bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analyse verschiedener Qualitätsmanagementsysteme in Arztpraxen für Sachsen
Authors: Gumpert Marcus , Reese Jens-Peter 
Published: February 2019

Zusammenfassung
Einleitung Seit 1. Januar 2004 sind alle an der vertragsärztlichen Versorgung teilnehmenden Ärzte, Psychotherapeuten und medizinische Versorgungszentren nach § 135a Absatz 2 Nr. 2 des Fünften Sozialgesetzbuches verpflichtet, einrichtungsintern ein Qualitätsmanagementsystem einzuführen und weiterzuentwickeln. Die Ärzte stehen vor der Frage, welches Qualitätsmanagementsystem für die eigene Praxis geeignet ist.
Methodik Insgesamt wurden 24 Arztpraxen per Zufallsstichprobe ausgewählt. Die Stichprobe wurde im Bundesland Sachsen erhoben, weil die Kassenärztliche Vereinigung Sachsen die notwendigen Informationen bereitstellt. Zuerst erfolgte die Bestimmung von 2 Primäreinheiten aus der Grundgesamtheit. Im Folgeschritt wurde für jede Primäreinheit eine Stichprobe über 3 Qualitätsmanagementsysteme gezogen. Die einzelnen Fragen wurden unabhängig von einem Qualitätsmanagementsystem entwickelt. Die Basis bildeten die Vorgaben der Richtlinie des Gemeinsamen Bundesausschusses, welche die konkreten Inhalte der Qualitätskategorien beschreibt. Insgesamt liegen in den 3 Befragungsgruppen 26 Qualitätskategorien mit verschiedenen Fragen vor. Zur Analyse der Daten wird in den einzelnen Fragenkomplexen das arithmetische Mittel gebildet. Anschließend wird mittels einer Varianzanalyse getestet, ob sich die Qualitätsmanagementsysteme im Mittel statistisch signifikant unterscheiden. Unter Beachtung der Kosten der einzelnen Qualitätsmanagementsysteme und deren Einführung wird die Effektstärke nach η2 und Cohenʼs d analysiert. Abschließend erfolgt eine Kosten-Nutzen-Analyse, indem durch ein Literaturstudium die direkten/ indirekten Kosten der verschiedenen Systeme recherchiert wurden.
Ergebnisse Beim „Qualität und Entwicklung in Praxen (QEP)“ liegen anhand von Musterdokumenten und Prozessunterstützungen die höchste Bewertung vor. Aufgrund einer spezifischen Hausarztausrichtung folgt mit guten Bewertungen „Qualität in sächsischen Arztpraxen (QisA)“. Die einzelnen Qualitätskategorien wie ‚Leistungsspektrum‘ oder ‚Erkrankungsspezifische Maßnahmen‘ weisen signifikante Unterschiede sowie nachhaltige Effektstärken zwischen den Systemen auf und führen zur sehr guten Bewertung beim QEP.
Schlussfolgerung Die Bewertungen der Qualitätsmanagementsysteme weisen signifikante Unterschiede auf. Weiterhin wird eine sehr hohe Effektstärke dargelegt. Die konkreten Unterschiede zwischen den Qualitätsmanagementsystemen sind durch Unterschiede in der Unterstützung von Prozessbeschreibungen sowie Musterdokumenten zu erklären.
Medizinische Ergebnisqualität: Unspezifische Outcome-Parameter einer stationären Rehabilitation des Stütz- und Bewegungsapparates in Österreich
Authors: Grote Vincent , Böttcher Elke , Mur Erich , Kullich Werner , Puff Henry 
Published: February 2019

