bluuebunny/crossref_metadata_2025 huggingface dataset:
In situ generation and reaction of a sub-picosecond electron pulse: ultrafast broadband spectroscopy
Authors: Nandi Amitabha , Ghosh Rajib , Mora Aruna K. , Nath Sukhendu
Published: October 2024

A sub-picosecond resolved broadband transient absorption spectrometer for in situ generation and study of ultrafast reaction of short pulse electrons in water has been reported.
Hydrogen bond network structures of protonated 2,2,2-trifluoroethanol/ethanol mixed clusters probed by infrared spectroscopy combined with a deep-learning structure sampling approach: the origin of the linear type network preference in protonated fluoroalcohol clusters
Authors: Hsu Po-Jen , Mizuide Atsuya , Kuo Jer-Lai , Fujii Asuka
Published: October 2024

Infrared spectroscopy combined with a deep-learning structure sampling approach reveals the origin of the unusual structure preference in protonated fluorinated alcohol clusters.
Identification of Ni3Fe alloy as a candidate catalyst for quinoline selective hydrogenation with computations
Authors: He Zhaochun , Liu Yonghua , Wang Tao
Published: October 2024

We computationally identified Ni3Fe as a promising catalyst for the quinoline (QL) selective hydrogenation to 1,2,3,4-tetrahydroquinoline (py-THQL) using density functional theory calculations and microkinetic modeling.
Electrocatalytic nitrogen cycle: mechanism, materials, and momentum
Authors: Li Laiquan , Xu Linyuan , Wang Hanyun , Wei Haohong , Tang Cheng , Li Guisheng , Dou Yuhai , Liu Hua Kun , Dou Shi Xue
Published: October 2024

As a self-sustaining cycle, the electrocatalytic nitrogen cycle represents an avenue for rectifying the nitrogen imbalance and for synthesizing value-added chemicals, thereby contributing to a sustainable and carbon-neutral society.
Stress regulation via surface micro-etching and reconstruction for enhancing triple-cation perovskite solar cells with an efficiency of 25.54%
Authors: Ding Yang , Feng Erming , Lu Siyuan , Chang Jianhui , Long Caoyu , Tong Sichao , Li Hengyue , Yang Junliang
Published: October 2024

A surface micro-etching and reconstruction strategy is developed to regulate the stresses in a perovskite film, achieving a benign transition from tensile stress to compressive stress.
Polyphenols for stroke therapy: the role of oxidative stress regulation
Authors: Luo Yusong , Liu Ruolan , Yuan Guoqiang , Pan Yawen
Published: October 2024

Molecular mechanisms of the antioxidant effects of polyphenols in stroke.
A road for macroporous silicon stabilization by ultrathin ALD TiO2 coating
Authors: Al Chimali Bachar , Carrasco Irene , Defforge Thomas , Dailleau Romain , Monnier Lisa , Baishya Kaushik , Macak Jan M. , Gautier Gael , Le Borgne Brice
Published: October 2024

Ultrathin TiO2 layers deposited by ALD can successfully passivate macroporous silicon while keeping photocatalytic activity.
Green fluorescent protein chromophore-based covalent organic polymers (GFPC-COPs): sensing of nitroaromatic organic pollutants and explosives
Authors: Anjum Gulshan , Kumar Ashish , Ramanathan Gurunath , Moorthy Jarugu Narasimha
Published: October 2024

Fluorescent covalent organic polymers based on green fluorescent protein chromophores serve as excellent sensory materials for sensing of nitroaromatic compounds containing acidic hydrogens, e.g., nitrophenols, nitrothiophenols and nitroanilines.
Electrodeposition of conductive polymer PEDOT on the surface of the LiNi0.8Co0.1Mn0.1O2 electrode for high-performance lithium-ion batteries
Authors: Wang Yiming , Li Ke , Wu Jiayi , Xie Guangming , Li Zhifeng , Wang Chunxiang
Published: October 2024

Electrochemical polymerization of PEDOT on the NCM811 cathode and aluminum foil enhances bonding strength and cycling stability by reducing side reactions with the electrolyte.
Flexible wearable piezoresistive physical sensors with photothermal conversion and self-cleaning functions for human motion monitoring
Authors: Chen Xingzhong , Tian Qianqian , Xiong Zheng , Wu Min , Gong Xiao
Published: October 2024

Superhydrophobic cotton fabrics were assembled into piezoresistive physical sensors with good photo-thermal properties, self-cleaning properties, and rapid response/recovery time for dynamic monitoring of human motion.
Photocatalytic hydrotrichloromethylation of unactivated alkenes with chloroform
Authors: Gong Dawei , Gao Caiyu , Li Qixuan , Li Yufei , Zhao Lina , Kong Degong
Published: October 2024

Trichloromethyl compounds are essential constituents in synthetic and medicinal chemistry.
Lewis acid-controlled Pd-catalyzed chemodivergent hydrocyanation of cyclopropenes
Authors: Yu Rongrong , Cai Song-Zhou , Fang Xianjie
Published: October 2024

We report a Lewis acid-controlled Pd-catalyzed chemodivergent hydrocyanation of cyclopropenes. In the absence of Al Lewis acid, the reaction predominantly yields ring-opened allylic nitrile products while the addition of Lewis acid favors the formation of cyano-substituted cyclopropane products.
The synergistic effect of adsorption and Fenton oxidation for organic pollutants in water remediation: an overview
Authors: Song Junzhe , Zhu Linan , Yu Sheng , Li Guobiao , Wang Dong
Published: October 2024

Water pollution from industrial sources presents a significant environmental challenge due to the presence of recalcitrant organic contaminants.
Electric field enhances the electronic and diffusion properties of penta-graphene nanoribbon anodes in lithium-ion batteries
Authors: Tran Thi Nhan , Anh Duy Nguyen Vo , Hieu Nguyen Hoang , Nguyen Truc Anh , Van Nguyen To , Bac Phung Thi Viet , Zulueta Yohandys A. , Nguyen Minh Tho , Schall Peter , Dang Minh Triet
Published: October 2024

