bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herleitung einer Instruktionsgrammatik
Authors: Kasper Simon 
Published: August 2014

Abstract
In this article a research programme is sketched, together with an outline of the theory of Instruction Grammar embedded within it. In the research programme, verbal action is viewed as a means for organizing and coordinating lifeworld interaction. Verbal interaction is a means to bring about action on the part of the interlocutor in order to realize purposes. Both the well-formedness and the situational appropriateness of utterances have to be determined with respect to the success and efficacy of that purpose. The competence of well-formed and appropriate verbal interaction (the “linking competence”) is the subject matter of the theory of Instruction Grammar. This competence draws on a number of sub-competences, ranging from action, perception, conceptualization and attribution to symbolization. In the research programme, all these sub-competences are constitutive of the linking competence whose exploration requires a multidisciplinary approach based on converging evidence. The basic claims of the theory of Instruction Grammar are then deduced using an example scenario. Utterances are characterized as instructions for an interlocutor to simulate perceptions, reenact attributions, and engage in action by himself.
IBM’s Health Analytics and Clinical Decision Support
Authors: Sun J. , Knoop S. , Shabo A. , Carmeli B. , Sow D. , Syed-Mahmood T. , Rapp W. , Kohn M. S. 
Published: August 2014

Summary
Objectives: This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making.
Methods: Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given.
Results: There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data.
Conclusion: Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation.
Challenges and Potential Solutions for Big Data Implementations in Developing Countries
Authors: Mayan J. C. , García M. J. , Almerares A. A. , Househ M. , Luna D. R. 
Published: August 2014

Summary
Background: The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data.
Objectives: To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector.
Methods: A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: “big data”, “developing countries”, “data mining”, “health information systems”, and “computing methodologies”. A thematic review of selected articles was performed.
Results: There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects.
Conclusions: The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs.
Transforming Health Care Delivery Through Consumer Engagement, Health Data Transparency, and Patient-Generated Health Information
Authors: Wald J. S. , Sands D. Z. 
Published: August 2014

Summary
Objective: Address current topics in consumer health informatics.
Methods: Literature review.
Results: Current health care delivery systems need to be more effective in the management of chronic conditions as the population turns older and experiences escalating chronic illness that threatens to consume more health care resources than countries can afford. Most health care systems are positioned poorly to accommodate this. Meanwhile, the availability of ever more powerful and cheaper information and communication technology, both for professionals and consumers, has raised the capacity to gather and process information, communicate more effectively, and monitor the quality of care processes.
Conclusion: Adapting health care systems to serve current and future needs requires new streams of data to enable better self-management, improve shared decision making, and provide more virtual care. Changes in reimbursement for health care services, increased adoption of relevant technologies, patient engagement, and calls for data transparency raise the importance of patient-generated health information, remote monitoring, non-visit based care, and other innovative care approaches that foster more frequent contact with patients and better management of chronic conditions.
Are Electronic Cardiac Devices Still Evolving?
Authors: Mabo P. , Carrault G. 
Published: August 2014

Summary
Objectives: The goal of this paper is to review some important issues occurring during the past year in Implantable devices.
Methods: First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, ...) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy.
Results: Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia’s in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed.
Conclusion: Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation.
Laparoscopos májresectiók
Authors: Kupcsulik Péter 
Published: August 2014

AbsztraktA májdaganatok kezelésében a sebészi eltávolítás jelenti a gyógyítás legfontosabb módszerét. A diagnosztika és a sebészi módszerek fejlődése javította az eredményeket és a túlélést. Az utóbbi évtizedben a minimálisan invasiv laparoscopos (LAP) módszereket egyre több májsebészeti centrum alkalmazza. A LAP-technika a korábbi kisebb resectióktól a kiterjesztett műtétek irányába fejlődik. Ez a változás viszonylag lassú, amelynek oka a beavatkozás bonyolultsága és a vérzéstől való félelem. Ennek ellenére a nagy resectiók aránya egyre növekszik. Eddig hozzávetőlegesen 6000 LAP-májresectiót végeztek világszerte, a major műtétek száma 700–800 lehet. A LAP-májresectio esetén a kisebb vérvesztés, fájdalomcsillapító-igény, rövidebb kórházi ápolási idő előnyös a beteg számára, a szövődmények és a halálozás a nyitott műtétekével azonos. Mai álláspont szerint alkalmazható benignus és malignus elváltozások kezelésére. Colorectalis májáttétek késői túlélése tekintetében nincs különbség a LAP- és a nyitott módszer között. A hepatocellularis carcinomás esetek túlélése jobb LAP-resectio után, mint nyitott műtéteket követően.
A terhességgel összefüggő emlődaganatok kezelése
Authors: Tajti Jr. János , Pieler József , Simonka Zsolt , Paszt Attila , Lázár György 
Published: August 2014

