bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Four Methods of Treating Ectopic Pregnancy: A Retrospective Cohort Study
Authors: Inal Zeynep , Inal Hasan 
Published: January 2018

Abstract
Objective To compare the results of expectant management, single and multidose methotrexate (MTX) and surgical management of ectopic pregnancy (EP).
Materials and Methods In this retrospective cohort study, the original files of 233 patients who were treated for EP between May 2009 and December 2016 were analyzed. The patients were assigned to the following groups based on the applied treatment methods: Group 1, expectant management (n = 24), Group 2, single-dose MTX (n = 144), Group 3, multiple-dose MTX (n = 25), and Group 4, surgical intervention (n = 40). The following parameters were recorded and assessed: sociodemographic characteristics, pelvic ultrasonography findings (gestational sac, ectopic mass appearance, positive fetal cardiac activity), serum beta-human chorionic gonadotropin (β-hCG) levels on Day 0, Day 4, and Day 7, and surgical procedures in women that underwent surgical interventions.
Results The sociodemographic characteristics were similar in all four groups. The percentage of ectopic mass and positive fetal cardiac activity was greater and the diameter of the mass was larger in Group 4 than in the other groups. The β-hCG values on Day 0, Day 4, and Day 7 were statistically different between the groups (p < 0.001). The cutoff value for the β-hCG change for EP resolution was 18% between Day 0 and Day 4 (AUC = 0.726, p < 0.001) and 15% between Day 4 and Day 7 (AUC = 0.874, p < 0.001). The probability of the requirement for an additional dose of MTX was 0.78 (95% CI 0.71 – 0.87; p < 0.001) times lower in patients who had a > 18% decrease in β-hCG levels from Day 0 to Day 4 in comparison to those who had a decrease < 18% from Day 0 to Day 4. The probability of the requirement for an additional dose of MTX was 1.64 (95% CI 1.25 – 2.16; p < 0.001) times greater in patients whose reduction in β-hCG levels from Day 4 to Day 7 was < 15% in comparison to those who had > 15% reduction from Day 4 to Day 7.
Conclusions Additional dose requirements for patients with EP may be predicted early in the changes in β-hCG levels between Day 0 and Day 4. Further prospective studies are required to elucidate this issue.
Outcome of Low-Invasive Local Split-Thickness Lengthening for Iliotibial Band Friction Syndrome
Authors: Inoue Hiroaki , Hara Kunio , Arai Yuji , Nakagawa Shuji , Kan Hiroyuki , Hino Manabu , Fujiwara Hiroyoshi , Kubo Toshikazu 
Published: January 2018

AbstractConventional surgical methods for iliotibial band friction syndrome (ITBFS) may affect the iliotibial band (ITB), delaying return to sports activities or impeding performance. We have developed a minimally invasive method. This study retrospectively analyzed the outcomes of this procedure in individuals with ITBFS. This study included 34 knees of 31 individuals. Surgery involved lengthening the central part of the ITB by splitting it into a superficial and a deep layer, maintaining the anterior and posterior fibers immediately above the lateral epicondyle. Outcomes included time to resume sports activity, personal best times to run a 5000-m race before and after surgery, and 2-month post-surgery muscle strengths. The mean postoperative time to return to competition was 5.8 weeks. Personal best times of 5000-m race improved in 13 of 17 runners. Two months post-surgery, the mean extensor muscle strengths on the healthy and affected sides did not significantly differ nor did the flexor muscle strengths. In ITBFS, the ITB itself is normal. Lengthening the limited region of the ITB immediately above the lateral femoral epicondyle removes the cause of ITBFS, with a reduction in inflammation. This technique resulted in early return to competition without degrading performance.
Is Breast Surgery Necessary for Breast Carcinoma in Complete Remission Following Neoadjuvant Chemotherapy?
Authors: Richter Hannah , Hennigs André , Schaefgen Benedikt , Hahn Markus , Blohmer Jens , Kümmel Sherko , Kühn Thorsten , Thill Marc , Friedrichs Kay , Sohn Christof , Golatta Michael , Heil Jörg 
Published: January 2018

