bluuebunny/crossref_metadata_2025_split huggingface dataset:
50 Jahre Minimal-invasive Chirurgie in der Urologie
Authors: Rassweiler Jens J. , Serdar Goezen Ali , Klein Jan , Rassweiler-Seyfried Marie-Claire 
Published: October 2019

ZusammenfassungDie Entwicklung der Minimal-invasiven Chirurgie (MIC) in der Urologie umfasst die Teilbereiche transurethrale Techniken, Endourologie und Extrakorporale Stosswellenlithotripsie, Uroradiologie sowie Laparoskopie und Robotische Chirurgie. Basierend auf persönlichen Erfahrungen mit der Entwicklung minimal-invasiver Verfahren seit Ende der 70iger Jahren präsentieren wir eine historische Analyse der Literatur mit dem Ziel, die wesentlichen Meilensteine der Minimal-Invasiven Therapie in der Urologie herauszuarbeiten.Motor der rasanten Entwicklung der MIC in der Urologie war die Einführung der digitalen Videotechnologie, Lasertechnologie, Fortschritte der Elektrochirurgie begleitet von den Glanzleistungen vor allem Deutscher Technologiefirmen mit zunehmender Miniaturisierung des Instrumentariums. Bedeutsam war auch die gute Kooperation zwischen Urologen, Ingenieuren und Radiologen.Die Laparoskopie wird trotz zahlreicher Weiterentwicklungen (3D-Prismentechnolgie, ETHOS-chair) zunehmend von der Robotik ersetzt. Auf Grund der auslaufendenden Patenten von Intuitive Surgical existiert seit diesem Jahr eine Konkurrenzsituation mit neuen Herstellern von Operationsrobotern. Allerdings müssen diese erst belegen, ob sie den hohen Qualitätsstandard der aktuellen Da Vinci-serie bieten können. Robotersysteme für die Endourologie werden zukünftig eine Rolle spielen, wie Avicenna RoboflexR für die flexible Ureteroskopie und AquaBeamR- für die roboter-assistierte Aquaablation der Prostata. Während RoboflexR ähnlich dem Da Vinci-system die Ergonomie des Eingriffes erleichtert, ersetzt die robotergestützte Aquablation erstmals den Operateur.
Die Wirkung von kurzen oberkörperspezifischen Bewegungs- und Trainingsinterventionen am Arbeitsplatz auf die Parameter Schmerz und Kraft
Authors: Dößereck Nils , Friese Max , Liebscher Robert , Lachtermann Ella , Dreher Matthias 
Published: October 2019

ZusammenfassungDas systematische Review untersucht die Auswirkungen von oberkörperspezifischen Kurzinterventionen am Arbeitsplatz auf muskuloskelettale Schmerzen sowie den muskulären Kraftzuwachs.Es wurde eine systematische Literaturrecherche in den Datenbanken PubMed und Google Scholar durchgeführt; eingeschlossen wurden ausschließlich randomisierte kontrollierte Studien. Als Interventionsdauer wurden mindestens 4 Wochen definiert und eine Einheit sollte zwischen 10 und 20 Minuten bei einem maximalen Wochenumfang von 75 Minuten betragen. Insgesamt wurden 16 Studien – unterteilt in 11 Cluster – eingeschlossen, welche die Auswirkungen von Kurzinterventionen auf die Variablen Kraft und Schmerz beschreiben. Alle neun Cluster die den Schmerz als Parameter beinhalten, beschreiben eine schmerzreduzierende Wirkung durch Bewegung und Training in mindestens einer der berücksichtigten Körperregionen. Ebenso wurde in neun der zehn Cluster, die den Parameter Stärke betrachteten, eine Kraftzunahme beschrieben. Es konnte gezeigt werden, dass selbst kurze Bewegungs- und Trainingsinterventionen einen positiven Effekt auf die untersuchten Parameter haben. Jedoch weisen die Studien eine große Heterogenität auf, sodass weitere Forschungsvorhaben notwendig sind.
Die Änderungen der Bedarfsplanungsrichtlinie und ihre Bedeutung für die Rheumatologie
Authors: Pittrof Ute 
Published: October 2019

