bluuebunny/crossref_metadata_2025_split huggingface dataset:
The environment of the wind–wind collision region of η Carinae
Authors: Panagiotou C. , Walter R. 
Published: November 2017

Context. η Carinae is a colliding wind binary hosting two of the most massive stars and featuring the strongest wind collision mechanical luminosity. The wind collision region of this system is detected in X-rays and γ-rays and offers a unique laboratory for the study of particle acceleration and wind magneto-hydrodynamics.
Aim. Our main goal is to use X-ray observations of η Carinae around periastron to constrain the wind collision zone geometry and understand the reasons for its variability.
Methods. We analysed 10 Nuclear Spectroscopic Telescope Array (NuSTAR) observations, which were obtained around the 2014 periastron. The NuSTAR array monitored the source from 3 to 30 keV, which allowed us to grasp the continuum and absorption parameters with very good accuracy. We were able to identify several physical components and probe their variability.
Results. The X-ray flux varied in a similar way as observed during previous periastrons and largely as expected if generated in the wind collision region. The flux detected within ~10 days of periastron is lower than expected, suggesting a partial disruption of the central region of the wind collision zone. The Fe Kα line is likely broadened by the electrons heated along the complex shock fronts. The variability of its equivalent width indicates that the fluorescence region has a complex geometry and that the source obscuration varies quickly with the line of sight.
Anti-M Alloimmunization: Management and Outcome at a Single Institution
Authors: Stetson Bethany , Scrape Scott , Markham Kara 
Published: November 2017

Objective The objective of this study was to review the management strategies and outcomes in gravidas with anti-M alloimmunization over 15 years.
Study Design Data collected from 195 pregnant patients with anti-M antibodies from July 2000 through June 2016 were reviewed retrospectively. We analyzed indirect antiglobulin test titer results, paternal or fetal/neonatal M antigen status, antepartum course, and perinatal outcomes.
Results Anti-M antibodies were found in 146 women and 195pregnancies. Among those with positive indirect antiglobulin tests, 193 pregnancies had titers at or below 1:4. Only one patient with an initial low titer experienced a more than twofold increase to a titer 1:64. Two women underwent an amniocentesis and cordocentesis. Ninety-five (73.6%) of the 129 infants tested were positive for the M antigen. Nine infants required phototherapy. There were no cases of hemolytic disease of the fetus or newborn, mild or severe.
Conclusion The incidence of severe hemolytic disease of the newborn due to anti-M is extremely low. We found no cases in our review of 195 pregnancies, despite several cases of severe hemolytic disease of the newborn reported in the literature. We have created an algorithm for the management of anti-M antibodies in pregnancy based on our data and extensive literature review.
Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study
Authors: Raggam Reinhard , Hafner Franz , Avian Alexander , Hackl Gerald , Cvirn Gerhard , Brodmann Marianne , Gary Thomas , Rief Peter 
Published: November 2017

AbstractThe aim of this study was prospective evaluation of the performance of the HAS-BLED score in predicting major bleeding complications in a real-world outpatient cohort, during long-term anticoagulation for venous thromboembolism (VTE), treated with a broad spectrum of anticoagulants. We analyzed 111 outpatients objectively diagnosed with VTE and treated long-term with various anticoagulants. Patients were grouped in three cohorts based on the anticoagulant regimen. Calculation of the HAS-BLED score and documentation of bleeding events were performed every 6 months for 1 year. Patients with a HAS-BLED score ≥ 3 had an increased risk for major bleeding events (odds ratio [OR]: 13.05, 95% confidence interval [CI]: 0.96–692.58, p = 0.028) and a trend to higher risk for minor bleeding events as well (OR: 2.25, 95% CI: 0.87–5.85, p = 0.091) when compared with patients with a HAS-BLED score < 3.This indicates that a HAS-BLED score ≥ 3 allows for identification of patients with VTE on long-term anticoagulation at an increased risk for major bleeding events, irrespective of the anticoagulant agent used.
Inhibitors in Patients with Congenital Bleeding Disorders Other Than Hemophilia
Authors: Marano Giuseppe , Mengoli Carlo , Piccinini Vanessa , Pupella Simonetta , Vaglio Stefania , Liumbruno Giancarlo , Franchini Massimo 
Published: November 2017

