bluuebunny/crossref_metadata_2025_split huggingface dataset:
RCS reduction for grazing incidence based on coding metasurface
Authors: Zhou Yulong , Cao Xiang‐yu , Gao Jun , Li Sijia , Liu Xiao 
Published: August 2017

A coding metasurface is proposed for reducing radar cross section (RCS) under grazing incidence. Two elements with different reflection phases are selected for the metasurface, and 7 × 7 artificial magnetic conductor unit cells are utilised to construct a metamaterial block. Then the arrangement of blocks is optimised by particle swarm algorithm (PSA). The phase difference between two elements contributes to RCS reduction under grazing incidence. The obtained results demonstrate that a wideband RCS reduction is achieved by the coding metasurface ranging from 6 to 13 GHz. In addition, the monostatic RCS reduction is also achieved under a grazing incidence. For x‐polarised incidence, the monostatic RCS reduction is >6 dB from 77° to 90°. For y‐polarised incidence, the monostatic RCS reduction is >6 dB from 69° to 80°, and the maximum reduction is 17.5 dB under the 75° incident angle.
Sleep in Autism
Authors: Malow Beth , Maxwell-Horn Angela 
Published: August 2017

AbstractAutism spectrum disorder (ASD) is a neurodevelopmental disorder that has increased in prevalence over the last several decades. A significant proportion of children with ASD have comorbid sleep disorders. The interplay between ASD and sleep is multifactorial and bidirectional. There is evidence for physiological differences in ASD that contribute to sleep problems, including sensory overresponsiveness (SOR) and abnormal melatonin production. Comorbidities associated with ASD (attention deficit hyperactivity disorder [ADHD], mood disorders) as well as medications used to treat these comorbidities often have effects on sleep architecture. In this article the authors discuss the etiology and manifestations of sleep disorders in children with ASD, as well as their clinical evaluation and treatment options.
Total Hip Arthroplasty in Overweight Patients: Do Obesity and BMI Affect Implant Positioning, Outcomes, and Complications?
Authors: Monestier Luca , Calvi Marco , Vulcano Ettore , Cherubino Mario , Harwin Steven , Surace Michele 
Published: August 2017

AbstractObesity is one of the most problematic issues for health organizations worldwide because of its relationship with several chronic diseases. It is also demonstrated to increase early onset of hip arthritis, consequently leading to early failure of implants of total hip arthroplasty (THA). The aim of the study was to assess the influence of obesity on the positioning of prosthetic components and potential complications. A total of 312 patients underwent THA from 2006 to 2015 at our institute. All procedures were performed by a single surgeon (M.F.S.). As indicated by the World Health Organization (WHO), our population was stratified on the basis of body mass index (BMI): Four underweight, 112 nonobese, 131 overweight, 51 grade-1 obese, 10 grade-2 obese, and 4 grade-3 obese patients were included. No superobese patients were reported. The population was assessed clinically (implant survival, surgery time, blood loss, and complications) as well as radiologically (femoral offset, cup abduction and anteversion, and periacetabular osteolysis). Higher cup inclination (48.70 vs. 45.94 degrees), surgical time (86 vs. 80 min), and total blood losses (1,026 vs. 761 mL) were reported in overweight/obese patients (p < 0.01). Statistical analysis documented a significant relationship between obesity and cup inclination, surgical time, intraoperative and total blood losses, as well as BMI and age at surgery (p < 0.05). The overall correct positioning of prosthetic components is not significantly related to obesity. Although maintained in the “safe zone,” cup abduction, blood loss, and operative time tend to significantly increase with BMI.
Shoulder Adhesive Capsulitis in Type 1 Diabetes Mellitus: A Cross-Sectional Study on 943 Cases in Sardinian People
Authors: Doria Carlo , Mosele Giulia , Badessi Francesca , Puddu Leonardo , Caggiari Gianfilippo 
Published: August 2017