AbstractThe likelihood of pathological complete remission (pCR) of breast cancer following neoadjuvant chemotherapy (NACT) is increasing; most of all in the triple negative and HER2 positive tumour subgroups. The question thus arises whether or not breast surgery is necessary when there is complete remission after NACT, and whether it provides any improvement of the oncological treatment result when tumour is no longer detectable. Avoiding surgery and possibly even radiotherapy would only be conceivable on the basis of a reliable diagnosis of pCR without operating. Current imaging does not achieve the necessary sensitivity and specificity to assure the diagnosis of pathological complete remission. Further studies are therefore required to determine which methods are best able to evaluate tumour response to NACT. Studies on image-guided, minimally invasive biopsies after NACT have delivered first promising results towards diagnosing pCR before surgery and could provide the basis for further studies on the possibility of avoiding surgery in this specific patient collective.
Die Mehrebenenanalyse als Verfahren zur Analyse rehabilitationswissenschaftlicher Forschungsfragen
Authors: Wirtz Markus Antonius 
Published: January 2018

ZusammenfassungIn rehabilitationswissenschaftlichen Studien liegen oft Daten vor, die Informationen auf unterschiedlichen hierarchischen Ebenen repräsentieren. Hierarchische Stichprobenstrukturen sind dadurch gekennzeichnet, dass Stichprobenmitglieder (z. B. Rehabilitanden) als gruppiert oder als Mitglieder natürlicher Teileinheiten (Cluster; z. B. Teams, Gruppen, Einrichtungen) betrachtet werden müssen. Werden bspw. Daten von Rehabilitanden aus verschiedenen Einrichtungen analysiert, so muss davon ausgegangen werden, dass die Zugehörigkeit zu der jeweiligen Einrichtung (Ebene 2; Cluster-Einheiten) mit der Ausprägung der Merkmale der Rehabilitanden (Ebene 1; Individualeinheiten) in Zusammenhang steht. Nehmen Rehabilitanden an verschiedenen Schulungsgruppen teil, so ist zu erwarten, dass die Ausprägung des Behandlungserfolgs der Rehabilitanden (Ebene 1) durch die Zugehörigkeit zu einer spezifischen Schulungsgruppe (Ebene 2) mit beeinflusst wird. Die Mehrebenenanalyse bzw. hierarchische lineare Modelle ermöglichen die simultane und integrierte Analyse von Daten unterschiedlicher Hierarchieebenen. In diesem Beitrag wird gezeigt, worauf bei der Erhebung hierarchisch strukturierter Stichproben, der Datenaufbereitung, der Hypothesenformulierung, der statistischen Datenanalyse und der Ergebnisinterpretation zu achten ist, damit Effekten der Clusterzugehörigkeit angemessen Rechnung getragen werden kann.
Der Umgang mit Angehörigen der Opfer der Aktion „T4“ durch die NS-Behörden und die Anstalten in Württemberg
Authors: Schmidt-Michel Paul-Otto , Müller Thomas 
Published: January 2018

ZusammenfassungDie Rolle der Angehörigen im Rahmen der „Euthanasie“-Aktion „T4“ ist in den letzten Jahren kontrovers diskutiert worden. Anhand von Dokumenten der NS-Bürokratie, Stellungnahmen der Anstaltspsychiater aus dem Jahr 1945 an die französische Besatzungsmacht und Briefen von Angehörigen an die Heilanstalt Weissenau/Württemberg werden diese Quellen unter dem Aspekt der Reaktionen der Angehörigen auf die Aktion „T4“ ausgewertet. Die Ergebnisse bezeugen ein breites Spektrum der Reaktionen der Angehörigen, die überwiegend durch Angst, Ohnmacht und Protest gekennzeichnet sind.
Relationship Between Race, Insurance Coverage, and Visual Acuity at the Time of Cataract Surgery
Authors: Stone Jordan S. , Fukuoka Hideki , Weinreb Robert N. , Afshari Natalie A. 
Published: January 2018

Objective:
To assess the relationship between sociodemographic variables (including race, age, and insurance coverage) and preoperative best-corrected visual acuity (BCVA) at the time of first-eye cataract surgery.

Methods:
Single-center retrospective chart review study at Shiley Eye Institute, University of California, San Diego (UCSD). Medical record data from 600 patients were collected from the appointment immediately preceding cataract surgery, including BCVA in the operated eye converted to the logarithmic minimal angle of resolution (logMAR), insurance coverage, race, sex, age, body mass index, smoking status (including pack years), systemic and ocular comorbidities, and ocular surgical history. Preoperative BCVA in the operated eye was the main outcome measure.

