bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new model for predicting intravenous immunoglobin-resistant Kawasaki disease in Chongqing: a retrospective study on 5277 patients
Authors: Tan Xu-Hai , Zhang Xiao-Wei , Wang Xiao-Yun , He Xiang-Qian , Fan Chu , Lyu Tie-Wei , Tian Jie 
Published: February 2019

AbstractAccurate evaluation of individual risk of intravenous immunoglobin (IVIG)-resistance is critical for adopting regimens for the first treatment and prevention of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods: The KD patients hospitalized in Chongqing Children’s Hospital, in west China, from October 2007 to December 2017 were retrospectively reviewed. Data were collected and compared between IVIG-resistant group and IVIG-responsive group. The independent risk factors were determined using multivariate regression analysis. A new prediction model was built and compared with the previous models. Results: A total of 5277 subjects were studied and eight independent risk factors were identified including higher red blood cell distribution width (RDW), lower platelet count (PLT), lower percentage of lymphocyte (P-LYM), higher total bile acid (TBA), lower albumin, lower serum sodium level, higher degree of CALs (D-CALs) and younger age. The new predictive model showed an AUC of 0.74, sensitivity of 76% and specificity of 59%. For individual’s risk probability of IVIG-resistance, an equation was given. Conclusions: IVIG-resistance could be predicted by RDW, PLT, P-LYM, TBA, albumin, serum sodium level, D-CALs and age. The new model appeared to be superior to those previous models for KD population in Chongqing city.
Peptidyl prolyl cis/trans isomerase activity on the cell surface correlates with extracellular matrix development
Authors: Lin Weilin , Bonin Malte , Boden Annett , Wieduwild Robert , Murawala Priyanka , Wermke Martin , Andrade Helena , Bornhäuser Martin , Zhang Yixin 
Published: February 2019

AbstractInteractions with the extracellular matrix (ECM) dictate cell fates. However, the complexity of dense ECM network and cell-surface molecules prevent the study of their dynamic interaction at the molecular level on living cells. Here, we focus on peptidyl prolylcis/transisomerases (PPIases) to dissect prolyl isomerization from other dynamic events. We reveal the contribution of PPIase on the mechanical properties of various ECM materials and on the dynamic cell–ECM interaction. To avoid complications associated with the existing spectroscopy-based methods such as light scattering, an assay was developed for detecting PPIase activity on living cell surface. This assay allows us to correlate PPIase activity with ECM development, and with the physiological and pathological states of the cells, including the functional properties of cancer cells and immune effector cells.
Disproving hidden variable models with spin magnitude conservation
Authors: Kurzyński Paweł , Laskowski Wiesław , Kołodziejski Adrian , Pál Károly F. , Ryu Junghee , Vértesi Tamás 
Published: February 2019

AbstractThe squares of the three components of the spin-s operators sum up to s(s + 1). However, a similar relation is rarely satisfied by the set of possible spin projections onto mutually orthogonal directions. This has fundamental consequences if one tries to construct a hidden variable (HV) theory describing measurements of spin projections. We propose a test of local HV models in which spin magnitudes are conserved. These additional constraints imply that the corresponding inequalities are violated within quantum theory by larger classes of correlations than in the case of standard Bell inequalities. We conclude that in any HV theory pertaining to measurements on a spin one can find situations in which either HV assignments do not represent a physical reality of a spin vector, but rather provide a deterministic algorithm for prediction of the measurement outcomes, or HV assignments represent a physical reality, but the spin cannot be considered as a vector of fixed length.
Effects of a revised 7Be e−-capture rate on solar neutrino fluxes
Authors: Vescovi D. , Piersanti L. , Cristallo S. , Busso M. , Vissani F. , Palmerini S. , Simonucci S. , Taioli S. 
Published: February 2019