Purpose To evaluate the prevalence of adhesive capsulitis (AC) of the shoulder in patients with type 1 diabetes mellitus (T1DM) in Sardinia.
Methods In this cross-sectional study, we evaluated 943 patients with T1DM attending the division of Endocrinology and Metabolism at the University Hospital in Sassari, Italy. The criteria for diagnosing AC were: pain for at least 1 month, inability to lie on the affected shoulder, and restricted active and passive shoulder joint movements in at least three planes. Age, gender, duration of DM, blood pressure, and presence of neuropathy and retinopathy were noted. Metabolic control of DM was evaluated with glycosylated hemoglobin A1c (GHbA1c) blood concentrations.
Results AC was diagnosed in 331 patients (prevalence: 35.1%). Age, duration of DM, high blood pressure levels, and the presence of neuropathy and retinopathy were significantly associated with AC. No significant association was observed between gender and AC. There was no significant difference in mean levels of GHbA1c in T1DM patients with or without AC.
Conclusion This study shows that AC of the shoulder is a common disorder in patients with T1DM in Sardinia. It is significantly associated with age, duration of DM, and related complications.
Level of Evidence Level IV, observational cross-sectional study.
Relationship between Clinical, MRI, and Arthroscopic Findings: A Guide to Correct Diagnosis of Meniscal Tears
Authors: Antinolfi P. , Cristiani R. , Manfreda F. , Bruè S. , Sarakatsianos V. , Placella G. , Bartoli M. , Caraffa A. 
Published: August 2017

Purpose The aim of this prospective study was to compare and correlate clinical, MRI, and arthroscopic findings in cases of suspected meniscal tears. Using arthroscopic findings as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of clinical investigation and MRI were evaluated to determine if is possible, after a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases.
Methods A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department. All patients had a clinical examination performed by an experienced knee surgeon. These examiners evaluated and recorded the results of three tests: medial and lateral joint line tenderness test, McMurray's test, and Apley's test. The injury was classified as a meniscal tear if there were at least two positive tests. Finally, using the arthroscopic findings as the gold standard, sensibility, specificity, accuracy, positive and negative predictive values of clinical examination, and MRI were evaluated and compared.
Results Clinical examination performed by an experienced knee surgeon reported better sensitivity (91 vs. 85%), specificity (87 vs. 75%), accuracy (90 vs. 82%), positive predictive value (94 vs. 88%), and negative predictive value (81 vs. 71%) than MRI for medial meniscal tears. These parameters showed minimal differences for lateral meniscal tears.
Conclusion Clinical examination performed by an experienced knee surgeon provided equal or better results to diagnose meniscal injuries in comparison to MRI. MRI is not necessary to confirm these lesions and should not be used as the primary diagnostic tool.
Level of Evidence Level II, prospective study.
Polyhydramnios or Excessive Fetal Growth Are Markers for Abnormal Perinatal Outcome in Euglycemic Pregnancies
Authors: Crimmins Sarah , Mo Cecilia , Nassar Yomna , Kopelman Jerome , Turan Ozhan 
Published: August 2017

Objective This study aims to investigate the perinatal outcome of fetuses with polyhydramnios and/or accelerated growth among women with a normal oral glucose challenge test (oGCT).
Methods Singleton, nonanomalous pregnancies with an oGCT(< 130 mg/dL) at 24 to 28 weeks, who subsequently demonstrate polyhydramnios (amniotic fluid index > 24 cm or maximum vertical pocket > 8 cm) and/or accelerated growth (abdominal circumference > 95th percentile) on two-third trimester examinations were studied. Maternal demographics, delivery, and neonatal information were recorded. Cases were compared with a reference group (normal oGCT with neither abnormal third-trimester growth nor polyhydramnios).
Results A total of 282 pregnancies were in the study group, and 663 were in the reference group. Deliveries in the study group were at a higher risk for birth weight (BW)% > 90%, standard deviation, and postpartum hemorrhage when compared with the reference group (adjusted odds ratio: 2.3–5.6). Pregnancies complicated by both polyhydramnios and accelerated fetal growth were significantly more likely to result in a BW% > 90% (odds ratio [OR]: 18.5; 95% confidence interval [CI]: 8.9–38.6) and PPH (OR: 4.2; 95% CI: 2.4–7.6).
Conclusion Pregnancies with normal oGCT that develop polyhydramnios and accelerated growth are at higher risk for maternal and neonatal complications. Isolated polyhydramnios without accelerated growth increases the risk for delivery complications but not neonatal morbidity.
Outcome Analysis of Congenital Diaphragmatic Hernia Cohort before and after Implementation of Standardized Protocol in a Tertiary Neonatal Unit
Authors: Sur Amitava , Awoseliya Adjemoke , Sharma Alok 
Published: August 2017

AbstractDespite evolving evidence and increased understanding, there is a strong argument that best outcomes in managing congenital diaphragmatic hernia (CDH) patients are achieved in centers which have a high admission rate of such patients and follow standardized operating protocols of management. Pneumothorax and air leak syndromes are one of the main causes of pre- and postoperative morbidity in these patients and experts believe that delivery room sedation and gentle ventilation strategies can minimize this. We observed a significant drop in incidence of pneumothorax and reduction of mortality following implementation of standardized guidelines at the neonatal unit at Southampton which is a tertiary-level neonatal care in the southern United Kingdom and a regional referral center for CDH patients.
Ewing's Sarcoma of the Cervical Spine
Authors: Bhattacharjee Meenakshi , Huh Winston , Thapar Vandana , Dahm Paul 
Published: August 2017

