bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-Life Care, Advance Directives, Withholding and Withdrawing Life-Sustaining Treatment, and the Goals of Medicine
Authors: Akabayashi Akira 
Published: May 2020

AbstractEnd-of-life care is a universal topic in bioethics throughout the world, with each region, religion, and culture claiming its own position. A comparison of these positions, however, is not the aim of this chapter. Although Japan imported the practice of issuing advance directives (ADs), it has not gained popularity, and I doubt that it will do so in the near future. In addition, from a global perspective, taking into consideration the high infant mortality rates and low adult life expectancy in LMICs, it is fair to assume that AD is not commonplace in those countries. The way in which AD is enacted also depends on local law and culture and is therefore highly contextualized.In this chapter, I also take up the issue of withholding and withdrawing of life-sustaining treatment, especially the removal of artificial ventilation. There has also been much discussion surrounding the “equivalence principle,” which supports withholding and withdrawing. My colleagues and I have challenged this consequentially based idea in an Open Peer Commentary published in the American Journal of Bioethics (2019); we wrote this commentary from an East Asian perspective, and I will briefly introduce it.Finally, in the current era of rapid development in medicine, I have sensed subtle changes in the goals of medicine as perceived by both patients and physicians (Original Article). The emergence of immune-checkpoint inhibitors, for example, may be enough to lead patients to think, “Perhaps if I try to live just a little longer, some dramatic treatment will be developed in the very near future.” From comfort care with QOL in the twentieth century to the idea of “a little bit more time in order to be cured” is emerging at the bedside.
Research Regulations, Ethics Committees, and Confronting Global Standards
Authors: Akabayashi Akira 
Published: May 2020

AbstractJapan’s modern system of scientific governance was imported from the West. Starting with the The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use: Good clinical practice (ICH-GCP).Japan needed to institute best global practice in order for Japanese research and pharmaceutical products to be recognized on the world stage. However, because the scientific governance system was imported, there was a mismatch between the basic concepts and underlying intentions of the system and Japanese culture.The lack of competent ethics committee members and ethics consultation support infrastructure in Japan is a serious concern. Scientific misconduct is a universal phenomenon; however, I will explore it here in the local context. Finally, I will illustrate how the advice by clinical ethics consultations differs from culture to culture, although the formats (individuals, teams, and committees) are the same.
Bounds on convex bodies in pairwise intersecting Minkowski arrangement of order $$\mu $$
Authors: Földvári Viktória 
Published: May 2020

AbstractThe $$\mu $$
μ
-kernel of an o-symmetric convex body is obtained by shrinking the body about its center by a factor of $$\mu $$
μ
. As a generalization of pairwise intersecting Minkowski arrangement of o-symmetric convex bodies, we can define the pairwise intersecting Minkowski arrangement of order $$\mu $$
μ
. Here, the homothetic copies of an o-symmetric convex body are so that none of their interiors intersect the $$\mu $$
μ
-kernel of any other. We give general upper and lower bounds on the cardinality of such arrangements, and study two special cases: For d-dimensional translates in classical pairwise intersecting Minkowski arrangement we prove that the sharp upper bound is $$3^d$$

3
d

. The case $$\mu =1$$

μ
=
1

is the Bezdek–Pach Conjecture, which asserts that the maximum number of pairwise touching positive homothetic copies of a convex body in $$\mathbb R^d$$

R
d

is $$2^d$$

2
d

. We verify the conjecture on the plane, that is, when $$d=2$$

d
=
2

. Indeed, we show that the number in question is four for any planar convex body.
On Sampling and Interpolation by Model Sets
Authors: Richard Christoph , Schumacher Christoph 
Published: May 2020

AbstractWe refine a result of Matei and Meyer on stable sampling and stable interpolation for simple model sets. Our setting is model sets in locally compact abelian groups and Fourier analysis of unbounded complex Radon measures as developed by Argabright and de Lamadrid. This leads to a refined version of the underlying model set duality between sampling and interpolation. For rather general model sets, our methods also yield an elementary proof of stable sampling and stable interpolation sufficiently far away from the critical density, which is based on the Poisson Summation Formula.
Bedürfnisse und Belastungen von palliativmedizinisch mitbetreuten Patienten mit fortgeschrittenen und/oder metastasierten Kopf-Hals-Tumoren
Authors: Roch C. , Schendzielorz P. , Scherzad A. , van Oorschot B. , Scheich M. 
Published: May 2020

