bluuebunny/crossref_metadata_2025_split huggingface dataset:
New predictive analytic‐aided response‐based system integrity protection scheme
Authors: Gawande Prashant , Dambhare Sanjay 
Published: January 2019

The ever‐increasing power demand coupled with limited power transfer corridors and minimum redundancy have forced power system operation close to its security limits. Further, increase in renewable penetration, market deregulation, and mal‐operation of protective devices under stressed conditions has imposed serious threats to power system stability. To overcome these operational challenges, a new response‐based system integrity protection scheme (SIPS) is proposed here. The proposed scheme works towards preserving system integrity in two ways. First, an apparent impedance‐based relay security index (RSI) is introduced to prevent the zone 3 mal‐operations of distance relays under stressed situations and achieve accelerated zone 3 operation during faults. Second, a system stability index (SSI) computed from the generator rotor angles is forecasted using a predictive analytic to foresee system instability, if any, and take corrective actions in real time. The scheme can be used for area‐based monitoring and control of system stability, does not require coherency group identification, remains unaffected by changes in network topology, and can effectively function for first swing stable contingencies. The scheme is tested on IEEE 39‐bus New England system and the results obtained validate the reliability of scheme in maintaining system integrity.
Comprehensive vibration generation model of transformer winding under load current
Authors: Zhang Fan , Ji Shengchang , Shi Yuhang , Ren Fuqiang , Zhan Cao , Zhu Lingyu 
Published: January 2019

This study proposes a comprehensive model to investigate winding vibration characteristics. The radial vibration model is firstly established based on the Euler–Bernoulli beam theory, and the radial acceleration is found to be the second derivative of deflection under the quasi‐static load. The fluid‐loading effect of oil on winding vibration is then investigated through experimental modal analysis and finite element method. This effect leads to the decrease of natural frequencies and the increase of damping ratios. The harmonic response of axial winding vibration at 100 Hz shows the symmetry distribution that vibration on the one quarter and three‐quarters of the winding height are larger than other positions. The radial acceleration is not affected by the clamping pressure, whereas the axial acceleration is in a reciprocal relationship with it.
Class of high step‐up switched Z‐source inverters: steady state analysis and objective function
Authors: Hasan Babayi Nozadian Mohsen , Babaei Ebrahim , Hosseini Seyed Hossein 
Published: January 2019

In this study, high step‐up switched Z‐source inverters (HSZSIs) with two main groups namely types I and II are proposed. Each of these groups includes several proposed structures. Owing to the features of the proposed structures such as high boost factor , continuous input current, and low voltage stress; they can be used in different applications such as renewable power systems. By using the same numbers of the passive elements in comparison with a conventional Z‐source inverter (ZSI), quasi‐ZSI, and series ZSI (SZSI), the proposed structures produce a higher boost factor. A new objective function is defined so that all compared parameters can be investigated with each other simultaneously. The power losses and efficiency analyses for all of the proposed structures are done and compared with the conventional structures. It is shown that for , the measured efficiencies for basic HSZSI type I, quasi‐HSZSI type I, basic HSZSI type II and quasi‐HSZSI type II are 91, 85, 96, and 92%, respectively. In addition, the total harmonic distortion calculation, dynamic performance and designing a closed‐loop control method for the proposed structures are shown. Finally, the experimental results are indicated for a 500 W prototype.
Closing the gap between Earth-based and interplanetary mission observations: Vesta seen by VLT/SPHERE
Authors: Fétick R. JL. , Jorda L. , Vernazza P. , Marsset M. , Drouard A. , Fusco T. , Carry B. , Marchis F. , Hanuš J. , Viikinkoski M. , Birlan M. , Bartczak P. , Berthier J. , Castillo-Rogez J. , Cipriani F. , Colas F. , Dudziński G. , Dumas C. , Ferrais M. , Jehin E. , Kaasalainen M. , Kryszczynska A. , Lamy P. , Le Coroller H. , Marciniak A. , Michalowski T. , Michel P. , Mugnier L. M. , Neichel B. , Pajuelo M. , Podlewska-Gaca E. , Santana-Ros T. , Tanga P. , Vachier F. , Vigan A. , Witasse O. , Yang B. 
Published: January 2019