AbstractIn this article, we present the case of a 6-year-old female presented to the emergency department with progressive ascending motor weakness leading to cardiac arrest. The recent medical history included neck trauma 1 month prior to admission, 2 weeks of subjective fevers, and 1 day of urinary incontinence. After stabilization, and a review of the recent signs and symptoms, a magnetic resonance imaging of the neck revealed a posterior neck mass from C2 to T2. Neurosurgical removal of the mass was consistent with Ewing's sarcoma. Neck pain is a common presentation in the pediatric population, with the most common cause being traumatic. When coupled with neurological deficits, further studies are warranted to evaluate for organic causes.
Epidermoid Cyst of the IV Ventricle: Case Report
Authors: Ribeiro Washington Clésio da Silva , Camelo Ricardo Macedo , da Silva Josias Inácio , Malta Moana Vergetti , Camelo Rafael Costa , Alves Filho Arnon Castro , Pontes Felipe Gomes de Barros , Porfírio Adans Soares , Oliveira Daniel Fonseca , Ribeiro Bruno Clécio da Silva , Ferreira Alessandro Henrique Rodrigues 
Published: August 2017

AbstractEpidermoid cysts constitute congenital, benign and rare lesions, corresponding to ∼ 0.2% to 1.8% of all intracranial tumors. Only 5% of the cases are located in the fourth ventricle. Despite their genesis in intrauterine life, they are usually diagnosed between the third and fifth decades of life due to their very slow growth pattern. The image weighted by the diffusion of the magnetic resonance is essential to establish the diagnosis. The ideal treatment consists of emptying the cystic content with complete capsule resection. In the present work, we report the case of a 31-year-old female with cerebellar syndrome that evolved with intracranial hypertension. The symptomatology was due to an obstructive hydrocephalus by an epidermoid cyst located inside the fourth ventricle, which was confirmed by the pathological anatomy.
Neurosarcoidosis Associated with Psychiatric Symptoms: Case Report
Authors: Neves Maick , Aguiar Paulo , Belsuzarri Telmo , Zeviani Wolnei , Mattos João , Navarro Juliano , Marques Renata , Francisco Letícia 
Published: August 2017

Background Sarcoidosis is a granulomatous disease predominant in women and black men that has inflammatory origin of unknown etiology; neurosarcoidosis is a rare and critical presentation of the disease.
Case description A 26-year-old black female presented frontal headache for 1 year, as well as behavioral and mood changes for 15 days. Skull tomography and nuclear magnetic imaging of the skull revealed damaged meninges, a right frontal bone lesion, and an intraparenchymal contrast-enhancing lesion. Screening with computed tomography (CT) scans was performed, and it showed signs of bronchiectasis in the lower third of the right lung, but it was asymptomatic. The biopsy showed signs of reactional lesion with the presence of non-caseating granulomas. After the treatment with corticosteroids, the patient presented progressive improvement.
Conclusions Neurosarcoidosis is a rare and critical pathology of sarcoidosis that presents a lytic bone lesion and clinical psychiatric symptoms; neurosarcoidosis is also rare in the literature.
Die laparoskopische Resektion einer Urachuszyste
Authors: Rohleder Stephan , Gödeke Jan , Münsterer Oliver 
Published: August 2017

Zusammenfassung
Zielsetzung Der vorliegende Beitrag zeigt Schritt für Schritt die laparoskopische Resektion einer Urachuszyste.
Indikation Der Urachus ist eine extraperitoneale Struktur von der Harnblase zum Nabel ziehend. Obliteriert in der Embryonalphase der Allantois nicht vollständig zum Lig. umbilicale medianum, können Urachusfisteln oder Urachuszysten verbleiben. Klinisch fällt häufig ein anhaltend nässender Nabel bis hin zu umbilikalem Urinaustritt auf. Aufgrund von Infektionen und der Gefahr der malignen Entartung im weiteren Verlauf werden Urachusfisteln oder -zysten i. d. R. chirurgisch entfernt.
Methode Beschrieben wird eine laparoskopische Resektion einer Urachuszyste in Rückenlage. Neben einem 3-mm-Kameratrokar im linken Oberbauch werden hierzu ein 3-mm-Trokar im linken Mittelbauch und ein 3-mm-Trokar epigastrisch platziert. Letzterer wird im Verlauf auf 5 mm für eine 5-mm-Clipzange erweitert. Für die Operation verwenden wir zudem eine 3-mm-30°-Optik und einen 3-mm-Monopolarhaken.
Schlussfolgerung Diese Technik der laparoskopischen Resektion von Urachusanomalien, insbesondere bei Urachusfisteln, ist aus unserer Sicht ein geeignetes minimalinvasives Verfahren. Die beschriebene laparoskopische Operationstechnik ermöglicht eine exakte Präparation und Mobilisierung der Fehlbildung unter direkter Sicht und sichere sowie vollständige Abtragung des Urachus unmittelbar am Blasendach.
Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey
Authors: Neimann Johannes , Knabl Julia , Puppe Julian , Bayer Christian , Gass Paul , Gabriel Lena , Seelbach-Goebel Birgit , Lermann Johannes , Schott Sarah 
Published: August 2017