Zusammenfassung
Hintergrund
Neue Therapieformen ermöglichen auch bei Patienten mit fortgeschrittenen und metastasierten Kopf-Hals-Tumoren gute Behandlungsansätze. Gespräche über das Lebensende, vorausschauende Versorgungsplanung und auch palliativmedizinische Konzepte geraten dadurch oft in den Hintergrund.

Ziel der Arbeit
Analyse von Symptomen, Belastungen sowie dem Vorliegen von Vorsorgedokumenten, von stationär palliativmedizinisch mitbetreuten Patienten durch Selbsteinschätzung. Erhebung der Integration der spezialisierten Palliativversorgung in die Versorgung stationär verstorbener Patienten anhand des Qualitätsindikators nach Earle.

Material und Methoden
Retrospektive Analyse der vom Palliativdienst mitbetreuten Patienten mit Kopf-Hals-Tumoren durch Nutzung des standardisierten IPOS Fragebogens.

Ergebnisse
Die häufigsten physischen Symptome waren „Schwäche“ (77 %), „Appetitlosigkeit“ (65 %) und „eingeschränkte Mobilität“ (65 %). „Schmerzen“ wurden von 42 % der Patienten angegeben. Die häufigsten emotionalen und psychosozialen Belastungen waren „Traurigkeit“ (97 %) und „Sorgen des Patienten“ (94 %), die „fehlende Möglichkeit Gefühle“ zu teilen (77 %), „unzureichende Informiertheit“ (85 %) und „organisatorische Probleme“ (77 %). Bei 23 % der Patienten lagen Vorsorgedokumente vor. Das Qualitätsziel nach Earle wurde nicht erreicht.

Diskussion
Die Patienten berichten in der Auswertung in hohem Maß Symptome und Belastungen, am häufigsten im emotionalen Bereich und bezüglich kommunikativer und praktischer Bedürfnisse. Hier zeigt sich möglicherweise auch ein Gesprächsbedarf über Wünsche und Vorstellungen im Hinblick auf das Lebensende. Palliativdienste sollten deshalb besonders auf die psychosozialen Bedürfnisse einzugehen.
Back pain, ankylosing spondylitis and social media usage; a descriptive analysis of current activity
Authors: Reilly Elizabeth , Sengupta Raj 
Published: May 2020

AbstractSocial media usage by back pain patients is a new and developing area. Analysing patterns of this online activity offers a new way to understand our patients’ concerns and behaviour around disease. Large volume data can be evaluated on a scale not feasible through alternative methods. A cross sectional review of specific terms relating to ‘back pain’ (BP) and ‘ankylosing spondylitis’ (AS) were tracked internationally on popular websites, blogs and boards over two 3 month periods, in 2016 and 2019. Relevant co-terms were also tracked in these discussions, such as ‘exercise’, ‘medication’ and ‘doctor’. The size of the current online BP conversation is significant; there were over 100,000 mentions/month across each study period, particularly ‘low-’ BP. Discussions about AS increased threefold between 2016 and 2019. More discussions took place online at the start of the week, and in the afternoons. Pregnancy, baby and mens’ health resources were the most popular sites for BP chats. People posting about AS were mainly female (80%) and predominantly had an established diagnosis, with health forums hosting more of these discussions than for BP. Exercise was more commonly mentioned in the context of BP, whereas medications were more common in the AS conversations. Analysing online discussions about BP and AS helps to identify themes amongst patients. Some are seeking a diagnosis, support, or treatment information. Understanding the massive scale of online conversations could help clinicians adopt targeted approaches to increase patient identification, meet patient concerns better, and optimise engagement.
Effects of diet, habitual water intake and increased hydration on body fluid volumes and urinary analysis of renal fluid retention in healthy volunteers
Authors: Hahn Robert G. 
Published: May 2020

Abstract
Purpose
To increase our knowledge about the causes and physiological consequences of concentrated urine, the relevance of which in the general population is uncertain.