ZUSAMMENFASSUNGAm 01.07.2019 ist die „Richtlinie über die Bedarfsplanung sowie die Maßstäbe zur Feststellung von Überversorgung und Unterversorgung in der vertragsärztlichen Versorgung“ (BPl-RL n. F.) in Kraft getreten. Sie definiert in § 8 erstmals die Ermittlung und Anpassung der jeweils bedeutsamen Verhältniszahlen für die unterschiedlichen Arztgruppen. Neu ist auch die Anpassung der Verhältniszahlen unter Berücksichtigung der Morbiditätsstruktur auf der Grundlage eines „zellenbasierten“ Ansatzes (§ 9 Abs. 4 bis 7 BPl-RL n.F). Die Modifikation der Basisverhältniszahl durch den Morbiditätsfaktor führt zur Erhöhung der Allgemeinen Verhältniszahl für Fachinternisten (§ 13 Abs. 4 BPl-RL n.F.). Sie liegt nun bei 14 437 Einwohner je Arzt, während sie bisher bei 21 508 Einwohner je Arzt lag. Um die Niederlassung von Rheumatologen zu fördern, wird in Zukunft ein Versorgungsanteil von 8 % der regionalen Verhältniszahlen der Fachinternisten diesen vorbehalten bleiben (§ 13 Abs. 6 Nr. 1 BPL-RL n. F.). Außerdem werden die Nachbesetzungsmöglichkeiten der übrigen Fachinternistengruppen durch „Maximalquoten“ für einzelne Gruppen beschränkt. Einzelheiten sind offen.
Praxiskauf im Lichte der Datenschutz-Grundverordnung (DSGVO) – Rechtskonforme Übertragung von Patientendaten
Authors: Reimer Felix 
Published: October 2019

ZUSAMMENFASSUNGDie DSGVO hat keine wesentlichen Erschwernisse für geordnete Praxisübergaben und der in diesem Zuge notwendigen Veräußerung und Übertragung von Patientendaten geschaffen. Ein gesetzlich vorgeschriebener Modus zur Einholung der erforderlichen Patienteneinwilligungen existiert auch im neuen Datenschutzrecht nach Inkrafttreten der DSGVO nicht. In Praxiskaufverträgen ist die datenschutzrechtskonforme Übereignung von Patientendaten auch weiterhin zweckmäßig in Anlehnung an das „Zwei-Schränke-Modell“ zu regeln. Es ist von den Vertragsparteien sicherzustellen, dass die vertraglichen Regelungen im Vollzug auch tatsächlich umgesetzt werden. Hierfür ist eine rechtzeitige Abstimmung mit dem Praxissoftware-Unternehmen des Abgebers zu empfehlen, dem das Thema „Praxisübergabe“ regelmäßig bekannt ist. Im Zuge der Datenübertragung auf den Übernehmer kommt es zu einer sogenannten Auftragsverarbeitung des Übernehmers für den Übergeber, die vertraglich zu regeln ist. Aktuell wird in Veröffentlichungen eine gesonderte Auftragsverarbeitungsvereinbarung neben dem schriftlichen Praxiskaufvertrag empfohlen (vgl. z. B. [1]), die zweckmäßig sein kann, aber nicht gesetzlich zwingend vorgeschrieben ist.
Mit Lehm heilen
Authors: Menschel Matthias 
Published: October 2019

SummaryDie Therapie nach Emanuel Felke umfasst Licht, frische Luft, Wasser und Lehm. In den Sommermonaten finden die Therapien hauptsächlich im Freien statt. Lehm kann durch seine physikalisch-chemischen und mechanischen Eigenschaften bei Indikationen von Arthrose bis zu vegetativen Störungen Symptome lindern. Die Lehmtherapie kann individuell angepasst als Halbbad, Lehmtretbad, Lehmhandbad, lokal angewendete Lehmpackung und Lehm-Serailbad stattfinden.
Stille Begleiter
Authors: Gundacker Stefanie 
Published: October 2019