Abstract
Background Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany.
Method This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care. The survey consisted of an anonymized 95-item questionnaire which collected data on different types of duty roster systems and the workload of obstetricians in Germany for the period from 17.02.2015 to 16.05.2015.
Results Out of a total of 2770 physicians who were contacted, 437 (16%) completed the questionnaire. Across all forms of care, the care provided outside normal working hours usually (75%) consisted of a combination of regular working times and on-call duty or even consisted entirely of standby duty. Level I perinatal centers were most likely 20% (n = 88) to have a shift system in place. Working a shift system was significantly more common in care facilities which had previously carried out a job analysis. The number of physicians in hospitals who are present during the night shift was higher in facilities with higher numbers of births and in facilities which offered higher levels of care. In addition to regularly working overtime and the fact that often not all the hours worked were recorded, it was notable that the systems used to compile duty rosters often did not comply with legal regulations or with collectively agreed working hours nor were they compatible with the staff planning requirements.
Outlook The results of this study show that the conditions of work, the working times, and the organization of working times in obstetric departments are in need of improvement. Recording the actual times worked together with an analysis of the activities performed during working times and while on standby would increase the level of transparency for employers and employees.
Epileptischer Anfall oder Synkope?
Authors: Knieß Tobias , Soda Hassan , Kippnich Uwe , Shammas Layal , Rashid Arsanusch 
Published: August 2017

ZusammenfassungEpilepsie ist eine der häufigsten neurologischen Erkrankungen im Erwachsenenalter und eine der häufigsten Diagnosen in neurologischen Kliniken. Im Rettungswesen werden epileptische Anfälle oder klinisch ähnliche suspekte Ereignisse, die nicht zwingend epileptisch sein müssen, unter der Meldediagnose „Krampfanfall“ geführt. Eine sichere diagnostische Einschätzung am Notfallort ist für die Mitarbeiter der Rettungsteams oft erschwert, da Patienten im oder nach einem Anfall in einem verwirrten Zustand sein können oder zum Ereignis eine Amnesie zeigen. Fehldiagnosen liegen bei bis zu 71%. Folge kann eine Über- oder Unterversorgung der Betroffenen sein, die im ungünstigsten Fall eine erhöhte Morbidität oder Mortalität nach sich ziehen kann. Eine verbesserte präklinische Diagnose ist durch eine strukturierte Anamnese durch den Rettungsdienst vor Ort möglich. Der dafür entwickelte Prehospital Epilepsy Emergency Score (PEES) stellt sich mit einer hohen Sensitivität (92%) und Spezifität (94%) als ein geeignetes Werkzeug zur strukturierten Fremdanamnese dar.
Rahmenbedingungen zur Sammlung von „Real-Life“-Daten am Beispiel der Augenklinik der Universität München
Authors: Kortüm Karsten , Kern Christoph , Meyer Gerhard , Priglinger Siegfried , Hirneiß Christoph 
Published: August 2017

