bluuebunny/crossref_metadata_2025_split huggingface dataset:
Train-the-Trainer: Professionalisierung der Lehre im klinischen Alltag – Selbsteinschätzung Lehrender zur didaktischen Kompetenz und den Rahmenbedingungen des Unterrichts
Authors: König Sarah , Stieger Philipp , Sippel Sonia , Kadmon Martina , Werwick Katrin , Sterz Jasmina , Hoefer Sebastian H. , Rüsseler Miriam , Walcher Felix , Adili Farzin 
Published: February 2019

Zusammenfassung
Hintergrund Didaktiktrainings tragen zur Verbesserung der Qualität der medizinischen Lehre bei. In einem Kurs des Train-the-Trainer-Konzepts (TTT-Konzepts) der Chirurgischen Arbeitsgemeinschaft Lehre (CAL) wurden dabei Lehrende (TN) verschiedener Professionen und Karrierestufen gemeinsam unterrichtet.
Ziel der Arbeit Einschätzungen zur eigenen Lehrtätigkeit im klinischen Alltag durch verschiedene Gruppen, wie assistenzärztliches (AÄ), oberärztliches Personal (OÄ) und Pflegende (KP), deren Wahrnehmung von Erschwernissen und Artikulation von Wünschen zur Lehrverbesserung.
Material und Methoden Vor Kursbeginn wurden biografische Daten, didaktische Vorerfahrungen, Lehrhindernisse sowie Wünsche zur Lehrverbesserung erfragt. Nach Abschluss wurden die TN gebeten, den Kurs zu bewerten. Die Antworten zu den geschlossenen und offenen Fragen wurden quantitativ und qualitativ ausgewertet.
Ergebnisse Von 2014 bis 2017 wurden 6 Basiskurse (TTT-A) an 3 Standorten durchgeführt. 97 TN nahmen an den Befragungen teil (AÄ n = 44, OÄ n = 19, KP n = 17). Mehr als ⅔ verfügten bereits über didaktische Vorkenntnisse. Zwischen ärztlichen und pflegerischen Berufsgruppen fanden sich hierbei keine signifikanten Unterschiede. Während AÄ und KP primär am Krankenbett unterrichteten, lehrten OÄ überwiegend im Rahmen von Vorlesungen, Wahlfächern und Seminaren. Für die Lehre im klinischen Alltag fühlte sich nur ein geringer Anteil aus allen Berufsgruppen gut vorbereitet. Als Haupterschwernisse wurden Zeit- und Personalmangel, eine zu hohe Anzahl von Studierenden und zu geringe eigene didaktische Vorkenntnisse angegeben. Fast ⅔ der AÄ empfanden die studentische Lehre als starke oder moderate Belastung, gegenüber ca. 50% der OÄ und 60% KP. Als Wünsche zur Lehrverbesserung wurden differenziertere Vorgaben zu Inhalt und Aufbau der Lehrveranstaltungen, eine höhere Wertschätzung der Lehre insgesamt sowie die regelmäßige didaktische Qualifizierung der Lehrenden genannt.
Diskussion Berufsgruppenbedingte Unterschiede im klinischen Alltag und individueller Karrierefortschritt üben einen Einfluss auf Art, Umsetzung und Wahrnehmung der Lehrtätigkeit aus. Durch Fokussierung auf Lernziele und wesentliche für den Unterricht am Krankenbett relevante Lehr- und Prüfungsformate können Dozententrainingsprogramme berufsgruppenübergreifend zum Wissens- und Kompetenzzuwachs beitragen. Hinweise auf einen nachhaltigen Effekt ermutigen zur Fortsetzung und Weiterentwicklung des TTT-Konzepts.
Increased Defect Size is Associated with Increased Complication Rate after Free Tissue Transfer for Midanterior Skull-Base Reconstruction
Authors: Nakamura Ryota , Takanari Keisuke , Nakamura Yutaka , Kambe Miki , Hishida Masashi , Ebisawa Katsumi , Fujimoto Yasushi , Fujii Masazumi , Kamei Yuzuru 
Published: February 2019