SummaryÜberhöhte Konzentrationen gelöster Substanzen oder Abflusshindernisse führen im Körper zur Steinbildung, am häufigsten in Form von Gallen- und Nierensteinen. Steine können über längere Zeit symptomlos bleiben, führen jedoch zu plötzlichen und heftigen Beschwerden, wenn sie Ausführgänge oder andere flüssigkeitsführende Gefäße verlegen. Im akuten Fall müssen die Ursachen ärztlich abgeklärt und die Steine eventuell chirurgisch entfernt werden, ansonsten stehen naturheilkundliche Therapien wie entkrampfende oder durchspülende Tees zur Verfügung.
Morphological Differences between the First and Second Permanent Upper Molars
Authors: Genaro Luis Eduardo , Ferreira Gabriely , Conte Marcelo Brito , Gonçalves Marcela de Almeida , Capote Ticiana Sidorenko Oliveira 
Published: October 2019

AbstractThe dental elements present similar and specific anatomical features, depending on the functions they have in the oral cavity. The permanent molars are the most complex structures, mainly the occlusal face, due to their function of food grinding. The aim of the present article is to present the upper first and second molars morphology, emphasizing the similarities and differences between them. Besides, the upper first and second molars of the collection of the Department of Morphology of Universidade Estadual de Paulista (UNESP), School of Dentistry, Araraquara, were evaluated regarding the presence of the oblique ridge, frequency and classification of the molar tubercle, and the crown morphology (upper second molars). In the 372 evaluated upper first molars, the molar tubercle was absent in most of the teeth. When present, the molar tubercle belonged to the mesiolingual cusp; 8.9% were classified as type I; 9.1% as type II; and 9.4% as type III. The oblique ridge was present in all upper first molars. The morphology of 401 upper second molars was also evaluated; 64.83% were tetracuspid; 35.16% tricuspid; and 17.02% presented compression morphology. In 100 tricuspid teeth, 50% presented oblique ridge, with it being prominent in 30%. No upper second molars presented molar tubercle. Although there are similarities between the upper first and second molars, we must always be aware of the features that differ between them, so their functionality can be restored.
A Randomized Controlled Trial of Intact Cord Milking versus Immediate Cord Clamping in Term Infants Born by Elective Cesarean Section
Authors: Zanardo Vincenzo , Guerrini Pietro , Severino Lorenzo , Simbi Alphonse , Parotto Matteo , Straface Gianluca 
Published: October 2019

Abstract
Objective We evaluated whether intact umbilical cord milking (UCM) is more effective than immediate cord clamping (ICC) in enhancing placental transfusion after elective cesarean delivery.
Study Design In a randomized trial, volume of placental transfusion was assessed by Δ hematocrit (Hct) between neonatal cord blood and capillary heel blood at 48 hours of age, corrected for the change in body weight.
Results There were no significant differences in cord blood mean Hct values at birth (UCM, 44.5 ± 4.8 vs. ICC, 44.9 ± 4.2%, p = 0.74). Conversely, at 48 hours of age, the UCM group had significantly higher capillary heel Hct values (UCM, 53.7 ± 5.9 vs. ICC, 49.8 ± 4.6%, p < 0.001), supporting a higher placental transfusion volume (Δ Hct, UCM 9.2 ± 5.2 vs. ICC 4.8 ± 4.7, p < 0.001), despite comparable neonatal body weight decrease (UCM, −7.3 vs. ICC, −6.8%, p = 0.77).
Conclusion Higher Δ Hct between cord blood at birth and capillary heel blood at 48 hours of age, corrected for the change in body weight, suggests that intact UCM is an efficacious and safe procedure to enhance placental transfusion among neonates born via elective cesarean delivery.
Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT03668782.
Surgical Management of Esophageal Achalasia in Pediatrics: A Systematic Review
Authors: Goneidy Ayman , Cory-Wright James , Zhu Limeng , Malakounides Georgina 
Published: October 2019