Zusammenfassung
Hintergrund Die Bedeutung der Analyse von Untersuchungsdaten aus der Behandlungsrealität nimmt stetig zu. Gründe hierfür sind u. a. verbesserte Auswertungsmöglichkeiten durch leistungsfähigere Informatiksysteme. Zudem stehen mehr und mehr Daten digital zur Verfügung. Vor einem Projektstart zur Auswertung von Routinedaten, sind technische, personelle, aber vor allem auch (daten-)schutzrechtliche Aspekte zu beachten. In diesem Manuskript werden diese Aspekte anhand eines Beispiels aus der Augenklinik München erarbeitet.
Material und Methoden Es werden die rechtlichen Rahmenbedingungen anhand der verschiedenen Gesetze sowie Richtlinien zur Dokumentation und zum Datenschutz beleuchtet. Auch die technischen Anforderungen an eine Infrastruktur sowie Software werden definiert. Im Rahmen einer Umfrage der Deutschen Ophthalmologischen Gesellschaft (Arbeitsgruppe IT) wurde der Stand der Digitalisierung an deutschen Augenkliniken erhoben. Abschließend erfolgt eine Definition des Personalbedarfs.
Ergebnisse Es konnte eine Datenbank mit den Behandlungsergebnissen von 330 801 Patienten aufgebaut werden. Darin enthalten sind alle Diagnosen, Prozeduren an der Klinik, klinischen Befunde sowie Ergebnisse aus Messuntersuchungen. Diese Datenbank wurde vom lokalen behördlichen Datenschutzbeauftragten freigegeben. An weniger als der Hälfte der deutschen Augenkliniken, die an der Umfrage teilnahmen (n = 54) findet eine komplette elektronische Datenerfassung statt. 14 Kliniken gaben an, noch komplett papierbasiert zu arbeiten.
Schlussfolgerung Im Rahmen dieser Arbeit konnte exemplarisch gezeigt werden, welche verschiedenen Rahmenbedingungen eingehalten werden müssen, um eine umfassende Datenbank mit Routineuntersuchungsdaten auszubauen. Dies wird in Zukunft immer wichtiger werden, da mehr und mehr Innovation im Bereich der entscheidungsunterstützenden Software im Bereich der Augenheilkunde zu erwarten ist. Hierfür ist eine gute Datenbasis unerlässlich.
Operative und interventionelle Therapie der Trikuspidalklappe – neue Entwicklungen
Authors: Schueler Robert , Welz Armin , Mellert Fritz , Nickenig Georg 
Published: August 2017

ZusammenfassungDie symptomatische hochgradige Trikuspidalklappeninsuffizienz hat eine hohe Mortalität und tritt häufig in Kombination mit linksseitigen Herzklappenerkrankungen auf. Die Behandlung der Trikuspidalklappeninsuffizienz erfordert eine genaue anatomische Kenntnis des Trikuspidalklappenapparats und für die Planung einer operativen oder interventionellen Behandlung ist eine genaue Evaluation der zugrunde liegenden Ätiologie unabdingbar. Minimalinvasive Behandlungsoptionen sind im Moment fast ausschließlich im Rahmen von Studien möglich. Erste klinische und prozedurale Erfahrungen mit den neuen Techniken sind vielversprechend. In diesem Übersichtsartikel werden die einzelnen Techniken und Optionen zusammengefasst.
Implementation and Feasibility of Electronic Patient-Reported Outcome (ePRO) Data Entry in the PRAEGNANT Real-Time Advanced and Metastatic Breast Cancer Registry
Authors: Wallwiener Markus , Heindl Felix , Brucker Sara , Taran Florin-Andrei , Hartkopf Andreas , Overkamp Friedrich , Kolberg Hans-Christian , Hadji Peyman , Tesch Hans , Ettl Johannes , Lux Michael , Rauh Claudia , Blum Simon , Nabieva Naiba , Brodkorb Tobias , Faschingbauer Cornelia , Langemann Hanna , Schulmeyer Carla , Volz Bernhard , Rübner Matthias , Lüftner Diana , Müller Volkmar , Belleville Erik , Janni Wolfgang , Fehm Tanja , Wallwiener Diethelm , Ganslandt Thomas , Beckmann Matthias , Schneeweiss Andreas , Fasching Peter , Gass Paul 
Published: August 2017

Abstract
Purpose Patient-reported outcomes (PROs) have been incorporated into clinical trials for many symptoms and medical conditions. A transition from paper-based capture of PROs to electronic PROs (ePROs) has recently started. This study reports on the feasibility of ePRO assessment in a prospective registry including molecular data for patients with advanced breast cancer.
Methods As part of the PRAEGNANT network, patients were invited by clinical trial staff, physicians, and nurses to complete three standardized Internet-based questionnaires (EQ 5D 5 L, CES-D and IPAQ). Feasibility was assessed by the staff members who assigned the user accounts by the patients. The completeness of the questionnaires was also assessed.
Results Fifteen of 17 patients who were asked agreed to participate to complete the PRO questionnaires (EQ-5D-5L and CES-D). However, the IPAQ (physical activity) questionnaire was only validly completed by 9 patients. Feasibility was ranked better by the physicians and dedicated clinical trial staff than by the nursing staff.
Conclusions Incorporating ePRO questionnaires into an advanced breast cancer registry is feasible, and no major hurdles were reported. Involving stakeholders from the start, the application is tailored to the capacities and abilities of both patients and clinical staff. The patientsʼ compliance was better with some questionnaires, but others may present difficulties.