Context. Over the past decades, several interplanetary missions have studied small bodies in situ, leading to major advances in our understanding of their geological and geophysical properties. These missions, however, have had a limited number of targets. Among them, the NASA Dawn mission has characterised in detail the topography and albedo variegation across the surface of asteroid (4) Vesta down to a spatial resolution of ~20 m pixel−1 scale.
Aims. Here our aim was to determine how much topographic and albedo information can be retrieved from the ground with VLT/SPHERE in the case of Vesta, having a former space mission (Dawn) providing us with the ground truth that can be used as a benchmark.
Methods. We observed Vesta with VLT/SPHERE/ZIMPOL as part of our ESO large programme (ID 199.C-0074) at six different epochs, and deconvolved the collected images with a parametric point spread function (PSF). We then compared our images with synthetic views of Vesta generated from the 3D shape model of the Dawn mission, on which we projected Vesta’s albedo information.
Results. We show that the deconvolution of the VLT/SPHERE images with a parametric PSF allows the retrieval of the main topographic and albedo features present across the surface of Vesta down to a spatial resolution of ~20–30 km. Contour extraction shows an accuracy of ~1 pixel (3.6 mas). The present study provides the very first quantitative estimate of the accuracy of ground-based adaptive-optics imaging observations of asteroid surfaces.
Conclusions. In the case of Vesta, the upcoming generation of 30–40 m telescopes (ELT, TMT, GMT) should in principle be able to resolve all of the main features present across its surface, including the troughs and the north–south crater dichotomy, provided that they operate at the diffraction limit.
Akutes Nierenversagen auf der Intensivstation – was ist neu?
Authors: Schmitz Michael , Heering Peter 
Published: January 2019

Was ist neu?
Diagnostik Der Einsatz von elektronischen Frühwarnsystemen (electronic alerts) für das akute Nierenversagen (ANV), kombiniert mit der Anwendung von standardisierten Kidney Care Bundles, kann das Outcome der Patienten verbessern. Aktuell gilt es, Wege zu finden, diese in den klinischen Alltag zu implementieren.
Prävention/konservative Therapie Eine Volumenersatztherapie soll mit balancierten Lösungen erfolgen. Der Einsatz von 0,9 %iger NaCl-Lösung soll vermieden werden. Eine dringlich indizierte radiologische Diagnostik mit jodhaltigem Kontrastmittel sollte nicht aufgrund einer Nierenfunktionsverschlechterung verzögert oder abgesetzt werden. Die prophylaktischen Maßnahmen hierbei unterscheiden sich nicht von den generellen Maßnahmen bei ANV (Euvolämie erzielen, Nephrotoxine meiden), spezifische Maßnahmen existieren nicht. Eine unkritische Hydrierung nicht hypovolämischer Patienten bietet keine Vorteile und ist mit erhöhtem Risiko für kardiale Dekompensationen und ANV verbunden.
Nierenersatztherapie Dosis und Modalität der Nierenersatztherapie sollen an die klinischen Bedürfnisse des Patienten angepasst werden. Die empfohlene Dosis von 20 – 25 ml/kg/h dient als Orientierung. Die weit verbreitete regionale Zitrat-Antikoagulation kann auch sicher für Patienten mit Leberschaden oder Laktatazidose angewendet werden, sofern auf Zeichen einer Zitrat-Akkumulation geachtet wird. Bei Laktatazidose kommt es insbesondere auf die Laktatclearance und weniger auf die Höhe der Laktatwerte bei Therapiebeginn an, wenn das Risiko einer Zitrat-Akkumulation abgeschätzt werden soll.
Aktuelles zu sexuell übertragbaren Infektionen
Authors: Rieg Siegbert , Usadel Susanne , Müller Matthias 
Published: January 2019