Results:
Univariate analysis revealed significant differences in BCVA between groups by insurance type (public, private, and uninsured), race (Asian, black, Hispanic, white, and other), and sex (male and female) (P<0.001, P<0.001, and P=0.019, respectively). Further multivariate analysis revealed significant pairwise differences, with better BCVA associated with white race (0.85, logMAR [Snellen 20/140]) than Hispanic race (1.06, [20/230], P=0.017), and better BCVA associated with private insurance (0.79, [20/125]) versus public insurance (0.96, [20/180], P=0.0002).

Conclusion:
Hispanic race and public insurance coverage were each associated with worse preoperative BCVA compared with white race and private insurance, respectively. This suggests that Hispanic race and public insurance may predispose patients to decreased access to cataract surgery. Additional large, prospective studies are required to rigorously test and elaborate on this finding.
Global Practice Patterns in the Management of Infantile Cataracts
Authors: Koo Euna B. , VanderVeen Deborah K. , Lambert Scott R. 
Published: January 2018

Objectives:
Surveys are an important tool to assess the impact of research on physicians' approach to patient care. This survey was conducted to assess current practice patterns in the management of infantile cataracts in light of the findings of the Infant Aphakia Treatment Study.

Methods:
Pediatric ophthalmologists were emailed a link to the survey using newsletters from American Association of Pediatric Ophthalmology and Strabismus, World Society of Pediatric Ophthalmology and Strabismus, and the Pediatric Listserv. The 17-question survey was anonymous and active during July to August 2016.

Results:
One hundred twenty-five respondents (North America, 65%; Asia, 12%; Europe, 9%; and other, 14%) reported operating on pediatric cataracts. Most practice in a university setting (55%). There was a strong consensus that unilateral cataract surgery should be performed between ages 4 to 6 weeks and aphakic contact lenses should be used to optically correct their eyes, particularly in children ≤6 months of age. For bilateral cataracts, there was a trend for surgeons to perform cataract surgery at an older age than unilateral cataract surgery. Surgeons who performed less than 5 versus greater than 20 pediatric cataract surgeries/year were more likely to use aphakic contact lenses in children undergoing cataract surgery more than 6 months of age (62% vs. 35%, P=0.04). Most respondents (73%) indicated that the Infant Aphakia Treatment Study had changed how they manage unilateral congenital cataracts.

Conclusion:
Most pediatric cataract surgeons perform congenital cataract surgery between ages 4 to 6 weeks and use aphakic contact lenses for initial optical correction in infants less than 6 months. Surgeons have equal preference for intraocular lenses and contact lenses in infants more than 6 months of age.
Medically unexplained physical symptoms in patients visiting the emergency department: an international multicentre retrospective study
Authors: Alsma Jelmer , Wouw Jens van de , Jellema Korné , Coffeng Sophie M. , Tobback Els , Delesie Liesbeth , Brand Crispijn L. van den , Vogelaers Dirk , Mariman An , Paepe Peter de , van Saase Jan L. , Weiland Anne 
Published: January 2018

Objective
The objective of this study was to assess the incidence and characteristics of patients presenting with physical symptoms that remain medically unexplained at the emergency department (ED).

Patients and methods
A retrospective chart study was carried out in three hospitals in The Netherlands and Belgium. All patients (age > 18 years) visiting the ED in 4 selected weeks in 2013 at the Erasmus University Medical Center (Erasmus MC) in Rotterdam, The Netherlands, and 1 selected week in 2013 at the Haaglanden Medical Center, Westeinde HMC in The Hague, The Netherlands, and the University Hospital Ghent (UZG), Belgium, were included. Descriptive statistics were used for data analysis.

Results
A total of 2869 patients (Erasmus MC 1674, HMC 691, UZG 504) were included. Medically unexplained physical symptoms in the emergency department (EDMUPS) were present in 13.4% of all ED visits (Erasmus MC 12.5%, HMC 18.7%, UZG 9.1%). No EDMUPS were identified in trauma patients. When excluding trauma patients, EDMUPS were present in 18.5% (Erasmus MC 16.8%, HMC 26.5%, UZG 13.3%) of the visits. The characteristics of patients with and without EDMUPS differed significantly; patients with EDMUPS were more often younger, female, self-referred, frequent visitors, were prescribed less medication and more often had a psychiatric disease. Dutch and Belgian Hospital differed in the distribution of patients in triage categories and in the incidence of psychiatric illnesses.