Under external electric fields, first principles calculations show a significant enhancement of the ionic conductivity and diffusion coefficients of penta-graphene nanoribbon anodes for fast-charging lithium-ion batteries.
Accessing the synthesis of natural products and their analogues enabled by the Barbier reaction: a review
Authors: Mushtaq Aqsa , Zahoor Ameer Fawad , Ahmad Mirza Nadeem , Khan Samreen Gul , Akhter Naheed , Nazeer Usman , Mansha Asim , Ahmad Hamad , Chaudhry Aijaz Rasool , Irfan Ahmad
Published: October 2024

The latest utilization of the Barbier reaction and its variants towards the procurement of diverse natural products i.e., alkaloids, terpenoids, lactones and lignans etc. has been summarized in this review article.
The significance of chirality in contemporary drug discovery-a mini review
Authors: Senkuttuvan Narmatha , Komarasamy Boopathi , Krishnamoorthy Rajavenkatesh , Sarkar Shuvajyoti , Dhanasekaran Sivasankaran , Anaikutti Parthiban
Published: October 2024

In this review, we wish to compile examples of chiral medicines approved by the FDA in the years 2022 and 2023 with an emphasis on their synthesis along with information on chiral induction as well enantiomeric excess.
Recent advances in biomimetic taste-based biosensors and their applications
Authors: Kang Jialu , Liu Jiejing , Geng Yufei , Yuan Yuxuan , Liu Shuge , Tan Yushuo , Du Liping , Wu Chunsheng
Published: October 2024

The most recent progress and applications of biomimetic taste-based biosensors based on biological taste sensing elements are outlined.
Biocrude production via hydrothermal liquefaction of Canadian lignocellulosic residues for sustainable transportation: screening, catalytic effect, and modelling
Authors: Churchill J. G. B. , Borugadda V. B. , Dalai A. K.
Published: October 2024

Underutilized Canadian lignocellulosic residues have potential to produce upgradable biocrude with hydrothermal liquefaction. K2CO3 + Fe was an effective catalyst to improve biocrude from low-ash feeds, while volatiles and fibres were yield predictors.
Accelerating sulfur conversion kinetics via CoS2–MgS heterostructure for lithium sulfur batteries
Authors: Men Xinliang , Deng Teng , Che Jiangxuan , Wang Juan
Published: October 2024

The CoS2–MgS heterostructure combines the high catalytic activity of CoS2 (Co2+ oxidized to Co3+) and the fast Li+ migration kinetics of MgS, which significantly improve the C-rate performance and cycling stability of lithium–sulfur batteries.
Cu2O-based catalysts applied for electrocatalytic CO2 reduction: a review
Authors: Liu Cong , Guo Rui-tang , Zhu Hao-wen , Cui Heng-fei , Liu Ming-yang , Pan Wei-guo
Published: October 2024

The application of sustainable energy-driven electrocatalytic carbon dioxide reduction reaction (CO2RR) technology enables the synthesis of valuable chemicals and feedstocks.
Mitigating intubation stress, mucosa injury, and inflammatory response in nasogastric tube intubation via suppression of the NF-κB signaling pathway by engineering a hydration lubrication coating
Authors: Liao Xi , Bai Meng-Han , Liu Yu-Wei , Wei Yu-Qing , Wang Jun-Yang , Wang Zhi-Guo , Hong Rui , Gou Ju-Xiang , Xu Jia-Zhuang , Li Zhong-Ming , Li Ka
Published: October 2024

The hydrated micelle coating, composed of hyaluronic acid and Pluronic, demonstrated superior hydrophilicity and aqueous lubricity to effectively alleviate mucosal lesions and inflammation caused by NGT insertion.
Development of a small molecule-based two-photon photosensitizer for targeting cancer cells
Authors: Lee Dong Joon , Cao Yu , Juvekar Vinayak , Sauraj  , Noh Choong-Kyun , Shin Sung Jae , Liu Zhihong , Kim Hwan Myung
Published: October 2024

BSe-B is a novel photosensitizer for photodynamic therapy using two-photon excitation, selectively targets cancer cell while sparing healthy tissue. It generates type-I reactive oxygen species and shows promise in diagnosis and treatment of cancer.
Efficient bionic nanozyme based on AuPt NPs@ZIF-90 used for cyclic catalysis multimodal tumor therapy
Authors: Huang Wan , Zhang Song , Luo Li , Pan Yalong , Han Lijun , Yu Yao
Published: October 2024

Novel efficient bionic nanozyme based on AuPt NPs@ZIF-90 used for cyclic catalysis multimodal tumor therapy.
Tailored BODIPY-based fluorogenic probes for phosgene detection: a comparative evaluation of recognition sites
Authors: Dartar Suay , Kaya Beraat Umur , Yayak Yanki Öncü , Vural Ezgi , Emrullahoğlu Mustafa
Published: October 2024

Rare examples of ICT-based fluorescent probes incorporating phosgene specific recognition units at the 2-position of the BODIPY core.
Revisiting the excited state proton transfer dynamics in N-oxide-based fluorophores: a keto–enol/enolate interplay to detect trace water in organic solvents
Authors: Savita  , Shukla Adarash Kumar , Bhattacharya Anupam
Published: October 2024

This work highlights the unique proton transfer ability observed in cyanoquinoxaline N-oxide-based fluorophores and its use in water detection.
Exhibition of magnetic memory effects and exchange bias in nanocrystalline CoSb2O4
Authors: Banerjee Anupam , Mondal Manas Kumar , De D. , Goswami S. , Das Souvick , Chakrabarti P. K.
Published: October 2024

Herein, super-spin-glass behaviour has been demonstrated through comprehensive memory studies in nanocrystalline CoSb2O4 prepared by a hydrothermal method.
Comparative Study of Two Semi-Occluded Vocal Tract Protocols: A Randomized Clinical Trial
Authors: Heller-Stark Amanda , Maxfield Lynn , Herrick Jennifer , Smith Marshall , Titze Ingo
Published: October 2024

Introduction:

Semi-occluded vocal tract exercises (SOVTEs) are widely used as a therapeutic tool to create flow resistance in the upper airway. The current study was a randomized controlled clinical trial to establish the efficacy of two SOVTE protocols, flow-resistant tube (FRT) and Lessac-Madsen Resonant Voice Therapy (LMRVT). Exploratory investigations included a noninferiority analysis of FRT to the widely adopted therapy protocol (LMRVT), as well as examining the dosing required to improve acoustic measures and subjective ratings.