Abstract
Objective Complications after skull-base reconstruction are often problematic. We consider that local factors, for example, localization of defect areas are possible risk factors. This study aimed to investigate our case series of skull-base reconstructions in our institution and to identify local risk factors that predispose to wound complications.
Design This study is presented as a retrospective study.
Setting Research work was took place at Nagoya University Hospital.
Participants Forty-eight patients who had undergone reconstruction after midanterior skull-base resection between January 2004 and December 2015 were included in this study. Defects apart from the skull-base were categorized into nasal and paranasal cavity (N), orbit (O), palate (P), and facial skin (S). Postoperative local complications including cerebrospinal fluid (CSF) leakage, local infection, wound dehiscence (fistula in face or palate), and flap necrosis (partial or total) were investigated.
Main Outcome Measures Main outcome measures were postoperative complications in patients with each defect.
Results Apart from the skull-base, defects included 28 ONP (58.3%), 10 ONPS (20.8%), 3 ON (6.3%), 3 ONS (6.3%), 1 NP (2.1%), and 1 OS (2.1%). Comparison based on numbers of resected regions revealed that a significantly higher complication rate was seen in patients with four resected regions than in those with three regions (90.0% vs. 45.2%, p < 0.05).
Conclusion There was a trend suggesting that more resected regions corresponded to a greater risk of complications in midanterior skull-base reconstruction. Reconstructive surgeons need to carefully consider the reconstruction of such complicated defects.
Carotid Aneurysm Review
Authors: Kraemer Cody Jo , Zhou Wei 
Published: February 2019

AbstractAneurysms of the carotid artery are rare with multiple underlying etiologies. Treatment is largely open surgery but medical and endovascular therapies have been used based on presentation, anatomy, and etiology. There is a moderate amount of retrospective case series data on surgical results but no prospective data or data comparing open versus endovascular therapy exists. Much research is still needed but difficult to obtain in this rare disease process.
Association between Industry Payments and Scholarly Impact among Academic Ophthalmologists
Authors: Solotke Michael , Forster Susan , Chow Jessica , Duran Jenesis , Karim Hasna , Marks Victoria , Roy Shireen , Torres Ashlynn , Adelman Ron 
Published: February 2019

Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact.
Design Retrospective cross-sectional study.
Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact.
Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p < 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p < 0.05).
Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.
Long-Term Management of Venous Thromboembolism: Lessons from EINSTEIN CHOICE and Other Extension Trials
Authors: Weitz Jeffrey , Chan Noel 
Published: February 2019

Many patients with venous thromboembolism (VTE) are at risk of recurrence if anticoagulant therapy is stopped. Whereas 3 months of anticoagulation treatment is sufficient for patients with VTE provoked by major surgery or trauma, in many cases a longer course is needed. Extended therapy with vitamin K antagonists (VKAs) requires frequent coagulation monitoring and dose adjustments to ensure that the international normalized ratio (INR) remains within the therapeutic range; furthermore, there is a risk of major bleeding even if a therapeutic INR is maintained. Therefore, more convenient and safer anticoagulants are needed.The non-VKA oral anticoagulants (NOACs)—apixaban, dabigatran, edoxaban and rivaroxaban—simplify extended therapy because they can be given in fixed doses without routine coagulation monitoring. Randomized clinical trials have demonstrated the efficacy and safety of NOACs for extended VTE treatment, but bleeding remains a concern. Patients and physicians may, therefore, be reluctant to continue anticoagulation beyond 3 to 6 months except in patients at high risk of recurrence. Acetylsalicylic acid (ASA) is often prescribed instead of an anticoagulant because of its perceived lower risk of bleeding; however, the recent EINSTEIN CHOICE trial demonstrated that once-daily rivaroxaban at a dose of either 20 or 10 mg reduced the risk of recurrent VTE by 70% compared with ASA without significantly increasing the risk of bleeding. In this review, we discuss the EINSTEIN CHOICE trial in the context of previous trials for extended VTE treatment and examine some of the lessons that can be applied to clinical practice.
PD-1/PD-L Pathway Potentially Involved in ITP Immunopathogenesis
Authors: Nie Mu , Liu Yang , Li Xiu-xiu , Min Ya-nan , Yang Dan-dan , Li Qiang , Feng Qi , Hou Yu , Li Guo-sheng , Sun Jian-zhi , Hou Ming , Shi Yan 
Published: February 2019

