bluuebunny/crossref_metadata_2025_split huggingface dataset:
Auswahl geeigneter Kontrollkliniken für die Durchführung der bundesweiten und einheitlichen Evaluation von Modellvorhaben nach § 64b SGB V. Analyse von Daten der Strukturierten Qualitätsberichte
Authors: Petzold T. , Neumann A. , Seifert M. , Küster D. , Pfennig A. , Weiß J. , Häckl D. , Swart E. , Schmitt J. 
Published: November 2016

Zusammenfassung
Hintergrund: Der Versorgungsbedarf psychisch erkrankter Patienten stellt besondere Anforderungen an sektorenübergreifende Versorgungsstrukturen dar. Mit dem §+64b SGB V wurde die Möglichkeit geschaffen, psychiatrische Erkrankungen durch multiprofessionelle, behandlungsphasen- und sektorenübergreifende Modellvorhaben zu betreuen und neue Finanzierungsformen zu implementieren. Diese Modellvorhaben in den Kliniken (Modellkliniken) gilt es, gegenüber der Regelversorgung zu evaluieren.
Ziel der Arbeit: Ziel der Analyse ist die Identifikation geeigneter Kliniken anhand definierter Kriterien als Vergleichsgruppe (Kontrollkliniken) mithilfe von Sekundärdaten.
Material und Methoden: Es erfolgte eine systematische Analyse Strukturierter Qualitätsberichte gemäß § 137 SGB V sowie zugeordneter Daten des Bundesinstituts für Bau-, Stadt- und Raumforschung (INKAR). Anhand a priori definierter K.O. Kriterien, Kriterien zum Patientenklientel (Gewichtung 50%) sowie Strukturmerkmale der Kliniken (25%) und des Umfelds (25%) wurde ein gewichteter Ähnlichkeitsscore zu jeder der 13 Modellkliniken berechnet, der max. 100 Punkte beträgt (perfekte Übereinstimmung).
Ergebnisse: Für die Auswahl von jeweils 10 Kontrollkliniken wurden alle Kriterien zusammengefasst. Der Median der gesamten Abweichung potentieller Kontroll- von Modellkliniken beträgt 34,3 (Spannweite: 17,6–66,7). Bei den 10 Kontrollkliniken je Modellklinik beträgt der Median 30,9 (Spannweite: 17,6–40,8).
Diskussion: Anhand des Algorithmus konnten strukturell ähnliche Vergleichskliniken identifiziert werden. Das Verfahren mit Nutzung der genannten Datenbanken und Ableitung spezifischer Kriterien der Strukturgleichheit eignet sich grundsätzlich für kontrollierte Designs zur Evaluation komplexer Interventionen basierend auf Routinedaten.
Was fördert die Verstetigung von Strukturen und Angeboten der Gesundheitsförderung?
Authors: Funk S. , Schaefer I. , Kolip P. 
Published: November 2016

ZusammenfassungDie Verstetigung gesundheitsförderlicher Interventionen als Voraussetzung für langfristige Wirkungen gewinnt zunehmend an Bedeutung. Es liegen jedoch nur vereinzelt Kenntnisse darüber vor, wie es gelingen kann, Projekte in dauerhafte Strukturen und Regelangebote zu überführen. Die Evaluationsstudie der Universität Bielefeld analysierte mit einem Mixed-methods-Ansatz die erreichte Verstetigung ausgewählter Initiativen, die im Rahmen des Nationalen Aktionsplans IN FORM gefördert wurden, und ermittelte Faktoren, die den Verstetigungsprozess beeinflusst haben. Es hat sich gezeigt, dass Verstetigung ein vielgestaltiger und kontextabhängiger Prozess ist, der bereits in der Planungsphase eines Projektes mitgedacht werden sollte. Neben konzeptionellen Einflussfaktoren, die durch Projektaktivitäten beeinflusst werden können, sind insbesondere Kontextfaktoren entscheidend für eine gelingende Verstetigung gesundheitsförderlicher Interventionen.
Hindernisse und Voraussetzungen für die Vermittlung älterer, depressiv erkrankter Menschen in Psychotherapie aus Sicht von HausärztInnen
Authors: Kammerer K. , Falk K. , Heintze C. , Döpfmer S. , Heusinger J. 
Published: November 2016

