controlling cardiovascular events and exhibits few effects on neurocognitive function. Further large-scale, well-designed interventional investigation is needed.
Assessment of non-technical skills of operating room nurses
Authors: Ribakova Anna , Deklava Liana 
Published: November 2018

Training of non-technical skills helps to achieve reduction of human errors that could contribute to safety of patients. For assessment of non-technical skills of Operating Room (OR) nurses, researchers of the University of Aberdeen developed intra-operative work organization protocol for observation of non-technical behaviour. This system includes taxonomy of non-technical skills, definitions, desirable and adverse behavioural markers, and Likert scale for behavioural assessment. The objective of this research is to assess non-technical skills of OR nurses in work environment and compare the findings with OR nurses self-assessment of non-technical skills. The study involved 15 interviews with OR nurses in sterile position (scrub nurses) and 15 observations of their work in four hospitals. Providing self-assessment, OR nurses note a tendency to minimal communication. In practice, nurses often show good ability to think analytically, to predict events and needs and are able to act decisively during surgery. OR nurses in Latvia partially associate their work with non-technical skills, however in practice these skills are used, and they were relatively highly valued during the study. Insufficient self-assessment of such skills of nurses as cooperation in performance of physical tasks, promotion of personnel safety and decisive action, indicates the need for development of scrub nurse's work standards with clearly defined area of responsibility and duties.
Zertifikate und ärztliche Tätigkeitsschwerpunkte in der Dermatologie: Rechtlicher Hintergrund
Authors: Elsner P. 
Published: November 2018

ZusammenfassungDer Arztberuf ist ein freier Beruf und kein Gewerbe; als Angehörige eines freien Berufs üben Ärzte ihren Beruf eigenverantwortlich und medizinisch unabhängig aus. Werbung für ihre ärztliche Tätigkeit ist Ärzten daher gemäß ihrer Berufsordnung nur eingeschränkt möglich, um Irrtümern und damit einer Verunsicherung von Patienten vorzubeugen, was das Vertrauen in den Arztberuf untergraben und langfristig negative Rückwirkungen auf die medizinische Versorgung der Bevölkerung haben könnte. Andererseits haben Patienten ein Recht darauf, über besondere Fähigkeiten und Qualifizierungen von Ärzten aufgeklärt zu werden, um den für ihre Behandlung geeigneten Arzt zu finden. Dieser inhärente Konflikt zwischen Werbeverbot und Informationsrecht und -pflicht wurde vom deutschen Bundesverfassungsgericht in mehreren Grundsatzurteilen im Sinne einer Lockerung des früher streng ausgelegten Werbeverbotes entschieden. Nach der Muster-Berufsordnung für Ärzte sind ÄrztInnen nunmehr „sachliche berufsbezogene Informationen gestattet“. „Qualifikationen und Tätigkeitsschwerpunkte“ dürfen angekündigt werden, „wenn diese Angaben nicht mit solchen nach geregeltem Weiterbildungsrecht erworbenen Qualifikationen verwechselt werden können“.Die von der Deutschen Dermatologischen Akademie ausgestellten Zertifikate als besondere Weiterbildungs- und Kompetenznachweise für FachärztInnen für Haut- und Geschlechtskrankheiten entsprechen diesen Anforderungen.
ADR evaluation of screening colonoscopies during 2016 – 2017 in a private health clinic in Peru
Authors: León Moreno Julio F. 
Published: November 2018

Abstract
Background and study aims High-quality colonoscopy is fundamental for preventing colorectal cancer (CRC). The adenoma detection rate (ADR) is a key colonoscopy quality measure. The aim of this study was to establish the screening colonoscopy ADR of a tertiary referral center in Peru, identify the relationship between the ADR and patient age, sex and the colonoscopist, and determine the endoscopic and histopathological characteristics of the lesions found.
Patients and methods A retrospective observational longitudinal study was undertaken between January 2016 and June 2017.
Results Eight colonoscopists performed screening colonoscopies on 620 patients scoring ≥ 6 points on the Boston Bowel Preparation Scale (BBPS); cecal intubation was complete in 595 patients (cecal intubation rate [CIR] 95.9 %). The overall ADR was 29.7 % (females 25.4 %, males 33.1 %, P = 0.040, 95 %Cl). The ADR colonoscopist range was 25.0 % to 34.4 %. The highest ADR (41.2 %, P = 0.013, 95 %Cl) was for patients aged 65 to 75 years. Adenoma colon locations were: left 49 %, transverse 21.6 % and right 29.4 %. Adenoma dysplasia grades: low 98 %, high 2 %. Sixty-three percent of the lesions were 5 mm to 10 mm. Resections performed: 78.5 % cold biopsy forceps (CBF), 3.4 % cold snare polypectomy (CSP) and 18.1 % endoscopic mucosal resection (EMR).
Conclusions The ADR established was in line with the joint American College of Gastroenterology (ACG)/American Society for Gastrointestinal Endoscopy (ASGE) recommendations and related to patient age and gender but not to the colonoscopist. Colonoscopists should ensure rigorous application of the colonoscopy quality actions. ADR should be evaluated frequently.
Notfälle an Bord von Linienflugzeugen: In-Flight Medical Emergencies (IFME) und In-Flight Cardiac Arrest (IFCA)
Authors: Hinkelbein Jochen , Adler Christoph , Bernhard Michael , Hohn Andreas , Jansen Stefanie , Komorowski Matthieu , Glaser Eckard , Warnecke Tobias , Kalina Steffen , Kerkhoff Steffen , Hinkelbein Franziska , Braunecker Stefan , Neuhaus Christopher 
Published: November 2018

