bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-frequency measurements of synchrotron absorbing HII regions and modeling of observed synchrotron emissivity
Authors: Polderman I. M. , Haverkorn M. , Jaffe T. R. , Alves M. I. R. 
Published: November 2018

Context. Cosmic rays (CRs) and magnetic fields are dynamically important components in the Galaxy, and their energy densities are comparable to that of the turbulent interstellar gas. The interaction of CRs and Galactic magnetic fields (GMF) produces synchrotron radiation clearly visible in the radio regime. Detailed measurements of synchrotron radiation averaged over the line-of-sight (LOS), so-called synchrotron emissivities, can be used as a tracer of the CR density and GMF strength.
Aims. Our aim is to model the synchrotron emissivity in the Milky Way using a three-dimensional dataset instead of LOS-integrated intensity maps on the sky.
Methods. Using absorbed HII regions, we measured the synchrotron emissivity over a part of the LOS through the Galaxy, changing from a two-dimensional to a three-dimensional view. Performing these measurements on a large scale is one of the new applications of the window opened by current low-frequency arrays. Using various simple axisymmetric emissivity models and a number of GMF-based emissivity models, we were able to simulate the synchrotron emissivities and compare them to the observed values in the catalog.
Results. We present a catalog of low-frequency absorption measurements of HII regions, their distances and electron temperatures, compiled from literature. These data show that the axisymmetric emissivity models are not complex enough, but the GMF-based emissivity models deliver a reasonable fit. These models suggest that the fit can be improved by either an enhanced synchrotron emissivity in the outer reaches of the Milky Way or an emissivity drop near the Galactic center.
Conclusions. Current GMF models plus a constant CR density model cannot explain low-frequency absorption measurements, but the fits improved with slight (ad hoc) adaptations. It is clear that more detailed models are needed, but the current results are very promising.
Machtvoll interagieren
Authors: Blumenrode Stefan 
Published: November 2018

ZusammenfassungMacht ist allgegenwärtig – auch in der psychiatrischen Pflege. Wie sie entsteht
und welche Auswirkungen sie haben kann, beleuchten wir in unserem Schwerpunkt.
Denn erst, wenn Macht als Bestandteil von pflegerischen Beziehungen wahrgenommen
wird, können diese Beziehungen wertschätzend und achtsam gestaltet werden.
Biografiearbeit als Schlüssel zum Patienten
Authors: Grau Sabine 
Published: November 2018

ZusammenfassungWenn Pflegende den biografischen Hintergrund ihrer Patienten kennen, fällt es
leichter, sie individuell zu begleiten und mit ihnen umzugehen. Unsere Autorin
beschreibt, wie Sie sich mit der Biografiearbeit an einen unbekannten Patienten
annähern – denn die Beziehung zu einem Menschen wird eine andere, wenn man seine
Geschichte kennt.
Würde statt Willkür
Authors: Kammer-Spohn Michael 
Published: November 2018

ZusammenfassungDie Pflege von psychisch Kranken ist häufig eine Gratwanderung zwischen
Patientenwillen und pflegerischer Fürsorge. Es gilt, das notwendige, aber
minimal mögliche Maß an Zwang und Gewalt auszuloten – denn fest steht: Ein
ethisch angemessener Umgang mit dem Machtkonflikt hat großen Anteil am
Behandlungserfolg.
Salvage nitrous oxide cryotherapy of refractory colon neoplasia embedded within an endoclip
Authors: Trindade Arvind , Benias Petros , Cerulli Maurice 
Published: November 2018

Abstract
Background and study aims This is a case report on use of the CryoBalloon as a salvage technique for ablation of residual neoplasia at an endoscopic mucosal resection site. The site contained an embedded clip that could not be removed at two different sessions by three experienced endoscopists. On follow-up endoscopy, the clips and residual polyp no longer remained. The subtle scar that was present was biopsied and confirmed complete eradication of neoplasia and no polyp tissue. This case shows the potential of the CryoBalloon to ablate unwanted tissue outside of the esophagus.
Morphometric analysis of the palatal shape and arch dimension in subjects with palatally displaced canine
Authors: Mucedero Manuela , Rozzi Matteo , Milazzo Alessia , Cozza Paola 
Published: November 2018

