bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurologischer Schaden nach Wirbelsäulen-OP
Authors: Hachenberg Thomas , Kols Kerstin 
Published: January 2018

ZusammenfassungSchlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle“ stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
New Phenylethanoid Glycosides from Cistanche phelypaea and Their Activity as Inhibitors of Monoacylglycerol Lipase (MAGL)
Authors: Beladjila Khadidja , Berrehal Djemaa , De Tommasi Nunziatina , Granchi Carlotta , Bononi Giulia , Braca Alessandra , De Leo Marinella 
Published: January 2018

AbstractFour new phenylethanoid glycosides (1–4), 1-β-p-hydroxyphenyl-ethyl-2-O-acetyl-3,6-di-α-l-rhamnopyranosyl-β-d-glucopyranoside (1), 1-β-p-hydroxyphenyl-ethyl-3,6-O-di-α-l-rhamnopyranosyl-β-d-glucopyranoside (2), 1-β-p-hydroxyphenyl-ethyl-2-O-acetyl-3,6-di-α-l-rhamnopyranosyl-4-p-coumaroyl-β-d-glucopyranoside (3), and 1-β-p-hydroxyphenyl-ethyl-3,6-di-α-l-rhamnopyranosyl-4-p-coumaroyl-β-d-glucopyranoside (4), together with three known compounds, were isolated from the n-butanol extract of Cistanche phelypaea aerial parts. The structural characterization of all compounds was performed by spectroscopic analyses, including 1D and 2D NMR, and HRESIMS experiments. The isolated compounds were assayed for their inhibitory activity on two enzymes involved in the peculiar glycolytic or lipidic metabolism of cancer cells, human lactate dehydrogenase (LDH), and monoacylglycerol lipase (MAGL), respectively. All the compounds showed negligible activity on LDH, whereas some of them displayed a certain inhibition activity on MAGL. In particular, compound 1 was the most active on MAGL, showing an IC50 value of 88.0 µM, and modeling studies rationalized the supposed binding mode of 1 in the MAGL active site.
Morality, loyalty and eloquence
Authors: Livnat Zohar , Kohn Ayelet 
Published: January 2018

Abstract
The new dialogic, conversational nature of television broadcast news (Hamo, 2009) poses a challenge to traditional commentators, who are forced to move from an authoritative monologue to a confrontational dialogue that requires additional flexibility and conversational skills. The paper focuses on an Israeli case study which presents a confrontational dialogue in which one of the discussants is an experienced military correspondent and commentator. We demonstrate the various resources he uses in order to cope with a complex discursive challenge by using multimodal tools, both verbal and visual (Kress 2010; Kress and Van Leeuwen 2001; Jewitt and Oyama 2001).
Besides interrupting his interlocutor’s eloquent discourse in any possible way, demonstrating his well-known direct and involved television persona, the military correspondent employs institutional discursive resources such as using authoritative voice and taking the role of the mediator. Concession structures (Anscombre 1985) reflect his inner moral conflict toward the issue (Livnat 2012).
Anisotropic emission of neutrino and gravitational-wave signals from rapidly rotating core-collapse supernovae
Authors: Takiwaki Tomoya , Kotake Kei 
Published: January 2018

Abstract
We present analysis on neutrino and GW signals based on three-dimensional (3D) core-collapse supernova simulations of a rapidly rotating 27 M⊙ star. We find a new neutrino signature that is produced by a lighthouse effect where the spinning of strong neutrino emission regions around the rotational axis leads to quasi-periodic modulation in the neutrino signal. Depending on the observer's viewing angle, the time modulation will be clearly detectable in IceCube and the future Hyper-Kamiokande. The GW emission is also anisotropic where the GW signal is emitted, as previously identified, most strongly towards the equator at rotating core-collapse and bounce, and the non-axisymmetric instabilities in the postbounce phase lead to stronger GW emission towards the spin axis. We show that these GW signals can be a target of LIGO-class detectors for a Galactic event. The origin of the postbounce GW emission naturally explains why the peak GW frequency is about twice of the neutrino modulation frequency. We point out that the simultaneous detection of the rotation-induced neutrino and GW signatures could provide a smoking-gun signature of a rapidly rotating proto-neutron star at the birth.
Pedicle screw placement assisted by 3D imaging (O-arm system with StealthStation® software) versus free-hand technique for multilevel posterior thoracolumbar fusion
Authors: Noshchenko Andriy , Cain Christopher M.J. , Zaghloul Khaled , Lindley Emily M. , Kleck Christopher , Burger Evalina L. , Patel Vikas V. 
Published: January 2018

Background:
Comparison of pedicle screw placement accuracy and risk of perioperative complications using O-arm/Stealth Navigation system (Medtronic, Memphis, TN) compared with the free-hand technique for multilevel posterior instrumented thoracolumbar fusion is an actual problem.