Context. Electron-capture on 7Be is the main production channel for 7Li in several astrophysical environments. Theoretical evaluations have to account for not only the nuclear interaction, but also the processes in the plasma in which 7Be ions and electrons interact. In recent decades several estimates were presented, pointing out that the theoretical uncertainty in the rate is in general of a few percent.
Aims. In the framework of fundamental solar physics, we consider a recent evaluation for the 7Be+e− rate, which has not been used up to now, in the estimate of neutrino fluxes.
Methods. We analyzed the effects of the new assumptions on standard solar models (SSMs) and compared the results obtained by adopting the revised 7Be+e− rate to those obtained by that reported in a widely used compilation of reaction rates (ADE11).
Results. We found that new SSMs yield a maximum difference in the efficiency of the 7Be channel of about −4% with respect to what is obtained with the previously adopted rate. This fact affects the production of neutrinos from 8B, increasing the relative flux up to a maximum of 2.7%. Negligible variations are found for the physical and chemical properties of the computed solar models.
Conclusions. The agreement with the Sudbury Neutrino Observatory measurements of the neutral current component of the 8B neutrino flux is improved.
Fluidity in an orthodontic practice. Why, for who, how?
Authors: Race P. 
Published: February 2019

The search for fluidity in an orthodontic practice must be an imperative axis of reflection. Fluidity is a quality that must be targeted because it is synonymous with efficiency and comfort and, consequently, profitability.
This profitability is not exclusively financial. It is also at the level of the human. It allows each member of the team to bring the best of himself in his function. And when a team is successful, patients feel it. A satisfied patient is the best advertisement a practice can have. Why deprive yourself?
Unwanted tooth movement produced
by the bonded retention wire : the “wire syndrome,” observations, theories, clinical consequences : second part
Authors: Roussarie F. , Douady G. 
Published: February 2019

Sometimes teeth can move even if they seem to have been perfectly stabilised by a retention wire. We call this phenomenon the “wire syndrome”.
It has been well described both in the mandibular and maxillary arches in part one of this article.
For the moment, there has been no mechanical explanation for this phenomenon in the scientific literature.
After an analysis of photographic documents from fellow specialists and an examination of cases from our own office, we have developed a theory to explain the mechanical element involved.
We will divide our analysis into two hypotheses. They could be inter-connected.
The first so-called “intrinsic” hypothesis groups together procedural erreurs which all lead to the use of an active bonded wire. In such cases, the wire is directly responsible for the movements. Its action is the same as that of an orthodontic device directly bonded on the teeth.
The second “extrinsic” hypothesis shows that a tooth with a well bonded wire can rotate if the link between the wire and the composite is broken and if force is present.
The clinical evidence we have gathered could allow us to combat this phenomenon efficiently.
Mixed-Methods-Design zur Analyse von Gefährdungssituationen mittels Kommunikationsprofilen – Part I: „Simulation und Reduktion von Zwangsmaßnahmen in der Psychiatrie“ (SRZP)
Authors: Debus Stephan 
Published: February 2019

ZusammenfassungKommunikationsanalysen von psychiatrischen Gefährdungssituationen in einem Mixed-Methods-Design (Inhaltsanalyse, statistische Auswertung) werden vorgestellt. Die Datenbasis besteht aus Videos von psychodramatisch re-inszenierten Konfliktsituationen. Verschiedene Alltagsszenen (z. B. Schule/Psychiatrie) können durch Äußerungsakte der Akteure (Lehrer [L] bzw. Therapeuten [T], Patienten [P] mit NL = 771, NT = 849, NP = 718) charakterisiert und verglichen werden. Die Verfahren bereichern die psychiatrische Prozess- und Konfliktforschung.
Zur Kommunikationsdynamik von Gefährdungssituationen – PART III: „Simulation und Reduktion von Zwangsmaßnahmen in der Psychiatrie“ (SRZP)
Authors: Debus Stephan , Radovic Marco 
Published: February 2019

ZusammenfassungWie kommunizieren Krankenpflegende im Zeitverlauf gefährdender Situationen? Auf der Datenbasis von Filmanalysen (vgl. Teil I und II) wird die Dynamik von Kommunikationsabläufen mithilfe von Short-Term-Sequenzanalysen, Baumdiagrammen und Long-Term-Zeitreihenanalysen darstellbar. Die Ergebnisse geben Einblick sowohl in typische Kommunikationsdynamiken von Direktiven (Aufforderungen) und Assertiven (Mitteilungen) als Schleifen negativer Reziprozität als auch in typische paradoxe Zeitverläufe, in denen die Handlungserfolge negativ mit den Ernsthaftigkeitsbemühungen der Krankenpflegenden korrelieren.
Semiotik und Soziale Psychiatrie: Kooperation, Nutzen und Ausblick – PART VI: „Simulation und Reduktion von Zwangsmaßnahmen in der Psychiatrie“ (SRZP)
Authors: Debus Stephan , Posner Roland 
Published: February 2019

