TY - JOUR A1 - Emuoyibofarhe, Justice O. A1 - Akindele, Akinyinka Tosin A1 - Ronke, Babatunde Seyi A1 - Omotosho, Adebayo A1 - Meinel, Christoph T1 - A Fuzzy Rule-Based Model for Remote Monitoring of Preterm in the Intensive Care Unit of Hospitals JF - International Journal of Medical Research & Health Sciences N2 - The use of Remote patient monitoring (RPM) systems to monitor critically ill patients in the Intensive Care Unit (ICU) has enabled quality and real-time healthcare management. Fuzzy logic as an approach to designing RPM systems provides a means for encapsulating the subjective decision-making process of medical experts in an algorithm suitable for computer implementation. In this paper, a remote monitoring system for preterm in neonatal ICU incubators is modeled and simulated. The model was designed with 4 input variables (body temperature, heart rate, respiratory rate, and oxygen level saturation), and 1 output variable (action performed represented as ACT). ACT decides whether-an alert is generated or not and also determines the message displayed when a notification is required. ACT classifies the clinical priority of the monitored preterm into 5 different fields: code blue, code red, code yellow, code green, and-code black. The model was simulated using a fuzzy logic toolbox of MATLAB R2015A. About 216 IF_THEN rules were formulated to monitor the inputs data fed into the model. The performance of the model was evaluated using-the confusion matrix to determine the model’s accuracy, precision, sensitivity, specificity, and false alarm rate. The-experimental results obtained shows that the fuzzy-based system is capable of producing satisfactory results when used for monitoring and classifying the clinical statuses of neonates in ICU incubators. KW - Remote patient monitoring KW - Fuzzy logic KW - Preterm KW - Incubator KW - Confusion matrix Y1 - 2019 SN - 2319-5886 VL - 8 IS - 5 SP - 33 EP - 44 PB - Sumathi CY - Trichy ER - TY - JOUR A1 - Cassel, Michael A1 - Risch, Lucie A1 - Mayer, Frank A1 - Kaplick, Hannes A1 - Engel, Aaron A1 - Kulig, Kornelia A1 - Bashford, Greg T1 - Achilles tendon morphology assessed using image based spatial frequency analysis is altered among healthy elite adolescent athletes compared to recreationally active controls JF - Journal of science and medicine in sport : official journal of Sports Medicine Australia N2 - Objectives: Although expected, tendon adaptations in adolescent elite athletes have been underreported. Morphologically, adaptations may occur by an increase in collagen fiber density and/or organization. These characteristics can be captured using spatial frequency parameters extracted from ultrasound images. This study aims to compare Achilles tendon (AT) morphology among sports-specific cohorts of elite adolescent athletes and to compare these findings to recreationally active controls by use of spatial frequency analysis. Design: Cross-sectional observational study. Method: In total, 334 healthy adolescent athletes from four sport categories (ball, combat, endurance, explosive strength) and 35 healthy controls were included. Longitudinal ultrasound scans were performed at the AT insertion and midportion. Intra-tendinous-morphology was quantified by performing spatial frequency analysis assessing eight parameters at standardized ROls. Increased values in five parameters suggest a higher structural organization, and in two parameters higher fiber density. One parameter represents a quotient combining both organization and fiber density. Results: Among athletes, only ball sport athletes exhibited an increase in one summative parameter at pre-insertion site compared to athletes from other sport categories. When compared to athletes, controls had significantly higher values of four parameters at pre-insertion and three parameters at midportion site reflecting differences in both, fiber organization and density. Conclusions: Intra-tendinous-morphology was similar in all groups of adolescent athletes. Higher values found in non-athletes might suggest higher AT fiber density and organization. It is yet unclear whether the lesser structural organization in young athletes represents initial AT pathology, or a physiological adaptive response at the fiber cross-linking level. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. KW - Tendon structure KW - Adaptation KW - Ultrasound KW - Athletic loading KW - Tendinopathy Y1 - 2019 U6 - https://doi.org/10.1016/j.jsams.2019.03.011 SN - 1440-2440 SN - 1878-1861 VL - 22 IS - 8 SP - 882 EP - 886 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Zinke, Fridolin A1 - Gebel, Arnd A1 - Granacher, Urs A1 - Prieske, Olaf T1 - Acute Effects of Short-Term Local Tendon Vibration on Plantar Flexor Torque, Muscle Contractile Properties, Neuromuscular and Brain Activity in Young Athletes JF - Journal of sports science & medicine N2 - The purpose of this study was to examine the acute effects of short-term Achilles tendon vibration on plantar flexor torque, twitch contractile properties as well as muscle and cortical activity in young athletes. Eleven female elite soccer players aged 15.6 +/- 0.5 years participated in this study. Three different conditions were applied in randomized order: Achilles tendon vibration (80 Hz) for 30 and 300 s, and a passive control condition (300 s). Tests at baseline and following conditions included the assessment of peak plantar flexor torque during maximum voluntary contraction, electrically evoked muscle twitches (e.g., potentiated twitch peak torque [PT]), and electromyographic (EMG) activity of the plantar flexors. Additionally, electroencephalographic (EEG) activity of the primary motor and somatosensory cortex were assessed during a submaximal dynamic concentric-eccentric plantar flexion exercise using an elastic rubber band. Large-sized main effects of condition were found for EEG absolute alpha-1 and beta-1 band power (p <= 0.011; 1.5 <= d <= 2.6). Post-hoc tests indicated that alpha-1 power was significantly lower at 30 and 300 s (p = 0.009; d = 0.8) and beta-1 power significantly lower at 300 s (p < 0.001; d = 0.2) compared to control condition. No significant effect of condition was found for peak plantar flexor torque, electrical evoked muscle twitches, and EMG activity. In conclusion, short-term local Achilles tendon vibration induced lower brain activity (i.e., alpha-1 and beta-1 band power) but did not affect lower limb peak torque, twitch contractile properties, and muscle activity. Lower brain activity following short-term local Achilles tendon vibration may indicate improved cortical function during a submaximal dynamic exercise in female young soccer players. KW - Postactivation potentiation KW - electromyography KW - electroencephalography KW - maximum voluntary contraction KW - soccer Y1 - 2019 SN - 1303-2968 VL - 18 IS - 2 SP - 327 EP - 336 PB - Department of Sports Medicine, Medical Faculty of Uludag University CY - Bursa ER - TY - JOUR A1 - Lorenz, Robert C. A1 - Matthias, Katja A1 - Pieper, Dawid A1 - Wegewitz, Uta A1 - Morche, Johannes A1 - Nocon, Marc A1 - Rissling, Olesja A1 - Schirm, Jacqueline A1 - Freitag, Simone A1 - Jacobs, Anja T1 - AMSTAR 2 overall confidence rating BT - lacking discriminating capacity or requirement of high methodological quality? JF - Journal of clinical epidemiology : including pharmacoepidemiology reports Y1 - 2019 U6 - https://doi.org/10.1016/j.jclinepi.2019.10.006 SN - 0895-4356 SN - 1878-5921 VL - 119 SP - 142 EP - 144 PB - Elsevier CY - New York ER - TY - JOUR A1 - Ashton, Michelle P. A1 - Eugster, Anne A1 - Dietz, Sevina A1 - Loebel, Doreen A1 - Lindner, Annett A1 - Kuehn, Denise A1 - Taranko, Anna E. A1 - Heschel, Babett A1 - Gavrisan, Anita A1 - Ziegler, Anette-Gabriele A1 - Aringer, Martin A1 - Bonifacio, Ezio T1 - Association of Dendritic Cell Signatures With Autoimmune Inflammation Revealed by Single-Cell Profiling JF - Arthrittis & Rheumatology Y1 - 2018 U6 - https://doi.org/10.1002/art.40793 SN - 2326-5191 SN - 2326-5205 VL - 71 IS - 5 SP - 817 EP - 828 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Mehren, Christoph A1 - Heider, Franziska A1 - Sauer, Daniel A1 - Kothe, Ralph A1 - Korge, Andreas A1 - Hitzl, Wolfgang A1 - Würtz-Kozak, Karin T1 - Clinical and radiological outcome of a new total cervical disc replacement design JF - Spine N2 - Study Design. A nonrandomized, prospective, and single- center clinical trial of the ProDisc Vivo prosthesis. Objective. The aim of this study was to investigate the clinical and radiological results of a refined total cervical disc replacement (cTDR), the ProDisc Vivo, with two years of follow-up (FU). The incidence of implant-related