Methods:
A retrospective, single-institution case series study was performed. Patients who underwent multilevel instrumented thoracolumbar fusion between 2011 and 2012 were included; age: >20 yr; gender: male and female. Patients with pedicle screw placement assisted by the O-arm navigation were assigned to the navigated group, while patients operated using a free-hand technique to the nonnavigated group. Breaches were defined by CT images and classified by screw extension beyond the cortex: mild (<2 mm), moderate (2-4 mm), and severe (>4 mm). Risk was defined by odds ratio (OR), and P-value by the χ2-test. Bayesian analysis was applied to take into consideration previous findings.

Results:
Placement of 597 pedicle screws (401 navigated and 196 nonnavigated) was defined in 70 patients: 41 (12 male) navigated and 29 (10 male) nonnavigated. The mean age was 62 yr (SD, 9.3). Risk of breaches was less in the navigated group, OR=0.36, P=0.002; in particular, the risk of mild breaches, OR=0.33 (P=0.003), and the risk of moderate and severe breaches, OR=0.48 (P=0.25); more significantly at thoracic levels, OR=0.04 (P=0.005); and specifically, medial and lateral breaches (P<0.03). The total risk of perioperative complications was less in the navigated group, OR=0.68 (P=0.3). The obtained results well complement previously published data.

Conclusions:
Pedicle screw placement using the O-arm is more accurate than a standard free-hand technique, specifically at the thoracic spine.
Biplanar Posterior Pelvic Fixator for Unstable Sacral Fractures: A New Fixation Technique
Authors: Abo-Elsoud Mohamed , Eldeeb Said , Gobba Mohamed , Sadek Fouad Zamel 
Published: January 2018

Summary:
Fixation of comminuted vertically unstable sacral fractures continues to be a surgical dilemma. Although triangular osteosynthesis is a good construct and resists vertical translation, complications still occur. Herein, we introduce a new biplanar fixation technique, using segmental spinal instrumentation as an alternative to triangular osteosynthesis. This technique is remarkably valuable in cases with sacral morphology and/or complex fracture patterns that preclude safe percutaneous iliosacral screw insertion.
Historical Analysis of Bibliometric Trends in the Journal of Pediatric Orthopaedics With a Particular Focus on Sex
Authors: Fischer James P. , Wininger Austin E. , Scofield David C. , Tucker Aamir , Kacena-Merrell Ethan J. , Whipple Elizabeth C. , Kacena Melissa A. , Loder Randall T. 
Published: January 2018

Background:
Orthopaedics is the clinical discipline with the lowest percentage of female residents and faculty. Pediatric orthopaedics has a higher percentage of women than other orthopaedic subspecialties. It was the purpose of this study to examine bibliometric trends in the Journal of Pediatric Orthopaedics (JPO) with a specific focus on sex.

Methods:
A bibliometeric analysis for the years 2015, 2005, 1995, 1985, 1981 was performed. The names of first and corresponding authors; corresponding author position; country of origin; number of institutions, countries, authors, printed pages, and references was tabulated. Author sex was identified for the first and corresponding authors using the “Baby Name Guesser” (www.gpeters.com/names/baby-names.php). A P<0.05 was considered significant.

Results:
There were 746 publications; 68.7% were from North America. The average number of authors, corresponding author position, collaborating institutions, countries, and number of references increased, whereas the number of printed pages decreased. Asia had the greatest number of authors (4.4), with Australia/New Zealand the fewest (3.4). Sex was determined for 98.3% of the first authors and 98.5% of the corresponding authors. There was a significant increase in the number of female first authors over time (5.9% to 25.6%, P<10−6), especially in Europe and North America. There were significant increase in the number of female corresponding authors over time (5.8% to 17.6%, P=0.000009). There was a significant trend to have a greater percentage of both female first and corresponding authors over time (P=0.0005) with a reverse trend for both male first and corresponding authors (P<10−6).

