bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gesundheitswissenschaftliche Forschung mit primärärztlichen Routinedaten der elektronischen Patientenakte: das BeoNet-Register
Authors: Lingner Heidrun , Aumann Ines , Wacker Margarethe , Kreuter Michael , Leidl Reiner , von der Schulenburg J.-Matthias , Welte Tobias 
Published: July 2017

ZusammenfassungEntscheidungen im Gesundheitswesen sollten sich auf verlässliche und aktuelle Daten stützen. Da solche Daten besonders aus dem ambulanten Sektor kaum vorhanden und/oder nur schwer und zeitverzögert zugänglich sind, soll das neu eingerichtete BeoNet-Register (BNR) die medizinische Versorgungsrealität und -qualität des ambulanten Sektors mithilfe von Routinedaten aus der elektronischen Patientenakte (eP) abbilden. Diese „real-world“-Daten sollen mit Primärerhebungen verknüpft eine breite Datenbasis zur Beantwortung von Fragen der Praxis, der Versorgungsforschung und Ökonomie bilden. Interessierte Praxisinhaber verpflichten sich zu einer längerfristigen Teilnahme an dem 2-phasigen Projekt (Pilot- und Roll-Out-Phase). Informationen der eP der Praxen werden pseudonymisiert, verschlüsselt und über standardisierte Schnittstellen zeitnah, vollständig und longitudinal in die Datenbank (DB) des BNR übertragen, ohne den Praxisbetrieb zu stören. Dafür wird die Behandlungsdatentransfer-Schnittstelle (BDT) als gemeinsamer Nenner unterschiedlicher Arztinformationssysteme genutzt. Die kompilierten Variablen beinhalten Informationen zur Praxis, Stammdaten des Patienten und medizinische Parameter inklusive Angaben zu Diagnose, Therapie und Überweisungen. Ergänzt werden sie durch zusätzliche erhobene ‚patient-reported outcomes‘. Datenerhebung und Datenschutz unterliegen strengen Anforderungen, die im Rahmen des Datenschutzkonzeptes und des Ethikantrages festgelegt und für alle Forscher bindend sind. Retrospektive Auswertungen seit der Einführung der eP sowie Analysen des aktuellen Erkrankungsspektrums des hausärztlichen, pneumologischen und pädiatrischen ambulanten Sektors sind möglich. Derzeit befinden sich 98 497 Patienten-IDs aus Hannover, München und Heidelberg nebst zugehörigen Informationen in der BNR- DB. Die BNR-Daten sind umfangreicher und detaillierter als die Abrechnungsdaten der Krankenkassen. (Semi-) automatisierte Daten- Prüfroutinen und regelmäßige Feedback-Berichte sowie Datenanalysen sind implementiert und werden kontinuierlich erweitert. Während der Pilotphase wurden 2 Anwendungsbeispiele des BNR erarbeitet. Hier wird das COPD-Projekt vorgestellt, dass die Inanspruchnahme von medizinischen Leistungen in Verbindung mit der Lebensqualität Betroffener analysiert. Die Roll-Out-Phase des Projektes startet 2016. Die Datenbasis des BNR für retro- und prospektive Querschnitts- und Längsschnittstudien wird Deutschlandweit und fortlaufend ausgeweitet.
Family Health Teams in Ontario – Vorstellung eines kanadischen Primärversorgungsmodells und Anregungen für Deutschland
Authors: Ulrich Lisa-R. , Pham Thuy-Nga Tia , Gerlach Ferdinand M. , Erler Antje 
Published: July 2017

