bluuebunny/crossref_metadata_2025_split huggingface dataset:
ICF und der Begriff „wesentliche Behinderung“ im Bundesteilhabegesetz (BTHG)
Authors: Wagener Wolfgang 
Published: December 2017

ZusammenfassungBisher ist nur klar, dass noch vieles unklar ist. Das Ende letzten Jahres noch schnell verabschiedete Bundesteilhabegesetz sollte den Perspektivwechsel vom Fürsorge-System zum Teilhabe-Recht unterstreichen. Darum soll die Eingliederungshilfe von existenzsichernden Leistungen der Sozialhilfe getrennt werden. Manches in diesem Gesetz ist hilfreich, vielleicht sogar wegweisend. Aber es bleibt viel Interpretationsspielraum. Aus (amts-)ärztlicher Sicht besonders kritisch ist die Bestimmung „wesentlicher Behinderung“. Im Gesetzentwurf wurden die in der ICF definierten neun Lebensbereiche unzulässig instrumentalisiert. Eine „fünf aus neun“-Festsetzung ist gescheitert. Bis Ende 2019 ist eine Definition zu finden. Dabei muss klar sein, dass jeder Arzt nach bestem Wissen und Gewissen auf der Gesetzesgrundlage eine gutachterliche Bewertung vornimmt, aber keine mathematische Gleichung löst. Dies entspräche weder der Menschenwürde, noch wäre damit jemandem geholfen. Es bleibt aufmerksam zu beobachten, was sich bis 2023 in der Umsetzung des BTHG tut, um Fehlentwicklungen, die primär finanzielle Interessen vertritt, ggf. frühzeitig entgegen treten zu können. Hier sind alle (Amts-)Ärzte nicht nur sozialmedizinisch, sondern sehr wohl auch sozialpolitisch gefordert.
Dekolonisation bei Nachweis von Methicillin-sensiblen Staphylococcus aureus bei Mitarbeitern einer neonatologischen Intensivstation
Authors: Richter Annika , Eder Ines , König Brigitte , Lutze Bettina , Rodloff Arne , Thome Ulrich , Weiss Melanie , Chaberny Iris 
Published: December 2017

Zusammenfassung
Hintergrund Auf einer neonatologischen Intensivstation am Universitätsklinikum Leipzig wurden im Jahr 2016 vermehrt Kolonisationen mit Methicillin-sensiblen Staphylococcus aureus Stämmen festgestellt. Typisierungsergebnisse zeigten einen prädominierenden spa-Typ t091. Aufgrund der nosokomialen Häufungen wurden verschiedene Maßnahmen zur Infektionsprävention etabliert, z. B. intensive Barrieremaßnahmen, Einzelzimmer, Kohortierung, Umgebungsuntersuchungen auf S. aureus, Schulungen. Ein Teil dieses Maßnahmenbündels war die Durchführung eines Mitarbeiterscreenings, um kolonisierte Mitarbeiter als mögliches Reservoir zu sanieren.
Methodik Mitarbeiter mit S. aureus-Nachweis führten in der eigenen Häuslichkeit eine 5-tägige Sanierung durch. Hierfür wurden Produkte mit dem Wirkstoff Octenidin verwendet. Kontrollabstriche erfolgten frühestens 48 Stunden nach Beendigung des Sanierungsintervalls (3 im Abstand von mind. 24 Stunden). Mitarbeiter mit 2 erfolglosen Sanierungsversuchen erhielten anstelle von Octenidin-, Mupirocin-haltige Nasensalbe.
Ergebnisse Bei 128 untersuchten Mitarbeitern wurde in 43 Fällen (33,6%) S. aureus nachgewiesen, der in 9 Fällen (20,9%; 9/43) dem Typ t091 entsprach. Unter den S. aureus-positiven Mitarbeitern waren 2 MRSA-Nachweise (4,7%; 2/43) als Zufallsbefund zu verzeichnen. Die Erfolgsquote nach dem ersten Sanierungsversuch von t091 und MRSA lag bei 0%. In 3 Fällen lagen nach dem zweiten Versuch 3 negative Kontrollabstriche vor und 8 Mitarbeiter konnten erst unter Einsatz von Mupirocin-haltiger Nasensalbe saniert werden.
Schlussfolgerungen Ursachen für die erschwerte Sanierung können vielfältig sein: Schwer umzusetzende Sanierung im eigenen Haushalt, Vorhandensein von dekolonisierungshemmenden Faktoren, nicht konsequente Durchführung aller Sanierungsmaßnahmen und eine mögliche Rekolonisation während der Arbeitszeit oder durch Familienangehörige. Weiterhin ist zu diskutieren, ob der Erfolg der Sanierung bei Verwendung von Mupirocin-Nasensalbe in der besseren Wirksamkeit von Mupirocin im Vergleich zu Octenidin begründet ist oder ob die unterschiedliche Konsistenz der Präparate ausschlaggebend ist.
Affinity purification mass spectrometry analysis of PD-1 uncovers SAP as a new checkpoint inhibitor
Authors: Peled Michael , Tocheva Anna S. , Sandigursky Sabina , Nayak Shruti , Philips Elliot A. , Nichols Kim E. , Strazza Marianne , Azoulay-Alfaguter Inbar , Askenazi Manor , Neel Benjamin G. , Pelzek Adam J. , Ueberheide Beatrix , Mor Adam 
Published: December 2017