Conclusion
Physical symptoms remain unexplained in a significant number of patients at the time of ED assessment.
A sleep-regulatory circuit integrating circadian, homeostatic and environmental information in Drosophila
Authors: Lamaze Angélique , Krätschmer Patrick , Jepson James E. C. 
Published: January 2018

SUMMARYIn the wild, when to go to sleep is a critical decision. Sleep onset is controlled by two processes: the circadian clock, and a homeostat measuring sleep drive [1, 2]. Environmental stimuli must also clearly intersect with the circadian clock and/or homeostat so that sleep is initiated only when appropriate. Yet how circadian, homeostatic and environmental cues are integrated at the circuit level is unclear. Recently, we found that DN1p clock neurons in Drosophila act to prolong morning wakefulness at elevated ambient temperatures [3]. Here we show that a subset of DN1p neurons exhibit temperature-sensitive increases in excitability, and define an output pathway linking DN1p neurons to downstream sleep-regulatory circuits. We show that DN1p neurons project axons to a subdomain of the Anterior Optic Tubercle (AOTU), and here make inhibitory synaptic connections with sleep-promoting tubercular-bulbar (TuBu) neurons. Using unbiased trans-synaptic labeling, we show that these TuBu neurons form synaptic connections with R-neurons innervating the ellipsoid body, subsets of which control homeostatic sleep drive [4]. DN1p excitability is clock-dependent, peaking in the late night and early morning [5]. Thus, integration of circadian and thermo-sensory information by DN1p neurons and subsequent inhibition of sleep-promoting TuBu neurons provides a mechanism by which an environmental stimulus can regulate sleep onset during a specific compartment of the day-night cycle. Furthermore, our results suggest that the AOTU functionally links circadian and sleep homeostat circuits in Drosophila.
Audit committee effectiveness and financial reporting timeliness
Authors: Oussii Ahmed Atef , Boulila Taktak Neila 
Published: January 2018

PurposeThe purpose of this paper is to investigate whether there is any relationship between the effectiveness of an audit committee and the financial reporting timeliness of Tunisian listed companies as proxied by external audit delay (AD). Analysis focuses on five audit committee characteristics: authority, financial expertise, independence, size and diligence.Design/methodology/approachEmpirical tests address 162 firm-year observations drawn from Tunisian listed companies during 2011-2013.FindingsMultivariate analyses indicate that audit committees with members who have financial expertise are significantly associated with shorter AD. Thus, the results suggest that audit committee financial expertise contributes to the improvement of financial statements’ timeliness.Research limitations/implicationsThe audit committee attributes examined in this study were based on DeZoortet al.(2002) framework. There could be other aspects of audit committee effectiveness such as audit committee tenure and audit committee chair characteristics, which were not addressed in the present study. Thus, future research may consider and examine these other components of audit committee effectiveness.Practical implicationsFindings have managerial implications. Companies can re-look into how to further improve audit committee composition in order to enhance the timeliness of financial reporting. The issues of audit committee effectiveness and timely reporting also affect regulators and policy makers since they need to play a role in the establishment of effective audit committees and the improvement of financial reporting timeliness.Originality/valueThis study is one of few that have examined the impact of audit committee effectiveness on ADs in an emerging market country. Findings lend credence to the belief that audit committee members’ financial expertise enhances the quality of financial reporting by firms in a North African market criticized for the lack of maturity of its corporate governance system (Klibi, 2015; Fitch Ratings, 2009).
Heat and mass transfer characteristics of MHD three-dimensional flow over a stretching sheet filled with water-based alumina nanofluid
Authors: A. Reddy P. Sudarsan , Chamkha A. 
Published: January 2018

Purpose
This paper aims to understand the influence of velocity slip, nanoparticle volume fraction, chemical reaction and non-linear thermal radiation on MHD three-dimensional heat and mass transfer boundary layer flow over a stretching sheet filled with water-based alumina nanofluid. To get more meaningful results, the authors have taken nonlinear thermal radiation in the heat transfer process.

Design/methodology/approach
Suitable similarity variables are introduced to convert governing partial differential equations into the set of ordinary differential equations, and are solved numerically using a versatile, extensively validated finite element method with Galerkin’s weighted residual simulation. The velocity, temperature and concentration profiles of nanoparticles as well as skin friction coefficient, Nusselt number and Sherwood number for different non-dimensional parameters such as volume fraction, magnetic, radiation and velocity slip parameters as well as the Prandtl number are examined in detail, and are presented through plots and tables.