ZusammenfassungWichtige Herausforderungen des deutschen Gesundheitssystems sind derzeit die Fragmentierung der Versorgung und ein zunehmender Mangel an hausärztlichem und pflegerischem Nachwuchs, die den komplexen und zeitaufwändigen Versorgungsbedürfnissen einer zunehmend älter und multimorbider werdenden Bevölkerung gegenüberstehen. Damit eine Primärversorgung auch zukünftig flächendeckend gewährleistet werden kann, sind neue Lösungsansätze, v. a in Form von innovativen Sektoren- und professionsübergreifenden Versorgungskonzepten, erforderlich. Solche Modelle können einerseits, u. a. durch ihren Teamansatz, die Berufsattraktivität für Nachwuchskräfte steigern und andererseits eine umfassende Versorgung anbieten, die auf den Bedarf komplex erkrankter Patienten zugeschnitten ist. Der Sachverständigenrat Gesundheit hat in seinem Gutachten 2014 das Modell einer regional vernetzten Versorgung vorgestellt, deren Kern lokale Gesundheitszentren zur Primär- und Langzeitversorgung bilden. Diese sollen zur Sicherstellung einer umfassenden patientenzentrierten Gesundheitsversorgung beitragen und insbesondere den Anforderungen des hausärztlichen Nachwuchses gerecht werden. Ein ähnliches Modell sind die sogenannten Family Health Teams (FHT) aus Ontario, Kanada. Dabei arbeitet ein Team aus Allgemeinmedizinern, examinierten Pflegekräften, Pharmazeuten, Sozialarbeitern und weiteren Gesundheitsprofessionen unter einem Dach strukturiert zusammen. Der vorliegende Beitrag stellt das Modell der kanadischen FHT vor und diskutiert, welche Ansätze daraus übertragbar und zur Sicherstellung der Primärversorgung in Deutschland hilfreich sein könnten.
Who will be the Radiologists of Tomorrow? A survey of radiology during the “Practical Year” in Germany
Authors: Dettmer Sabine , Fischer Volkhard , Paeßens Carolin , Meyer Simone , Wacker Frank , Rodt Thomas 
Published: July 2017

Purpose Aim of our study was to evaluate the motivation of medical students in their final year of medical school to choose radiology for further specialization by means of a Germany-wide survey.
Materials and Methods The survey was performed during the 2015/16 semester among German medical students in their four months radiology elective during the final year. Invitations for the study were distributed by the Student Secretariats of each university. The survey was web-based with EvaSys 7.0 software. Questions on radiology contents during medical studies and “practical year” were part of the survey. Plans for residency and possible advantages and disadvantages of radiology as medical specialty were inquired. Descriptive statistics and group comparisons were used as analysis methods.
Results 89 students participated in the survey at the beginning and 60 students at the end of the practical year. Of these 39 students could be identified who answered both questionnaires. Most students were satisfied with their final year radiology elective (mean 1.8 on a range from 1 to 5). Nevertheless, they criticized mentoring during routine work (mean 2.1) and a lack of educational courses (mean 2.1). Most students (83 %) were uncertain about their residency choice at the beginning of their “practical year” and about one fifth changed their plans. From the students’ point of view main advantages of radiology included contact with many other clinical disciplines (87 %) and the working conditions (68 %). The reduced patient contact (42 %), the large amount of work at a computer (43 %), and the dependency on referring physicians (42 %) were regarded as the main disadvantages. The students regarded the way radiology is taught during the studies as not practical enough. With regard to radiology the majority of students (63 %) felt poorly prepared for their future work.
Conclusion The “practical year” is important regarding the choice of future specialization. There was a high degree of satisfaction with the “practical year” in radiology. The mentoring during routine work and a lack of educational courses was mildly criticized. These factors provide room for improvement to foster students’ interest in radiology.
Key Points
Citation Format
Loss-of-function mutation in
Mirta22/Emc10
rescues specific schizophrenia-related phenotypes in a mouse model of the 22q11.2 deletion
Authors: Diamantopoulou Anastasia , Sun Ziyi , Mukai Jun , Xu Bin , Fenelon Karine , Karayiorgou Maria , Gogos Joseph A. 
Published: July 2017