ZusammenfassungDer Beitrag zeigt, wie die Themen der Sozialen Psychiatrie im Rahmen einer semiotischen Kulturtheorie etwa durch Begriffe wie „Institution“, „Code“, „Sinn“, „Kommunikation“ oder „ästhetische Erfahrung“ diskutiert werden können. In diesem Sinne hatte die Soziale Psychiatrie zwar immer schon Bezug zur Kulturtheorie, insbesondere zu einer phänomenologisch-hermeneutisch begründeten Theorie des „Sinns“. Mit der Theorie der Semiosen (Zeichenprozesse) wird gezeigt, wie der kommunikative Sinn von Sprechakten formal repräsentiert werden kann: zum Nutzen einer arbeitsteiligen Kooperation.
Ein Kommunikationsmodell zur Durchsetzungsmacht in psychiatrischen Gefährdungssituationen – PART V: „Simulation und Reduktion von Zwangsmaßnahmen in der Psychiatrie“ (SRZP)
Authors: Debus Stephan 
Published: February 2019

ZusammenfassungDie Ergebnisse aus Part II – IV werden unter der soziologisch-machttheoretischen Perspektive von Heinrich Popitz analysiert. Dabei entsteht ein auf Durchsetzungsmacht, Aktionsmacht und instrumenteller Macht basierendes Kommunikationsmodell, das mithilfe der eingeführten sprechakttheoretischen Methoden (PART I) empirisch revidiert, erweitert und kritisiert werden kann. Zum Abschluss werden alle (aus PART II – V) entwickelten Strukturspezifika von psychiatrischen Gefährdungssituationen mit Alarmauslösung zusammengefasst.
„Wenn es uns nicht so schwer gemacht werden würde“ – Zugangsbarrieren und Optimierungspotenziale zur Kinder- und Jugendrehabilitation aus Perspektive der Kinder- und Jugendärzte
Authors: Schumann Nadine , Hoffmann Laura , Schröder Sara Lena , Richter Matthias 
Published: February 2019

Zusammenfassung
Ziel Die Studie exploriert Zugangsbarrieren sowie Optimierungspotenziale zur Kinder- und Jugendrehabilitation aus Sicht ambulant tätiger Kinder- und Jugendärzte.
Methodik Leitfadengestützte Einzelinterviews (N=25) und Fokusgruppendiskussionen (N=3) mit Kinder- und Jugendärzten wurden nach der Methodik von Meuser und Nagel ausgewertet und anschließend in einer Expertenrunde mit dem mitteldeutschen Rentenversicherungsträger und dem kinderärztlichen Berufsverband diskutiert.
Ergebnisse Barrieren zeigen sich aufgrund von Informationsdefiziten bzgl. trägerorientierter Zugangskriterien. Eine wahrgenommene zeitintensive Antragsstellung, hohe Ablehnungsquoten mit intransparenten Begründungen sowie eine fehlende Rückkopplung des Trägers an den Arzt hemmen die Antragsmotivation. Optimierungspotenziale münden in dem Wunsch einer direkten Rückkopplung der Antragsentscheidung an den Arzt, fallspezifischen Ablehnungsbegründungen, adressatenorientierten Informationsangeboten sowie einer erhöhten Reha-Präsenz auf pädiatrischen Kongressen und Weiterbildungen.
Schlussfolgerung Zur Stärkung der Rehabilitation im pädiatrischen Versorgungskontext sind Informationen und Kompetenzen in der Zuweisung und Antragsstellung bei ambulant tätigen Kinder- und Jugendärzten zu fördern sowie Kommunikationsbarrieren zwischen Leistungsträgern und -erbringern abzubauen.
…und jetzt auch noch reiten? Fallbericht zur Behandlung eines Kleinkindes im Syndrom reaktionsloser Wachheit
Authors: Steppacher Inga , Kissler Johanna 
Published: February 2019