Conclusions:
In this study, we noted that the number of female first and corresponding authors in Journal of Pediatric Orthopaedics has been steadily increasing. This should result in more female pediatric orthopaedic surgeons in academic faculty positions.
Obesity’s Influence on Operative Management of Pediatric Supracondylar Humerus Fractures
Authors: Li Neill Y. , Bruce William J. , Joyce Cara , Decker Norman M. , Cappello Teresa 
Published: January 2018

Background:
As childhood obesity remains an ongoing issue for the United States there has been an increasing number of studies detailing its effect on fracture complexity, management, and outcomes. This study utilizes a national database to examine whether obese children with supracondylar humerus fractures are more likely to require open reduction and internal fixation than nonobese children.

Methods:
The Healthcare Cost and Utilization Project Kid’s Inpatient Database of 2003, 2006, 2009, 2012 were queried for pediatric supracondylar humerus fractures [International Classification of Disease (ICD-9), 812.41] between 2 and 12 years. Patients were separated into those undergoing closed reduction percutaneous pinning (CRPP), open reduction internal fixation (ORIF), or both. Obesity was determined by comorbidity and ICD-9 coding (ICD-9, 278.00, 278.01). Univariable and multivariable logistic regression models were utilized with P<0.05 considered significant.

Results:
Between 2003 and 2012, 31,905 patients between the ages of 2 and 12 years sustained supracondylar humerus fractures. In total, 105 patients (0.3%) were obese. A majority of patients, 27,658 (86.7%), underwent CRPP. Odds for ORIF increased in association with age, obesity, white race, and private insurance. Significant association was found between age and obesity (P<0.05) in those undergoing ORIF. Obese children between 2 and 7 years of age had no difference in ORIF or CRPP compared with normal-weight children. Those between 8 and 12 years who were obese were significantly more likely to undergo ORIF (OR, 4.29; 95% confidence interval, 1.78-10.36).

Conclusions:
Supracondylar humerus fractures sustained in obese children between 8 and 12 years are over 4 times more likely to require ORIF compared with normal-weight children of the same age. Providers should identify and counsel older obese children and their families regarding the potential for increased difficulty in fracture management that may require open surgical intervention.

Level of Evidence:
Level IV—case series.
Nonprimary Maternal Cytomegalovirus Infection After Viral Shedding in Infants
Authors: Boucoiran Isabelle , Mayer Bryan T. , Krantz Elizabeth M. , Marchant Arnaud , Pati Sunil , Boppana Suresh , Wald Anna , Corey Larry , Casper Corey , Schiffer Joshua T. , Gantt Soren 
Published: January 2018

Background:
Most infants with congenital Cytomegalovirus (CMV) infection are born to seropositive women as a result of maternal CMV nonprimary infection (reinfection or reactivation). Although infected children are known to transmit CMV to their seronegative mothers, the frequency and magnitude of nonprimary maternal CMV infection after exposure to viral shedding by children in their household have not been characterized.

Methods:
A cohort of Ugandan newborns and their mothers were tested weekly for CMV by quantitative polymerase chain reaction of oral swabs. Infant primary infection and maternal nonprimary infection were defined by the onset of persistent high-level oral CMV shedding. Strain-specific antibody testing was used to assess maternal reinfection. Cox regression models with time-dependent covariates were used to evaluate risk factors for nonprimary maternal infection.

Results:
Nonprimary CMV infection occurred in 15 of 30 mothers, all after primary infection of their infants by a median of 6 weeks (range: 1–10) in contrast to none of the mothers of uninfected infants. The median duration of maternal oral shedding lasted 18 weeks (range: 4–42) reaching a median maximum viral load of 4.69 log copies/mL (range: 3.22–5.64). Previous-week infant CMV oral quantities strongly predicted maternal nonprimary infection (hazard ratio: 2.32 per log10 DNA copies/swab increase; 95% confidence interval: 1.63–3.31). Maternal nonprimary infections were not associated with changes in strain-specific antibody responses.