AbstractThe binding of programmed death 1 (PD-1) to its ligands PD-L1 and PD-L2 on antigen-presenting cells turns off autoreactive T cells and induces peripheral tolerance. Aberrant PD-1/PD-L signalling could result in a breakdown of peripheral tolerance and lead to autoimmune diseases. In this study, we detected PD-1 and PD-L expression on T cells and dendritic cells (DCs) in immune thrombocytopenia (ITP) patients with active disease by flow cytometry. The effects of PD-L1-Fc fusion protein (PD-L1-Fc) on T cells and on secretion of interferon-γ (IFN-γ) and interleukin-2 (IL-2) were detected by flow cytometry and enzyme-linked immunosorbent assay, respectively. Compared with healthy controls, PD-1 expression was significantly increased in CD4+ T cells and CD8+ T cells from patients with active ITP. However, PD-L1 expression on monocyte-derived DCs was lower in patients with active ITP than in healthy controls. In vitro assays revealed that PD-L1-Fc increased T cell apoptosis, inhibited activation and proliferation of CD4+ T cells and CD8+ T cells and decreased IFN-γ and IL-2 secretion in patients with active ITP. These results suggest that the aberrant PD-1/PD-L negative co-stimulatory pathway may play a role in ITP. Enhancing PD-1/PD-L signalling might be a promising therapeutic approach for ITP patients by enhancing T cell apoptosis, inhibiting T cell activation and proliferation and reducing secretion of inflammatory factors.
Primary Total knee Arthroplasty: A Viable Surgical Option for Complex Tibial Plateau Fractures in Elderly
Authors: Abdelbadie Ahmed , El-Hennawy Ayman , Sallam Asser 
Published: February 2019

AbstractThe optimal treatment of complex tibial plateau fractures in elderly is still controversial. The aim of the study was to retrospectively analyze the clinical and radiological outcomes of primary total knee arthroplasty (TKA) versus open reduction and internal fixation (ORIF) in elderly patients presenting with acute complex tibial plateau fractures. Between June 2011 and December 2015, we have analyzed the clinical outcomes of 22 primary total knee replacements and 21 ORIFs. The mean follow-up was 27 months. The intra- and postoperative complications, as well as the knee society score (KSS), were our outcome measures. The knee range of motion and the KSS knee and function scores were significantly better in the TKA patients compared with ORIF patients. Early postoperative full weight-bearing was allowed in the TKA patients with lower complications rate. In conclusion, primary TKA utilizing a stemmed tibial component is an effective treatment option for elderly patients with a complex acute fracture of the tibial plateau. This is a Type III therapeutic study.
Resurfaced versus Non-Resurfaced Patella in Total Knee Arthroplasty
Authors: Allen William , Eichinger Josef , Friedman Richard 
Published: February 2019

AbstractThe prevalence of knee osteoarthritis is increasing, as is the projected use of total knee arthroplasty (TKA) to treat severe cases that fail to respond to conservative measures. Implant designs are either cruciate retaining or posterior stabilized, and while both have high success rates, management of the patella still remains a controversial topic. Although studies indicate that resurfacing the patella provides no significant clinical differences compared with non-resurfacing techniques, surgeons continue to resurface the patella during TKA. Rates of patella resurfacing continue to be as high as 90% in the United States, while European countries tend to favor non-resurfacing techniques. The purpose of this article is to discuss relevant research on patella resurfacing during TKA, to compare the results, and give evidence-based recommendations on how it should be approached going forward.
Aiding self-knowledge
Authors: Doyle Casey 
Published: February 2019