Method:

Sixty-seven participants with voice disorder were randomized into one of five groups: 4-week FRT (
n
= 14), 8-week FRT (
n
= 19), 4-week LMRVT (
n
= 15), 8-week LMRVT (
n
= 5), and control (
n
= 14). Voice Handicap Index (VHI) and Vocal Fatigue Index scores were collected pre- and posttreatment. Acoustic analysis using the Acoustic Voice Quality Index was completed. We compared VHI between controls and 8-week FRT and LMRVT, adjusting for pre-VHI using linear regression. We examined the efficacy of 4-week protocols relative to controls and conducted a noninferiority comparison of FRT (4 and 8 weeks) to LMRVT (4 and 8 weeks) using 5- and 10-point margins. Finally, we compared the 4- versus 8-week sessions for both therapies.

Results:

A statistically significant reduction of VHI in both 8-week FRT relative to controls (−10.60, 95% CI [−19.80, −1.40],
p
= .025) and 8-week LMRVT (−15.74, 95% CI [−29.40, −2.08],
p
= .025) was found. We also found an improvement in 4-week FRT relative to controls (−10.11, 95% CI [−20.03, −0.20],
p
= .046), but the 4-week LMRVT result was not statistically significant (
p
= .057). FRT was found to be noninferior to LMRVT in terms of VHI using a 10-point margin (FRT − LMRVT: 0.69, 95% CI [−5.76, 7.15],
p
= .01), but not using a 5-point margin (
p
= .054). There were no statistically significant differences in VHI scores between 4- and 8-week sessions for either therapy.

Conclusions:

Both FRT and LMRVT improved VHI scores relative to controls. FRT was noninferior to LMRVT in terms of VHI scores. There were no statistically significant differences in VHI scores between 4- and 8-week therapy sessions.
Determination of sub‐synchronous interactions between AC systems and Grid‐Forming converters in bipolar HVDC connections
Authors: Puricelli Francesco Giacomo , Rault Pierre , Cardozo Carmen , Beerten Jef
Published: October 2024

Numerous High‐Voltage Direct Current (HVDC) interconnections in a bipolar configuration are currently in the design phase and set to become operational in the next decade. In the meantime, the shift from Synchronous Generators (SGs) to converter‐interfaced units is raising concerns over the stability of power systems. Grid‐Forming (GFM) control in converters, as opposed to Grid‐Following (GFL) mode, is anticipated to replicate, to some extent, the stabilizing behaviour of SGs. An open research question is whether mimicking the behaviour of SGs with GFM converters would, in turn, induce sub‐synchronous oscillations similar to those present in power systems dominated by SGs. This paper investigates sub‐synchronous interactions between converters and asynchronous AC systems at the terminals of a bipolar HVDC connection. A modal analysis based on a state‐space approach reveals the participation of converters as well as the influence of control modes and system parameters on these low‐frequency oscillations. Time‐domain simulations of a non‐linear model in EMTP software support the findings of the modal analysis.
Ways and models of providing integration of information technology science with mathematical sciences
Authors: Suyarov Akram , Rakhimov Sobir , Sharopova Nafisa
Published: October 2024

The results of scientific research on the application of information technologies to the educational system show that one of the most important problems in the educational process of higher educational institutions is the integration and classification of knowledge, with the aim of studying its theoretical, scientific and methodological aspects. If integration serves to strengthen the structural connection between different knowledge systems, to generalize them, to further enrich students’ holistic perceptions of nature and society, then differentiated education provides students with in-depth knowledge according to their abilities and opportunities, and creates the basis of a project-based model of teaching.
A technique avoiding cardioplegia delivery complications: a case using systemic hyperkalemia cardiopulmonary bypass combined with circulatory arrest
Authors: Takeichi Tomohisa , Morimoto Yoshihisa , Yamada Akitoshi , Tanaka Takanori
Published: October 2024

We conducted a high-risk redo mitral valve replacement through a right mini-thoracotomy without rib spreading (redo-MICS MVR) under systemic hyperkalemia combined with circulatory arrest to circumvent complications associated with cardioplegia delivery. The patient, a 75-year-old man, had a predicted mortality rate of 20%. Initial antegrade cardioplegia successfully induced cardiac arrest, which was administered every 30 min. However, upon infusion of the second dose of cardioplegia, the aortic root pressure was approximately 20 mmHg. Despite multiple attempts to re-cross the clamp, the aortic root pressure did not improve. Consequently, retrograde cardioplegia was considered, but due to significant adhesion of the inferior vena cava, this approach was abandoned. Thus, the procedure was altered to utilize systemic hyperkalemia without aortic cross-clamping (ACC). Given the preoperative transesophageal echocardiography (TEE) diagnosis of mild aortic regurgitation, maintaining a clear surgical field was challenging, necessitating the combination of redo-MVR with circulatory arrest. This case exemplifies the successful management of cardioplegia delivery complications using systemic hyperkalemia and circulatory arrest, resulting in a favorable postoperative recovery for the patient.
Ösophaguskarzinome: Neues in Prävention und Therapie
Authors: Decker Annegrit , Quante Michael
Published: October 2024

Was ist neu?

Präventionsstrategien bei Ösophaguskarzinomen Den Schlüsselfaktor gastrointestinaler Tumorprävention bildet die Behebung inflammatorischer Einflüsse, welche sich für die 2 ösophagealen Tumorentitäten Plattenepithel- und Adenokarzinom unterscheiden. Der steigenden Inzidenz der Adenokarzinome sollte durch Therapie von Übergewicht und gastroösophagealer Refluxkrankheit begegnet werden. Ein endoskopisches Screening ist in Deutschland nicht etabliert, hingegen erfolgt bei Barrett-Metaplasie eine engmaschige Surveillance. Für den gezielten Einsatz der Endoskopie ist zukünftig eine bessere Stratifizierung von Risikopatienten vonnöten; entsprechende Prädiktionsmodelle sind Gegenstand aktueller Forschung.