Zusammenfassung
Fragestellung Im Rahmen der Dokumentation von Patienten, die eine stationäre Rehabilitation in Anspruch nehmen, werden obligatorisch Kennzahlen zur Medizinischen Ergebnisqualität (MEQ) standardisiert erfasst. Veröffentlichungen dazu sind jedoch noch die Ausnahme. Ziel ist die Bereitstellung von elementaren klinischen Referenzdaten und Darstellung der Veränderung bei einer stationären Rehabilitation des Stütz- und Bewegungsapparates.
Material und Methoden Die in Leistungsprofilen von Kostenträgern geforderten Outcome-Parameter beinhalten neben krankheitsspezifischen Kennwerten auch unspezifische allgemeine Gesundheitsmerkmale, wie Körpermaße, Kreislaufparameter und gesundheitliche Beschwerden. Die Daten von 11 414 Patienten (54,7±12,3 Jahre, Range: 14–95; 53% Frauen), die eine Orthopädische Rehabilitation oder eine Gesundheitsvorsorge Aktiv erhielten, wurden statistisch aufbereitet.
Ergebnisse Unspezifische Indikatoren der MEQ können zu 3 Faktoren zusammengefasst werden (Varianzaufklärung 71%). Es bestehen Ausgangswertunterschiede in Abhängigkeit von Indikation und Geschlecht. Der Effekt des stationären Rehabilitationsaufenthalts ist vergleichbar. 74% der Patienten profitieren unmittelbar von der Rehabilitation. 20% der Patienten zeigen keine Änderung, 6% verschlechtern sich. Im Gegensatz zu Kreislaufkennwerten und Beschwerden bleiben anatomische Merkmale nahezu unverändert.
Diskussion und Schlussfolgerung Im stationären Rehabilitationssetting werden Risikofaktoren bei der Mehrzahl der Patienten reduziert und das Allgemeinbefinden verbessert, wobei derartige Erfolge nicht alle Rehabilitanden erreichen. Es besteht ein Bedarf an differenzierten Behandlungspfaden, um die Erfolgsquote und die Nachhaltigkeit zu verbessern. Klinische Referenzwerte können dabei einen wertvollen Beitrag zur Qualitätssicherung und Evaluation liefern.
Synthetic Approaches to Nitro-Substituted Isoxazoles
Authors: Averina Elena , Vasilenko Dmitry , Sedenkova Kseniya , Kuznetsova Tamara 
Published: February 2019

Nitro-substituted isoxazoles are of utmost interest both as versatile intermediates for targeted organic synthesis and as perspective bioactive compounds for drug development. Nevertheless, the existing approaches to them usually lack generality and strongly depend on the position of the nitro group and on the presence of other substituents in the isoxazole ring. This review provides the first systematization of all available data concerning synthetic approaches to 3-, 4-, and 5-nitroisoxazoles. There are a number of preparative approaches to 4-nitroisoxazoles based on classical heterocyclization reactions of nitro-substituted compounds and the nitration of isoxazoles. 3-Nitro- and, especially, 5-nitroisoxazoles are much less readily available. A few methods affording 3-nitroisoxazoles have been reported, often employing the heterocyclization of unsaturated compounds by treatment with sodium nitrite. The sole general preparative method for 5-nitroisoxazoles, containing a variety of functional groups, employs the heterocyclization of electrophilic alkenes by treatment with tetranitromethane activated with triethylamine.1	Introduction2	Synthesis of 4-Nitroisoxazoles2.1	Nitration of Isoxazoles2.2	Condensations of α-Nitro Ketones or Their Oximes2.3	1,3-Dipolar Cycloaddition of Nitrile Oxides to Acetylenes and Their Synthetic Equivalents2.4	Heterocyclization of Acetylene Derivatives by Treatment with Sodium Nitrite2.5	Heterocyclization of Nitro Derivatives of 1,3-Diketones and Their Synthetic Equivalents2.6	Miscellaneous Methods3	Synthesis of 3-Nitroisoxazoles3.1	Heterocyclization of Acetylene Derivatives or 1,3-Dihalogenoalkenes by Treatment with Sodium Nitrite3.2	Heterocyclization of Morita–Baylis–Hillman Acetates by Treatment with Sodium Nitrite3.3	1,3-Dipolar Cycloadditions4	Synthesis of 5-Nitroisoxazoles4.1	1,3-Dipolar Cycloadditions4.2	Synthesis Using Polynitro Compounds5	Conclusion
Retrosigmoid Approach for Resection of Large Cystic Vestibular Schwannoma
Authors: Link Michael J. , Driscoll Colin L. W. , Feng Yening , Peris-Celda Maria , Graffeo Christopher S. 
Published: February 2019