Zusammenfassung
Zielsetzung Ältere Menschen mit depressiven Erkrankungen nehmen seltener Psychotherapie in Anspruch als jüngere Menschen. HausärztInnen sind für die Vermittlung in psychotherapeutische Behandlung insbesondere für ältere Menschen von großer Bedeutung. Dieser Beitrag präsentiert Ergebnisse zur hausärztlichen Sicht auf die Hindernisse und Voraussetzungen für eine Vermittlung älterer, depressiv erkrankter Menschen in Psychotherapie.
Methodik Hausärztliche LehrärztInnen wurden mit einem Fragebogen zur Versorgung älterer Menschen (60+) mit depressiven Erkrankungen befragt. In 2 offenen Fragen wurde die Sicht auf Hindernisse und Voraussetzungen für die Vermittlung älterer, depressiv erkrankter Menschen in psychotherapeutische Behandlung erfragt.
Ergebnisse Die meisten Aussagen betreffen Hindernisse, die auf PatientInnen-Seite wahrgenommen werden, gefolgt von Barrieren, die auf Seiten des Versorgungssystems gesehen werden. Vor allem hinderliche Einstellungen und Emotionen, aber auch funktionale Einschränkungen auf Seiten der PatientInnen wurden als Barriere genannt. Hinsichtlich des Versorgungssystems wurden strukturelle Aspekte, wie fehlende Psychotherapieplätze, aber auch das Handeln der Versorgungsakteure sowie eine ungenügende Kooperation aufgeführt. Als Voraussetzungen wurden spezielle Therapieangebote für ältere Menschen genannt.
Schlussfolgerungen Der Umgang mit Vorbehalten gegenüber Psychotherapie auf Seiten älterer Menschen erfordert Zeit, die in der hausärztlichen Praxis in der Regel nicht vergütet wird. Kooperationen mit PsychotherapeutInnen werden als wichtige Voraussetzung für eine Vermittlung gesehen, wobei hier unterschiedliche Professionsbilder aufeinandertreffen. Insbesondere für Menschen mit Mehrfacherkrankungen wird der Zugang als schwierig angesehen.
Tracking the decoy: maximizing the decoy effect through sequential experimentation
Authors: Kaptein Maurits C , Van Emden Robin , Iannuzzi Davide 
Published: November 2016

AbstractThe decoy effect is one of the best known human biases violating rational choice theory. According to a large body of literature, people may be persuaded to switch from one offer to another by the presence of a third option (the decoy) that, rationally, should have no influence on the decision-making process. For example, when asked to choose between a laptop with a good battery but a poor memory and a laptop with a poor battery but a good memory, customers may be induced to shift their preference if the offer is accompanied by a third laptop that has a battery as good as the latter but even worse memory—an effect that has clear applications in marketing practice. Surprisingly, renowned decoy studies have resisted replication, inducing scholars to challenge the scientific validity of the phenomenon and question its practical relevance. Using a treatment allocation scheme that takes inspiration from the lock-in amplification schemes used in experimental physics, we were able to explore the entire range of decoy attribute values and demonstrate that some of the reproducibility issues reported in the literature result from a suboptimal initial conditions. Furthermore, we demonstrate that our approach is able to sequentially identify the features of the decoy that maximize choice reversal. We thus reinstate the scientific validity and practical relevance of the decoy effect and demonstrate the use of lock-in amplification to optimize treatments.
Epipolymorphisms associated with the clinical outcome of autoimmune arthritis affect CD4+T cell activation pathways
Authors: Spreafico Roberto , Rossetti Maura , Whitaker John W. , Wang Wei , Lovell Daniel J. , Albani Salvatore 
Published: November 2016

SignificanceJuvenile idiopathic arthritis, a common chronic childhood rheumatic disease, is characterized by joint inflammation and synovial accumulation of activated autoreactive T cells. Although current therapies induce high rates of disease remission, 50–80% patients flare upon treatment withdrawal, thus requiring continued exposure to the safety risks and costs of an immunosuppressive biologic. Unfortunately, at the time of therapy withdrawal, patients who will maintain inactive disease are clinically indistinguishable from those who will not. We identified differences in the DNA methylation status of T-cell activation genes—detectable at a protein level and established at the time of therapy withdrawal—that were specifically associated with clinical outcome, demonstrating the mechanistic and diagnostic relevance of epigenetic features in autoimmune arthritis.
Late Archaic–Early Formative period microbotanical evidence for potato at Jiskairumoko in the Titicaca Basin of southern Peru
Authors: Rumold Claudia Ursula , Aldenderfer Mark S. 
Published: November 2016