Therapie der Plattenepithelkarzinome des Ösophagus Neben endoskopischen Resektionsoptionen sehr früher Befunde besteht die Hauptneuerung der letzten Jahre im prognoseverbessernden Einsatz von Immun-Checkpoint-Inhibitoren in der adjuvanten und palliativen Systemtherapie. Der PD-L1-Status dient hierbei als stratifizierender Biomarker.

Therapie der Adenokarzinome des Ösophagus und des ösophagogastralen Übergangs Aufgrund ihrer engen molekularbiologischen Verwandtschaft erfolgt die Systemtherapie der AEG-Tumore analog der Magenkarzinome. In der perioperativen Therapie lokal fortgeschrittener Befunde hat jüngst die Chemotherapie nach dem FLOT-Protokoll ihren Stellenwert weiter unterstreichen können. In metastasierten Stadien wird die Chemotherapie biomarkerstratifiziert durch Checkpoint-Inhibitoren sowie Antikörper gegen Her2 und fortan auch Claudin-18.2 ergänzt. Mit dem Antikörper-Wirkstoff-Konjugat Trastuzumab-Deruxtecan wurde eine Her2-gerichtete Zweitlinienoption etabliert.
Neue ESC-Leitlinie 2023: Infektiöse Endokarditis
Authors: Flachskampf Frank Arnold
Published: October 2024

Was ist neu?

Das Endokarditis-Team Bei komplizierter Endokarditis sollte der Patient in einem Herzklappenzentrum behandelt werden, das über ein etabliertes Endokarditis-Team und eine Herzchirurgie verfügt.

Prävention Eine Antibiotika-Prophylaxe wird in erster Linie für Hochrisiko-Patienten (frühere Endokarditis, Klappenprothesen, kongenitale Shuntvitien) bei zahnärztlichen Eingriffen empfohlen, kann jedoch auch bei nativen Klappenerkrankungen wie der bikuspiden Aortenklappe erwogen werden.

Echokardiografie und andere bildgebende Verfahren Eine transösophageale Echokardiografie (TEE) ist zur Erfassung eventueller lokaler Komplikationen bei linksseitiger Endokarditis auch dann indiziert, wenn bereits transthorakal die Diagnose einer Endokarditis gestellt worden ist. In echokardiografischen Zweifelsfällen sollten die kardiale CT und/oder nuklearmedizinische Verfahren zu Hilfe genommen werden.

Antibiotische Therapie Bei stabilem Krankheitsverlauf und Ausschluss lokaler Komplikationen (z.B. Abszess) mittels TEE kann in bestimmten Fällen nach 10 Tagen gezielter intravenöser Antibiotikatherapie auf eine ambulante orale oder – falls erforderlich – parenterale Antibiotikatherapie unter engmaschiger ambulanter Kontrolle umgestellt werden („Outpatient-step-down-Therapie“).

Kardiochirurgische Therapie Die Indikationen der chirurgischen Therapie der linksseitigen Endokarditis (Herzinsuffizienz, Abszess/Fistel/Pseudoaneurysma, große Vegetationen mit hohem Embolie-Risiko) sind weitgehend unverändert. Ein chirurgisches Eingreifen bei rechtsseitiger Endokarditis wird, mit höherer Empfehlungsstärke als zuvor, bei schwerer endokarditischer Trikuspidal-Insuffizienz mit Dysfunktion des rechten Ventrikels, sehr großen Vegetationen nach septischer Lungenembolie und bei erforderlicher linksseitiger Endokarditis-Chirurgie empfohlen.
Impfen bei pneumologischen Erkrankungen – Teil 2: RSV, Pneumokokken, Pertussis und Herpes Zoster
Authors: Kodde Cathrin , Sander Leif Erik
Published: October 2024

Was ist neu?

Respiratory Syncytial Virus RSV ist einer der häufigsten Erreger von Infektionen der oberen und unteren Atemwege. Insbesondere für Säuglinge und Kleinkinder sowie für ältere vorerkrankte Menschen stellt eine RSV-Infektion ein Risiko für eine lebensbedrohliche Erkrankung dar. Im Sommer 2023 wurden erstmals 2 wirksame RSV-Impfstoffe zugelassen. Diese basieren auf rekombinanten Virushüllenproteinen der RSV-Stämme und regen das Immunsystem zur Bildung von Antikörpern an. Aktuelle Daten zeigen einen anhaltenden Schutz durch die einmalige Impfung. Die Impfung ist für Schwangere als passive Immunisierung des Ungeborenen sowie für Personen über 60 Jahre in der EU zugelassen. Die STIKO empfiehlt allen Personen ≥75 Jahre sowie Personen im Alter von 60 bis 74 Jahren, die eine schwere Grunderkrankung haben und/oder in einer Pflegeeinrichtung leben, eine einmalige RSV-Impfung. Zu den Grunderkrankungen gehören u.a. schwere Formen von Lungen- und Atemwegserkrankungen sowie Herz-Kreislauf-Erkrankungen.

Pneumokokken
Streptococcus pneumoniae ist einer der Haupterreger der ambulant erworbenen Pneumonie (CAP). Seit Anfang 2022 ist ein 20-valenter Konjugat-Impfstoff (PCV20) zugelassen, der seit Herbst 2023 von der STIKO für alle Personen über 60 Jahre sowie für Personen über 18 Jahre mit Risikofaktoren oder einer beruflichen Impfindikation empfohlen wird. Damit löst PCV20 den 23-valenten Polysaccharid-Impfstoff (PPV23) ab, der bislang noch in der Altersgruppe über 60 Jahren empfohlen wurde.

Pertussis Obwohl Keuchhusten in erster Linie als Kinderkrankheit angesehen wird, betrifft die Mehrzahl der Infektionen Erwachsene. Patienten mit chronischen Atemwegserkrankungen haben ein höheres Risiko für einen schweren klinischen Verlauf. Daher wird empfohlen, dass alle Erwachsenen bei der nächsten planmäßigen Tetanusimpfung eine Auffrischungsimpfung gegen Keuchhusten erhalten sollten, die als Kombinationsimpfstoff (Tdap) verabreicht wird. Für Risikogruppen (medizinisches Personal, Gemeinschaftseinrichtungen) wird eine Auffrischungsimpfung alle 10 Jahre empfohlen.