Zusammenfassung
Hintergrund Im Jahr 2017 wurden weltweit etwa 4 Milliarden Menschen mit einem Flugzeug transportiert. Die International Air Transport Association (IATA) prognostiziert für Europa bis zum Jahr 2034 eine durchschnittliche jährliche Steigerung der Passagierzahlen von 2,7%. In der zivilen Luftfahrt treten Notfälle an Bord (sogenannte In-Flight Medical Emergencies, IFME) mit einer Häufigkeit von 1 pro 14 000 bis 1 pro 50 000 transportierte Passagiere auf. Belastbare Daten über die exakte Häufigkeit und Art von medizinischen Notfällen an Bord von Flugzeugen existieren nicht. Ein Herz-Kreislauf-Stillstand tritt statistisch gesehen nur in 0,3% der Notfälle an Bord auf. Dieses Ereignis ist jedoch mit einer Mortalität von 86% assoziiert und stellt daher Passagiere und Crew zugleich vor eine große Herausforderung. Mit der Leitlinie zum In-Flight Cardiac Arrest (IFCA) wurden 28 spezifische Empfehlungen erarbeitet. Ziel der Leitlinie war es, spezifische Handlungsempfehlungen für mitfliegende Ärzte, Kabinenpersonal (Cabin Crew) und auch Fluglinien zur Behandlung des Herz-Kreislauf-Stillstands an Bord von Luftfahrzeugen zu generieren.
Image-guided versus palpation-guided injections for the
treatment of chronic lateral epicondylopathy: a randomized controlled clinical
trial
Authors: Malahias Michael-Alexander , Kaseta Maria-Kyriaki , Kazas Sotirios-Tsambikos , Megaloikonomos Panayiotis D , Mavrogenis Andreas F , Babis George C 
Published: November 2018

Abstract
Background There have been several studies published comparing the
ultrasound-guided with the “blind” infiltrations in the shoulder’s area. On the
contrary, there is only very limited data regarding the necessity of ultrasound
guidance in lateral epicondylitis.
Materials and Methods A prospective, randomized, blinded at initial and
follow-up evaluation, comparative clinical trial was conducted, involving 44
patients with a history of chronic persistent epicondylopathy. The patients were
randomly divided into 2 groups of 22 people each. Group A patients underwent
three ultrasound-guided betamethazone injections, while group B included those
who underwent three “blind” injections, centered at the palpable point of
maximum pain. The evaluation was done before and after (4 and 12 weeks) the
injections using the Visual Analogue Scale for pain (VAS, 0–10) and the Roles
& Maudsley score.
Results There was not any significant statistical difference between the
two groups as for mean VAS at 4 weeks (p = 0.150, t-test) and mean VAS at 12
weeks (p = 0.286, t-test). Furthermore, the final success rate, as measured by
the Roles & Maudsley score, was slightly superior in group B (67 % of the
patients with excellent or good results) when compared with group A (46 % of the
patients), but without any statistical difference (p = 0.161, chi-square).
Conclusion Our trial proved that an ultrasound-guided injection is not
superior than a palpation-guided injection of corticosteroids in the treatment
of lateral epicondylopathy.
Enteral self-expandable metal stent placement for malignant afferent limb syndrome using single-balloon enteroscope: report of five cases
Authors: Yane Kei , Katanuma Akio , Hayashi Tsuyoshi , Takahashi Kuniyuki , Kin Toshifumi , Nagai Kazumasa , Tanaka Kazunari , Komatsu Naohiro , Endo Masato , Kobayashi Yousuke , Takigawa Yukiko , Utsunomiya Ran 
Published: November 2018

AbstractEndoscopic enteral self-expandable metal stent (SEMS) placement is a useful alternative treatment option for malignant afferent limb syndrome (ALS). We investigated the safety, efficacy, and follow-up results of enteral SEMS placement using a single-balloon enteroscope for the treatment of malignant ALS.
Single-operator cholangioscopy for diagnosis of cholangioadenoma (bile duct adenoma) and its potential impact on surgical management
Authors: Eccles John , Thiesen Aducio , Sandha Gurpal 
Published: November 2018