Objectives This video was aimed to describe the surgical indications, relevant anatomy, and surgical steps of retrosigmoid approach for resection of a large cystic vestibular schwannoma (VS).
Design The operative steps are described in a surgical instructional video.
Setting The surgery took place at a tertiary skull base referral center.
Participant Patient is a 62-year-old man who reported with right sided profound hearing loss with no word recognition, progressive dizziness and tinnitus, excruciating burning pain in the V2 distribution of right trigeminal nerve, wide-based gait, and a right cerebellopontine angle (CPA) cystic VS measuring 3.3 cm.
Main Outcome Measures The large cystic VS was resected through retrosigmoid approach.
Results The surgery resulted in removal of the large cystic VS with initial delayed facial weakness that completely resolved (House Brackmann grade 1) by 3 month follow-up. The patient had no other postoperative complications and is convalescing well from the procedure.
Conclusion Cystic VS presents some unique challenges compared with their solid counterparts. The cystic tumor capsule may be very adherent to the adjacent structures, and distinguishing thin cyst walls from the arachnoid of the CPA, can be quite challenging. The retrosigmoid approach provides adequate surgical exposure for VS tumor resection.The link to the video can be found at: https://youtu.be/sFNvRWG465Q.
National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release
Authors: Mertz Kevin , Trunzter Jeremy , Wu Edward , Barnes James , Eppler Sara L. , Kamal Robin N. 
Published: February 2019

Background Complex regional pain syndrome (CRPS) occurs in 2 to 8% of patients that receive open or endoscopic carpal tunnel release (CTR). Because CRPS is difficult to treat after onset, identifying risk factors can inform prevention. We determined the incidence of CRPS following open and endoscopic CTR using a national claims database. We also examined whether psychosocial conditions were associated with CRPS after CTR.
Methods We accessed insurance claims using diagnostic and procedural codes. We calculated the incidence of CRPS following open carpal tunnel release and endoscopic carpal tunnel release within 1 year. The response variable was the presence of CRPS after CTR. Explanatory variables included procedure type, age, gender, and preoperative diagnosis of anxiety or depression.
Results The number of open CTRs (85% of total) outweighs the number of endoscopic procedures. In younger patients, the percentage of endoscopic CTRs is increasing. Rates of CRPS are nearly identical between surgery types for both privately insured (0.3%) and Medicare patients (0.1%). Middle aged (range: 40–64 years) and female patients had significantly higher rates of CRPS than did the general population. Preoperative psychosocial conditions did not correlate with the presence of CRPS in surgical patients.
Clinical Relevance The decision between endoscopic and open CTR should not be made out of concern for development of CRPS postsurgery, as rates are low and similar for both procedures. Rates of CRPS found in this study are much lower than rates found in previous studies, indicating inconsistency in diagnosis and reporting or generalizability of prior work. Preoperative psychosocial disorders and CRPS are unrelated.
Major Pathologic Response after Induction Therapy Has a Long-Term Impact on Survival and Tumor Recurrence in Stage IIIA/B Locally Advanced NSCLC
Authors: Schreiner Waldemar , Dudek Wojciech , Rieker Ralf Joachim , Lettmaier Sebastian , Fietkau Rainer , Sirbu Horia 
Published: February 2019