Was ist neu?
Syphilis und Gonorrhö Die Inzidenzen sexuell übertragbarer Infektionen (STI), insbesondere der Syphilis und der Gonorrhö, steigen weltweit weiter an. Es gibt erste Berichte von Infektionen mit Neisseria gonorrhoeae, die nicht mehr auf die Standardtherapie aus Ceftriaxon und Azithromycin ansprechen. Das neue Antibiotikum Zoliflodacin gegen N. gonorrhoeae wirkte in einer Phase-II-Studie gut bei der unkomplizierten rektalen und urogenitalen Gonorrhö, ist bei einer pharyngealen Infektion aber nicht ausreichend aktiv.
Chlamydia trachomatis und Mycoplasma genitalium Ein Lymphogranuloma venereum sollte bei Nachweis von Chlamydia trachomatis-Serovaren L1 – L3 über 21 (statt 7) Tage mit Doxycyclin behandelt werden. Da M. genitalium zunehmend Resistenzen gegenüber Azithromycin im Zusammenhang mit der Kurzzeittherapie aufweist, wird auch hier eine verlängerte Therapie empfohlen.
Humanes Immundefizienz-Virus Mit der PrEP (Präexpositionsprophylaxe) steht eine neue medikamentöse HIV-Präventionsstrategie zur Verfügung, die jedoch nur mit Risiko-Aufklärung/-Beratung und begleitenden Laboruntersuchungen eingesetzt werden darf. „Checkpoint“-Modellprojekte integrieren Präventionsberatung, Vorsorge, Diagnostik und Therapie von STI für besonders vulnerable Gruppen.
Humanes Papilloma-Virus Die HPV-Impfung wird von der STIKO nun auch für Jungen im Alter von 9 – 14 Jahren bzw. vor Aufnahme sexueller Aktivität empfohlen.
Zika-Virus Die US-amerikanischen Centers for Disease Control (CDC) reduzieren für Männer das empfohlene Intervall zwischen einem Aufenthalt in einem Zika-Endemiegebiet bis zum ungeschützten Geschlechtsverkehr bzw. bis zur angestrebten Konzeption von 6 auf 3 Monate.
Akute Bronchitis
Authors: Kleibrink Björn , Taube Christian 
Published: January 2019

Was ist neu?
Stand der Dinge Die akute Bronchitis ist eine selbstlimitierende, akute Entzündung der Atemwege und tritt meistens im Rahmen einer viral bedingten Erkältung in Erscheinung. Obwohl sie in der Regel nach zwei bis drei Wochen selbstlimitierend abklingt, sind viele Patienten ungeduldig und fordern mitunter eine Antibiotikabehandlung.
Diagnostik Anamnese und körperliche Untersuchung sind bei unkomplizierter akuter Bronchitis ausreichend. Bei älteren, multimorbiden oder immunsupprimierten Patienten oder Auffälligkeiten bei Vitalparametern ist eine weitergehende Differenzialdiagnostik notwendig. Die Bestimmung des Procalcitonins konnte in prospektiven Studien bisher keinen sicheren Nutzen zeigen.
Therapie Bei der unkomplizierten akuten Bronchitis erfolgt eine symptomatische Therapie. Um Fehlverschreibungen zu verhindern, sind die Edukation von Arzt und Patient sowie eine Verschreibung erst bei Zweitkontakt erfolgreich. Die antibiotische Therapie bleibt einem Risikokollektiv vorbehalten. Es bleibt abzuwarten, ob mittels Procalcitonin in Zukunft Patienten bestimmt werden können, bei denen auf eine antibiotische Therapie verzichtet werden kann.
Nebenwirkungsmanagement in der Immunonkologie
Authors: Reinmuth Niels , Bitzer Michael , Deschler-Baier Barbara , Fischer Jürgen , Kuon Jonas , Leipe Jan , Rawluk Justyna , Schulz Christian , Heußel Claus , Schultheiß Michael 
Published: January 2019