AbstractThe most worrying complication of replacement therapy for severe hemophilia A and B is currently the occurrence of inhibitory alloantibodies against infused factor VIII and factor IX, respectively. Inhibitors compromise the management of hemorrhage in affected patients, with a considerable increase in complications, disability, and costs. While these alloantibodies have been extensively studied in the past years in hemophilia A and B, those occurring in patients with other inherited bleeding disorders are less well characterized and still poorly understood, mostly due to the rarity of these hemorrhagic conditions. This narrative review will deal with inhibitors arising in patients with inherited bleeding disorders other than “classical” hemophilia, focusing in particular on those developing in patients with congenital deficiency of coagulation factor V, factor VII, factor XI, and factor XIII.
Severe Trampoline Injuries: Incidence and Risk Factors in Children and Adolescents
Authors: Salokorpi Niina , Suo-Palosaari Maria , Pesälä Juha , Serlo Willy , Sinikumpu Juha-Jaakko , Korhonen Linda 
Published: November 2017

Introduction Severe trampoline injuries in children and adolescents are rare; however, minor injuries are common and their incidence is increasing. Severe injuries are most commonly head and neck injuries. They may result in long-term morbidity. This study aimed to illustrate these severe injuries and to find out their incidence and risk factors.
Materials and Methods This is a population-based, prospective study in the Oulu region of Finland completed over 2 years (May 1, 2015 to April 31, 2017). All children (<16 years of age) with severe trampoline injuries were included. Cervical spine fractures, chest wall and skull fractures, lesions of internal organs, hip and knee dislocations, and permanent disorders of the peripheral veins or nerves were in prior defined as severe. Multiple jumpers, stunts, younger age, previous injuries, insufficient use of safety equipment, and lack of supervision were hypothesized as risk factors.
Results There were 11 injured patients (10 boys). The annual incidence was 6.28/100,000 children <16 years of age. Mean age was 11.5 years. Severe injuries included five ligamentous cervical spine injuries and two sternal bone fractures. In addition, there were one lumbar spine ligament injury, two hip dislocations, and one severe axillary plexus nerve lesion. Eight out of 11 accidents were not seen by any adult and none of them happened under professional supervision. Most injuries (N = 8) happened by failed backflips.
Conclusion Most severe injuries happened in unsuccessful flips. Children should have an adult supervisor and flips should not be attempted.
Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery
Authors: Kalem Ziya , Yuce Tuncay , Bakırarar Batuhan , Söylemez Feride , Namlı Kalem Müberra 
Published: November 2017

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery.
Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups.
Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care.
Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.
Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
Authors: Sanjuan-Cerveró Rafael , Vazquez-Ferreiro Pedro , Gomez-Herrero Diego , Carrera-Hueso Francisco 
Published: November 2017

Introduction Collagenase Clostridium Histolyticum (CCH) has become a therapeutic alternative for Dupuytren disease. However, its efficacy in the medium to long term is unknown. The objective of our study is to carry out a systematic review of the studies conducted on the subject.
Material and Methods Systematic bibliographic search. Analysis depending on the time of progression, looking into 2 groups with the follow-up cut-off point of 1 year. Analysis of the number of patients who reached the primary endpoint, of the mean correction in degrees, and of the proportional correction of each joint.
Results The 50 selected clinical trials encompass a total of 4,622 patients (an average of 92.70). A total of 7,546 joints were treated with the mean being 148.15 joints per trial (3,925 metacarpophalangeal [MCP] and 2,350 proximal interphalangeal [PIP]). In less than one year of progression, the primary end point was reached in 48.9% of the joints (69.77% of the MCPs and 30.14% of the PIPs), the mean correction in degrees was 45.5 (standard deviation [SD]: 19.18) degrees; 40.8 degrees in the MCP (SD: 10.12) and 35.6 in the PIP (SD: 13.23), and the proportional correction of the joints was 72.9% (SD: 14.43) (83.9% for MCPs [SD: 12.58] and 64.2 for the PIPs [SD: 16.35]). In the follow-ups over 1 year, the primary end point was reached at a rate of 57.5% (68.9% of the MCPs and 43.3% of the PIPs), the mean correction in degrees was 37.6 degrees (SD: 10.93) (37.3 degrees in the MCPs [SD: 9.98] and 23.7 in the PIPs [SD: 16.33]) and the proportional correction of the joints was 87.3% (SD: 10.96) (90.3% for MCP [SD: 6.94] and 75% for PIP [SD: 13.54]).
Conclusions The results indicate a satisfactory response to CCH treatment maintained in the short and medium term. The recurrence rate is uncertain given the available data.
Use of Intramedullary Cannulated Headless Screws in the Treatment of Hand Fractures - An Anatomical Study on Long Fingers
Authors: Rivera Vegas María , Estefanía Díez Miguel , Martínez Núnez Pablo , Astorga Veganzones Rebeca 
Published: November 2017