Abstract
Background Major pathologic response (MPR) determines favorable outcome in locally advanced non-small cell lung cancer after induction therapy (IT) followed by lung resection. The aim of this retrospective study was to identify the prognostic relevance of MPR in long-term interval.
Methods In 55 patients, the survival rate according to MPR and non-MPR was estimated by Kaplan–Meier method and compared using log-rank, Breslow, and Tarone–Ware tests.
Results The IT included chemoradiation with 50.4 Gy (range: 45–56.4 Gy) combined with platinum-based chemotherapy in 52 patients (94.5%) and platinum-based chemotherapy in 3 patients (5.5%). Perioperative morbidity and 30-day mortality were 36 and 3.6%, respectively. The estimated 5-year postoperative and progressive-free survivals were statistically significantly improved in MPR versus non-MPR with 53.5 versus 18% and 49.4 versus 18.5%, respectively. According to the log-rank, Breslow, and Tarone–Ware tests, the MPR demonstrates prognostic significance in early, long-term, and whole postoperative interval.
Conclusion MPR is associated with a robust correlation to long-term postoperative and recurrence-free survival improvement, and can potentially simplify the multidisciplinary debate and allow further stratification of adjuvant treatment in multimodality therapy.
Mechanical Bowel Preparation versus No Preparation in Duhamel Procedure in Children with Hirschsprung's Disease
Authors: Hosseinpour Mehrdad , Ahmadi Bahareh , Etezazian Sanaz 
Published: February 2019

Abstract
Introduction Mechanical bowel prep (MBP) prior to surgical treatment of Hirschsprung's disease (HSCR) has been a great problem of pediatric surgeons for a long time. We conducted a single-institution randomized controlled trial to evaluate the efficacy of no MBP in children with HSCR undergoing the Duhamel procedure.
Materials and Methods In this study, children with HSCR who were candidate for the Duhamel procedure were included (40 cases vs. 40 controls). In the case group, intraoperatively after transection of the bowel at the level of transitional zone, feces bulk was pulled up from the upper part of the rectum to the sigmoid colon above the peritoneal reflection and aganglionic bowel was resected. Inspissated stool in the distal of the rectum was removed by rectal washout intraoperatively. In the control group, routine MBP was performed. Cleanness of the rectum was evaluated intraoperatively.
Results In this study, a total of 80 children were enrolled. In 32 patients (80%), the goal of MPB was achieved in 4 hours. Mean polyethylene glycol volume was 1372.3 ± 231.9 mL. Preoperative rectal washout fluid was 635 ± 233.3 mL. There was no statistically significant difference in individual complication rates between groups. Four patients (5%) had intra-abdominal infection and 16 (20%) had wound infection. We had no anastomotic leak in our groups. All children or parents in the control group described the preoperative MBP as the most unpleasant part of the hospital administration.
Conclusion For young children with HSCR who were scheduled for Duhamel operation, we had found no clear benefit of MBP. However, a multicenter randomized controlled trial is needed to more definitely determine the best preoperative approach for children with HSCR.
Surgical Management of Pediatric Lymphedema: A Systematic Review
Authors: Kanth Aditi M. , Krevalin Max , Adetayo Oluwaseun A. , Patel Ashit 
Published: February 2019

Background Lymphedema is a rare, progressive, and debilitating condition caused by failure of the lymphatic system to adequately drain the protein-rich fluid exiting the capillaries. Conservative management is often emphasized in pediatric patients, resulting in a paucity of literature describing surgical treatment in this population.
Methods A systematic review was performed using PubMed, ScienceDirect, and Google Scholar to identify all studies describing surgical management of lymphedema in the pediatric population.
Results Of the 343 relevant articles identified, 14 met the criteria for full review. Articles were divided into the following treatment categories: genital lymphedema, excisional procedures for extremity lymphedema, and physiologic procedures for extremity lymphedema. Outcomes for genital lymphedema were overall positive. For extremity lymphedema, excisional procedures yielded good results overall and included the majority of patients in this study. Physiologic procedures had mixed outcomes in the small population included in this study, but definitive conclusions cannot be drawn due to the paucity of existing data.
Conclusion While conservative management of pediatric lymphedema is well described, the literature remains sparse regarding surgical treatment. Further studies are needed to evaluate efficacy and outcomes in all three categories in this population.
An experimental investigation of differential object marking in Mexican Spanish
Authors: Bautista-Maldonado Salvador , Montrul Silvina 
Published: February 2019