Significance
Despite substantial progress in the field of schizophrenia (SCZ) genetics, the heterogeneity of genetic etiology and neural complexity has rendered the task of developing improved treatments inauspicious. Thus, there is need to identify convergent neural substrates and underlying molecular mechanisms that can serve the prevention or reversal of disease progression. Our extensive characterization of an animal model of the 22q11.2 deletion, one of the strongest genetic risk factors for SCZ, when combined with a loss-of-function (LoF) mutation for a microRNA-dependent upregulated target, offers a proof of principle for such approaches. Hence, identification of variants that confer protection against disease by disabling protein function via LoF effects holds great promise for devising therapeutic schemes to restore or prevent disease symptoms.
Caffeine induces gastric acid secretion via bitter taste signaling in gastric parietal cells
Authors: Liszt Kathrin Ingrid , Ley Jakob Peter , Lieder Barbara , Behrens Maik , Stöger Verena , Reiner Angelika , Hochkogler Christina Maria , Köck Elke , Marchiori Alessandro , Hans Joachim , Widder Sabine , Krammer Gerhard , Sanger Gareth John , Somoza Mark Manuel , Meyerhof Wolfgang , Somoza Veronika 
Published: July 2017

Significance
This study shows that caffeine's effect on gastric acid secretion (GAS) is more complex than has been previously thought. Oral and gastric bitter taste receptors are involved in the regulation of GAS in humans. This regulatory process can be modified by the bitter-masking compound homoeriodictyol. Practical applications of the results may include treatment of gastroesophageal reflux disease or peptic ulcer by manipulating gastric pH by means of bitter tastants and inhibitors.
mTORC1 activates SREBP-2 by suppressing cholesterol trafficking to lysosomes in mammalian cells
Authors: Eid Walaa , Dauner Kristin , Courtney Kevin C. , Gagnon AnneMarie , Parks Robin J. , Sorisky Alexander , Zha Xiaohui 
Published: July 2017

Significance
Through unknown mechanisms mTORC1 triggers translocation of SREBP-2, an endoplasmic reticulum (ER) resident protein, to the Golgi to produce mature SREBP-2, which translocates to the nucleus to act as a transcription factor. Low ER cholesterol is a well-known inducer of SREBP-2 activation. We thus investigated whether mTORC1 activates SREBP-2 by reducing ER cholesterol levels. We report that, in cultured mammalian cells, an increase in mTORC1 activity is accompanied by a decrease in ER cholesterol and by SREBP-2 activation. Conversely, a decrease in mTORC1 activity coincides with higher ER cholesterol and lower SERBP-2 activity. We demonstrate that, by suppressing autophagy and by maintaining endosomal recycling, mTORC1 actively prevents membrane-derived cholesterol from reaching lysosomes, thereby reducing cholesterol ER and activating SREBP-2.
Antibody-induced uncoating of human rhinovirus B14
Authors: Dong Yangchao , Liu Yue , Jiang Wen , Smith Thomas J. , Xu Zhikai , Rossmann Michael G. 
Published: July 2017

Significance
Rhinoviruses (RVs) frequently cause respiratory infections in humans. However, there are currently no approved antiviral treatments or vaccines available. Using cryo-electron microscopy (cryo-EM), we have shown that the antigen-binding fragment of a neutralizing antibody, C5, binds to RV-B14 and causes significant structural rearrangements of the capsid to allow release of the viral genome. C5-induced virus uncoating depends upon temperature and virus–Fab molar ratio. These results present so far the highest resolution cryo-EM structures of a virus–antibody complex and suggest a conserved mechanism whereby antibodies neutralize infections by RVs and related viruses via induction of premature genome release from the capsid.
Interarm Systolic and Diastolic Blood Pressure Difference Is Diversely Associated With Cerebral Atherosclerosis in Noncardioembolic Stroke Patients
Authors: Chang Yoonkyung , Choi Gyeong Seon , Lim Soo Mee , Kim Yong-Jae , Song Tae-Jin 
Published: July 2017

Abstract

BACKGROUND
Interarm systolic and diastolic blood pressure differences (IASBD, IADBD) are not infrequent in various populations. Cerebral atherosclerosis, including extracranial cerebral atherosclerosis (ECAS) and intracranial cerebral atherosclerosis (ICAS), is an important risk factor for stroke. In this study, we aimed to investigate the relationship of IASBD, IADBD with presence and burden of ICAS and ECAS.