Herpes Zoster Herpes Zoster (Gürtelrose) wird durch das Varizella-Zoster-Virus verursacht, das bei einer Reaktivierung zu den charakteristischen schmerzhaften Hautausschlägen und Komplikationen, wie einem Zoster Oticus, einer Meningitis einer postherpetischen Neuralgie führen kann. Personen mit chronischen Lungenerkrankungen wie COPD oder Asthma bronchiale haben ein erhöhtes Risiko für Herpes Zoster bedingte Komplikationen. Seit 2018 ist ein rekombinanter adjuvantierter Totimpfstoff zugelassen, der einen hohen Schutz gegen Herpes Zoster und seine Komplikationen bietet. Die Impfung wird allen Personen über 60 Jahren und für bestimmte Risikogruppen ab 50 Jahren empfohlen.
Ergebnisse einer Befragung orthopädischer
Rehabilitationseinrichtungen zur Umsetzung der Medizinisch-beruflich
orientierten Rehabilitation: Bedarfsidentifizierung und Analyse der
Arbeitsanforderungen
Authors: Bühne David , Alles Torsten , Mathis Elling Jan , Hetzel Christian
Published: October 2024

Ziel der Studie Untersuchungen im Kontext der Medizinisch-beruflich
orientierten Rehabilitation (MBOR) deuten darauf hin, dass die Umsetzung der
MBOR durch eine ausgeprägte Heterogenität gekennzeichnet ist und zudem keine
flächendeckende Erfüllung der durch die Rentenversicherungsträger definierten
Rahmenvorgaben erfolgt. Vor diesem Hintergrund zielte die vorliegende
Untersuchung darauf ab, die Umsetzung des MBOR-Anforderungsprofils in der
Orthopädie in Bezug auf die Identifikation besonderer beruflicher Problemlagen
(BBPL) sowie die Anamnese der Arbeitsanforderungen zu erheben.

Methodik 2023 erfolgte eine als Vollerhebung angelegte schriftliche
Befragung von Rehabilitationseinrichtungen mit Zulassung für die orthopädische
MBOR. Zum Einsatz kam ein in Anlehnung an das MBOR-Anforderungsprofil
entwickeltes Instrument. 86 der 317 angeschriebenen Einrichtungen beantworteten
den Fragebogen und erfüllten zugleich die Einschlusskriterien (Durchführung von
MBOR-Heilverfahren).

Ergebnisse Während die Einrichtungen überwiegend berichteten, dass nahezu
alle Personen mit BBPL eine MBOR erhalten, lag der einrichtungsinterne
MBOR-Anteil überwiegend bei weniger als zehn Prozent. In Bezug auf die
Anforderungsanamnese wurde in den Untersuchungsergebnissen vor allem der Wunsch
deutlich, die Objektivität und Validität der Informationen durch einen stärkeren
Einbezug der Arbeitgeber bzw. Werks-/Betriebsärzte im Vorfeld der Reha zu
steigern.

Schlussfolgerung Den Angaben der Befragten folgend, wird die Umsetzung der
MBOR in Bezug auf die Verfahren zur Identifikation von Personen mit BBPL sowie
die Anamnese der Arbeitsanforderungen vielfach dem Anforderungsprofil
entsprechend realisiert. Zentrale Herausforderungen liegen in der Deckung des
MBOR-Bedarfs sowie der stärkeren Einbindung von Arbeitgebern.
Versorgung von Patient*innen der Außerklinischen Intensivpflege in
ärztlich geleiteten Einrichtungen – eine Querschnitterhebung der Deutschen
Interdisziplinären Gesellschaft für Außerklinische Beatmung
Authors: Hornemann Donatha , Schucher Bernd , Bayarassou Hakim , Jaschke Christoph , Fabritius Georg , Platz Thomas , Schmidt-Wilcke Tobias , Pohl Marcus , Groß Martin
Published: October 2024

Hintergrund Patient*innen der Außerklinischen Intensivpflege (AKI) sind
meist mit einer Trachealkanüle versorgt und häufig invasiv beatmet. Seltener
sind sie nichtinvasiv beatmet. Ab 01. Januar 2025 muss bei ihnen halbjährlich
das Beatmungsentwöhnungs- und Dekanülierungspotential erhoben werden. Liegt
Potential vor, soll die Einweisung in eine spezialisierte Einrichtung
erfolgen.

Ziel: Ärztlich geleitete Einrichtungen, die das Dekanülierungs- und
Beatmungsentwöhnungspotential erheben und dessen Umsetzung gewährleisten können,
sollten charakterisiert werden.

Methode Unter Schirmherrschaft der Deutschen Interdisziplinären
Gesellschaft für Außerklinische Beatmung (DIGAB) e.V. und mit Unterstützung der
Arbeitsgemeinschaft Neurologisch-neurochirurgische Frührehabilitation fand eine
Online-Querschnitterhebung statt.

Ergebnisse Zertifizierungen nach DGAI, DGP, DGNR oder DGMP besaßen n=11
(61,1%) von 18 teilnehmenden Einrichtungen. Am häufigsten war der leitende Arzt
Facharzt für Neurologie, gefolgt von Innere Medizin und Pneumologie,
Anästhesiologie und Pädiatrie. Viele Berufsgruppen und Qualifikationen sowie
diagnostischen und therapeutischen Methoden wurden vorgehalten. Insgesamt sahen
n=10 (55,6%) regional keine ausreichenden Möglichkeiten zur stationären Aufnahme
von Patient*innen der AKI zur Beatmungsentwöhnung oder Dekanülierung. Ca. ein
Drittel der Einrichtungen bot Televisiten an.

Diskussion Patient*innen der AKI benötigen aufgrund medizinischer
Komplexität und eingeschränkter Teilhabe eine interdisziplinäre, intersektoral
organisierte Versorgung. Zwar wurden Interdisziplinarität und eine Vielzahl
diagnostischer und therapeutischer Methoden von den teilnehmenden Einrichtungen
vorgehalten, jedoch waren ihre Strukturmerkmale uneinheitlich.