AbstractThe immune oncological treatment approach uses immune checkpoint inhibitors to prevent tumor cells from shutting down the immune system, and thus from escaping immune response. Following the clinical success of immune checkpoint inhibitors, the number of approved immune oncological therapies continues to increase. Response rates and overall survival with anti-PD-1/PD-L1 and CTLA-4 blockade could be further improved by combining both treatment approaches. However, checkpoint inhibition is associated with a unique spectrum of side effects termed immune-related adverse events. These typically occur 3 to 6 months after treatment start and resolve with adequate management procedures if detected early on. Therefore, profound patient education, sensitizing and monitoring are mandatory. We describe in this article selected frequent and rare adverse events that are clinically relevant. Furthermore, using case reports, interdisciplinary experts share their practice-based experience in the management of frequent pneumonic, endocrine, and gastro-intestinal immune-related adverse events.
Perspektiven 2025 – ein Positionspapier der Deutschen Gesellschaft für Innere Medizin
Authors: Vogelmeier Claus , Floege Jürgen , Gamstätter Thomas 
Published: January 2019

ZusammenfassungAnlässlich des 200. Geburtstag ihres Gründers, Friedrich Theodor von Frerichs, setzt sich die Deutsche Gesellschaft für Innere Medizin (DGIM) mit dem vorliegenden Papier Perspektiven für ihre Arbeit in den kommenden Jahren, die durch Herausforderungen für Medizin und Wissenschaft geprägt sein werden. Basierend auf den 10 als zentral erfassten, kritisch beleuchteten Themenbereichen – Ärzte als Forscher, „Klug entscheiden“, digitale Medizin, Ökonomisierung der Medizin, Aus- und Weiterbildung, demografischer Wandel und Multimorbidität, internistische Systemmedizin, Infektiologie und Hygiene, Intensivmedizin und Notaufnahme sowie Pflege und medizinische Assistenzberufe – soll das Papier die grundlegenden Positionen der Fachgesellschaft darlegen.
Diagnostic yield of capsule endoscopy for small bowel arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia: a systematic review and meta-analysis
Authors: Singh Kevin , Zubair Ayla , Prindle Andrew , Nadeem Ahmed , Khan Gulam 
Published: January 2019

Abstract
Background and study aims Small bowel arteriovenous malformations (AVMs) pose a bleeding risk and have traditionally been diagnosed by invasive enteroscopic procedures in patients with hereditary hemorrhagic telangiectasia (HHT). Capsule endoscopy (CE) is emerging as a safe and non-invasive alternative for small intestinal evaluation, but its diagnostic yield and utility in diagnosing small bowel AVMs in HHT patients are understudied. The aim of this study was to meta-analyze the utility of CE for diagnosing AVMs in HHT patients.
Methods A meta-analysis and systematic review of the literature on CE in HHT patients identified in the PubMed, EMBASE, Scopus, and Cochrane databases from inception to March 2018 were conducted. Summary effects were estimated using a random effects model.
Results After applying exclusion criteria, five studies (n = 124 patients) were eligible for meta-analysis. The pooled diagnostic yield for visualization of small bowel AVMs by CE was 77.0 % (95 % CI 65.8 – 85.4 %, P < 0.001).
Conclusions CE has a good diagnostic yield for small bowel AVMs in HHT. It can be regarded as a sufficient, noninvasive diagnostic modality for identifying small bowel AVMs in HHT patients.
Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction
Authors: Kerdsirichairat Tossapol , Irani Shayan , Yang Juliana , Brewer Gutierrez Olaya , Moran Robert , Sanaei Omid , Dbouk Mohamad , Kumbhari Vivek , Singh Vikesh , Kalloo Anthony , Khashab Mouen 
Published: January 2019