SummaryObjectivesThe aim of this study is to analyse the morphological variations of the palate shape and maxillary arch dimension in a group of subjects with unilaterally or bilaterally impacted maxillary canines compared with a control group, using three-dimensional (3D) geometric morphometric.MaterialsThe subject of this study consisted of pre-treatment records of 46 (18 males and 28 females) patients with one or both canines palatally displaced. A control group of 26 subjects was selected from a list of orthodontic patients at the same dental hospital. The subjects were divided in two study groups: unilateral palatally displaced canine (UPDC) and bilateral palatally displaced canine (BPDC). Study casts were scanned to analyse the palate’s shape and maxillary arch dimension. The 3D geometric morphometric analysis was used to study the entirety of the shape of the palate. The virtual 3D models were measured with a specific software to analyse the maxillary arch dimension. (VAM, Vectra; Canfield Scientific, Fairfield, New Jersey, USA).ResultsWhen comparing the groups with the geometric morphometrics analysis, no significant palatal shape change was found. For the analysis of linear measurements, only a significant reduction of intercanine width was found in the UPDC and BPDC groups when compared with the control subjects.ConclusionsPatients with palatally displaced permanent canine showed no maxillary transverse constriction or variation in palatal vault morphology but the absence of permanent teeth was associated with a reduction in the intercanine width.
Effect of Carotid Siphon Anatomy on Aneurysm Occlusion After Flow Diversion for Treatment of Internal Carotid Artery Aneurysms
Authors: Rinaldo Lorenzo , Brinjikji Waleed , Cloft Harry J , Kallmes David F , Rangel-Castilla Leonardo 
Published: November 2018

Abstract

BACKGROUND
Flow diversion (FD) is effective for treatment of intracranial internal carotid artery (ICA) aneurysms.

OBJECTIVE
To determine whether carotid siphon (CS) geometry influences the efficacy of FD when employed for ICA aneurysms.

METHODS
Outcomes of a consecutive series of patients with ICA aneurysms treated with FD were retrospectively reviewed. CS anatomy was quantified through measurement of the posterior, anterior, and anterosuperior bend angles in accordance with previously described methodology. The relationship of CS geometry to likelihood of incomplete aneurysm occlusion at 1 yr after treatment was assessed with multivariate logistic regression analysis.

RESULTS
There were 167 ICA aneurysms in 164 patients treated with FD during the study period. The mean age of our cohort was 55.7 yr (standard deviation [SD]: 12.3) and a majority of patients were female (145/164, 86.8%). Anterior (47.4 degrees vs 8.5, P < .001) and anterosuperior bend angles (100.9 vs 76.5, P = .002) were significantly greater in aneurysms that required repeat FD after initial treatment. On multivariate logistic regression analysis, increasing patient age (unit odds ratio [OR]: 1.05, 95% confidence interval [CI] 1.01-1.08; P = .003) and anterior bend angle ≥–3.5 (OR: 2.47, 95% CI 1.04-5.86; P = .046) were associated with increased odds of incomplete aneurysm occlusion at 1 yr after treatment.

CONCLUSION
These findings suggest that variations in CS anatomy may influence the efficacy of FD treatment and should be analyzed prior to offering FD for treatment of ICA aneurysms. Further investigation into the hemodynamic effects of CS geometry is warranted.
Persistent Postsurgical Pain Following Thoracotomy: A Comparison of Thoracic Epidural and Paravertebral Blockade as Preventive Analgesia
Authors: Wong Jonathon , Cooper Jackie , Thomas Rik , Langford Richard , Anwar Sibtain 
Published: November 2018

Abstract

Objective
Persistent postsurgical pain (PPP) is common following thoracotomy. Thoracic epidural (TEB) and paravertebral blockade (PVB) are both established forms of perioperative analgesia for thoracotomy. There is currently a lack of data on their influence on PPP; this study aims to evaluate both techniques on PPP.

Design
Observational study, prospectively collected data.

Methods
Adults who underwent thoracotomy had either TEB or PVB for analgesia and were prospectively interviewed at six months. A numerical rating scale, the short form of the Leeds Assessment of Neuropathic Symptoms and Signs, and the EuroQol-5 dimension (EQ-5D) index were used to assess pain, neuropathic pain, and quality of life.