Objective To quantify the cartilaginous and tendinous lesions produced upon percutaneous introduction of intramedullary cannulated screws as osteosynthesis material in metacarpal and phalangeal fractures.
Materials and Methods Seven anatomical models and one non-replanted hand were used. The measurements of 30 metacarpals and proximal and middle phalanges were taken. Cannulated screws with complete and partial threads were placed percutaneously through the metacarpal head and the proximal and middle phalanges, reproducing the actions performed in the clinic. The following measurements were performed: A) Percentage of the damaged cartilaginous area and its location. B) Damage to the extensor apparatus and its distance to the bone insertion point. C) Bone marrow size.
Results (A) The percentages of the damaged areas in the metacarpals, proximal and middle phalanges were 5.7%, 13.35% and 9.62%, respectively. (B) The damage to the extensor apparatus was less than 3 mm with a 4-mm distance to the bone insertion point and (C) We have obtained the measurements of the intramedullary bone and from them, we calculated the width of the most appropriate screw.
Conclusion In conclusion, the use of retrograde and percutaneous cannulated screws is a reliable technique with regard to the associated morbidity, and we present an approximation regarding the most appropriate screw for each location.
Bone Marrow Cellular Therapies: Novel Therapy for Knee Osteoarthritis
Authors: Khlopas Anton , Newman Jared , Ng Mitchell , Roche Martin , Husni M. , Spindler Kurt , Mont Michael , Muschler George , Piuzzi Nicolas 
Published: November 2017

AbstractCellular therapies are emerging as potentially promising treatments for numerous musculoskeletal conditions, such as knee osteoarthritis (OA). As orthopaedic surgeons represent a sizable portion of the providers who deliver these therapies, it is particularly essential for them to understand their fundamental principles. One major principle is to identify the appropriate sources for obtaining these cells, with bone marrow being most common. Therefore, the purpose of this review was to provide an overview of cell-based therapies available for the treatment of knee OA with a focus on bone marrow-derived cellular therapies. Specifically, we discuss (1) bone marrow aspiration technique, (2) processing to bone marrow aspirate concentrate, and (3) the rational and clinical evidence for the use of bone marrow cellular therapies for the treatment of knee OA.
Side-by-side partially covered self-expandable metal stent placement for malignant hilar biliary obstruction
Authors: Kitamura Katsuya , Yamamiya Akira , Ishii Yu , Mitsui Yuta , Nomoto Tomohiro , Yoshida Hitoshi 
Published: November 2017

Abstract
Background and study aims This study investigated the feasibility of side-by-side (SBS) partially covered self-expandable metal stent (PCSEMS) placement for unresectable malignant hilar biliary obstruction (MHBO).
Patients and methods We retrospectively analyzed 33 patients from a single center who underwent endoscopic biliary drainage for unresectable MHBO from July 2013 to June 2015. In all patients with bilateral obstruction during complete bilateral intrahepatic cholangiograms, we performed endoscopic SBS placement of a 6-mm diameter PCSEMS using an 8-French delivery system. All patients underwent endoscopic sphincterotomy. Generally, patients with recurrent biliary obstruction (RBO) after stent placement underwent endoscopic reintervention. Our study outcomes included the technical and functional success rates, RBO rate, time to RBO (TRBO), reintervention rate, and incidence of adverse events.
Results Seventeen patients with unresectable MHBO during complete bilateral intrahepatic cholangiograms underwent endoscopic SBS PCSEMS placement (median age, 78 years; men, 9). Lesions were Bismuth types II (n = 10), III (n = 1), and IV (n = 6), including 10 cholangiocarcinomas, 3 gallbladder cancers, and 4 metastatic cancers. In all patients, the PCSEMS was placed across the duodenal papilla. The technical and functional success rates were 100 % and 82 %, respectively. The median procedure time was 43 minutes (interquartile range [IQR]: 36 – 52 minutes). Twelve patients had RBO (71 %), including 9 stent occlusions due to sludge and 3 stent migrations. The median TRBO was 79 days (IQR: 58 – 156 days) during the follow-up period (median 192 days [IQR: 88 – 551 days]). The median TRBO of patients with Bismuth type II lesions was significantly longer than that of patients with Bismuth types III and IV lesions (87 days [IQR: 70 – 244 days] vs. 54 days [IQR: 35 – 100 days]; P  = 0.030). Thirteen patients (76 %) required endoscopic reintervention. Endoscopic stent removal was possible in 6 patients without tumor ingrowth into the uncovered distal part of the stent. One late adverse event (≥ 31 days) occurred (cholangitis).
Conclusions Endoscopic SBS placement of a PCSEMS was feasible in patients with unresectable MHBO. Additionally, reinterventional stent removal was possible in the absence of tumor ingrowth.
Emotionserkennung, Theory of Mind und Empathie bei Multipler Sklerose
Authors: Ayache Samar S. , Chalah Moussa A. , Kuempfel Tania , Padberg Frank , Lefaucheur Jean-Pascal , Palm Ulrich 
Published: November 2017