Abstract
Introduction There are no evidence-based guidelines on the surgical management of esophageal achalasia (OA) in children. This can be a challenging condition with significant physical and psychological morbidity. Our aim was to identify the most common management modalities and their outcomes.
Materials and Methods A systematic review was performed through a literature search of health care databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming at identifying pediatric series discussing the diagnosis and management of OA. Duplicates, case series with < 9 patients, and follow-up of < 1 year were excluded. The included papers were analyzed for diagnostic methods, primary treatment method, complications, follow-up duration, outcome measures recorded, and outcome.
Results Data from 33 papers for 742 children treated for OA was analyzed. Eleven mentioned multiple management modalities. In summary, 25 described Heller's esophagomyotomy (HM), 13 esophageal dilatation (EOD), and 6 peroral esophageal myotomy (POEM). Mean follow-up was 43.7 months (12–180). Outcome measures were heterogeneous. However, analysis of reported success showed a mean success of 78% for HM (p = 1.79 × 10–7), 44.9% for EOD (p = 0.24), and 99.3% for POEM (p = 0.001). Reported complications were 12.8% for HM, 5% for EOD, and 24.4% for POEM. Further interventions were required for 10.9% of HM, 62.3% of EOD, and 0.01% of POEM patient groups.
Conclusion Methods of diagnosis and measures of successful outcomes were heterogeneous, limiting the strength of evidence. HM showed superior short-term success rates to EOD. POEM is a promising modality but requires investment in equipment and training. Information about sustainability of response and long-term outcomes is lacking.
General practitioners’ practical approach to initiating end-of-life conversations: a qualitative study
Authors: Deckx Laura , Thomas Hayley R , Sieben Nicolas A , Foster Michele M , Mitchell Geoffrey K 
Published: October 2019

Abstract

Background
As doctors who provide care across the life-course, general practitioners (GPs) play a key role in initiating timely end-of-life discussions. Nonetheless, these discussions are often not initiated until close to death. Given the ageing of the population, GPs will be confronted with end-of-life care more often, and this needs to become a core skill for all GPs.

Objective
To describe GPs’ approach to initiating end-of-life discussions.

Methods
Fifteen GPs or GP trainees from South-East Queensland, Australia, were purposively recruited to participate in a semi-structured interview. We analysed transcripts using a thematic analysis.

Results
GPs’ approach to initiating end-of-life discussions was summarized by four themes: (1) Preparing the ground; (2) finding an entry point; (3) tailoring communication and (4) involving the family.

Conclusions
Emphasis on the doctor–patient relationship; assessing patient readiness for end-of-life discussions; and sensitive information delivery is consistent with factors previously reported to be important to both GPs and patients in this context. Our findings provide a framework for GPs initiating end-of-life discussions, which must be tailored to patient and GP personality factors. Further research is required to evaluate its outcomes.
Predictive Ability of Mixed-Effects Height–Diameter Models Fit Using One Species but Calibrated for Another Species
Authors: Vanderschaaf Curtis L 
Published: October 2019

Abstract
Mixed-effects individual tree height–diameter models are presented for important pines in the Western Gulf, USA. Equations are presented for plantations of loblolly (Pinus taeda L.), longleaf (Pinus palustris P. Mill.), shortleaf (Pinus echinata Mill.), and slash (Pinus elliottii Engelm.) pine. To produce localized individual tree height estimates, these models can be calibrated after obtaining height–diameter measurements from a plot/stand of interest. These equations can help answer an interesting question of whether a model fit for one species can be calibrated to produce reasonable height estimates of another species. In situations where mixed-effects models have not been developed for a particular species, perhaps an equation from another species can be used. This question was addressed by calibrating these models using independent data of loblolly, longleaf, and slash pine plantations located in South Carolina. For each calibration species, in addition to the models developed described above, previously published models, but of the same model form, fit using other species from across the USA were examined.
Results show that models of a variety of species can be calibrated to provide reasonable predictions for a particular species. Predictions using this particular model form indicate that model calibration is more important than species-specific height–diameter relations.
A nationwide parent survey of antibiotic use in Australian children
Authors: Anderson Rebecca , Rhodes Anthea , Cranswick Noel , Downes Marnie , O’Hara Jonathan , Measey Mary-Anne , Gwee Amanda 
Published: October 2019