Zusammenfassung
Hintergrund Die Zahl der Menschen, die schwerstbehindert Unfälle oder Geburtskomplikationen überleben, steigt aufgrund verbesserter medizinischer Möglichkeiten stetig, nicht jedoch das wissenschaftlich gesicherte Wissen um geeignete Therapiemaßnahmen. Verschiedene Veröffentlichungen beschreiben die Reittherapie bereits als effiziente zusätzliche Therapiemethode, ob sie jedoch bei schwerster Behinderung mit Beatmungspflicht eingesetzt werden kann, ist bis jetzt noch ungeklärt.
Methode In dieser Einzelfallstudie wurde ein schwerstbehindertes Kleinkind mit dem Syndrom reaktionsloser Wachheit exemplarisch untersucht. Wir untersuchten den Effekt des Reitens auf Muskelspannung, Gelenkbeweglichkeit und Herzfrequenz.
Ergebnisse Die erwarteten Effekte des Reitens auf Muskeltonus, Gelenkbeweglichkeit und Herzfrequenz zeigten sich deutlich. Es ergaben sich signifikante Verbesserungen im Zustand des Kindes im Hinblick auf alle untersuchten Aspekte. Zusätzlich ergab sich ein eher unvermuteter Effekt auf die Notwendigkeit der Sauerstoffgabe und die Eigenatmung des Kindes. Während des Reitens atmete das Kind selbständig, die zusätzliche Gabe von Sauerstoff war nicht notwendig.
Schlussfolgerung Die Reittherapie zeigte auch bei unserer schwerst und mehrfach geschädigten Patientin positive Effekte und erwies sich hier als sinnvoller zusätzlicher Therapieansatz.
Functional (Psychogenic) Neurological Disorders: Assessment and Acute Management in the Emergency Department
Authors: Nakhate Vihang , Stephen Christopher , Perez David , Anderson Jordan 
Published: February 2019

AbstractFunctional neurological disorders (FND) are complex and prevalent neuropsychiatric conditions. Importantly, some patients with FND develop acute onset symptoms requiring emergency department (ED) evaluations. Historically, FND was a “rule-out” diagnosis, making assessment and management in the ED difficult. While the rapid triage of potential neurological emergencies remains the initial task, advancements have altered the approach to FND. FND is now a “rule-in” diagnosis based on validated neurological examination signs and semiological features. In this perspective article, we review signs and semiological features that can help guide the initial assessment of FND in the acute setting. Thereafter, we outline potential approaches to introduce a suspected diagnosis of FND to patients in the ED, while emphasizing the need for a comprehensive neurological evaluation. Physical and occupational therapy may be useful adjunct assessments in some individuals. Notably, clinicians in the ED setting are important members of the interdisciplinary approach to FND.
Emergency Evaluation and Management of Encephalitis and Myelitis in Adults
Authors: Venkatesan Arun , Bradshaw Michael 
Published: February 2019

AbstractInfection of the central nervous system is often a life-threatening emergency. In many cases, the clinician faces an unknown pathogen and must rely upon clinical acumen and a thorough, systematic diagnostic investigation to establish a diagnosis and initiate appropriate treatment. Because patients typically present with a syndrome, such as temporal lobe encephalitis, rather than a known pathogen (e.g., herpes simplex virus 1 encephalitis), we describe diagnostic considerations in the context of their neuroanatomic tropisms and patterns of disease. This paradigm reflects the challenges clinicians face; however, tropisms are not absolute, patterns of disease are not specific, and this approach does not obviate the need for empirical treatment while a systematic diagnostic investigation is underway. Specific treatment is available for many infectious agents, including bacterial, fungal, and parasitic pathogens, as well as the herpesviruses. In cases with no specific treatment, clinicians must strive to establish the diagnosis (and thereby spare unneeded treatment), anticipate and recognize complications and pitfalls, and initiate appropriate supportive care, all of which are best achieved with a well-prepared multidisciplinary team.
Acute Dizziness
Authors: Edlow Jonathan , Gurley Kiersten 
Published: February 2019

AbstractDizziness is a common chief complaint with an extensive differential diagnosis that includes both benign and serious conditions. Physicians must distinguish the majority of patients who suffer from self-limiting conditions from those with serious illnesses that require acute treatment. The preferred approach to the diagnosis of an acutely dizzy patient emphasizes different aspects of the history to guide a focused physical examination, with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes. Currently, misdiagnoses are frequent and diagnostic testing costs are high. This partly relates to use of an outdated diagnostic paradigm. This commonly used traditional approach relies on dizziness “symptom quality” or “type” (vertigo, presyncope, disequilibrium) to guide inquiry. It does not distinguish benign from dangerous causes and is inconsistent with current best evidence. A better approach categorizes patients into three groups based on timing and triggers. Each category has its own differential diagnosis and targeted bedside approach: (1) acute vestibular syndrome, where bedside physical examination differentiates vestibular neuritis from stroke; (2) spontaneous episodic vestibular syndrome, where associated symptoms help differentiate vestibular migraine from transient ischemic attack; and (3) triggered episodic vestibular syndrome, where the Dix-Hallpike and supine roll test help differentiate benign paroxysmal positional vertigo from posterior fossa structural lesions. The “timing and triggers” diagnostic approach for the acutely dizzy derives from current best evidence and offers the potential to reduce misdiagnosis while simultaneously decreasing diagnostic test overuse, unnecessary hospitalization, and incorrect treatments.
Acute Stroke
Authors: Poli Loris , Costa Paolo , Morotti Andrea 
Published: February 2019