ZusammenfassungDie Multiple Sklerose (MS), eine chronisch-entzündliche Erkrankung des zentralen Nervensystems, verursacht häufig körperliche Einschränkung,
Affektstörungen, Fatigue und kognitive Störungen. Ein Teil der Letzten ist die soziale Kognition, die bei MS Patienten häufig beeinträchtigt
ist. Sie umfasst die Theory of Mind, die Empathie und die soziale Wahrnehmung von Emotionen, die von Stimuli aus Gesichts-, Körper- und
Stimmwahrnehmung geboten werden. Sozialkognitive Defizite verschlechtern die Affektdekodierung, die interpersonelle Kommunikation und die
Lebensqualität. Trotz des Einflusses dieser Einschränkungen auf das Globalbefinden haben nur wenige Studien die Zusammenhänge und
Überlappungen mit anderen MS Symptomen untersucht. Diese Übersichtsarbeit zielt auf die Definition und Anatomie sozialer Kognition ab und
stellt die neuropsychologischen und bildgebenden Studien zur sozialen Kognition bei MS dar. Die Ergebnisse der verfügbaren Studien zeigen,
dass sozialkognitive Defizite bereits in frühen Stadien der MS sichtbar sind. Über den Erkrankungsverlauf zeigen neuropsychologische und
bildgebende Studien eine Zunahme der Krankheitsschwere und der Einschränkung der sozialen und nicht sozialen Kognition. Dies folgt der
Hypothese eines Diskonnektionssyndroms bei zunehmender Zerstörung grauer und weißer Substanz. Diese strukturellen Läsionen übersteigen eine
Schwelle an kompensatorischen und neuroplastischen Mechanismen und führen letztlich zum Auftreten der kognitiven Defizite. Angesichts der
Belastung durch die Erkrankung ist eine weitere Untersuchung sozial-kognitiver Defizite bei MS dringend erforderlich, um Patienten
spezifische therapeutische Ansätze zu bieten und die Lebensqualität zu verbessern.
Evaluation einer stationären nicht operativen Behandlung von akuten, subakuten und chronischen Rückenschmerzen
Authors: Haase Ingo , Haase Kilian , Kladny Bernd 
Published: November 2017