Abstract

Background
Antimicrobial resistance is increasing globally, largely due to high rates of antibiotic use and misuse. Factors that influence frequent antibiotic use in children are poorly understood.

Objectives
This study describes rates of antibiotic use in Australian children and investigates parental factors including knowledge, attitudes and behaviours that influence antibiotic use.

Methods
An online questionnaire relating to antibiotic use was administered as part of the Royal Children’s Hospital National Child Health Poll to a randomly recruited nationwide sample of parents or guardians of children aged 0–17 years in Australia. Data on antibiotic use in children and parental knowledge of appropriate indications for antibiotics and behaviours were collected. Standard binary logistic regression was used to assess associations between parent demographics and behaviour with antibiotic administration.

Results
The survey was completed by 2157 parents (64% completion rate), of which 1131 (52%) reported having given oral antibiotics to one or more of their children in the preceding 12 months. Of the 3971 children represented overall, 1719 (43%) had received at least one course of antibiotics. The average number of courses per child was 0.86 overall and 1.96 courses per child among those with reported antibiotic use. Notably, 194/1131 (17%) parents reported giving antibiotics to their child without a prescription. Poor parental knowledge of antibiotic indications was associated with antibiotic use.

Conclusions
Reducing excessive use of antibiotics in children is necessary in the global strategy for preventing antimicrobial resistance. This study identified areas for public health interventions to educate parents and increase regulation of access to antibiotics.
Bayesian inference of stellar parameters based on 1D stellar models coupled with 3D envelopes
Authors: Jørgensen Andreas Christ Sølvsten , Angelou George C 
Published: October 2019

ABSTRACT
Stellar models utilizing 1D, heuristic theories of convection fail to adequately describe the energy transport in superadiabatic layers. The improper modelling leads to well-known discrepancies between observed and predicted oscillation frequencies for stars with convective envelopes. Recently, 3D hydrodynamic simulations of stellar envelopes have been shown to facilitate a realistic depiction of superadiabatic convection in 1D stellar models. The resulting structural changes of the boundary layers have been demonstrated to impact not only the predicted oscillation spectra but evolution tracks as well. In this paper, we quantify the consequences that the change in boundary conditions has for stellar parameter estimates of main-sequence stars. For this purpose, we investigate two benchmark stars, Alpha Centauri A and B, using Bayesian inference. We show that the improved treatment of turbulent convection makes the obtained 1D stellar structures nearly insensitive to the mixing length parameter. By using 3D simulations in 1D stellar models, we hence overcome the degeneracy between the mixing length parameter and other stellar parameters. By lifting this degeneracy, the inclusion of 3D simulations has the potential to yield more robust parameter estimates. In this way, a more realistic depiction of superadiabatic convection has important implications for any field that relies on stellar models, including the study of the chemical evolution of the Milky Way Galaxy and exoplanet research.
On the environment of low surface brightness galaxies at different scales
Authors: Pérez-Montaño Luis Enrique , Cervantes Sodi Bernardo 
Published: October 2019