Results
Eighty-two patients who underwent a thoracotomy were recruited (TEB N = 36, PVB N = 46). Pain scores had a median (interquartile range [IQR]) of 1 (0 to 4.5) and 1.5 (0 to 4, P = 0.89), presence of PPP was 58.3% (95% confidence interval [CI] = 40.0–74.5%) and 60.9% (95% CI = 45.4–74.9%, P = 0.81), and presence of neuropathic pain was 30.6% (95% CI = 16.3–48.1%) and 28.2% (95% CI = 16.0–43.5%, P = 0.85). Reported quality of life was 0.71 (0.14–0.85) and 0.80 (0.19–0.91, P = 0.21). Patients who had PPP reported worse quality of life measures compared with those who were pain free, with a median (IQR) EQ-5D index of 0.69 (–0.15 to 0.85) and 0.85 (0.72 to 1, P = 0.0007); quality of life was worst when there was a neuropathic component (median = 0.39, IQR = –0.24 to 0.75).

Conclusions
There was no statistical difference in the development of persistent postsurgical pain between patients who received a TEB or a PVB; however, patients who developed PPP had a significantly lower quality of life, which was worse with a neuropathic component.
COMMENT ON THE PAPER ‘LUMINESCENCE MODELS BY S.W.S. MCKEEVER AND R. CHEN, RADIATION MEASUREMENTS 27(5/6), 1997, pp. 625–661’
Authors: Kazakis Nikolaos A 
Published: November 2018

Abstract
The present comment concerns the correct presentation of the equations giving the CW-OSL intensity in the case of second- and general-order kinetics. Those equations have also been published with their wrong formulation in two eminent books in their topic. Since most researchers (especially early stage) would use directly the proposed functions as published in the various sources, they should be notified of their correct formulation.
Maternal Prenatal Screening and Serologies
Authors: Snow Timothy M. , Coble Melissa 
Published: November 2018

Background:
Maternal prenatal screening is essential in preventing pregnancy complications as well as preventing and/or predicting neonatal and infant medical issues after delivery that are due to certain communicable diseases.

Purpose:
This article is aimed at gathering and presenting the most recent information regarding the most common prenatal screening laboratory studies and the implications with the various diseases.

Methods/Search Strategy:
An extensive medical database search was performed and the most relevant medical texts regarding the subject of prenatal screening were obtained.

Findings/Results:
Maternal screenings should be performed at the first provider visit once pregnancy has been confirmed. Additional screenings vary based on the specific disease and on maternal risk factors. Methods of screenings involve measuring antigen or antibody titers, a combination of antigen/antibody titers, or by specialized genetic tests.

Implications for Practice:
Providers responsible for pregnant women should be able to identify which diseases they need to screen for and how to interpret the findings. Neonatal providers should be able to interpret the findings and they should also be able to manage neonates appropriately.

Implications for Research:
Future research should be aimed at developing better, cost-effective tests for both existing diseases and new diseases that either impact large or small populations of pregnant women and their fetuses.
Congenital Syphilis and the Prozone Phenomenon
Authors: Spydell Lauren E. 
Published: November 2018

Background:
There is a global rise in maternal syphilis and infants born with congenital syphilis.

Clinical Findings:
This case report presents a 32-week gestation premature male infant with initial clinical findings significant for respiratory failure as well as blueberry muffin spot rash and hepatosplenomegaly, which are consistent with congenital syphilis.

Primary Diagnosis:
This case study is unique in that the diagnosis of congenital neurosyphilis was demonstrated despite negative maternal serology because of the prozone phenomenon. This phenomenon refers to an overwhelming acute infection that interferes with testing by antibody flocculation or clumping of antibodies, causing a false-negative result and allows an infection such as syphilis to go undetected during pregnancy when Venereal Disease Research Laboratory test is performed.

Interventions:
The infant received a 10-day course of aqueous penicillin G 150,000 U/kg every 8 hours per Centers for Disease Control and Prevention and Redbook recommendations for congenital neurosyphilis.

Outcomes:
The infant was discharged home on day of life 38 and was followed as an outpatient with serial rapid plasma reagin titers confirming adequate treatment of congenital neurosyphilis. He was also referred to the high-risk infant clinic to monitor for developmental milestones secondary to prematurity and central nervous system infection.