Abstract
Background and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach has recently gained traction. We aimed to report on a large cohort of patients who underwent DGE with focus on long-term outcomes.
Patients and methods This two-center, retrospective study involved consecutive patients who underwent D-GE between October 2014 and May 2018. The primary outcomes were technical and clinical success. Secondary outcomes were adverse events (AEs), rate of reintervention, procedure time, time to resume oral diet, and post-procedure length of stay (LOS).
Results A total of 57 patients (50.9 % female; median age 65 years) underwent D-GE for GOO. The etiology was malignant in 84.2 % and benign in 15.8 %. Technical success and clinical success were achieved in 93 % and 89.5 % of patients, respectively, with a median follow-up of 196 days in malignant GOO and 319.5 days in benign GOO. There were 2 (3.5 %) AEs, one severe and one moderate. Median procedure time was 39 minutes (IQR, 26 – 51.5 minutes). Median time to resume oral diet after D-GE was 1 day (IQR 1 – 2 days). Median post D-GE LOS was 3 days (IQR 2 – 7 days). Rate of reintervention was 15.1 %.
Conclusions D-GE is safe and effective in management of both malignant and benign causes of GOO. Clinical success with D-GE is durable with a low rate of reintervention based on a long-term cohort.
Integrative chinesische Medizin im Rahmen der assistierten Reproduktionstechnologie
Authors: Giese Nora , Sulistyo-Winarto Fransiscus 
Published: January 2019

SummaryErgebnisse aus aktuellen Studien legen nahe, dass die chinesische Medizin die assistierte Reproduktionstechnologie sinnvoll unterstützen kann. Aktuelle Studienergebnisse zeigen u. a. die Verbesserung der Schwangerschaftsrate bei zusätzlicher chinesischer Arzneimitteltherapie. In verschiedenen RCTs konnten Effekte der Akupunktur nachgewiesen werden, u. a. verbesserter Blutfluss zum Uterus und zu den Ovarien sowie die Entlastung von emotionalem Disstress.Die Autoren diskutieren aktuelle Studienergebnisse und geben Empfehlungen zum Vorgehen in der Praxis sowie zu ausgewählten Rezepturen und Behandlungsschemata zur Unterstützung der assistierten Reproduktionstechnologie.
Der Fall: Ihre Patientin mit Kinderwunsch hat vor kurzem die Pille abgesetzt. Der Zyklus ist noch unregelmäßig. Wie gehen Sie vor?
Authors: Kowalcek Ingrid , Mietzner Anna , Stapelfeldt Elmar , Reißenweber-Hewel Heidrun 
Published: January 2019

SummaryDer Fall: Ihre Patientin mit Kinderwunsch hat vor kurzem die Pille abgesetzt. Der Zyklus ist noch unregelmäßig. Wie gehen Sie vor?
Rückgang der Spermienqualität: Umweltmedizinische Ursachen
Authors: Mutter Joachim , Hensinger Peter 
Published: January 2019

SummaryDie abnehmende Spermienqualität der letzten Jahrzehnte hat dazu geführt, dass die Normwerte für das Spermiogramm herabgesetzt wurden. Die inzwischen recht umfangreiche Forschung legt den Schluss nahe, dass diverse Umweltfaktoren zur abnehmenden Spermienqualität zumindest beitragen. Dazu zählen u. a. Schwermetall- und Arsenbelastungen, der Einsatz von Glyphosat und Pestiziden in der Landwirtschaft, die Verwendung von Bisphenyl A in Verpackungen. Aber auch elektromagnetische Felder niederer Intensität, denen praktisch jeder ausgesetzt ist, z. B. durch Mobilfunk, Laptop- und WLAN-Nutzung werden diskutiert.Im Beitrag wird die aktuelle Datenlage zu den aufgrund der weiten Verbreitung wichtigsten umweltmedizinischen Faktoren für Spermienschäden zusammengefasst.
Rebuilding the Standing Prescription Renewal Orders
Authors: Nelson Scott , Rector Hayley , Brashear Daniel , Mathe Janos , Wen Haomin , English Stacey , Hedges William , Lehmann Christoph , Ozdas-Weitkamp Asli , Stenner Shane 
Published: January 2019