Findings
It is noticed that the rate of heat transfer enhances with higher values of nanoparticle volume fraction parameter. It is worth mentioning that the heat transfer rates improve as the values of increase. Increasing values of M, R, θw and β decelerates the thickness of the thermal boundary layer in the fluid regime. The heat transfer rates decelerate as the values of suction parameter increase.

Originality/value
The authors have written this paper based on the best of their knowledge on heat and mass transfer analysis of nanofluids. The information in this paper is new and not copied from any other sources.
European private equity real estate compliance under the AIFMD
Authors: Sleptcova Maiia , Falkenbach Heidi , Majamaa Wisa 
Published: January 2018

Purpose
The purpose of this paper is to investigate the effect of Alternative Investment Fund Managers Directive (AIFMD) on European private equity real estate (PERE) industry.

Design/methodology/approach
The paper draws upon a set of 12 semi-structured interviews with European PERE fund managers to explore their views on the reporting and risk management under the AIFMD, the costs and benefits associated with the AIFMD compliance and the effect of the AIFMD on European PERE industry.

Findings
A “one size fits all” approach adopted by the AIFMD results in difficulties in understanding and implementing the AIFMD requirements by PERE managers. Due to the limited applicability of the AIFMD risk reporting requirements to PERE funds, PERE managers have developed their own risk metrics, which they report internally. The formalization of risk management process and the separation of risk management function constitute the two most significant changes experienced by PERE managers. The managers recognize a positive branding effect from the authorization and improved risk awareness in their organizations due to the AIFMD.

Research limitations/implications
The current paper focuses on PERE fund managers and does not address other real estate funds falling under the AIFMD.

Practical implications
PERE fund managers require feedback and guidance from authorities and best practice recommendations from industry organizations to enable proper compliance. Industry-specific reporting requirements would benefit both the industry players and authorities.

Originality/value
Given the broad scope of the AIFMD, it is of interest to look at how PERE fund managers have adapted to the regulatory change.
Understanding Public Service Innovation as Resource Integration and Creation of Value Propositions
Authors: Skålén Per , Karlsson Jenny , Engen Marit , Magnusson Peter R. 
Published: January 2018

AbstractThis paper departs from research on Public Service Logic (PSL) to advance a framework of public service innovation (PSI) by incorporating the notions of resource integration and value proposition. The framework consists of three resource integration processes, referred to as value creation, value co‐creation and value facilitation, through which users and employees detect problems and suggest solutions that contribute to service innovation by creating new, or by developing existing, value propositions. To test and illustrate the framework, a study of six service innovation groups in primary care was drawn on. Four aggregates of service innovation ideas were identified in the study: access, patient experience, physical environment and organization of work. In line with the framework, the findings suggest that users and employees contribute to PSI by drawing on their knowledge and experience of conducting resource integration, and by detecting problems and suggesting solutions to these problems.
Lotus Flavonoids and Phenolic Acids: Health Promotion and Safe Consumption Dosages
Authors: Limwachiranon Jarukitt , Huang Hao , Shi Zhenghan , Li Li , Luo Zisheng 
Published: January 2018

AbstractNelumbo nucifera Gaertn., also known as the sacred lotus, is extensively cultivated in Southeast Asia, primarily for food and as an herbal medicine. This article reviews studies published between 1995 and 2017, on flavonoid and phenolic acid profiles and contents of 154 different cultivars of lotus. So far, some 12 phenolic acids and 89 to 90 flavonoids (47 flavonols, 25 to 26 flavons, 8 flavan‐3‐ols, 4 flavanons, and 5 anthocyanins) have been isolated from different parts of the lotus plant, including its leaves (whole leaf, leaf pulp, leaf vein, and leaf stalk), seeds (seedpod, epicarp, coat, kernel, and embryo), and flowers (stamen, petal, pistil, and stalk), although not all of them have been quantified. Factors affecting flavonoids and phenolic acid profiles, including types of tissues and extracting factors, are discussed in this review, in order to maximize the application of the lotus and its polyphenols in the food industry. Health promotion activities, attributed to the presence of flavonoids and phenolic acids, are described along with toxicology studies, illustrating appropriate usage and safe consumption dosages of lotus extracts. This review also presents the controversies and discusses the research gaps that limit our ability to obtain a thorough understanding of the bioactivities of lotus extracts.