METHODS
This was a retrospective hospital-based cross-sectional study. In total, 1,063 consecutive noncardioembolic ischemic stroke patients, who were checked for bi-brachial blood pressures from ankle–brachial index and brain magnetic resonance angiographic images of cerebral arteries, were included. The IASBD and IADBD were defined as absolute value of the blood pressure difference in both arms.

RESULTS
In all included patients, patients with IASBD ≥10 and IADBD ≥10 were noted in 9.4% (100/1,063) and 5.3% (56/1,063). The patients with IASBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.001) and ECAS (P = 0.027) and patients with IADBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.042) but not ECAS (P = 0.187). Multivariate analysis after adjusting gender, age, and a P value &lt;0.1 in univariate analysis showed IASBD ≥10 mm Hg was associated with the presence of both ECAS and ICAS [odds ratio (OR): 2.96, 95% confidence interval (CI): 1.65–5.31]. The IADBD ≥10 mm Hg was related with presence of ICAS only (OR: 1.87, 95% CI: 1.05–3.37) but not with ECAS only (OR: 1.50, 95% CI: 0.73–3.06).

CONCLUSIONS
Our study showed IASBD and IADBD were diversely associated with cerebral atherosclerosis. In noncardioembolic stroke patients with IASBD ≥10 or IADBD ≥10, the possibility of accompanying cerebral atherosclerosis should be considered.
NuNec™ Cervical Disc Arthroplasty Improves Quality of Life in Cervical Radiculopathy and Myelopathy: A 2-yr Follow-up
Authors: Turner Isobel , Choi David 
Published: July 2017

Abstract

BACKGROUND
Anterior cervical disc replacement is an alternative to fusion for the treatment of selected cases of radiculopathy and myelopathy. We report clinical and radiological outcomes after disc replacement with the NuNec™ artificial cervical disc (Pioneer® Surgical Technology, Marquette, Michigan) with subgroup analysis.

OBJECTIVE
To review clinical and radiological outcomes after anterior cervical disc replacement with the NuNec™ artificial cervical disc.

METHODS
A consecutive case series of patients undergoing cervical disc replacement with the NuNec™ artificial disc was conducted. Clinical outcomes were assessed by questionnaires preoperatively and up to 2 yr postoperatively including neck and arm pain, Neck Disability Index, Euroqol 5-dimensions, and Short Form-36; x-rays from the same period were analyzed for range of movement and presence of heterotopic ossification.

RESULTS
A total of 44 NuNec™ discs were implanted in 33 patients. Clinical improvements were seen in all outcomes; significant improvements on the Neck Disability Index, Euroqol 5-dimensions, and physical domain of the Short Form-36 were maintained at 2 yr. There was a mean of 4° range of movement at the replacement disc level at 2 yr, a significant reduction from baseline; there was also progression in levels of heterotopic ossification. Complications included temporary dysphagia (10%) and progression of disease requiring foraminotomy (6%); no surgery for adjacent level disease was required. There was no significant difference in the outcomes of the radiculopathy and myelopathy groups.

CONCLUSION
Clinical outcomes using the NuNec™ disc replacement are comparable with other disc replacements. Although the range of movement is reduced, the reoperation rate is very low.
Ninety-Day Mortality as a Reporting Parameter for High-Grade Serous Ovarian Cancer Cytoreduction Surgery
Authors: Spencer Ryan J. , Hacker Kari E. , Griggs Jennifer J. , Rice Laurel W. , Reynolds R. Kevin , Uppal Shitanshu 
Published: July 2017

OBJECTIVE:
To evaluate the utility of using 90-day as an adjunct to 30-day mortality rates after surgical cytoreduction for serous ovarian cancer and to compare them across hospitals of differing case volumes over time.