AbstractBackground and study aims Cholangioadenoma is not recognized commonly and is often only diagnosed on surgical specimens. Direct per oral single-operator cholangioscopy (SOC) allows characterization of common bile duct (CBD) lesions through direct visualization and directed forceps biopsies with potential for impacting surgical management decisions. This is a retrospective review of all SOC cases diagnosed with cholangioadenoma. Patient demographics and outcomes were recorded. Three patients (all male), average age 68 years (range 62 – 76 years), were identified to have a cholangioadenoma. The clinical indication for SOC was deranged liver enzymes with a dilated CBD and a CBD abnormality identified on biliary imaging. The site of cholangioadenoma was proximal, mid and distal CBD, respectively. All patients had a successful SOC with targeted biopsy-proven diagnosis. One patient had a synchronous cholangiocarcinoma and underwent palliative stenting whereas the other two patients underwent appropriate curative resection based on cholangioadenoma location. We conclude that SOC is safe and effective for diagnosis of cholangioadenoma and has potential impact on decisions for surgical management.
Endoscopic submucosal dissection for rectal neoplasia extending to the dentate line: European experience
Authors: Probst Andreas , Ebigbo Alanna , Märkl Bruno , Ting Saskia , Schaller Tina , Anthuber Matthias , Fleischmann Carola , Messmann Helmut 
Published: November 2018

Abstract
Background and study aims The ideal treatment strategy for rectal neoplasia extending to the dentate line (RNDL) is not well defined. Endoscopic mucosal resection (EMR) and submucosal dissection (ESD) compete with surgical techniques such as transanal endoscopic microsurgery (TEM). Non-Asian data and prospective data on ESD are lacking. The study aim was to evaluate the role of ESD in treatment of RNDL in a Western center.
Patients and methods Eighty-six patients with rectal adenomas were included. ESD was performed in 86 rectal adenomas including 24 RNDLs (27.9 %) and 62 lesions distant from the dentate line (72.1 %).
Results En bloc resection rate was comparable (91.7 % vs. 93.5 %, P = 0.670) between ESD for RNDL and non-RNDL. R0 resection rate was significantly lower in ESD for RNDL compared to that for non-RNDL (70.8 % vs 88.7 %; P = 0.039), but most non-R0 resection was unclear margin (Rx) and was not obvious positive margin (R1). Accordingly, the recurrence rate after ESD for RNDL (4.5 %) was not statistically different from that for non-RNDL (0 %, P = 0.275) and was lower than that previously reported for EMR. Median procedure time was 127 vs. 110 minutes (P = 0.182). Risk of delayed bleeding (20.8 % vs. 0 %, P = 0.001) and postinterventional pain (33.3 % vs. 14.5 %, P = 0.07) increased in RNDL cases, but they were managed conservatively. Incidence of stricture (4.2 % vs. 1.6 %, P = 0.483) and perforation (0 % vs. 1.6 %, P = 1.000) were similar.
Conclusions ESD is a feasible and safe resection technique for RNDLs. A randomized controlled trial comparing ESD to other methods (EMR or transanal surgery) is warranted.
Treatment of Pulmonary Vasculitis
Authors: Guillevin Loïc , Terrier Benjamin 
Published: November 2018

AbstractPulmonary vasculitis can be heterogeneous and have some pathophysiological, clinical, and biological specificities that might influence treatment choices. Main vasculitides associated with pulmonary vasculitis include antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, immune complex small vessel vasculitis, and antiglomerular basement membrane disease. Patient characteristics and association of lung involvement with other manifestations affecting disease severity may also influence treatment strategy. Alveolar hemorrhage frequently requires urgent treatment to control the underlying disease and provide supportive care such as mechanical ventilation. The level of evidence of each treatment strategy varies according to the underlying disease, but treatment is usually based on a combination of glucocorticoids and immunosuppressive agents, especially cyclophosphamide and rituximab. The role of plasma exchanges, widely used in patients with severe vasculitis, is controversial, based on results from recent prospective randomized controlled trials.
Therapeutic Intervention in Musculoskeletal Radiology: Current Practice and Future Directions
Authors: Farrell Terence , Hynes John , Hughes Nicola , O'Byrne Ciara , Eustace Stephen , Walsh John 
Published: November 2018

AbstractOver the last several decades, the volume and range of therapeutic musculoskeletal (MSK) interventions that radiologists can offer their patients has dramatically increased. With new materials and improving imaging modalities, as well as significant investment in research, the field of MSK interventional radiologic intervention will likely continue to expand. In this article, we summarize the range of interventions currently available to the MSK radiologist. We also seek to explore new and emerging techniques that may become commonplace in the near future while considering the challenges that may lie ahead in the field of MSK radiology.
Pathogenesis of ANCA-Associated Pulmonary Vasculitis
Authors: Alba Marco , Jennette J. , Falk Ronald 
Published: November 2018

AbstractAntineutrophil cytoplasmic antibodies (ANCAs) are autoantibodies specific for antigens located in the cytoplasmic granules of neutrophils and lysosomes of monocytes. ANCAs are associated with a spectrum of necrotizing vasculitis that includes granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. Pulmonary vasculitis and related extravascular inflammation and fibrosis are frequent components of ANCA vasculitis. In this review, we detail the factors that have been associated with the origin of the ANCA autoimmune response and summarize the most relevant clinical observations, in vitro evidence, and animal studies strongly indicating the pathogenic potential of ANCA. In addition, we describe the putative sequence of pathogenic mechanisms driven by ANCA-induced activation of neutrophils that result in small vessel necrotizing vasculitis and extravascular granulomatous necrotizing inflammation.