Conclusions:
Nonprimary CMV infection was common in mothers after primary infection in their infants, consistent with infant-to-mother transmission. Because infants frequently acquire CMV from their mothers, for example, through breast milk, this suggests the possibility of “ping-pong” infections. Additional research is needed to characterize the antigenic and genotypic strains transmitted among children and their mothers.
Significance of Early Postoperative Eyelid Position on Late Postoperative Result in Mueller’s Muscle Conjunctival Resection and External Levator Advancement Surgery
Authors: Danesh Jennifer , Ugradar Shoaib , Goldberg Robert , Joshi Naresh , Rootman Daniel B. 
Published: January 2018

Purpose:
The purpose of this study was to determine whether advancement of the levator aponeurosis in external levator resection surgery or Mueller’s muscle and conjunctiva in Mueller’s muscle conjunctival resection (MMCR) surgery has a differential effect on variation in eyelid position during the postoperative period.

Methods:
In this retrospective observational cohort study, 2 groups of patients were defined. The first underwent MMCR surgery without tarsectomy by surgeon 1. The second underwent external levator resection without dissection posterior to the levator aponeurosis by surgeon 2. Marginal reflex distance (MRD1) was calculated based on digital photographs at baseline, 1 week postoperatively and at 3-month follow up. The primary outcome measure was change in MRD1 over time. The secondary outcome was defined as the proportion of patients with minimal early postoperative change (change of MRD1 less than 0.5 mm at 1 week postoperatively). Repeated measures analysis of variance, t test, and chi-square analyses were performed.

Results:
Of the 114 eyes in the sample, there were 68 in the MMCR group and 46 in the external levator resection group. A significant interaction between group and time was noted (p < 0.05), indicating change in MRD1 over time was different between the groups. Bonferroni corrected multiple comparisons yielded significant differences between each time point for MMCR surgery (p < 0.01). No difference in MRD1 was noted for the external levator resection group from the early to late postoperative visit. Comparing each time point across groups revealed significantly lower MRD1 for the MMCR group at the early postoperative visit (p < 0.01). Preoperative and late postoperative MRD1 did not significantly differ between the groups. Regarding the secondary outcome, patients undergoing MMCR surgery were 3.7× as likely to demonstrate <0.5 mm of change in MRD1 at week 1 (p < 0.05). When considering the 39.7% (n = 27) MMCR patients in this category, 59.3% (n = 16) went on to show an MRD1 increase >1 mm from the early postoperative to the late postoperative time points.

Conclusions:
Both external levator resection and MMCR can effectively elevate the eyelid in cases of primary involutional ptosis, and have similar late postoperative results. The authors found that MMCR cases undergo greater change between the early and late postoperative period, suggesting the process of eyelid elevation after MMCR may be dynamic, involving postoperative physiologic modification.
Meeting Management Standards and Improvement in Clinical Outcomes Among Patients With Hip Fractures
Authors: Trinh Lieu Thi Thuy , Achat Helen , Loh Sze Ming , Pascoe Robert , Asarreh Hassan , Stubbs Joanne 
Published: January 2018

ABSTRACT

Objectives:
To determine the association between management standards and clinical outcomes among patients with hip fracture (HF).

Methods:
Data from a prospective cohort study were linked with hospital administration data.

Results:
In 2014 and 2015, 493 patients had surgery for HF. The proportion of patients meeting care standards ranged from 69% for surgery within 48 hours to 96% for being seen by a geriatrician. Thirty-nine per cent of patients received all the standards. The mean waiting time for surgery was 44 hours (median, 34 hours; interquartile range [IQR], 22–58 hours). The mean length of stay for patients who were alive at discharge was 17 days (median, 13 days; IQR, 6–24 days). Fifty-six patients were readmitted within 28 days of discharge (12%), and 40 patients died within 28 days of admission (8.1%). Patients who received all standards were less likely to be readmitted or die. Surgery within 48 hours and being seen by a physiotherapist were associated with a lower mortality rate.