Schlussfolgerung Für Zentren, die ein Dekanülierungs- und
Beatmungsentwöhnungspotential erheben sowie bei Feststellung umsetzen, sollten
Qualitätskriterien etabliert werden. Es besteht Forschungsbedarf bezüglich 1.
der Präzisierung dieser Kriterien, 2. der Kapazitäten der Einrichtungen, die die
Beatmungs- und Trachealkanülenentwöhnung durchführen, 3. der ambulanten
Beatmungs- und Trachealkanülenentwöhnung und 4. der telemedizinischen Strukturen
für Patient*innen der AKI.
Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis
Authors: Mohamed Tahagod , Alexander Robin , Davidson Brielle , Klamer Brett , Gehred Alison , Starr Michelle C. , Slagle Cara , Krawczeski Catherine , Harer Matthew W.
Published: October 2024

Objective Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive AKI biomarker. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized. The objective of this study was to evaluate the current literature to determine normal uNGAL values for preterm neonates without AKI.

Study Design Systematic review and meta-analysis of all articles published before November 2021 evaluating uNGAL values in preterm neonates without AKI.

Results Of 1,607 studies evaluated for eligibility, 11 were included in the final meta-analysis (210 males, 202 females). uNGAL values were higher in the preterm neonates <29 weeks and ranged between 20.7 and 782.65 ng/mL. Meta mean estimates of gestational age (GA), birthweight, and neutrophil gelatinase-associated lipocalin were 29.4 weeks (95% confidence interval [CI]: 28.8–30.0), 1,241 g (95% CI: 1,111–1,372), and 148.9 ng/mL (95% CI: 48–231), respectively.

Conclusion In limited studies, a wide range of uNGAL values in preterm neonates without AKI are reported. Future studies should identify normal uNGAL values in preterm neonates using larger cohorts by GA and birthweight.

Key Points
Transtuberositäre, ventral öffnende hohe Tibiaosteotomie zur Korrektur eines negativen Slope
Authors: Harrer Jörg , Ferner Felix , Lutter Christoph , Petersen Wolf , Perl Mario , Simon Michael
Published: October 2024

Ein knöchernes Genu recurvatum tritt klinisch durch eine Überstreckbarkeit des Kniegelenks in Erscheinung. Neben den Problemen durch die Hyperextension kann es hierdurch langfristig außerdem zu einer Insuffizienz des hinteren Kreuzbandes (HKB) kommen. Kausale Therapie dieser Tibiakopfextensionsdeformität stellt eine Slope-erhöhende Tibiakopfosteotomie dar. Hierbei gibt es bisher nur wenige Publikationen zu klinischen Ergebnissen, insbesondere zur reinen Slope-Korrektur ohne Veränderung der Frontalachse. Im Folgenden wird die Technik der transtuberositären ventral öffnenden Tibiakopf-Flexions-Osteotomie (Transtuberositary Anterior Opening Wedge High Tibial Osteotomy, TT-AOW HTO) zur Erhöhung des tibialen Slope gezeigt (mit Ablösen und „Bioplating“ der Tuberositas tibiae). Nach vorgeschalteter Arthroskopie erfolgt nach der Osteotomie von ventral die Interposition eines autologen Beckenkammspans und die Osteosynthese mit 2 winkelstabilen Platten von medial und anteromedial.
Chronotype, sleep hygiene, and sleep characteristics among athletes
of different disciplines
Authors: Borghi Stefano , Bizzozero Sara , Vitale Jacopo A. , Tallini Elisa , Corazza Francesco , La Torre Antonio , Banfi Giuseppe , Codella Roberto
Published: October 2024

The objective of the study was to assess chronotype, sleep hygiene, and sleep
characteristics of Italian athletes in order to identify differences among sport
disciplines (team- vs individual-sports), level of competition (Elite vs
Non-Elite) and sexes. Moreover, correlations between chronotype, sleep hygiene
and sleep quality were evaluated. Two hundred eighty Italian athletes
(Females:113; Males:167) participated in the study. They completed the
Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Index (SHI) and the
MorningnessEveningness Questionnaire (MEQ). Among the athletes, 66.4% were
intermediate-type, 21.8% were morning-type and 11.8% were evening-type. 55.4% of
the sample was classified as good sleeper (PSQI<5), while 16.1% had poor
sleep hygiene (SHI≥35). Females had higher total sleep time (p=0.022) than
males. Individual-sports showed more morning-oriented score (p=0.001) and lower
PSQI (p=0.006) and SHI (p<0.001) scores, with earlier timing of sleep
(bedtime:p<0.001; wake-up time:p<0.001) compared to teamsports. Elite
athletes exhibited greater sleep efficiency (p=0.009), and lower sleep latency
(p=0.018) and wake after sleep onset (p=0.043) than Non-Elite athletes.
Additionally, significant correlations were found between PSQI and SHI (r=0.43,
p<0.001), and between MEQ and SHI (r=−0.35, p<0.001). This study yields
crucial insights into the sleep behaviors of Italian athletes, revealing that
nearly half of the sample were bad sleepers.
Age- and sex-related variations of normal spleen T1rho and the more stable liver T1rho to spleen T1rho ratio
Authors: Wáng Yì Xiáng J. , Yu Wei-Ling , Deng Min
Published: October 2024

We aim to evaluate the potential age- and sex-related variations of normative values of spleen T1rho.

Two T1rho sequences were used, with one based on fast spin echo sequence (FSE) and the other based on gradient echo sequence (GRE). Spleen and liver FSE T1rho values were measured in 52 healthy volunteers (36 females, 16 males), and spleen and liver GRE T1rho values were measured in 14 healthy volunteers (6 females, 8 males).

For FSE data, an age-related decreasing trend of spleen T1rho was noted for both females and males. This trend was consistent with female liver T1rho values, while such a trend was not noted for male liver T1rho. Females had a higher T1rho than males, both for the spleen (92.8 vs 77.3 ms, p<0.0001) and for the liver (44.2 vs. 38.9 ms, p<0.0001, FSE data). The spleen T1rho value was approximately double the liver T1rho value. The spleen T1rho and liver T1rho were positively correlated, both for FSE data (r=0.611) and GRE data (r=0.541). When the spleen T1rho was used to normalize the liver T1rho, the ratio of T1rholiver/T1rhospleen largely removed the sex and age effect. The spleen T1rho in menstrual phase women was 10.7% lower (p=0.012) than that of non-menstrual phase women, while the liver T1rho in menstrual phase women was 3.8% lower than that of non-menstrual phase women.