Practice Recommendations:
Providers within the neonatal setting should consider early congenital syphilis testing on infants with similar clinical presentation regardless of negative maternal testing.
Eleven Principles for Teaching Quality Improvement Virtually: Engaging With Geographically Distributed Learners
Authors: Bryan Jennifer L. , Stewart Diana E. , Uriarte Jessica , Hernandez Alexandra , Naik Aanand D. , Godwin Kyler M. 
Published: November 2018

Abstract:
Health care professionals in the United States are expected to engage in quality improvement (QI) as part of their daily practice. This has created the need for QI training at all levels of health professional education. A reported barrier to increasing QI-trained health care professionals is the lack of QI-trained faculty at health care institutions and the limited availability of practitioners, given their daily clinical demands. E-learning is a potential solution. E-learning allows learning outside the traditional classroom setting, where instructors can flexibly deliver practical QI curricula to an interprofessional audience in multiple practice locations. The 11 principles presented in this article are derived from established evidence and experience and provide QI educators with practical principles for course design, implementation, and learner feedback of an e-learning course in QI.
Systematic Review and Meta-analysis of Nonsteroidal Anti-inflammatory Drugs to Improve GI Recovery After Colorectal Surgery
Authors: Chapman Stephen J. , Garner Joesph J. , Drake Thomas M. , Aldaffaa Mohammed , Jayne David G. 
Published: November 2018

BACKGROUND:
The management of delayed GI recovery after surgery is an unmet challenge. Uncertainty over its pathophysiology has limited previous research, but recent evidence identifies intestinal inflammation and activation of µ-opioid receptors as key mechanisms. Nonsteroidal anti-inflammatory drugs are recommended by enhanced recovery protocols for their opioid-sparing and anti-inflammatory properties.

OBJECTIVES:
The purpose of this study was to explore the safety and efficacy of nonsteroidal anti-inflammatory drugs to improve GI recovery and to identify opportunities for future research.

DATA SOURCES:
MEDLINE, Embase, and the Cochrane Library were systematically searched from inception up to January 2018.

STUDY SELECTION:
Randomized controlled trials assessing the effect of nonsteroidal anti-inflammatory drugs on GI recovery after elective colorectal surgery were eligible.

MAIN OUTCOME MEASURES:
Postoperative GI recovery, including first passage of flatus, stool, and oral tolerance, were measured.

RESULTS:
Six randomized controlled trials involving 563 participants were identified. All of the participants received patient-controlled morphine and either nonsteroidal anti-inflammatory drug (nonselective: n = 4; cyclooxygenase-2 selective: n = 1; either: n = 1) or placebo. Patients receiving the active drug had faster return of flatus (mean difference: –17.73 h (95% CI, –21.26 to –14.19 h); p < 0.001), stool (–9.52 h (95% CI, –14.74 to –4.79 h); p < 0.001), and oral tolerance (–12.00 h (95% CI, –18.01 to –5.99 h); p < 0.001). Morphine consumption was reduced in the active groups of 4 studies (average reduction, 12.9–30.0 mg), and 1 study demonstrated significantly reduced measures of systemic inflammation. Nonsteroidal anti-inflammatory drugs were not associated with adverse events, but 1 study was temporarily suspended for safety.

LIMITATIONS:
The data presented are relatively outdated but represent the best available evidence.

CONCLUSIONS:
Nonsteroidal anti-inflammatory drugs may represent an effective and accessible intervention to improve GI recovery, but hesitancy over their use after colorectal surgery persists. Additional preclinical research to characterize their mechanisms of action, followed by well-designed clinical studies to test safety and patient-reported efficacy, should be considered.
Methodologic Validation of a Faster Pelvic Floor Test: Two Randomized Studies in Anal Acoustic Reflectometry
Authors: Nicholson James E. , Klarskov Niels , Heywood Nick A. , Sharma Abhiram , Kiff Edward S. , Telford Karen J. 
Published: November 2018

BACKGROUND:
Anal acoustic reflectometry investigates the opening and closing function of the anal canal using reflected sound waves to measure a cross-sectional area at different pressures. Anal acoustic reflectometry is reliable and repeatable, distinguishes between continence and incontinence and between subgroups of incontinence, correlates with symptom severity, and does not distort the anal canal during investigation.

OBJECTIVE:
The purpose of this study was to validate anal acoustic reflectometry methodology by asking 2 questions: can anal acoustic reflectometry be used alongside manometry (order study) and can anal acoustic reflectometry be performed faster (filling study). The secondary aim was to assess the response of the anal canal to stretch using anal acoustic reflectometry.

DESIGN:
This research included 2 prospective randomized studies.

SETTINGS:
The study was conducted at a tertiary referral center.

PATIENTS:
Patients undergoing investigation for fecal incontinence were included.