AbsztraktEsetismertetés:A 25 éves primipara, terhességének 32. hetében, önvizsgálat során a bal emlő külső-felső negyedében csomót észlelt. A komplex emlővizsgálat 4 cm átmérőjű területen meszesedést írt le. A finomtű-biopsia malignus ductalis karakterű sejteket, „C5” kategóriát, a core-biopsia III-as gradusú, invasiv ductalis carcinomát véleményezett („B5b”), távoli disseminatio nem igazolódott. A terhesség terminálását követően az elváltozás széles excisióját végeztük sentinelnyirokcsomó-biopsiával, amelynek pozitivitása miatt axillaris blockdissectio történt. A sebészi kezelést adjuváns onkológiai kezelés követte. A későbbiekben a jobb inguinalis régióban lévő angiomyxoma jelent meg, amelyet in toto excindaltunk.Megbeszélés:A terhességgel összefüggő malignus betegségek incidenciája emelkedik, amelyek közül az emlődaganatok kitüntetett helyen állnak. Terhességasszociált emlődaganatról akkor beszélünk, amennyiben annak diagnózisa a graviditas alatt vagy az azt követő első évben történik. A terhességgel járó élettani változások miatt a betegség felismerése nehezebbé válik, s ennek következtében sokszor ezek a betegek elkésve kerülnek látókörünkbe. A betegség terápiája összetett, mivel az anya kezelése mellett a magzat biztonságára is nagy hangsúlyt kell fektetni – mindez a társszakmák fokozott együttműködését igényli. A kezelési stratégia az egyes trimeszterekben eltérő. Sebészi kezelés a terhesség bármely szakában végezhető. A sugárkezelésről, magzatkárosító hatása miatt, megoszlanak a vélemények. A kemoterápia a terhesség második és harmadik harmadában megengedett. Betegünk közel három évvel a műtétet követően panaszmentes, fiúgyermeke egészséges.
Addressing Glycemic Targets from Diagnosis to Discharge
Authors: Malaskovitz Joyce , Hodge Charlotte 
Published: August 2014

In Brief
On any given day, from 25 to 50% of all hospitalized patients meet criteria for a diagnosis of diabetes, prediabetes, or hyperglycemia. It is essential for all health care providers, including diabetes clinicians, to examine current processes to ensure the delivery of the highest quality care, with a focus on glucose control, improved outcomes, and patient safety from admission through discharge.
Pharmacotherapy for Hyperglycemia in Noncritically Ill Hospitalized Patients
Authors: Mendez Carlos E. , Umpierrez Guillermo E. 
Published: August 2014

In Brief
Hyperglycemia in the hospital setting affects 38–46% of noncritically ill hospitalized patients. Evidence from observational studies indicates that inpatient hyperglycemia, in patients with and without diabetes, is associated with increased risks of complications and mortality. Substantial evidence indicates that correction of hyperglycemia through insulin administration reduces hospital complications and mortality in critically ill patients, as well as in general medicine and surgery patients. This article provides a review of the evidence on the different therapies available for hyperglycemia management in noncritically ill hospitalized patients.
Sustainability of Improved Glycemic Control After Diabetes Self-Management Education
Authors: Nicoll Katie G. , Ramser Kristie L. , Campbell Jennifer D. , Suda Katie J. , Lee Marilyn D. , Wood G. Christopher , Sumter Robert , Hamann Gale L. 
Published: August 2014

Objective. The purpose of this study was to evaluate glycemic control as measured by A1C during a 2-year period after patients received diabetes self-management education (DSME).
Methods. Patients who completed DSME in 2009 and received medical follow-up with A1C measurements for at least 2 years after DSME were included in the evaluation. Primary endpoints were changes in A1C from before to immediately after, 1 year after, and 2 years after DSME. Secondary outcomes included the effects of the following factors on change in A1C: sex, duration of diabetes, uncontrolled diabetes (A1C ≥ 9%), health insurance coverage, and self-reported education level.
Results. Forty-three patients were included in the evaluation. Mean A1C before DSME was 10.2 ± 3.7%. Mean A1C after DSME was 7.8 ± 2.2% (P &lt; 0.0001), a 23.5% reduction. Mean A1C at 1 and 2 years after DSME was 7.8 ± 2.1% for each year and remained unchanged from just after DSME to 1 and 2 years after DSME (P &gt; 0.05). Patients with a duration of diabetes of &lt; 1 year had a significantly greater reduction in mean A1C than those with a duration of diabetes ≥ 1 year (28.7 and 20.2%, respectively, P = 0.001).
Conclusion. DSME improved glycemic control to a substantial degree, and the effect was sustained for up to 2 years. Although the reduction in A1C was significant for all patients receiving DSME, there was a significantly greater reduction for patients who had a duration of diabetes of &lt; 1 year than for those with a duration of diabetes &gt; 1 year.
Analysis of the SMAD4 gene in asthma
Authors: Miletic Aleksandra , Petrovic-Stanojevic Natasa , Radojkovic Dragica , Nikolic Aleksandra 
Published: August 2014