complications was recorded as a secondary outcome variable. Summary of Background Data. Previous generations of the ProDisc artificial cervical disc replacement generate high primary stability due to keel-based designs with opening of the anterior cortex during the implantation and subsequent high rates of heterotopic ossifications. Methods. Clinical outcome scores included the Neck Disability Index (NDI), Visual Analogue Scale (VAS), arm and neck pain self-assessment questionnaires. The radiological outcome included the range of motion (ROM) and the occurrence of heterotopic ossifications. The incidence of implant-related complications with new implant design was recorded as a secondary outcome variable. Results. A total of 55 patients received a single-level treatment with the ProDisc Vivo cTDR between C3/4 and C6/7, with a follow-up rate of 78%. The clinical outcome scores improved in all parameters significantly (P 1/4 0.0001) (NDI: 68.3 -> 17.4; VAS arm: 6.3 -> 1.4; VAS neck: 4.9 -> 1.6). The ROM of the indexsegment did not show a significant change (P 1/4 0.26) (7.9 degrees -> 9.2 degrees). Heterotopic ossifications at the index segment was found as grade 0 in 5%, grade 1 in 22%, grade 2 in 10%, grade 3 (with functional impairment of the prosthesis) in 7%, and grade 4 in 3% of the cases. We observed three implant-related complications (5.5%), with two implant dislocations anteriorly and one low-grade infect. Conclusion. cTDR with ProDisc Vivo demonstrated a significant and sustained improvement of all clinical outcome parameters. A less invasive implantation mechanism with lower primary stability of the cTDR might be a reason for a higher dislocation rate than the keel-based previous generation ProDisc C. KW - heterotopic ossifications KW - implant-related complications KW - outcomes KW - ProDisc Vivo KW - total disc arthroplasty KW - total disc replacement Y1 - 2018 U6 - https://doi.org/10.1097/BRS.0000000000002799 SN - 0362-2436 SN - 1528-1159 VL - 44 IS - 4 SP - E202 EP - E210 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Klatt, Stefanie A1 - Noel, Benjamin A1 - Musculus, Lisa A1 - Werner, Karsten A1 - Laborde, Sylvain A1 - Lopes, Mariana Calabria A1 - Greco, Pablo J. A1 - Memmert, Daniel A1 - Raab, Markus T1 - Creative and Intuitive Decision-Making Processes: A Comparison of Brazilian and German Soccer Coaches and Players JF - Research Quarterly for Exercise and Sport N2 - Purpose: The concepts of creativity and intuition have been well studied in isolation, but less is known about their distinctive contributions to option generation in decision making. Method: We examined the relation between creative and intuitive decision making in two studies-one involving coaches and one involving soccer players-using video footage of real soccer matches. Additionally, we analyzed whether this relation is culture generic or culture specific by conducting matched cross-cultural studies in a European and a South American country. Results: In Study 1, results indicate a conceptual overlap of creativity and intuition for Brazilian and German soccer coaches. Furthermore, coaches did not differ in their evaluation of creative and intuitive actions of players of both cultures. In Study 2, we found that for both subsamples the total number of generated options was positively correlated with the quality of the first and the final option and that the quality of players' first (intuitive) option was higher than that of options generated later. Moreover, results indicate a positive correlation between a player's creativity score and the quality of the first generated option for the whole sample. Conclusion: Overall, our findings provide meaningful information regarding athletes' and coaches' option-generation processes in decision making in complex team sports. KW - Choice KW - cognitive process KW - evaluation KW - soccer Y1 - 2019 U6 - https://doi.org/10.1080/02701367.2019.1642994 SN - 0270-1367 SN - 2168-3824 VL - 90 IS - 4 SP - 651 EP - 665 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Heidler, Maria-Dorothea A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Determinants of Return to Work After Multicomponent Cardiac Rehabilitation JF - Archives of Physical Medicine and Rehabilitation N2 - Objectives: To explore predictors of return to work in patients after acute