Abstract
Differential Object Marking (DOM) is a phenomenon widely attested in Spanish. In two experimental studies using
production and acceptability judgments we examined the extent to which Mexican Spanish presents some variation among monolingual
speakers with respect to expansion of DOM. We tested whether DOM with animate and specific objects is categorical in this variety,
and whether DOM is expanding to inanimate definite and indefinite objects as observed by diachronic studies of Mexican and other
Latin American varieties. We also tested DOM with other constructions: bare plurals, the verbs like tener and
haber, small clauses and causative and perception verbs. Our study contributes new data documenting
linguistic variation in native speakers and confirms synchronic and diachronic analyses of DOM in Spanish.
Subjectivity in Spanish causal connectives
Authors: Cárcamo Morales Benjamín 
Published: February 2019

AbstractRecent literature has focused on specifying the nature of causal relations. Although the identification of whether connectives prototypically convey objective or subjective relations has been carried out for languages such as French, Dutch and English, the same has not occurred in the case of Spanish. The present study examines frequently used connectives and lexical cue phrases in terms of domain, propositional attitude, and presence of a Subject of Consciousness (SoC) in order to determine the degrees of subjectivity conveyed by the connectives. The findings show thatdebido a (que)is a highly specific connective used in objective causal relations about facts which do not involve SoC. On the contrary, the connectivesporqueandya quepresent similar flexibility that result in both being used to convey subjective and objective causal relations. This study supports the assumption of subjectivity being a cognitive mechanism that shows across different languages.
Nucleophilic substitution at di- and triphosphates: leaving group ability of phosphate versus diphosphate
Authors: van Beek Bas , van Bochove Marc A , Hamlin Trevor A , Bickelhaupt F Matthias 
Published: February 2019

Abstract
Adenosine triphosphate (ATP) is the universal energy carrier in biochemical processes. Herein, we aim for a better understanding of the origin of the high-energy content of the triphosphate moiety involved, the influence of various physicochemical factors thereon, and implication for the actual SN2@P-induced hydrolysis, which drives uphill biochemical processes, such as, DNA replication. To this end, we have investigated the SN2@P-induced hydrolysis of triphosphate (PPP) versus that of diphosphate (PP) using density functional theory (DFT) at COSMO(H2O)-ZORA-OLYP/TZ2P. We find that SN2@P-induced hydrolysis of PPP is favored over that of PP, both kinetically and thermodynamically. The energetic advantage of PPP over PP is slightly diminished by the coordination of Mg2+ counterions. Our activation strain and energy decomposition analyses reveal that the activation barrier for PPP hydrolysis is lower compared to that for PP due to a weaker P
α
–O leaving group bond.
Analysis and Interpretation of Google Trends Data on Public Interest in Cosmetic Body Procedures
Authors: Tijerina Jonathan D , Morrison Shane D , Nolan Ian T , Vail Daniel G , Lee Gordon K , Nazerali Rahim 
Published: February 2019

Abstract

Background
Several online resources such as Google Trends (GT) enable plastic surgeons to track search volume trends for cosmetic procedures. Understanding these data may allow surgeons to better anticipate patients’ interests and meet their needs.

Objectives
The authors sought to evaluate the correlation between GT search volumes and annual surgery volumes.

Methods
Search terms were generated using the “related queries” feature of GT. Data were obtained for the terms breast augmentation, buttock augmentation, buttock implants, buttock lift, calf augmentation, liposuction, lower body lift, thighplasty, abdominoplasty, and brachioplasty from January 2004 to November 2017. Annual volumes for respective procedures were obtained from statistics reports of the American Society of Plastic Surgeons (ASPS) from 2006 to 2017 and American Society of Aesthetic Plastic Surgery (ASAPS) from 2004 to 2017. Correlations were evaluated applying univariate linear regression of GT data to both ASPS and ASAPS data.