AbstractSome self-knowledge must be arrived at by the subject herself, rather than being transmitted by another’s testimony. Yet in many cases the subject interacts with an expert in part because she is likely to have the relevant knowledge of their mind. This raises a question: what is the expert’s knowledge like that there are barriers to simply transmitting it by testimony? I argue that the expert’s knowledge is, in some circumstances,proleptic, referring to attitudes the subject would hold were she to reflect in certain ways. The expert’s knowledge cannot be transmitted by testimony because self-knowledge cannot be proleptic.
Impact of Larval Competition on Life-History Traits of the Black Soldier Fly (Diptera: Stratiomyidae)
Authors: Jones Brittny M , Tomberlin Jeffery K 
Published: February 2019

AbstractThe black soldier fly, Hermetia illucens (L.), is economically important due to its use in waste management and as an alternative protein source for livestock, poultry, and aquaculture. While industry promotes mass production of the black soldier fly, little is known about the impact of larval competition on development time, resulting immature and adult weight, or adult longevity. The goal of this research was to examine the life-history traits of black soldier flies when reared at four densities (500, 1,000, 1,500, and 2,000 larvae/4-liter container) provided 54-g Gainesville diet at 70% moisture (feed rates of 0.027, 0.036, 0.054, and 0.108 g) every other day. Results were as expected with the lowest larval density (500) producing heavier individuals (by 26%) than the greatest larval density (2,000) across all life stages. In addition to weights, larvae reared at the lowest density developed 63% faster than those reared at the greatest density. In regard to pupal development time, those reared at the lowest larval density developed 3% slower than the greatest density. A 21% difference between the two extreme densities was found in survivorship to prepupal stage, with the lowest larval density having the greatest survivorship (92%) compared with the greatest larval density (70%). All densities displayed over 90% adult emergence rates. Such information is vital for optimization of the process of converting waste products to protein at an industrial scale with the black soldier fly.
Genetic variation and structure of Diaphorina citri (Hemiptera: Liviidae) in populations from México
Authors: Pérez-Valencia Laura Izascum , Michel Andrew P , Moya-Raygoza Gustavo , Rodríguez Aarón 
Published: February 2019

AbstractThe Asian citrus psyllid, Diaphorina citri Kuwayama, is native to Asia but has recently invaded North America. Asian citrus psyllid is a significant pest of citrus crops by its direct feeding but, more importantly, as the vector of the bacterium ‘Candidatus Liberibacter asiaticus’, which causes Huanglongbing disease. Asian citrus psyllid was first found in México in 2001 and 2002 and, since then, has spread quickly across the country, suggesting rapid adaptation to new environments. Yet, we lack information on the genetic variation and structure that could facilitate or inhibit adaptation. Using six microsatellite markers, we analyzed genetic variation and structure among six localities in México: three in western states near the Pacific coast and two in the Yucatán Peninsula near the Gulf of México. We found low genetic diversity (no more than three alleles per locus) and intermediate differentiation between all populations. Asian citrus psyllid populations clustered into two genetic groups, but, surprisingly, these clusters were present in western populations. The first group included El Arenal, and the second group included Autlán de Navarro, Colima, and Tecomán. Interestingly, both of the Yucatán populations shared variation from the two clusters, suggesting admixture. We infer that reproductive isolation, barriers to gene flow, local selection, and the possibility of multiple invasions have influenced the current genetic structure of Asian citrus psyllid in México.
Efficacy of Autologous Platelet-Rich Plasma Combined With Ablative Fractional Carbon Dioxide Laser for Acne Scars: A Systematic Review and Meta-Analysis
Authors: Chang Hua-Ching , Sung Chih-Wei , Lin Ming-Hsiu 
Published: February 2019

Abstract

Background
Acne scars are common and challenging clinical complications of acne vulgaris. Ablative fractional carbon dioxide (CO2) laser is a well-established treatment for acne scars; however, some postlaser adverse effects have been noted. Autologous platelet-rich plasma (PRP) can improve tissue regeneration. Several studies have investigated the efficacy of combination therapy of CO2 laser and PRP for acne scars.

Objectives
The authors sought to conduct a meta-analysis of the efficacy of PRP combined with ablative fractional CO2 laser for treating acne scars by examining clinical trial results.

Methods
A systematic review was performed by searching PubMed, Embase, Cochrane Library, and Web of Science, and a meta-analysis was conducted to assess the clinical outcomes after combination therapy of PRP and ablative fractional CO2 laser compared with laser alone.