SignificanceAntibodies targeting PD-1 have elicited clinical responses in multiple tumors. Nevertheless, response to anti–PD-1 interventions is limited to a fraction of patients, and a comprehensive understanding of the signaling downstream of PD-1 could provide biomarkers for tumor response. We used affinity purification-mass spectrometry to uncover proteins associated with PD-1 and found that the adaptor protein SAP inhibits PD-1 functions by blocking the enzymatic interaction between the phosphatase SHP2 and the subset of its substrates that also bind to SAP. Signaling downstream of PD-1 in T cell subsets did not correlate with PD-1 expression but was inversely correlated with SAP levels. Thus, SAP is a modulator of PD-1 function and a potential biomarker for reduced responses to PD-1–based interventions.
Distinctive roles of age, sex, and genetics in shaping transcriptional variation of human immune responses to microbial challenges
Authors: Piasecka Barbara , Duffy Darragh , Urrutia Alejandra , Quach Hélène , Patin Etienne , Posseme Céline , Bergstedt Jacob , Charbit Bruno , Rouilly Vincent , MacPherson Cameron R. , Hasan Milena , Albaud Benoit , Gentien David , Fellay Jacques , Albert Matthew L. , Quintana-Murci Lluis ,   the Milieu Intérieur Consortium, Abel Laurent , Alcover Andres , Aschard Hugues , Aström Kalle , Bousso Philippe , Bruhns Pierre , Cumano Ana , Duffy Darragh , Demangel Caroline , Deriano Ludovic , Di Santo James , Dromer Françoise , Eberl Gérard , Enninga Jost , Fellay Jacques , Fontes Magnus , Freitas Antonio , Gelpi Odile , Gomperts-Boneca Ivo , Hercberg Serge , Lantz Olivier , Leclerc Claude , Mouquet Hugo , Patin Etienne , Pellegrini Sandra , Pol Stanislas , Raussel Antonio , Rogge Lars , Sakuntabhai Anavaj , Schwartz Olivier , Schwikowski Benno , Shorte Spencer , Soumelis Vassili , Tangy Frédéric , Tartour Eric , Toubert Antoine , Ungeheuer Marie-Noëlle , Quintana-Murci Lluis , Albert Matthew L. 
Published: December 2017

Significance
Identifying the drivers of the interindividual diversity of the human immune system is crucial to understand their consequences on immune-mediated diseases. By examining the transcriptional responses of 1,000 individuals to various microbial challenges, we show that age and sex influence the expression of many immune-related genes, but their effects are overall moderate, whereas genetic factors affect a smaller gene set but with a stronger effect. We identify numerous genetic variants that affect transcriptional variation on infection, many of which are associated with autoimmune or inflammatory disorders. These results enable additional exploration of the role of regulatory variants in the pathogenesis of immune-related diseases and improve our understanding of the respective effects of age, sex, and genetics on immune response variation.
Iron balance and iron supplementation for the female athlete: A practical approach
Authors: Pedlar Charles R , Brugnara Carlo , Bruinvels Georgie , Burden Richard 
Published: December 2017

ABSTRACTMaintaining a positive iron balance is essential for female athletes to avoid the effects of iron deficiency and anaemia and to maintain or improve performance. A major function of iron is in the production of the oxygen and carbon dioxide carrying molecule, haemoglobin, via erythropoiesis. Iron balance is under the control of a number of factors including the peptide hormone hepcidin, dietary iron intake and absorption, environmental stressors (e.g. altitude), exercise, menstrual blood loss and genetics. Menstruating females, particularly those with heavy menstrual bleeding are at an elevated risk of iron deficiency. Haemoglobin concentration [Hb] and serum ferritin (sFer) are traditionally used to identify iron deficiency, however, in isolation these may have limited value in athletes due to: (1) the effects of fluctuations in plasma volume in response to training or the environment on [Hb], (2) the influence of inflammation on sFer and (3) the absence of sport, gender and individually specific normative data. A more detailed and longitudinal examination of haematology, menstrual cycle pattern, biochemistry, exercise physiology, environmental factors and training load can offer a superior characterisation of iron status and help to direct appropriate interventions that will avoid iron deficiency or iron overload. Supplementation is often required in iron deficiency; however, nutritional strategies to increase iron intake, rest and descent from altitude can also be effective and will help to prevent future iron deficient episodes. In severe cases or where there is a time‐critical need, such as major championships, iron injections may be appropriate.
Aligning dynamic networks with DynaWAVE
Authors: Vijayan Vipin , Milenković Tijana 
Published: December 2017