Conclusions:
The management standards, collectively and in particular, assessment by a physiotherapist and surgery within 48 hours were significantly associated with better clinical outcomes.
Overall Emergency Department Rating: Identifying the Factors That Matter Most to Patient Experience
Authors: Aaronson Emily L. , Mort Elizabeth , Sonis Jonathan D. , Chang Yuchiao , White Benjamin A. 
Published: January 2018

ABSTRACT

Background:
Patient experience is becoming an area of interest in Emergency Medicine as more is understood about its impact on outcomes and the expectation that it will soon be tied to reimbursement. No study has investigated the predictors of emergency department (ED) patient satisfaction in over a decade. As the care environment, access to information, and consumer interests change, determinants of satisfaction have likely evolved. Our objective was to examine the factors that were most predictive of ED satisfaction.

Methods:
A retrospective cohort study at an urban, university-affiliated ED. The relationship between overall satisfaction and patients' responses to individual questions was assessed using a chi-square test and a multivariable logistic regression model.

Results:
During the study period, 7,872 patients participated in a telephone interview. Logistic regression found 13 questions predictive of high overall ED rating and 9 questions predictive of low overall ED rating. Six questions appeared in both analyses, related to timeliness, cleanliness, the physician's ability to listen carefully, teamwork, and the perception of being helped by the care.

Conclusions:
There are strong predictors of overall ED satisfaction related to communication, wait time, environment, and perception that care was helpful. Further efforts should focus on identifying interventions in each of these domains.
Effect of Telenursing on Outcomes of Provided Care by Caregivers of Patients With Head Trauma After Discharge
Authors: Shahrokhi Akram , Azimian Jalil , Amouzegar Atousa , Oveisi Sonia 
Published: January 2018

Telenursing is a suitable tool for increasing health-related awareness of the caregivers for a better home care. But its efficacy may be affected by several factors. Considering the important complications of head trauma injury and high rate of readmission, we aimed to assess the effect of telenursing on care provided by the family members of patients with head trauma.
This randomized controlled trial investigated 72 patients with head trauma, who were randomly allocated to intervention and control groups (36 patients in each group). The caregivers in both groups were provided with 1-hr face-to-face training session on patients' home care and educational booklets. The patients in the intervention group were followed up every week through phone calls by the telenurse for 12 weeks, who recorded the patient's status, as well. Caregivers in the intervention group could call the telenurse any time they desired. The health status of the control group was followed once by a phone call after 12 weeks. Data on patients' readmission and pressure ulcer (based on Norton's scale) rate and time were compared between the groups and analyzed using SPSS software, version 19. Thirty-three patients with a mean ± SD age of 31.12 ± 10.83 years were studied in the control group and 35 patients with a mean ± SD age of 34.11 ± 12.34 years in the intervention group (p = .098). None of the patients in the intervention group were readmitted, whereas 2 patients in the control group were readmitted s(p = .139). Risk of pressure ulcer did not differ between the groups (p = .583). Telenursing had no significant effect in readmission and decubitus prevention for patients with head trauma. Considering the chronic nature of the illness, a longer follow-up period is deemed necessary for an accurate conclusion.
Trauma and Intensive Care Nursing Knowledge and Attitude of Foley Catheter Insertion and Maintenance
Authors: Shaver Brenda , Eyerly-Webb Stephanie A. , Gibney Zoe , Silverman Linda , Pineda Candace , Solomon Rachele J. 
Published: January 2018

In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education.
A prospective cohort study was conducted with registered nurses from the emergency room, trauma/surgical, and medical intensive care units. Participant's clinical knowledge and attitude toward Foley catheter usage and CAUTIs were evaluated using a 20-question survey tool before and after a CAUTI education program.
Forty-eight nurses completed the presurvey, educational training, and postsurvey. The mean postsurvey score was significantly higher (86.9 ± 8.3%) than the presurvey score (76.0 ± 12.3%) for the knowledge section of the survey. There was no marked difference in participant attitude following the educational training, with mean presurvey and postsurvey scores of 91.3 ± 7.0% and 89.8 ± 5.3%, respectively. After the course, participants were more confident in their clinical knowledge; however, perception regarding CAUTI prevention did not improve. A series of unannounced rounding observations before and after the intervention showed an improvement in proper Foley catheter maintenance.
Catheter-associated urinary tract infection prevention education was an effective countermeasure to address gaps in clinical knowledge, but modifying attitudes was difficult to achieve. In the short term, the training appeared to improve proper maintenance in clinical practice.