Significance
The potato is perhaps the most important of the high Andean crops. Cultivated the length of the Andean cordillera and across disparate ecological zones, it is now also a principal global staple. For this study, we analyzed starch microremains recovered from 14 groundstone tools from Late Archaic to Early Formative period contexts at Jiskairumoko, an early village site in the Titicaca Basin of the south-central Andes of Peru. A total of 50 starches were identified as consistent with cultivated potato. These data are significant because they contribute to the empirical foundation for understanding the development of food production in the study area and underscore the utility of starch analysis in addressing questions relating to geophyte domestication and cultivation.
RNA modification enzyme TruB is a tRNA chaperone
Authors: Keffer-Wilkes Laura Carole , Veerareddygari Govardhan Reddy , Kothe Ute 
Published: November 2016

Significance
RNAs are intimately involved in numerous cellular functions such as gene expression. Typically, RNAs adopt a 3D fold, and their sequences may be chemically altered to contain modified nucleotides such as pseudouridines. There are many RNA modification enzymes, but often their cellular functions remain unknown. In this proof-of-principle study, we show that the tRNA pseudouridine synthase TruB is a tRNA chaperone. In contrast to its modification activity, the ability of TruB to fold tRNA is critical for cellular fitness. It is likely that other modification enzymes and RNA-binding proteins act as RNA chaperones increasing the efficiency of RNA maturation. This connection of RNA modification with RNA folding may have arisen during the evolution from an RNA to a ribonucleoprotein world.
Cortical networks involved in visual awareness independent of visual attention
Authors: Webb Taylor W. , Igelström Kajsa M. , Schurger Aaron , Graziano Michael S. A. 
Published: November 2016

Significance
Do specific areas of the brain participate in subjective visual experience? We measured brain activity in humans using fMRI. Participants were aware of a visual stimulus in one condition and unaware of it in another condition. The two conditions were balanced for their effect on visual attention. Specific brain areas were more active in the aware than in the unaware condition, suggesting they were involved in subjective awareness independent of attention. The largest cluster of activity was found in the temporoparietal junction (TPJ), supporting a recent suggestion that the TPJ plays a role in computations concerning awareness.
Evolution of directional hearing in moths via conversion of bat detection devices to asymmetric pressure gradient receivers
Authors: Reid Andrew , Marin-Cudraz Thibaut , Windmill James F. C. , Greenfield Michael D. 
Published: November 2016

Significance
In most acoustic animals, directional hearing evolved alongside basic ear structure. Pyraloid moths differ because their ears generally function as simple bat detectors with little directional ability. Those pyraloid moths that broadcast mating calls represent a yet more special case, as these species localize sound but the ability evolved well after hearing and may be constrained by fundamental auditory features. Analyzing a species with male calling songs, we report a localization mechanism wherein the membrane structure of each ear affords sharp sensitivity to sound arriving from a distinct angle. Females can thereby track male calls but only via an indirect, curvilinear trajectory. Such inefficiency may characterize specialized perceptual traits that rely on general ones having already undergone extensive prior evolution.
Cesarean Delivery Rates Revisiting a 3-Decades-Old Dogma
Authors: D’Alton Mary E. , Hehir Mark P. 
Published: November 2016

(JAMA 2015;314(21):2238–2240)
Cesarean delivery rates have become a major public health concern. Because of some studies showing that higher rates could be associated with negative outcomes, including increased maternal morbidity and mortality and neonatal intensive care unit admission along with unnecessary consumption of health care resources, there have been efforts in some developed countries to decrease national cesarean delivery rates. A cross-sectional, geographical study was conducted by Molina and colleagues estimating annual cesarean delivery rates in World Health Organization (WHO) member countries from data collected during the period 2005 to 2012. The research estimated that, in 2012, there were 22.9 million cesarean deliveries worldwide. The combined data were then analyzed in association with maternal and neonatal mortality rates from those countries where these rates were available. The study concluded that a cesarean delivery rate of 19% resulted in the best outcomes in terms of optimal levels of maternal and neonatal mortality.
Does Preprocedural Ultrasound Increase the First-Pass Success Rate of Epidural Catheterization Before Cesarean Delivery? A Randomized Controlled Trial
Authors: Tawfik Mohamed M. , Atallah Magdy M. , Elkharboutly Walaa S. , Allakkany Nasser S. , Abdelkhalek Mostafa 
Published: November 2016