METHODS:
We performed a retrospective cohort study using the National Cancer Database of women undergoing cytoreductive surgery for high-grade serous carcinoma between 2004 and 2012. The primary outcome of the study was mortality rate by hospital volume. The secondary outcome was to evaluate the performance of hospital rankings based on 30- and 90-day mortality rates. Hospitals were categorized by cases per year as low volume (10 or fewer), intermediate (11–20), high (21–30), and ultra-high (31 or more).

RESULTS:
A total of 24,827 women from 602 hospitals were included. Overall 30-day mortality was 2.1% (95% CI 1.95–2.3) compared with 90-day mortality of 5.1% (95% CI 4.8–5.4%, P<.001). For each hospital volume category, the 90-day mortality was approximately double that of the 30-day mortality. Substituting 90-day in place of 30-day mortality for hospital ranking, 57 hospitals (9.5%) changed ranks (26 worsened and 31 improved). Based on the logistic regression model (after controlling for age, race–ethnicity, income, Charlson comorbidity index, insurance status, hospital volume, distance from place of residence to the hospital, receipt of neoadjuvant chemotherapy, and year of diagnosis), care at the ultra–high-volume centers was an independent predictor of lower odds of death at 90 days [adjusted odds ratios (OR) 0.60, 95% CI 0.38–0.96, P=.034] but not at 30 days (adjusted OR 0.64, 95% CI 0.35–1.18).

CONCLUSION:
Compared with low-volume centers, ultra–high-volume centers are associated with significantly lower 30- and 90-day risk-adjusted mortality. The 90-day mortality rate is double that of the 30-day rate and may be a better metric for assessing the initial quality of care for patients with ovarian cancer.
Lipschütz Ulcers
Authors: Wolters Vera , Hoogslag Isabella , van' t Wout Jan , Boers Kim 
Published: July 2017

BACKGROUND:
Lipschütz ulcers are characterized by painful vulvar ulceration, most commonly in young women. Because these lesions are so rarely seen, the diagnosis can be challenging.

CASE:
An 18-year-old woman, without any prior sexual activity, developed painful blue vulval lesions. These became necrotizing ulcers, and she began antiviral therapy for presumptive herpes infection. Herpes cultures, however, were negative. Serology consistent with a recent Epstein-Barr virus infection resulted in a diagnosis of Lipschütz ulcers.

CONCLUSION:
Lipschütz ulcers, associated with acute Epstein-Barr virus infection or other viral and bacterial infections, are a type of nonsexually transmitted vulvar ulceration. It is important to avoid selective attention to sexually transmitted infections as the etiology to avoid unnecessary antiviral therapy and immune suppressants. By considering other etiologies, the patient will be spared potentially embarrassing persistent questioning about her sexual history.
ORIF Patella Fracture With a Tension Band Construct
Authors: Blum Laura , Hake Mark 
Published: July 2017

Summary:
Patellar fractures can occur as a result of direct or indirect injuries. Indirect injury is more common and occurs when the patella fails in tension when the force exerted by the extensor mechanism exceeds that of the bone. Common mechanism of indirect injury is rapid knee flexion with fully contracted quadriceps muscle. Treatment with a tension band construct is indicated for transverse patella fractures without significant comminution. This can be performed with 18-gauge wire and either 2 parallel, longitudinally oriented cannulated screws or 2 Kirschner wires. Biomechanical studies have shown higher load to failure when performed with cannulated screws. We presented our technique for management of a transverse patella fracture with disrupted extensor mechanism using tension banding technique with cannulated screws.
Acute Compartment Syndrome of the Leg
Authors: Konda Sanjit R. , Kester Benjamin S. , Fisher Nina , Behery Omar A. , Crespo Alexander M. , Egol Kenneth A. 
Published: July 2017

Introduction:
Acute compartment syndrome (ACS) is well known among orthopaedic surgeons. The timely diagnosis and management of ACS is crucial to avoiding its sequelae, including renal failure, ischemic contractures, and limb loss. Despite its relative importance, ACS poses a challenge to many residents and clinicians as diagnosis relies largely on clinical judgment.