coronary syndrome and coronary artery bypass grafting, taking into account cognitive performance, depression, physical capacity, and self-assessment of the occupational prognosis. Design: Observational, prospective, bicentric. Setting: Postacute 3-week inpatient cardiac rehabilitation (CR). Participants: Patients (N=401) <65 years of age (mean 54.5 +/- 6.3y), 80% men. Interventions: Not applicable. Main Outcome Measures: Status of return to work (RTW) 6 months after discharge from CR. Results: The regression model for RTW showed negative associations for depression (odds ratio 0.52 per SD, 95% confidence interval 0.36-0.76, P=.001), age (odds ratio 0.72, 95% confidence interval 0.52-1.00, P=.047), and in particular for a negative subjective occupational prognosis (expected incapacity for work odds ratio 0.19, 95% confidence interval 0.06-0.59, P=.004; unemployment odds ratio 0.08, 95% confidence interval 0.01-0.72, P=.024; retirement odds ratio 0.07, 95% confidence interval 0.01-0.067, P=.021). Positive predictors were employment before the cardiac event (odds ratio 9.66, 95% confidence interval 3.10-30.12, P<.001), capacity to work (fit vs unfit) at discharge from CR (odds ratio 3.15, 95% confidence interval 1.35-7.35, P=.008), and maximum exercise capacity (odds ratio 1.49, 95% confidence interval 1.06-2.11, P=.022). Cognitive performance had no effect. KW - Acute coronary syndrome KW - Cardiac rehabilitation KW - Coronary artery bypass grafting KW - Motivation KW - Rehabilitation KW - Return to work Y1 - 2019 U6 - https://doi.org/10.1016/j.apmr.2019.04.003 SN - 0003-9993 SN - 1532-821X VL - 100 IS - 12 SP - 2399 EP - 2402 PB - Elsevier CY - Philadelphia ER - TY - JOUR A1 - Sturm, Heidrun A1 - Wildermuth, Ronja A1 - Stolz, Regina A1 - Bertram, L. A1 - Eschweiler, G. W. A1 - Thomas, C. A1 - Rapp, Michael Armin A1 - Joos, S. T1 - Diverging awareness of postoperative delirium and cognitive dysfunction in German Health Care Providers JF - Clinical interventions in agins N2 - Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD. KW - cross-sectoral care KW - delirium prevention KW - postoperative cognitive dysfunction KW - POCD KW - dementia KW - clinical pathways KW - risk screening Y1 - 2019 U6 - https://doi.org/10.2147/CIA.S230800 SN - 1178-1998 VL - 14 SP - 2125 EP - 2135 PB - DOVE Medical Press CY - Albany ER - TY - JOUR A1 - Heidler, Maria-Dorothea T1 - Dysphagie bei tracheotomierten Patienten nach Langzeitbeatmung JF - Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : ains ; Organ der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin N2 - Unabhängig von der Art der kritischen Erkrankung haben tracheotomierte Patienten ein hohes Risiko, eine Schluckstörung zu entwickeln. Diese ist potenziell lebensbedrohlich, da sie zu Aspiration und Pneumonie führen kann. Vor einer oralen Nahrungsgabe sollte daher unbedingt eine Schluckdiagnostik mittels Bolusfärbetest und/oder FEES durchgeführt werden. Da ein physiologischer Luftstrom durch den Larynx und ein adäquater subglottischer Druck Schlüsselkomponenten eines effektiven Schluckaktes sind, sollte eine Oralisierung bei geblockter Trachealkanüle möglichst vermieden werden. Dysphagien sind eine häufige und potenziell lebensbedrohliche Komplikation bei langzeitbeatmeten tracheotomierten Patienten. Denn sie können zu Aspiration (Eindringen von Speichel und Nahrung in die Luftwege) und einer sich daraus entwickelnden Pneumonie führen [1]. Bevor diese Patienten auf orale Ernährung umgestellt und mit einem Sprechventil versehen werden, muss daher unbedingt die Schluckfähigkeit geprüft werden. N2 - Independent of the type of critical illness, tracheostomized patients have a high risk of developing a dysphagia. This is potentially life-threatening as it can lead to aspiration and pneumonia. It is therefore essential to perform swallowing diagnostics by means of a bolus dyeing test and/or FEES before oral feeding. Since a physiological airflow through the larynx and adequate subglottic pressure are key components of an effective swallowing act, oralisation should be avoided as far as possible with a blocked tracheal cannula. KW - Tracheotomie KW - Dysphagie KW - Aspiration KW - Schluckdiagnostik Y1 - 2019 U6 - https://doi.org/10.1055/a-0769-6551 SN - 0939-2661 SN - 1439-1074 VL - 54 IS - 3 SP - 218 EP - 222 PB - Thieme CY - Stuttgart ER -