INTERVENTION:
For the order study, patients were prospectively randomized to anal acoustic reflectometry, manometry, 2-minute rest and then manometry, anal acoustic reflectometry, or vice versa. For the filling study, patients were prospectively randomized to fast rate anal acoustic reflectometry (5 cm H2O/1 s), manometry, 2-minute rest and then manometry, normal rate anal acoustic reflectometry (5 cm H2O/3 s), or vice versa.

MAIN OUTCOME MEASURES:
The primary outcome was no difference in anal acoustic reflectometry or manometry variables. Demographic and clinical data were recorded.

RESULTS:
The order study included 30 patients with a median age of 63 years (range, 30–84 y); 77% were women. No difference was found among all of the variables of anal acoustic reflectometry and manometry regardless of which test was performed first. The filling study included 50 patients with a median age of 62 years (range, 30–78 y); 80% were women. No difference was found between fast and normal rates of anal acoustic reflectometry and manometry in any order.

LIMITATIONS:
This study was limited by its comparison with water-perfused manometry.

CONCLUSIONS:
Anal acoustic reflectometry and manometry can be performed at the normal or fast rate of anal acoustic reflectometry in any order. A fast rate of anal acoustic reflectometry did not augment the response of the anal canal to stretch as measured by anal acoustic reflectometry and manometry. This study validates a faster anal acoustic reflectometry technique and vindicates previous data. See Video Abstract at http://links.lww.com/DCR/A821.
Free Flap Transfer with Arteriovenous Loop Establishment for Upper Limb Salvage in a Crush Injury
Authors: Radwan Mohammad S. , Barakat Ammar Z. , Jaber Mohammad M. , Mashal Ashraf A. 
Published: November 2018

Summary:
Constructing arteriovenous (AV) loops saves a crushed limb when healthy recipient vessels are unavailable at the site of injury by supporting a transferred free flap. Literature about using AV loops in the upper limb defect is scarce. We present a case with a devastating upper limb crush injury that was successfully managed with fibula flap transfer preceded by AV loop construction. A 38-year-old woman was admitted to our hospital with severe crushing trauma to her right forearm and hand. There was significant skin loss with injuries to blood vessels and tendons. She underwent multiple staged operations beginning with repair of the ulnar artery, debridement of necrotic tissue, and placement of 2 K-wires to stabilize the bones. Thereafter, a long saphenous AV loop was constructed between the brachial artery and the basilic vein. Finally, transfer of the fibula flap to the forearm. We used the staged procedure to provide adequate time for the AV loop maturation and adaptation. At around the patient’s 7-month follow-up visit, her forearm and hand were stable, no complications related to the AV loop or the transferred fibula flap were noted. Utilizing AV loops to support transferred free flaps upper limb defects showed a promising successful outcome.
Outbreak of Yersiniabactin-producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit
Authors: Wisgrill Lukas , Lepuschitz Sarah , Blaschitz Marion , Rittenschober-Böhm Judith , Diab-El Schahawi Magda , Schubert Sören , Indra Alexander , Berger Angelika 
Published: November 2018

Background:
The Gram-negative bacterium Klebsiella pneumoniae is a frequent pathogen causing outbreaks in neonatal intensive care units. Some Enterobacteriaceae can acquire the ability to sequester iron from infected tissue by secretion of iron-chelating compounds such as yersiniabactin. Here we describe an outbreak and clinical management of infections because of a highly virulent yersiniabactin-producing, nonmultiresistant K. pneumoniae strain in a neonatal intensive care unit. Outbreak investigation and effectiveness assessment of multidisciplinary infection control measurements to prevent patient-to-patient transmission of highly pathogenic K. pneumoniae were undertaken.

Methods:
Outbreak cases were identified by isolation of K. pneumoniae from blood or stool of infants. Clinical data were abstracted from medical charts. K. pneumoniae isolates were genotyped using whole genome sequencing, and yersiniabactin production was evaluated by luciferase assay.

Results:
Fourteen cases were confirmed with 8 symptomatic and 6 colonized patients. Symptomatic patients were infants of extremely low gestational and chronologic age with fulminant clinical courses including necrotizing enterocolitis and sepsis. Whole genome sequencing for bacterial isolates confirmed the presence of an outbreak. All outbreak isolates produced yersiniabactin.

Conclusions:
Yersiniabactin-producing K. pneumoniae can display a high pathogenicity in extremely premature infants with low chronologic age. This outbreak also underlines the considerable potential of today’s infection control systems for recognizing and controlling nosocomial infections in highly vulnerable populations.