(Anesth Analg 2016) [Epub ahead of print].
Many obstetric studies have compared preprocedural ultrasound for epidural catheterization with the landmark palpation technique and found the former to be safe and efficacious. However, several of these studies were unblinded and had inconsistent designs regarding patient characteristics, single or multiple operator involvement, and operator expertise. The authors of the present study addressed these issues in this double-blind, randomized controlled trial, which compared preprocedural ultrasound with conventional palpation for epidural catheterization performed by a single, experienced anesthesiologist as a component of double-interspace combined spinal-epidural (CSE) anesthesia for cesarean delivery. The primary outcome was the success rate of epidural catheterization at the first needle pass. Secondary outcomes included the success rate of epidural catheterization at the first skin puncture, number of performed needle passes and skin punctures, duration of the epidural procedure, patient satisfaction, and complications.
Anesthetic Considerations for the Parturient After Solid Organ Transplantation
Authors: Moaveni D.M. , Cohn J.H. , Hoctor K.G. , Longman R.E. , Ranasinghe J.S. 
Published: November 2016

(Anesth Analg 2016;123:402–410)
There are an increasing number of women conceiving after organ transplant. According to the 2014 National Transplantation Pregnancy Registry report, a total of 1396 female organ transplant recipients reported 2463 pregnancies. In the present review, authors discuss concerns important to the obstetric anesthesia management of pregnant solid organ transplant recipients.
Placental Implantation Abnormalities and Risk of Preterm Delivery: A Systematic Review and Meta-Analysis
Authors: Vahanian S.A. , Lavery J.A. , Ananth C.V. , Vintzileos A. 
Published: November 2016

(Am J Obstet Gynecol 2015;213(suppl):S78–S90)
A rise in placental implantation abnormalities (PIAs) such as placenta previa, placenta accreta, vasa previa, and velamentous cord insertion have led to an increase in cesarean delivery rates in the past 2 decades. PIAs account for 5.6% to 8.7% of indicated preterm deliveries at <35 weeks’ gestation. This study presented a metaanalysis of PIAs in relation to preterm delivery and other adverse perinatal outcomes.
Cerebral Palsy: Causes, Pathways, and the Role of Genetic Variants
Authors: MacLennan A.H. , Thompson S.C. , Gecz J. 
Published: November 2016

(Am J Obstet Gynecol 2015;213(6):779–788)
Cerebral palsy (CP) is a neurological disorder of permanent nature. It has multiple clinical types; patterns of neuropathology as seen on brain imaging, associated developmental pathologies (intellectual disability, autism, epilepsy, and visual impairment) and also rare pathogenic genetic variations (mutations). This review addresses causes, pathways and genetic variants associated with CP.
Global, Regional, and National Levels and Trends in Maternal Mortality Between 1990 and 2015, With Scenario-based Projections to 2030: A Systematic Analysis by the UN Maternal Mortality Estimation Inter-Agency Group
Authors: Alkema Leontine , Chou Doris , Hogan Daniel , Zhang Sanqian , Moller Ann-Beth , Gemmill Alison , Fat Doris Ma , Boerma Ties , Temmerman Marleen , Mathers Colin , Say Lale 
Published: November 2016

(Lancet 2016;387: 462–674)
World leaders at the landmark Millennium Summit in September 2000 agreed to adopt the Millennium Development Goals (MDGs) with the goal of improving the lives of the world’s poor. Countries and international agencies agreed to monitor progress on these goals that addressed development and health outcomes between 1990 and 2015. One of the goals, MDG 5, strived for a reduction of 75% in the world-wide maternal mortality ratio over these 25 years. The objective of this current study was to project the levels and trends in maternal mortality for 183 countries for the period 2016 to 2030 based on the data obtained for MDG 5.
Mortality in Mothers After Perinatal Loss: A Population-based Follow-up Study
Authors: Hvidtjørn D. , Wu C. , Schendel D. , Thorlund Parner E. , Brink Henriksen T. 
Published: November 2016

(BJOG 2016;123:393–398)
Parents who have suffered a perinatal loss experience a mourning process. Research has shown that traumatic or untimely death increases the risk of poor physical and mental health in those affected by the loss. Certainly the loss of a fetus or neonate would fit into this category. The aim of this study was to analyze mortality in mothers who have experienced a perinatal loss and explore possible underlying mechanisms.
Prolonged Second Stage of Labor, Maternal Infectious Disease, Urinary Retention and Other Complications in the Early Postpartum Period
Authors: Stephansson O. , SandstrÖm A. , Petersson G. , WikstrÖm A.-K. , Cnattingius S. 
Published: November 2016