Abstract

Motivation
Network alignment (NA) aims to find similar (conserved) regions between networks, such as cellular networks of different species. Until recently, existing methods were limited to aligning static networks. However, real-world systems, including cellular functioning, are dynamic. Hence, in our previous work, we introduced the first ever dynamic NA method, DynaMAGNA++, which improved upon the traditional static NA. However, DynaMAGNA++ does not necessarily scale well to larger networks in terms of alignment quality or runtime.

Results
To address this, we introduce a new dynamic NA approach, DynaWAVE. We show that DynaWAVE complements DynaMAGNA++: while DynaMAGNA++ is more accurate yet slower than DynaWAVE for smaller networks, DynaWAVE is both more accurate and faster than DynaMAGNA++ for larger networks. We provide a friendly user interface and source code for DynaWAVE.

Availability and implementation
https://www.nd.edu/∼cone/DynaWAVE/.

Supplementary information
Supplementary data are available at Bioinformatics online.
Nitrous oxide for labor analgesia
Authors: Hellams Audrey , Sprague Taylor , Saldanha Christina , Archambault Mark 
Published: December 2017

ABSTRACT
Inhaled nitrous oxide (N2O) has been used worldwide for over 100 years as labor analgesia but has not gained widespread use in the United States. Nitrous oxide provides a noninvasive option for laboring women. This article outlines its efficacy and safety as an analgesic compared with epidural and IV pain medications.
Job openings for PAs by specialty
Authors: Morgan Perri , Leach Brandi , Himmerick Kristine , Everett Christine 
Published: December 2017

ABSTRACT

Objective:
Physician assistants (PAs) have adapted to roles in virtually every practice specialty. One factor that has affected PAs' specialty choices has been the availability of jobs. We describe 2014 job postings for PAs at the national level by practice specialty.

Methods:
National data on 2014 job postings for PAs were obtained from a leading labor analytics firm. Each job posting (N = 34,137) was coded with regard to practice specialty and analyzed descriptively.

Results:
The largest proportions of job postings were in the surgical (28%) and medical subspecialty (23%) categories, followed by primary care (19%), other (18%), and emergency/urgent care (12%).

Conclusions:
Job opportunities for PAs are plentiful and are focused in subspecialty practice. Future research should examine trends in job postings for PAs. Trend analyses will be useful for multiple purposes, including informing PAs who are seeking employment and tracking demand for the profession as a whole.
Comparing Lumbar Disc Space Preparation With Fluoroscopy Versus Cone Beam-Computed Tomography and Navigation
Authors: Hurley Richard K. , Anderson Edward R. , Lawson Bryan K. , Hobbs Joseph K. , Aden James K. , Jorgensen Anton Y. 
Published: December 2017

Study Design.
Cadaveric study.

Objective.
This cadaveric study sought to evaluate the efficacy of disc space preparation with cone beam-computed tomography with navigation (CBCT+N) for instrument placement compared with instrument placement with conventional fluoroscopy.

Summary of Background Data.
Disc space preparation from a transforaminal lumbar approach is challenging with respect to visualization, and surgeons currently rely on tactile feel and two-dimensional imaging in the operating room to assess instrument positioning.

Methods.
Two orthopedic spine surgeons performed 40 disc space preparations after eight cadavers were randomly assigned to fluoroscopy versus CBCT+N. Digital images of each vertebral endplate were captured and the percent disc removed by area for the total disc and by quadrants was determined using digital imaging software.

Results.
There were 20 lumbar disc levels prepared in the fluoroscopy group. There were 3 thoracolumbar, and 17 lumbar disc levels prepared in the experimental group. Percent disc removed relative to the total area of the disc, as determined by the digital imaging software, was higher in the CBCT+N group (P ≤ 0.0001). More disc was removed in both the anterior contralateral and posterior contralateral quadrants in the CBCT+N group (P = 0.0006 and P ≤ 0.0001 respectively). The intraclass correlation coefficient among blinded reviewers for percent disc removed was 0.759 (95% confidence interval, 0.587–0.866)]. There was no difference in time to complete disc space preparation, number of instrument passes, or number of endplate violations between the two groups (P = 0.28, P = 0.92, and P = 0.34 respectively).