Zusammenfassung
Hintergrund Rückenschmerzen zählen in Deutschland zu den Volkskrankheiten. Spezielle Verfahren zur Behandlung stehen zur Verfügung. Im Rahmen einer evaluativen Studie sollte die Wirksamkeit eines akutstationären konservativen Behandlungsangebots hinsichtlich Schmerzstärke, Beeinträchtigung, körperlicher Funktionsfähigkeit und Lebensqualität untersucht werden.
Patienten und Methoden Es wurden im Rahmen einer prospektiven beobachtenden Studie alle im Verlauf von 2 Jahren wegen Rückenschmerzen akutstationär aufgenommenen Patienten bei Aufnahme, bei Entlassung sowie 3, 6 und 12 Monate nach Entlassung schriftlich befragt. Der Fragebogen beinhaltete etablierte Messinstrumente wie Numerische Rating-Skalen (NRS) zur Messung von Schmerzintensität und Beeinträchtigung, den Funktionsfragebogen Hannover (FFbH – R) und den EQ-5D (Lebensqualität). Im Zentrum der Auswertung stand die Verlaufsbeobachtung hinsichtlich der genannten Zielparameter.
Ergebnisse 1010 Patienten bilden die Basis der Untersuchung. Es zeigten sich kurz-, mittel- und langfristig positive Verläufe hinsichtlich Schmerzintensität, Beeinträchtigung und Lebensqualität (r = 0,51 – 0,85) und überwiegend mittlere Effekte bei der körperlichen Funktionsfähigkeit (r = 0,45 – 0,62). Die Zahl derjenigen, die Arbeitsunfähigkeit wegen Rückenbeschwerden angegeben haben, sank entsprechend von 19% nach 3 Monaten auf 6% nach 6 Monaten und 4% nach 1 Jahr. Innerhalb der ersten 3 Monate nach Entlassung mussten sich 7% wegen der Wirbelsäulenerkrankung einer Operation unterziehen (leicht ansteigend auf 10% nach 6 Monaten und 12% nach 1 Jahr).
Schlussfolgerung Die bei allen Zielgrößen beobachteten Verläufe sprechen dafür, dass die konservative Behandlung von Rückenschmerzen effektiv ist. Letztlich geht es aber nicht um die Alternative „entweder Operation oder konservative Behandlung“, sondern vielmehr um ein „Sowohl-als-auch“ in einem sinnvollen Algorithmus.
Gesünder nach der Psychotherapie? Sekundärdatenanalyse der Arbeitsunfähigkeitszeiten vor und nach ambulanter Verhaltenstherapie, tiefenpsychologisch fundierter und analytischer Psychotherapie
Authors: Epping Jelena , de Zwaan Martina , Geyer Siegfried 
Published: November 2017

Zusammenfassung
Einleitung Arbeitsunfähigkeitszeiten gelten als guter Indikator für den Krankenstand der berufstätigen Bevölkerung. In dieser Studie wurde untersucht, wie sich die Arbeitsunfähigkeitszeiten (AU) im Jahr nach dem Ende der Psychotherapie im Vergleich zum Einjahreszeitraum vor Beginn der Therapie verändern. Dabei wurden 3 sozialrechtlich anerkannte Therapieverfahren (Verhaltenstherapie, tiefenpsychologisch fundierte und analytische Psychotherapie) miteinander verglichen.
Material und Methoden Die Untersuchung wurde mit pseudonymisierten Daten der AOK Niedersachsen (N=2 900 065 Versicherte) durchgeführt. Ärztlich attestierte AU-Zeiten vor und nach der Psychotherapie wurden für Patientinnen und Patienten (N=9 916) verglichen, die eine der 3 sozialrechtlich anerkannten Therapieverfahren durchliefen. Außerdem wurde eine parallelisierte Kontrollgruppe (KG) gebildet, um Vergleiche mit Personen ohne Psychotherapie zu ermöglichen. Die Untersuchungen wurden nach Geschlecht stratifiziert.
Ergebnisse Psychotherapiepatienten weisen im Jahr vor Beginn der Therapie mehr AU-Tage auf als die parallelisierte KG. Im Vorher-Nachher-Vergleich hat sich die Zahl der AU-Tage bei Psychotherapiepatienten von 20 auf 12 verringert. Bei Patienten, die eine Verhaltenstherapie oder eine tiefenpsychologisch fundierte Psychotherapie durchliefen, hat sich die Anzahl fast halbiert. Dieses Ergebnis ließ sich nicht auf die analytische Psychotherapie übertragen.
Diskussion Neben dem zentralen Ergebnis der Reduktion der AU-Tage für den Großteil der Psychotherapiepatienten deckte die Analyse der AU-Zeiten vor und nach durchlaufener Psychotherapie eine Besonderheit der Patienten der analytischen Psychotherapie auf. Diese zeigten bereits vor Beginn der Therapie deutlich weniger AU Tage und nach der Therapie keine wesentliche Veränderung im Gegensatz zu anderen Psychotherapiepatienten. Sie waren zudem etwas jünger und hatten einen höheren Berufsbildungsabschluss. Fragen zur (Selbst-)Selektion von Patienten mit besserem Gesundheitszustand zu analytischer Psychotherapie werden diskutiert.
Schlussfolgerung Patienten der analytischen Psychotherapie unterscheiden sich hinsichtlich der mittleren Dauer der Arbeitsunfähigkeit wie auch hinsichtlich ihrer soziodemografischen Zusammensetzung von Patienten der beiden anderen Therapieverfahren. In der Psychotherapieforschung muss aufgrund unterschiedlicher Patientenprofile immer nach Psychotherapierichtung unterschieden werden.