Since women in the menstrual phase tend to have lower body iron, the fact that both liver T1rho and spleen T1rho are shorter among women in the menstrual phase than women in the non-menstrual phase indicates that liver and spleen T1rho physiological variations may not be dominantly affected by the iron content of the tissue. If a pathology has only affected the liver while the spleen is normal, there is a possibility the ratio T1rholiver/T1rhospleen may offer better characterization of liver pathologies.
Postoperative Protocols for Lower Extremity Free Flap Reconstructions: Literature Review and a National Survey of the United Kingdom's Major Trauma Centers
Authors: Glynou Sevasti Panagiota , Georgiannakis Ariadni , Ackling Edward , Bystrzonowski Nicola , Pafitanis Georgios , Diver Andrew
Published: October 2024

Background Evidence for postoperative care of lower extremity free flap reconstruction (LEFF) varies and is yet to be standardized, despite established guidelines by the British Orthopedic Association Standard for Trauma (BOAST-4). This study assesses postoperative protocols for LEFF clinical monitoring, warming, dangling, and compression in the United Kingdom's (UK) major trauma centers (MTCs).

Methods An online questionnaire was distributed to consultant leads of all UK adult MTCs. Data requested the existence of a standardized protocol, intensity, and takeback of LEFF procedures and specific practices in clinical monitoring, warming, dangling, and compression. Analysis was performed in Excel.

Results The survey was returned by 23 (79.3%) units and most (86.9%) had standardized LEFF monitoring protocols. Centers typically performed four to eight surgeries monthly and on average had 2.7 salvageable LEFFs in 2022. Clinical monitoring was common (>92%) and included color, capillary refill, and temperature assessment. Compression initiation varied between 45.5% (starting after day 7) and 40.9% (from days 3 to 5). Continuous compression was favored (78.3%), using pillows (88.9%). Dangling protocols begin between days 3 and 7, for 5 minutes (52.2%) with frequencies of three to four times daily (25–37.5%). The preferred tool for LEFF warming was the Bair hugger (82.6%) and the mean termination day for warming was 3.61.

Conclusion The survey highlights the need for evidence-based and consensus in UK MTC protocols for LEFFs. We encourage ongoing research and collaborative efforts in creating an accepted protocol among MTCs that could be incorporated into the BOAST-4 guidelines for postoperative care standardization and improved patient outcomes.
Silyl Ethers as Latent Pronucleophiles in Enantioselective Lewis Base Catalyzed Synthesis of Allylic Ethers from Allylic Fluorides
Authors: Lange Markus , Barakat Abdulrahman , Vilotijevic Ivan
Published: October 2024

Allylic ethers are a common occurrence in natural products, and are often used as intermediates in target-oriented synthesis. Their synthesis often relies on the use of transition-metal catalysts. Here, we report an organocatalytic method for the allylation of O-centered nucleophiles, the Lewis base catalyzed allylation of silyl ethers with allylic fluorides. The method relies on the concept of latent pronucleophiles in Lewis base catalysis to overcome common limitations in substrate scope, even permitting the allylation of sterically congested O-pronucleophiles. When chiral Lewis base catalysts are used, the allyl ethers are produced in an enantioenriched form through kinetic resolution of fluorides, where the stereoselectivity is determined by the chiral catalyst.
Efficient Synthesis of Benzospirocyclohexadienones via PIFA-Promoted Intramolecular Dearomative Spiroannulation
Authors: Wang Mingan , An Xinkun , Zhang Tingting , Ma Haoyun , He Xie
Published: October 2024

A rapid and convenient method for the synthesis of differently substituted spiro[cyclohexane-1,1′-isochromane]-2,5-dien-4-one derivatives via phenyliodine(III) bis(trifluoroacetate) (PIFA)-promoted intramolecular oxidative dearomatization at the para position is disclosed, with the aim of building a library of new spirocyclohexadienone scaffolds. Subsequently, this strategy is modified to access novel cyclohexanedienone-containing polycyclic compounds.
Nonpharmacological Prevention and Management of Delirium: Past, Present, and Future
Authors: Ryan Sophia L.
Published: October 2024

Delirium has been recognized, documented, and examined for centuries. In 500 BC Hippocrates described hyper- and hypoactive forms of delirium. As medicine, surgery, and critical care have accelerated over the last century, so too has our understanding of delirium and its profound risks to patients, families, and health care teams. It has also been increasingly understood that it is the accumulation of risk factors that ultimately precipitates delirium and nonpharmacological interventions to reduce these risks remain the cornerstone of delirium prevention and management. However, over the last three decades, these nonpharmacological strategies have moved from a single-component approach to a multicomponent approach, targeting multiple risk factors. Additionally, our understanding of what constitutes a risk factor for delirium has evolved, and in particular, it has been recognized that delirium can sometimes be a byproduct of our interventions and health care systems. In the surgical setting, for example, optimization of risk factors prior to surgery, when possible, is now seen as a key way to prevent postoperative delirium. Similarly, critical care medicine now operates with the appreciation of the profound risk to patients of prolonged mechanical ventilation, sedation, and immobilization and seeks to minimize each to reduce the risk of delirium, among other negative effects. The future of delirium prevention and management lies in both better implementation of best practices that have been defined over the last three decades as well as taking more of a whole patient view. This includes harnessing the electronic medical record, artificial intelligence, and so on to risk assess and individualize care for each patient; restructuring care to reduce deliriogenic practices and care environments; redefining what usual care looks like (e.g., utilizing music and involving loved ones, etc.); policy changes to change systematic priorities. In this paper, we will explore the past, present, and future of nonpharmacological prevention and management of delirium across care settings.
A Prospective Study of CSF Flow Dynamics Across Foramen Magnum in Adult Chiari Malformation/Syringomyelia Complex and its Clinical Correlation with Outcomes after Surgery
Authors: Prakash Manas , Shrivastava Adesh , Chouksey Pradeep , Raj Sumit , Mishra Rakesh , Agrawal Amit , Nair Suresh
Published: October 2024

Introduction Chiari I malformation refers to cerebellar tonsillar descent below the foramen magnum and is frequently associated with syringomyelia. Prior cerebrospinal fluid (CSF) flow studies correlated the clinical severity of these lesions with general flow velocity or bulk flow at the foramen magnum; however, these techniques have not assessed the effect on surgical outcomes. The study aims to present clinical and radiological factors and CSF flow parameters (pre- and postoperative) that affect the surgical outcome.