Conclusion.
The results of this cadaveric investigation reveal that CBCT+N guidance may be used to assess instrument placement for interbody disc space preparation in a similar length of time, with no difference in instrument passes or endplate violations, in comparison with fluoroscopy.

Level of Evidence: 5
Diagnostic Benefits of Axial-Loaded Magnetic Resonance Imaging Over Recumbent Magnetic Resonance Imaging in Obese Lower Back Pain Patients
Authors: Lorenc Tomasz , Palczewski Piotr , Wójcik Damian , Glinkowski Wojciech , Gołębiowski Marek 
Published: December 2017

Study Design.
Single center before-after case series study.

Objective.
To determine when and in which kind of lower back pathologies, axial-loaded magnetic resonance imaging (MRI) provides additional benefit over recumbent MRI.

Summary and Background Data.
Systems simulating physiological axial loading of the spine in patients examined in the supine position have recently been introduced in clinical practice. However, indications for examinations with axial loading have yet to be clearly specified.

Methods.
Ninety patients (46 men, 44 women, aged 20–90 yr) with lower back pain underwent lumbar spine MRI with and without axial loading. MRI was performed in a supine position on a 1.5 T system using a compression device. A high-resolution 3D T2-weighted sequence was used for image acquisition. Clinical characteristics of patients were established using questionnaire surveys and demographic data. MR images were assessed for the appearance of changes after axial loading. After determining which patients showed significant changes, logistic regression analysis was performed with 15 independent variables (clinical, demographic, and imaging-related).

Results.
After axial loading, 48.9% of patients showed additional changes. Multivariate analysis revealed that only obesity was a statistically significant predictor of the occurrence of changes (P < 0.05). After axial loading, 11 potentially clinically relevant changes appeared in seven patients, the most common being absolute spinal stenosis (n = 7).

Conclusion.
Axial loading may increase the diagnostic value of lumbar spine MRI in patients with obesity and/or those with suspected spinal canal stenosis.

Level of Evidence:
4
Preinjury Patient Characteristics and Postinjury Neurological Status Are Associated With Mortality Following Spinal Cord Injury
Authors: Casper David S. , Zmistowski Benjamin , Schroeder Gregory D. , McKenzie James C. , Mangan John , Vatson Jayanth , Hilibrand Alan S. , Vaccaro Alexander R. , Kepler Christopher K. 
Published: December 2017

Study Design.
Retrospective cohort study.

Objectives.
This study investigates the association between spinal cord injuries (SCI) and post-injury mortality.

Summary of Background Data.
SCIs) are severe conditions treated in the acute trauma setting. Owing to neurological deficits, unstable spinal columns, and associated injuries, these patients often have complex inpatient hospitalizations with significant morbidity and mortality. It is assumed that a high rate of postinjury mortality would follow such severe injuries; however, the effect of SCI and its treatment on predictors of longevity remain largely unknown.

Methods.
Patients seen at a regional referral center for SCI were reviewed from a prospectively maintained database. Four hundred and twenty-six patients with SCI and varying degrees of injury between 2004 and 2009 were collected. Injury characteristics, including injury severity score, level of SCI, and type of SCI were retrieved. To determine independent predictors of 5-year mortality, a logistic regression using patient and injury characteristics at the time of presentation was performed.

Results.
Average age was 47.4 years (range: 14–95), and 74.5% (318/426) were male. Half of the cohort sustained low-energy mechanisms of injury (220/426; 52.4%). The 30-day, 90-day, 1-year, 2-year, and 5-year mortality rates in the SCI cohort were 6.6% (28/426), 9.2% (39/426), 12.0% (51/426), 15.0% (64/426), and 17.8%, respectively (76/426). Logistic regression demonstrated that increasing age (B = 1.06, P < 0.001), increasing ICU length-of-stay (B = 1.06; P = 0.002), decreased motor score at presentation (B = 0.98; P = 0.004), and lack of surgical intervention (B = 0.38; P < 0.001) were independent predictors of mortality at 5 years.

Conclusion.
There is substantial mortality associated with SCI. A significant proportion of the mortalities occurred acutely after injury. Mortality was associated with neurological deficit and severity of injury, as well as with preinjury patient characteristics. To combat this high rate of death, efforts are needed to address the concomitant disease processes associated with neurological deficits.