(BJOG 2016;123:608–616)
A prolonged second stage of labor is known to be associated with increased risk of certain maternal complications, such as infection, urinary retention, hematoma, and ruptured sutures in the early postpartum period. Urinary retention can lead to other adverse consequences for the affected woman, including bladder denervation, detrusor atony, and long-term voiding problems. This current population-based cohort study was undertaken to study the association between prolonged second stage of labor and these early postpartum complications.
Prediction of Escape Red Blood Cell Transfusion in Expectantly Managed Women With Acute Anaemia After Postpartum Haemorrhage
Authors: Prick B.W. , Schuit E. , Mignini L. , Jansen A.J.G. , van Rhenen D.J. , Steegers E.A.P. , Mol B.W. , Duvekot J.J. 
Published: November 2016

(BJOG. 2015;122(13):1789–1797)
Severe postpartum hemorrhage (blood loss of at least 1000 mL) remains a relatively common obstetric complication. In fact, the incidence has been increasing in some developed countries, and the worldwide prevalence has been reported at 1.9%. The purpose of this study was to determine clinical predictors of the need for escape red blood cell (RBC) transfusion (a transfusion administered beyond the acute blood loss phase) in postpartum anemic women who were initially managed expectantly. In addition, the study evaluated whether health-related quality of life (HRQoL) scores provided additional predictive value beyond the clinical predictors determined.
Intraobserver and Interobserver Agreement Among Obstetric Experts in Court Regarding the Review of Abnormal Fetal Heart Rate Tracings and Obstetrical Management
Authors: Sabiani L. , Le Dû R. , Loundou A. , d’Ercole C. , Bretelle F. , Boubli L. , Carcopino X. 
Published: November 2016

(Am J Obstet Gynecol. 2015;213:856.e1–e.8)
It has been noted that the fear of litigation has an impact on obstetricians and institutions, and obstetricians pay some of the highest premiums among physicians for malpractice insurance. The objective of this study was to evaluate the intraobserver and interobserver agreement among obstetric experts in court (OECs) regarding the retrospective review of abnormal fetal heart rate tracings (AFHRTs) and obstetrical management of patients with AFHRT during labor.
The Risks of Planned Vaginal Breech Delivery Versus Planned Caesarean Section for Term Breech Birth: A Meta-Analysis Including Observational Studies
Authors: Berhan Y. , Haileamlak A. 
Published: November 2016

(BJOG. 2016;123:49–57)
The optimal route of delivery for a term singleton breech presentation has been debated for >50 years with several randomized and observational studies performed to address the question. The Term Breech Trial was a large, international study that showed decreased perinatal morbidity and mortality with cesarean section (CS). Following publication of this article in 2000, the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynaecologists both recommended CS for term breech deliveries. A few years later, however, both organizations revised their recommendations to suggest a trial of labor in certain situations. Regardless, the vast majority of term breech presentations are now delivered by CS in high resource countries. The aim of this current meta-analysis was to establish the absolute and relative risks of planned vaginal breech delivery for term pregnancies.
A Prospective Observational Study of Maternal Oxygenation During Remifentanil Patient-controlled Analgesia Use in Labour
Authors: Messmer A. , Potts J. M , Orlikowski C.E. 
Published: November 2016

(Anaesthesia 2016;71:171–176)
Remifentanil patient-controlled analgesia (PCA) has been used for labor analgesia for many years at some institutions. However, its use has not gained widespread acceptance. Studies have shown high levels of maternal satisfaction with remifentanil PCA for labor, but safety concerns, especially the adverse effects of sedation and respiratory depression, seem to be contributing to the reluctance of many anesthesiologists to adopt this analgesic technique. The objective of this study was to evaluate maternal oxygen desaturation during remifentanil PCA for labor.
Use of an Intrathecal Catheter for Analgesia, Anesthesia, and Therapy in an Obstetric Patient With Pseudotumor Cerebri Syndrome
Authors: Gragasin F.S. , Chiarella A.B. 
Published: November 2016

(A A Case Rep. 2016;6:160–162)
In this case report, a 32-year-old primigravida woman with a history of idiopathic intracranial hypertension (IIH) presented to the labor and delivery suite at 40 weeks gestation in active labor and with pseudotumor cerebri syndrome (PTCS). PTCS, which includes IIH, is a rare disorder mainly of obese women of childbearing age, characterized by increased intracranial pressure in the absence of a space-occupying lesion, ventriculomegaly, or abnormal cerebrospinal fluid (CSF) composition. Symptoms include headache, pulsatile tinnitus, back pain, dizziness, photophobia, neck pain, cognitive dysfunction, radicular pain, diplopia, and in some cases, permanent vision loss. This patient was diagnosed with IIH at age 14 and was treated with multiple lumbar punctures and diuretics until age 18 years. She was then asymptomatic until 23 years of age, at which time she had a recurrence and resumed diuretic therapy until her pregnancy.