Abstract
Considering the importance of the TGF-β signaling pathway for normal lung function and especially its roles in inflammation and tissue remodeling, key features of asthma pathology, it can be assumed that these molecules may harbor mutations in asthmatics. The aim of this study was to analyze the SMAD4 gene in patients with asthma. Analysis has encompassed exons 10, 11, 12 and 13 encoding the carboxy-terminal (MH2) domain of the SMAD4 protein, where mutations most frequently occur. The study included 50 patients (20 men and 30 women) with asthma aged between 17 and 73 years (average age 45.2±15.6 years). Polymerase chain reaction (PCR) was used to amplify exons 10, 11, 12 and 13 of the SMAD4 gene and the obtained PCR products were subjected to direct DNA sequencing. No nucleotide changes were found in any of the analyzed exons in either of the subjects. Based on the results of this study, it seems that mutations in the carboxy-terminal (MH2) domain of the SMAD4 are not present in asthmatic patients. Future research should be directed at the analysis of the complete gene, including regulatory elements, in order to resolve the exact role of SMAD4 in asthma.
Analysis and prediction of upper extremity movements by cyclograms
Authors: Kutilek Patrik , Socha Vladimir , Hana Karel 
Published: August 2014

Abstract
Quantification of upper extremity movement is a common objective in both research and clinical practice. Currently, methods based on angle-angle diagrams, also called cyclograms, seem to be promising. Nevertheless, compared to the study of lower limbs, the concept of angle-angle diagrams has not been systematically used to study upper limb movements during walking. The paper describes two examples of new methods based on angle-angle diagrams for application in rehabilitation and assistive robotics. The cyclograms represent information about the relationship between the angles and their changes over time. We used cyclograms as patterns for learning artificial neural networks and predicting the movement of upper-limb. Together with artificial intelligence, cyclograms offer wide scope of application in prosthesis control systems. Using bilateral cyclogram, the information about the relationship between the right and left arm joint angles is used to evaluate the symmetry of movements. The method based on the orientation of the bilateral cyclogram can be used as an additional method for determining the symmetry of movements of the upper limbs or exo-prosthesis.
Surgical treatment of stress urinary incontinence and vaginal prolapse for the woman with epispadia
Authors: Aniuliene Rosita , Aniulis Povilas , Druktenyte Vitalija , Zilaitiene Birute 
Published: August 2014

Abstract
Patient K.L., 32 years old. Menses started at thirteen years old, C 5/28. Patient had two vaginal deliveries in 2004 and 2010. Dysplasia cervicis uteri CIN2-3 was diagnosed in 2007, subsequently diathermoconisation cervicis uteri was performed. The woman was born with epispadia — extrophia of urethra to abdominal wall, without pubic bone. At the age of 8 she underwent an operation in Moscow. During the operation the neck of the bladder was formed as well as urethra, which opens in vulva, place of clitoris. When she was 8 years old, her bladder capacity was 30 ml, in teenage years — 90 ml. The patient also reported history of recurrent urinary tract infections. 2011.08.02 Patient took medical advice in out patient department Kaunas university hospital with a complaint of stress urinary incontinence: when going, coughing, sneezing, doing exercises, having sex and at rest of time. Also it was the sexual intercourse problems with orgasm. She was urinating 8 times per day but none at night. Gynecological examination: absence of pubic bone, vulva is abnormal: absence of labium major and clitoris. Urethra opens into the place of clitoris. Front and back walls of vagina are moving down (POP-Q II-III stage prolapsed). Cervix of uterus is short, epithelised (after diathermoconisation). Uterus is normal in size, in retro-versio-flexio position. — without pathology. Sonography: internal genital organs without pathology. Boney, Valsalva test are positive, Ulmstein test negative. Urodynamic study revealed a bladder capacity of 134 ml, voided volume 173 ml. Pressure of detrusor — 10cmH2O. Compliancenormal, max flow rate 13,8 ml/s, voiding time 24 s. Spontaneous contractions of detrusor were not observed. Surgical treatment: 2011.10.10 TOT (tension obturator tape). Anterior and posterior colporrhaphy and perineoplastic was performed. There were no complications during and after surgery. On the 2 day after operation patient was released from hospital.
Online Education Improves Canadian Dietitians’ Attitudes and Knowledge Regarding Recommending and Ordering Multivitamin/Mineral Supplements
Authors: da Silva Liz , Brody Rebecca , Byham-Gray Laura , Parrott J. Scott 
Published: August 2014