Level of Evidence: 3
Different Genotypes of Adhesion Operon Genes in Staphylococcus epidermidis Isolates From Various Ocular Infections
Authors: Sharifinejad Mehrnoush , Shokatpour Narjes , Farnaghi Farshad , Abedinyfar Zohreh , Amoli Fahimeh Asadi , Doustdar Farahnoosh 
Published: December 2017

Background:

Staphylococcus epidermidis is one of the common causes of bacterial keratitis and post-operation infections. One of the most important virulence factors of S. epidermidis is biofilm formation. Poly-N-acetylglucosamine (PNAG) production is critical for biofilm formation in S. epidermidis. The intercellular adhesion (ica) operon is formed by icaA, icaD, icaB, and icaC genes, which participate in the biosynthesis of PNAG. Strains of S. epidermidis from different infections show different genotypes in relation to adhesion operon genes. Therefore, regarding the fact that the pathogenic strain in each community has unique genotypes, this study investigated the relation between ica operon genotypes and various ocular infections. However, the correlation between the ica operon genes and the mecA gene was analyzed in the isolates.

Methods:
For this study, samples of the conjunctiva, cornea, and intraocular fluid of patients with ocular infection were collected. After culture and incubation, detection of S. epidermidis was performed using biochemical and coagulase tests. The antibiotic susceptibility of the bacteria was evaluated by the disk diffusion method. After this, DNA was extracted from the bacteria and the presence of icaA, icaD, is256, and mecA genes was analyzed using polymerase chain reaction.

Results:
All 50 coagulase-negative Staphylococcus samples isolated from different eye infections were characterized as S. epidermidis. Most of the samples (36%) were isolated from the cornea and the others were, respectively, from the conjunctiva (24%), vitreous (20%), anterior chamber (8%), eyelid (6%), and nasolacrimal duct (6%). The icaA, icaD, and is256 genes were detected with different genotypes in isolates from keratitis and endophthalmities compared with conjunctivitis. Overall, the most isolated genotype from ocular infections was icaA+. icaD+. is256+. (46%). Most of the isolates (82.60%) had mecA, icaA, and icaD genes simultaneously, which indicates a strong relationship between the adhesion genes and the antibiotic resistance gene.

Conclusions:
The adhesion operon genes were observed with different genotypes in S. epidermidis samples isolated from various ocular infections.
The Epidemiology of Healthcare-associated Infections in Pediatric Cardiac Intensive Care Units
Authors: Alten Jeffrey A. , Rahman A. K. M. Fazlur , Zaccagni Hayden J. , Shin Andrew , Cooper David S. , Blinder Joshua J. , Retzloff Lauren , Aban Inmaculada B. , Graham Eric M. , Zampi Jeffrey , Domnina Yuliya , Gaies Michael G. 
Published: December 2017

Background:
Healthcare-associated infections (HAIs) represent serious complications for patients within pediatric cardiac intensive care units (CICU). HAIs are associated with increased morbidity, mortality and resource utilization. There are few studies describing the epidemiology of HAIs across the entire spectrum of patients (surgical and nonsurgical) receiving care in dedicated pediatric CICUs.

Methods:
Retrospective analyses of 22,839 CICU encounters from October 2013 to September 2016 across 22 North American CICUs contributing data to the Pediatric Cardiac Critical Care Consortium clinical registry.

Results:
HAIs occurred in 2.4% of CICU encounters at a rate of 3.3 HAIs/1000 CICU days, with 73% of HAIs occurring in children <1 year. Eighty encounters (14%) had ≥2 HAIs. Aggregate rates for the 4 primary HAIs are as follows: central line–associated blood stream infection, 1.1/1000 line days; catheter-associated urinary tract infections, 1.5/1000 catheter days; ventilator-associated pneumonia, 1.9/1000 ventilator days; surgical site infections, 0.81/100 operations. Surgical and nonsurgical patients had similar HAIs rates/1000 CICU days. Incidence was twice as high in surgical encounters and increased with surgical complexity; postoperative infection occurred in 2.8% of encounters. Prematurity, younger age, presence of congenital anomaly, Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Categories (STAT) 4–5 surgery, admission with an active medical condition, open sternum and extracorporeal membrane oxygenation were independently associated with HAIs. In univariable analysis, HAI was associated with longer hospital length of stay and durations of urinary catheter, central venous catheter and ventilation. Mortality was 24.4% in patients with HAIs versus 3.4% in those without, P < 0.0001.

Conclusions:
We provide comprehensive multicenter benchmark data regarding rates of HAIs within dedicated pediatric CICUs. We confirm that although rare, HAIs of all types are associated with significant resource utilization and mortality.