Materials and Methods The institutional ethics committee approved the study. We collected the prospective clinical data, including pre- and postoperative symptoms. Functional grades were determined along with the change in clinical improvement based on clinical examination notes, the change in functional grade was calculated, and the radiologic data were analyzed according to the degree of clinical improvement. The surgical procedure included suboccipital bony decompression with duroplasty. Patients were followed up at 1 month, 3 months, and 1 year.

Results There were a total of 25 patients. The mean age of the patients was 45.52 ± 13.37 years, with 40% being males and 60% being females. After the surgery, there was a significant increase in the anterior and posterior CSF flows at the foramen magnum. Most had a resolution in the headache and sensory symptoms, while the lower cranial nerve and motor symptoms had a minor resolution at follow-up. Age, sex, and headache do not correlate with the outcome or syrinx improvement. Motor power in the lower limb (preintervention) and syrinx shape (preintervention) were significantly associated with the variable “anterior flow at the foramen magnum” (preintervention; p < 0.05). Average flow, cervicomedullary angle (postintervention), sensory symptom progression, and CSF flow change anterior to the foramen magnum were significantly associated with the variable “anterior flow at the foramen magnum” (postintervention; p < 0.05).

Conclusion Even after surgery, persistent foramen magnum CSF outflow obstruction has a robust negative correlation with the outcome. The Chiari outcome predictability index has shown a significant correlation with patient outcomes and can be used to inform patients about the expected outcome. The results of the present study will be helpful in stratifying patients according to their desired outcomes.
Bürokratie gefährdet Versorgung
Authors: Pintarelli-Rauschenbach Manuela
Published: October 2024

Die jüngste VPT-Umfrage (► Seite 6) zeigt deutlich: Die Verwaltungsarbeit und der Fachkräftemangel
gefährden die Versorgung unserer Patientinnen und Patienten. Praxen müssen aufwendig fehlerhaft
ausgestellte Rezepte korrigieren: Rund 40 Prozent der Befragten gaben an, dass 10 bis 20 Prozent der
Verordnungen einer Nachbearbeitung bedürfen. Das erschwert den Arbeitsalltag massiv! Diese Zeit
könnten wir viel sinnvoller für die Patientenversorgung nutzen.
Long-Term Orthopaedic and Radiological Outcomes of Symphysis Approximation without Osteotomy in Primary Bladder Exstrophy Repair
Authors: Promm Martin , Hofbauer Raphael , Brandl Roland , Gossler Christopher , Brandstetter Susanne , Kertai Michael , Hofmann Aybike , Schnabel Marco J. , Rösch Wolfgang H.
Published: October 2024

Introduction Previous assumptions suggested that the technique of approximation without osteotomy in primary exstrophy repair (PER) could only be applied in newborns and anticipated poorer outcomes. Recent studies indicated that this technique can be successfully executed not only in immediate PER but also yields favorable long-term results. Therefore, we evaluated and compared the orthopaedic and radiological long-term outcomes after pubic symphysis approximation without osteotomy in immediate and delayed PER.

Methods From March 2018 to December 2020, individuals with PER and approximation of the symphysis without osteotomy were recruited. Patients <12 years and with a history of orthopaedic surgery of the bony pelvis were excluded. Orthopaedic examinations and magnetic resonance imaging (MRI) of the bony pelvis including the hip joints were performed and pubic diastasis, the acetabulum angle (ACA), and the center-edge angle (CEA) were evaluated.

Results Twenty-nine patients were included, 11 of them had an immediate and 18 had a delayed PER. Between the two groups, no significant differences could be observed concerning hip pain (p = 0.419), mobility impairment (p = 0.543), sports impairment (p = 0.543), hip impingement (p = 1.000), leg length discrepancy (p = 0.505), and width of the pubic diastasis as measured by MRI (p = 0.401). There were also no significant differences with regard to CEA right (median 30 degrees, p = 0.976), CEA left (median 31.5 degrees, p = 0.420), ACA right (median 19 degrees, p = 0.382), and ACA left (median 17 degrees, p = 0.880).

Conclusion There were no significant differences in clinical orthopaedic or radiological long-term outcomes between bladder exstrophy patients after immediate and delayed bladder closure with symphysis approximation without osteotomy. Establishing core outcome sets is essential to get robust and comparable results, further advancing and substantiating our initial insights.
Time-resolved x-ray imaging of nanoscale spin-wave dynamics at multi-GHz frequencies using low-alpha synchrotron operation
Authors: Mayr S. , Förster J. , Finizio S. , Schultheiss K. , Gallardo R. A. , Narkovicz R. , Dieterle G. , Semisalova A. , Bailey J. , Kirk E. , Suszka A. , Lindner J. , Gräfe J. , Raabe J. , Schütz G. , Weigand M. , Stoll H. , Wintz S.
Published: October 2024

Time-resolved x-ray microscopy is used in a low-alpha synchrotron operation mode to image spin dynamics at an unprecedented combination of temporal and spatial resolution. Thereby, nanoscale spin waves with wavelengths down to 70 nm and frequencies up to 30 GHz are directly observed in ferromagnetic thin film microelements with spin vortex ground states. In an antiparallel ferromagnetic bilayer system, we detect the propagation of both optic and acoustic modes, the latter exhibiting even a strong non-reciprocity. In single-layer systems, quasi-uniform spin waves are observed together with modes of higher order (up to the 4th order), bearing precessional nodes over the thickness of the film. Furthermore, the effects of magnetic material properties, film thickness, and magnetic fields on the spin-wave spectrum are determined experimentally. Our experimental results are consistent with numerical calculations from a micromagnetic theory even on these so-far unexplored time- and length scales.