Results
We identified 4 eligible studies for the meta-analysis, including 3 randomized controlled trials. Our results demonstrated that clinical improvement after combination therapy was significantly higher than that after laser alone (odds ratio = 2.992, P = 0.001). Regarding major side effects, patients who underwent combination therapy experienced significantly shorter duration of crust compared with CO2 laser alone (standard mean difference = −1.140, P &lt; 0.001); relatively shorter durations of erythema and edema were also noted after combination therapy. Furthermore, patient satisfaction rates were significantly higher after combination therapy than after laser alone (odds ratio = 3.169, P = 0.002).

Conclusions
The combination of autologous PRP and ablative fractional CO2 laser has synergistic positive effects on the clinical outcomes for acne scars and can accelerate the recovery of laser-damaged skin.

Level of Evidence: 2
Smartphone Applications in Plastic Surgery: A Cross-Sectional Survey of 577 Plastic Surgeons, Fellows, Residents, and Medical Students
Authors: Grow Jacob Nathaniel , Vargo James D , Nazir Naiman , Korentager Richard 
Published: February 2019

Abstract

Background
There are now over 2.2 million mobile applications (apps) in existence, with more than 250 identifiable by searching “plastic surgery.” Unfortunately, only 30% of these are academically relevant, which makes finding useful plastic surgery apps both challenging and inefficient.

Objectives
The authors sought to evaluate the use of digital resources and awareness of available apps within plastic surgery to improve their clinical/educational utilization.

Methods
An extensive search of the Apple and Android databases was performed to identify all relevant plastic surgery apps. An American Society of Plastic Surgeons-sponsored survey was distributed to a random cohort of American Society of Plastic Surgeons members (practicing surgeons, fellows, and residents) and students applying to an integrated plastic surgery residency. The survey queried utilization of resources to access medical information and awareness of apps relevant to clinical/educational plastic surgery.

Results
A total 153 relevant applications were identified between the Apple iTunes and Google Play stores. Of the 577 respondents (273 practicing surgeons, 117 residents, 11 fellows, and 177 medical students), 99.31% own a smartphone/tablet. Furthermore, medical students and residents/fellows utilized both smartphones and computers more frequently than practicing physicians (P &lt; 0.0001 and P = 0.0022, respectively). Digital resources were also utilized more frequently than printed material (P &lt; 0.00001). For app awareness, 82.1% of respondents reported knowing of fewer than 10 apps relevant to plastic surgery, and only 8.41% were aware of more than 20.

Conclusions
Smartphone usage is nearly ubiquitous among plastic surgeons, and most utilize these devices daily to access medical information. However, awareness of the many available and relevant plastic surgery apps is extremely limited.
Behavioral responses vary with prey species in the social spider, Stegodyphus sarasinorum
Authors: Parthasarathy Bharat , Somanathan Hema 
Published: February 2019

AbstractPredators living in social groups often show consistent interindividual differences in prey capture behavior that may be linked to personality. Though personality predisposes individuals for certain behaviors, responses can also be influenced by context. Studies examining personality-dependent participation in prey capture have largely employed only one prey species, offering the predator no choice. In nature, predators encounter a range of prey species, therefore participation in or leading a prey capture event must also depend on prey attributes (e.g., size and risk). In the social spider Stegodyphus sarasinorum, collective prey capture is mediated by personality types as a consequence of which some individuals are consistently more likely to attack. Here, we examined if an individual’s consistency to attack persisted within and between the 2 prey species (honeybees and grasshoppers) and if the same individuals attacked first with both prey species. Our results showed that interindividual differences in attacking persisted within and between the 2 prey species. Spiders showed greater participation in attacking grasshoppers relative to bees. Identities of the first attackers were not the same for bees and grasshoppers. Spiders showed greater consistency over time in attacking bees relative to grasshoppers. Bees attracted fewer attackers than size-matched grasshoppers. These results suggest that greater task specialization may be necessary to successfully subdue bees. Spiders handled bees more cautiously, which is likely to explain the observed plasticity in attacking the 2 prey species. Thus, participation in prey capture in social spiders is influenced by the attributes of prey species.