Results
Geographical and temporal variations in search volume were detected during the study. Search volume trends that correlated significantly with both ASPS and ASAPS surgery volume trends were: “butt implants surgery” (ASPS: R2 = 0.366, P = 0.049; ASAPS: R2 = 0.380, P = 0.019); “liposuction” (ASPS: R2 = 0.690, P = 0.002; ASAPS: R2 = 0.578, P = 0.002); and “liposuction surgery” (ASPS: R2 = 0.672, P = 0.002; ASAPS: R2 = 0.476, P = 0.006). Several search terms demonstrated no significant relationships, negative correlations, or were significant with only one database.

Conclusions
This study characterizes GT as a convenient and informative data set for plastic surgeons to analyze patient interest in cosmetic body-sculpting procedures. GT represents a useful instrument for tailoring marketing strategies and addressing the needs of our patient population.
Management of Recurrent Symptomatic Macromastia: A Single Surgeon’s Experience
Authors: Qureshi Ali A , Stevens W Grant 
Published: February 2019

Abstract

Background
Breast reduction for symptomatic macromastia can have excellent long-term results and relief of symptoms. However, patients may require a re-reduction for recurrent symptoms. Previous reports of re-reduction after a primary inferior pedicle reduction have called into question the safety of blood supply to the nipple-areola complex with re-reduction.

Objectives
To examine a single surgeon’s experience and management of recurrent symptomatic macromastia after inferior pedicle breast reduction.

Methods
A retrospective review was performed of a single surgeon’s breast reduction experience using billing data to identify cases of breast re-reduction from January 2003 and January 2018. Breast re-reduction was performed either with a Wise pattern, inferior pedicle or with a smile reduction with an inferior pedicle. Liposuction was used in re-reductions only.

Results
In 15 years, 3530 breast reductions were performed in 1758 patients. In 7 patients, 14 total re-reductions were performed, including 13 secondary breast re-reductions (12 bilateral, 1 unilateral) and 1 tertiary, unilateral breast re-reduction. Seven Wise pattern, inferior pedicle and 7 smile reductions with inferior pedicle procedures were done at the breast level. This translates to a re-reduction incidence of 1 in 250 or 0.4% rate of re-reduction at the patient level in our practice. The minor complication rate was 14% (1 seroma), and the major complication rate was 0%. There were no instances of partial or complete nipple areola necrosis.

Conclusions
Recurrent symptomatic macromastia can be managed with re-reduction with re-creation of the inferior pedicle or a smile breast reduction as we describe without increased risk to nipple-areolar complex viability.

Level of Evidence: 4
MetaMarker: a pipeline for de novo discovery of novel metagenomic biomarkers
Authors: Koohi-Moghadam Mohamad , Borad Mitesh J , Tran Nhan L , Swanson Kristin R , Boardman Lisa A , Sun Hongzhe , Wang Junwen 
Published: February 2019

Abstract

Summary
We present MetaMarker, a pipeline for discovering metagenomic biomarkers from whole-metagenome sequencing samples. Different from existing methods, MetaMarker is based on a de novo approach that does not require mapping raw reads to a reference database. We applied MetaMarker on whole-metagenome sequencing of colorectal cancer (CRC) stool samples from France to discover CRC specific metagenomic biomarkers. We showed robustness of the discovered biomarkers by validating in independent samples from Hong Kong, Austria, Germany and Denmark. We further demonstrated these biomarkers could be used to build a machine learning classifier for CRC prediction.

Availability and implementation
MetaMarker is freely available at https://bitbucket.org/mkoohim/metamarker under GPLv3 license.

Supplementary information
Supplementary data are available at Bioinformatics online.