Background Managing prescription renewal requests is a labor-intensive challenge in ambulatory care. In 2009, Vanderbilt University Medical Center developed clinic-specific standing prescription renewal orders that allowed nurses, under specific conditions, to authorize renewal requests. Formulary and authorization changes made maintaining these documents very challenging.
Objective This article aims to review, standardize, and restructure legacy standing prescription renewal orders into a modular, scalable, and easier to manage format for conversion and use in a new electronic health record (EHR).
Methods We created an enterprise-wide renewal domain model using modular subgroups within the main institutional standing renewal order policy by extracting metadata, medication group names, medication ingredient names, and renewal criteria from approved legacy standing renewal orders. Instance-based matching compared medication groups in a pairwise manner to calculate a similarity score between medication groups. We grouped and standardized medication groups with high similarity by mapping them to medication classes from a medication terminology vendor and filtering them by intended route (e.g., oral, subcutaneous, inhalation). After standardizing the renewal criteria to a short list of reusable criteria, the Pharmacy and Therapeutics (P&T) committee reviewed and approved candidate medication groups and corresponding renewal criteria.
Results Seventy-eight legacy standing prescription renewal orders covered 135 clinics (some applied to multiple clinics). Several standing orders were perfectly congruent, listing identical medications for renewal. We consolidated 870 distinct medication classes to 164 subgroups and assigned renewal criteria. We consolidated 379 distinct legacy renewal criteria to 21 criteria. After approval by the P&T committee, we built subgroups in a structured and consistent format in the new EHR, where they facilitated chart review and standing order adherence by nurses. Additionally, clinicians could search an autogenerated document of the standing order content from the EHR data warehouse.
Conclusion We describe a methodology for standardizing and scaling standing prescription renewal orders at an enterprise level while transitioning to a new EHR.
Hip Hype: FAI Syndrome, Amara's Law, and the Hype Cycle
Authors: Kassarjian Ara 
Published: January 2019

AbstractFemoroacetabular impingement (FAI) has taken us on a roller-coaster ride of innovation, heightened expectations, disillusionment, and confusing diagnostic and treatment pathways. This article reviews and analyzes the phases of FAI diagnosis and treatment over the past 15 years and discusses its parallels to Amara's law and Gartner's hype cycle.
Pharmacomechanical Catheter-Directed Thrombolysis in Acute Femoral–Popliteal Deep Vein Thrombosis: Analysis from a Stratified Randomized Trial
Authors: Kearon Clive , Gu Chu-Shu , Julian Jim , Goldhaber Samuel , Comerota Anthony , Gornik Heather , Murphy Timothy , Lewis Laurence , Kahn Susan , Kindzelski Andrei , Slater Dennis , Geary Randolph , Winokur Ronald , Natarajan Kannan , Dietzek Alan , Leung Daniel , Kim Stanley , Vedantham Suresh 
Published: January 2019

Background and Objectives The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial reported that pharmacomechanical catheter-directed thrombolysis (PCDT) did not reduce post-thrombotic syndrome (PTS), but reduced moderate-to-severe PTS and the severity of PTS symptoms. In this analysis, we examine the effect of PCDT in patients with femoral–popliteal deep vein thrombosis (DVT) (without involvement of more proximal veins).
Patients and Methods Within the ATTRACT trial, 300 patients had DVT involving the femoral vein without involvement of the common femoral or iliac veins and were randomized to receive PCDT with anticoagulation or anticoagulation alone (no PCDT). Patients were followed for 24 months.
Results From 6 to 24 months, between the PCDT versus no PCDT arms, there was: no difference in any PTS (Villalta scale ≥ 5: risk ratio [RR] = 0.97; 95% confidence interval [CI], 0.75–1.24); moderate-or-severe PTS (Villalta scale ≥ 10: RR = 0.93; 95% CI, 0.57–1.52); severity of PTS scores; or general or disease-specific quality of life (p > 0.5 for all comparisons). From baseline to both 10 and 30 days, there was no difference in improvement of leg pain or swelling between treatment arms. From baseline to 10 days, major bleeding occurred in three versus none (p = 0.06) and any bleeding occurred in eight versus two (p = 0.032) PCDT versus no PCDT patients. Over 24 months, recurrent venous thromboembolism occurred in 16 PCDT and 12 no PCDT patients (p = 0.24).
Conclusion In patients with femoral–popliteal DVT, PCDT did not improve short- or long-term efficacy outcomes, but it increased bleeding. Therefore, PCDT should not be used as initial treatment of femoral–popliteal DVT. (NCT00790335).