AbstractStroke remains one of the leading determinants of death and severe disability worldwide. It is a medical emergency with a narrow window for recognition and administration of outcome-modifying treatment in the emergency department. Ischemic stroke accounts for the majority of cerebrovascular events and revascularization therapies such as intravenous thrombolysis and endovascular thrombectomy are the mainstays of treatment in carefully selected patients. Intracerebral hemorrhage is less common but remains the deadliest type of stroke. Blood pressure reduction and hemostatic treatment in case of coagulopathy are the cornerstones of acute intracerebral hemorrhage treatment. Admission to dedicated stroke units is associated with improved outcome in patients suffering from acute stroke.
Emergency Management of Epilepsy and Seizures
Authors: Bazil Carl , Bank Anna 
Published: February 2019

AbstractSeizure- and epilepsy-related complications are a common cause of emergency medical evaluation, accounting for 5% of 911 calls and 1% of emergency department visits. Emergency physicians and neurologists must be able to recognize and treat seizure- and epilepsy-related emergencies. This review describes the emergency evaluation and management of new onset seizures, breakthrough seizures in patients with known epilepsy, status epilepticus, acute symptomatic seizures, and acute adverse effects of antiepileptic drugs.
Altered Mental Status in the Emergency Department
Authors: Smith Austin , Han Jin 
Published: February 2019

AbstractAltered mental status is an umbrella term that covers a broad spectrum of disease processes that vary greatly in chronicity and severity. Causes can be a primary neurologic insult or a result of a systemic illness resulting in end-organ dysfunction of the brain. Acute changes in mental status are more likely than chronic changes to be immediately life-threatening and are therefore the focus of this review. Given the potential time-sensitive nature, acute changes in mental status must be addressed immediately and with urgency. We recommend a primary survey followed by a secondary survey with special attention to immediate life-threatening reversible causes. We then recommend a systems-based approach searching for any other life-threatening or reversible causes. Because the differential for altered mental status is broad, a comprehensive emergency department evaluation including a detailed history and physical exam as well as laboratory and radiographic testing is needed.
Prevalence of Obesity in Young Patients with Severe Haemophilia and Its Potential Impact on Factor VIII Consumption in Germany
Authors: Olivieri Martin , Königs Christoph , Heller Christine , Horneff Silvia , Oldenburg Johannes , Halimeh Susan , Kentouche Karim , Knöfler Ralf , Fischer Lars , Pfrepper Christian , Kurnik Karin , Bidlingmaier Christoph 
Published: February 2019

AbstractSimilar to the general population, overweight and obesity have increasingly become a medical and economic burden also in patients with haemophilia in industrialized nations. In this study in seven German haemophilia centres, we identified a prevalence of overweight and obesity of 25.2% among 254 young patients <30 years (median: 13 years; range: 0–30 years) with severe haemophilia A and without a history of inhibitors. The median FVIII dosage based on bodyweight was significantly higher in normal weight compared with overweight or obese patients (96.9 vs. 72.9 IU/kg/week, respectively; p < 0.0001). This suggests that an individualized dosing regime which might be based on FVIII pharmacokinetics, physical activity and pre-existing haemophilic arthropathy is applied rather than dosing by bodyweight only. The bleeding rates observed in obese (median: 1; range: 0–17) versus normal weight patients (median: 2; range: 0–28) did not differ significantly (p = 0.057). Lower bleeding rates might be due to reduced activity or expected higher FVIII plasma levels in overweight patients. Due to the increasing prevalence of overweight/obesity in patients with haemophilia an interdisciplinary approach for individualized haemophilia treatment and weight loss programmes might be helpful for optimal and economical treatment for this group of patients.