Methods:
Timely diagnosis and thorough compartment release are essential to optimizing outcomes in ACS. This video highlights a clinical case in which compartment syndrome of the leg was considered, diagnosed, and surgically managed.

Results:
This video will present the indications for compartment release and a video-guided demonstration of compartment checks using an arterial line transducer, a 4-compartment fasciotomy with 2 incisions, and temporizing vessel loop closure.

Conclusions:
Compartment syndrome can be a devastating complication of common fractures. It is essential that orthopaedic practitioners understand the immediacy of intervention. We have a responsibility to provide timely, accurate diagnosis along with expedient surgical management.
Exchange Nailing for Hypertrophic Femoral Nonunion
Authors: Marquez-Lara Alejandro , Luo T. David , Senehi Rebecca , Aneja Arun , Beard Hoyt Randy , Carroll Eben A. 
Published: July 2017

Summary:Exchange nailing has proven to be a reliable surgical technique for the management of aseptic femoral shaft nonunions. Similar to primary intramedullary nail fixation for femur fractures, exchange nailing for aseptic hypertrophic nonunions of the femur relies on successful navigation of the starting point and proper nail trajectory to minimize coronal and sagittal plane deformities. Compared with the supine position, the lateral decubitus position has the advantage of allowing gravity to displace the soft tissue around the piriformis start site to facilitate nail entry. In addition, the C-arm position and access to the affected limb from both sides by the surgeon and surgical assistant facilitate visualization of existing deformities and the ability to perform correction maneuvers. The purpose of this review is to highlight technical pearls associated with exchange nailing in a lateral decubitus position. Although other techniques are available, and should be used when indicated, exchange nailing provides patients with the opportunity to an early return to activity, improvement in pain and disability, and ultimate bony union.
Intramedullary Fixation of Midshaft Clavicle Fractures
Authors: Fritz Erik M. , van der Meijden Olivier A. , Hussain Zaamin B. , Pogorzelski Jonas , Millett Peter J. 
Published: July 2017

Summary:
Clavicle fractures are among the most common fractures occurring in the general population, and the vast majority are localized in the midshaft portion of the bone. Management of midshaft clavicle fractures remains controversial. Although many can be managed nonoperatively, certain patient populations and fracture patterns, such as completely displaced and shortened fractures, are at risk of less optimal outcomes with nonoperative management; surgical intervention should be considered in such cases. The purpose of this article is to demonstrate our technique of midshaft clavicle fixation using minimally invasive intramedullary fixation.
Re-irradiation of cervical and endometrial cancer
Authors: Llewelyn Megan , Taylor Alexandra 
Published: July 2017

Purpose of review
Re-irradiation historically has been associated with unacceptable toxicity and limited benefit. Recent advances in radiotherapy can change the treatment paradigm to provide new salvage treatments for recurrences of cervical and endometrial cancer.

Recent findings
Image-guided brachytherapy is an effective method for salvaging central pelvic recurrence, although it has resulted in 20–25% severe late toxicity. Pelvic sidewall disease is not accessible to brachytherapy, so a combined modality approach with radical surgery and intraoperative radiotherapy is an alternative approach. Stereotactic body radiotherapy (SBRT) now provides the option of radical re-irradiation with local control rates of 50–80% and a low incidence of severe late complications.

Summary
Initial outcomes using SBRT and image-guided brachytherapy for re-irradiation of gynaecological cancer are encouraging. There has been good local control and acceptable toxicity. Further, large-scale studies are required to define optimal target doses and OAR limits.