ABSTRACT
We select a volume-limited sample of galaxies derived from the SDSS DR7 to study the environment of low surface brightness (LSB) galaxies at different scales, as well as several physical properties of the dark matter haloes where the LSB galaxies of the sample are embedded. To characterize the environment, we make use of a number of publicly available value-added galaxy catalogues. We find a slight preference for LSB galaxies to be found in filaments instead of clusters, with their mean distance to the nearest filament typically larger than for high surface brightness (HSB) galaxies. The fraction of isolated central LSB galaxies is higher than the same fraction for HSB ones, and the density of their local environment lower. The stellar-to-halo mass ratio using four different estimates is up to ∼20 per cent for HSB galaxies. LSB central galaxies present more recent assembly times when compared with their HSB counterparts. Regarding the λ spin parameter, using six different proxies for its estimation, we find that LSB galaxies present systematically larger values of λ than the HSB galaxy sample, and constructing a control sample with direct kinematic information drawn from ALFALFA, we confirm that the spin parameter of LSB galaxies is 1.6–2 times larger than the one estimated for their HSB counterparts.
Primary Dural Closure in Minimally Invasive Spine Surgery Using an Extracorporeal Knot: Technical Note
Authors: Luque Leopoldo Luciano , Sainz Ariel , Seclen Daniel , Argañaraz Romina , Martin Clara , Fessler Richard G 
Published: October 2019

Abstract

BACKGROUND
Minimally invasive spine surgeries (MISS) are currently used for a wide variety of intradural spinal pathologies. Although MISS techniques have brought great benefits, primary dural closure can prove a challenge due to the narrow corridor of the tubular retractor systems.

OBJECTIVE
To present the surgical technique we developed for dural closure using an extracorporeal knot that is simple and reproducible.

METHODS
We describe the use of an extracorporeal knot for primary dural closure in MISS surgeries using standard instrumental. We illustrate this operative technique with figures and its application in a surgical case with images and demonstration video2.

RESULTS
Using our surgical technique, a watertight dural closure with separated knots was performed without specific instruments.

CONCLUSION
The use of extracorporeal knots facilitates primary dural closure in MISS surgeries.
Exponentially suppressed cosmological constant with enhanced gauge symmetry in heterotic interpolating models
Authors: Itoyama H , Nakajima Sota 
Published: October 2019

Abstract
A few 9D interpolating models with two parameters are constructed and the massless spectra are studied by considering compactification of heterotic strings on a twisted circle with a Wilson line. It is found that there are some conditions between radius $R$ and Wilson line $A$ under which the gauge symmetry is enhanced. In particular, when the gauge symmetry is enhanced to $SO(18)\times SO(14)$, the cosmological constant is exponentially suppressed. We also construct a non-supersymmetric string model that is tachyon-free in all regions of moduli space and whose gauge symmetry involves $E_8$.
Multiple Hereditary Exostoses: Genetics, Multimodality Imaging Features, Complications, Differential Diagnosis, and Treatment
Authors: Bowman Sean R. , White Eric A. , Tomasian Anderanik , Gross Jordan S. , Patel Dakshesh B. , Matcuk George R. 
Published: October 2019

Osteochondromas are a common type of benign bone tumor that occur during childhood. Osteochondromas can be solitary or multifocal as a part of a syndrome, known as multiple hereditary exostoses (MHE). This differentiation was first discovered in 1786 by John Hunter, a famous Scottish surgeon. In 1814, MHE was found to have a familial association. Later, in the 1900s, MHE was differentiated from other disorders, such as Ollier disease (multiple enchondromatosis) and Trevor disease (dysplasia epiphysealis hemimelica). MHE is known by other names including hereditary multiple osteochondromas, diaphyseal aclasis, hereditary deforming chondrodysplasia, and Ehrenfried disease.
MHE occurs more frequently in males than in females (1.5–2:1) and whites. Males also tend to be more severely affected. In patients with MHE, the mean number of osteochondromas is typically 15 to 18. Osteochondromas typically occur within the first decade of life (80%) and continue to increase in size until physeal closure. Osteochondromas are most commonly asymptomatic, although they can present with various symptoms including pain and limb length discrepancies. Osteochondromas have key imaging characteristics that help to differentiate them from other types of skeletal lesions and to characterize malignant potential.1