Purpose: To determine the attitudes and knowledge of Fraser Health registered dietitians (RDs) regarding recommending and ordering multivitamin/mineral supplements prior to and following an online education module. Methods: The educational intervention consisted of narrated slides with electronic resources. After undergoing external review for face and content validity, 6 attitude questions and a 15-item knowledge test were administered pre- and postintervention. The attitude questionnaire utilized a 5-point Likert scale and had a maximum summative score of 30 points. The knowledge test was worth a maximum of 15 points. Results: Of the eligible RDs (n = 123), 57 (46.3%) completed the study and 55 participants were included in the final analyses. Summative attitude scores were higher on the post-intervention questionnaire compared with the preintervention questionnaire (t = 92.5, P < 0.001). The proportion of correctly answered knowledge questions pre- (78.0% ± 10.0%) to postintervention (mean = 87.4% ± 6.0%) increased significantly (t = 7.16, P < 0.001). Conclusions: Postintervention, RD attitudes and knowledge improved confirming that the education strategy was effective. Future work should focus on optimizing the module and knowledge questions.
Reflections on Perceived Preparedness of Dietetic Internship Graduates Following Entry into Practice
Authors: Brissette Christy , Leung Eman , Darling Pauline B. , Keith Mary 
Published: August 2014

Purpose: To report on the perceived level of preparedness of dietetic internship (DI) graduates for entrance into practice as dietitians. Methods: Graduates of an Ontario based, nonintegrated DI program from 2007–2011 who were at least 1 year postgraduation were surveyed to determine their level of perceived preparedness for practice using an electronic, content validated, self-administered questionnaire. Results: Of 38 eligible graduates, 23 (61%) responded. Seventy-five percent of respondents were working as clinical dietitians, and 30% were working as community dietitians. Eighty-five percent of graduates reported feeling well or very well prepared for practice. Clinical and professional practice tasks were scored highest in terms of preparedness (ratings above 4.5/5) and research-related tasks such as using the research literature (4.1/5), making evidence-based decisions (4.2/5), and engaging in practice-based research (4.1/5) scored lower. Training gaps identified by 32% of respondents included community nutrition and management skill training. Conclusions: Overall, results indicate that this DI program provides a positive training experience that prepares its graduates for entrance into practice as dietitians. Qualitative comments identifying gaps and improvements have guided changes to the curriculum including strengthening community-based placements. Post-graduate surveys represent an important tool in assuring that training programs evolve to meet the needs of students entering the workforce.
Epilepsy surgery failure in children: a quantitative and qualitative analysis
Authors: Englot Dario J. , Han Seunggu J. , Rolston John D. , Ivan Michael E. , Kuperman Rachel A. , Chang Edward F. , Gupta Nalin , Sullivan Joseph E. , Auguste Kurtis I. 
Published: August 2014

Object
Resection is a safe and effective treatment option for children with pharmacoresistant focal epilepsy, but some patients continue experience seizures after surgery. While most studies of pediatric epilepsy surgery focus on predictors of postoperative seizure outcome, these factors are often not modifiable, and the reasons for surgical failure may remain unclear.

Methods
The authors performed a retrospective cohort study of children and adolescents who received focal resective surgery for pharmacoresistant epilepsy. Both quantitative and qualitative analyses of factors associated with persistent postoperative seizures were conducted.

Results
Records were reviewed from 110 patients, ranging in age from 6 months to 19 years at the time of surgery, who underwent a total of 115 resections. At a mean 3.1-year follow-up, 76% of patients were free of disabling seizures (Engel Class I outcome). Seizure freedom was predicted by temporal lobe surgery compared with extratemporal resection, tumor or mesial temporal sclerosis compared with cortical dysplasia or other pathologies, and by a lower preoperative seizure frequency. Factors associated with persistent seizures (Engel Class II–IV outcome) included residual epileptogenic tissue adjacent to the resection cavity (40%), an additional epileptogenic zone distant from the resection cavity (32%), and the presence of a hemispheric epilepsy syndrome (28%).

Conclusions
While seizure outcomes in pediatric epilepsy surgery may be improved by the use of high-resolution neuroimaging and invasive electrographic studies, a more aggressive resection should be considered in certain patients, including hemispherectomy if a hemispheric epilepsy syndrome is suspected. Family counseling regarding treatment expectations is critical, and reoperation may be warranted in select cases.