Methods
Twenty healthy volunteers (mean age 42 years) recorded all intake of food and water for 2 weeks. During the 2nd week, they increased their daily consumption of water by 716 mL (32%). The volunteers delivered a 24-h and a morning urine sample for analysis of osmolality and creatinine during the first 4 days of both weeks, and a sample each time they voided on the other days. The water content of food and liquid was calculated and the body fluid volumes were measured by bioimpedance. Haemodynamic stability was assessed with the passive leg-raising test.

Results
There was a curvilinear correlation between the daily intake of water and biomarkers measured in the 24-h collection of urine (coefficient of determination 0.37–0.70). Habitual low intake of water was associated with larger body fluid volumes. The increased fluid intake during the 2nd week was best reflected in the 24-h collection (−15 and −20% for the osmolality and creatinine, respectively, P < 0.002), while morning urine and body fluid volumes were unchanged. Increased fluid intake improved the haemodynamic stability in volunteers with a low intake of water (< median), but only in those who had minimally concentrated morning urine.

Conclusions
The 24-h collection reflected recent intake of fluid, whereas the morning urine seemed to mirror long-term corrections of the fluid balance. Concentrated urine was associated with larger body fluid volumes.
Quality of life and associated factors after surgical treatment of vulvar cancer by vulvar field resection (VFR)
Authors: Trott Sophia , Höckel Michael , Dornhöfer Nadja , Geue Kristina , Aktas Bahriye , Wolf Benjamin 
Published: May 2020

Abstract
Purpose
To investigate patient-reported quality of life (QoL) and associated factors in vulvar cancer patients treated surgically by vulvar field resection (VFR) without adjuvant radiation.

Methods
We retrospectively evaluated patient-reported QoL as part of the prospective monocentric VFR trial using the 30-item European Organization for Research and Treatment of Cancer quality-of-life questionnaire (EORTC QLQ-C30) supplemented by a question assessing sexual activity. All patients had been treated by VFR and no participant had received adjuvant radiotherapy. The gynecologic cancer lymphedema questionnaire (GCLQ) was used to determine the presence of lymphedema. Structured telephone interviews were conducted to assess postoperative sequelae and long-term complications.

Results
Forty-three VFR patients (median age 63 years) were available for QoL assessment. Thirty-eight (88%) had received inguinal lymph-node dissection in addition to VFR. Mean global QoL (global health status) rating among all patients was 66.1 (± 25.5) on a scale from 0 to 100 with higher scores indicating better QoL. Higher GCLQ scores were significantly associated with lower global QoL scores (Spearman's rank correlation ρ =− 0.7, p < 0.0001). The presence of preoperative co-morbidities and postoperative wound-healing complications were also linked to reduced QoL (p < 0.01 for both). In a multivariable regression model, there was a significant interaction between preoperative co-morbidities and wound-healing complications with regard to global QoL (p < 0.05).

Conclusion
Overall, VFR patients exhibit good quality of life postoperatively. The presence of lymphedema, wound-healing complications, and preoperative morbidities were associated with reduced QoL. Prospective longitudinal studies have to confirm our findings in the future.
Audiovestibular clinician experiences and opinions about cisplatin vestibulotoxicity
Authors: Prayuenyong Pattarawadee , Kasbekar Anand V. , Hall Deborah A. , Baguley David M. 
Published: May 2020

Abstract
Purpose
Vestibulotoxicity associated with cisplatin chemotherapy is known to exist, but the extent, severity, and impact is unclear from the literature. This study explored knowledge, experiences, and opinions of audiovestibular professionals about cisplatin vestibulotoxicity.

Methods
An online survey was disseminated to clinicians working in the audiovestibular field.

Results
Ninety-three respondents participated in the survey. Most professionals were aware of potential vestibulotoxicity associated with cisplatin chemotherapy. Thirty-three percent of the respondents reported that they had seen patients with cisplatin vestibulotoxicity. Forty percent of them were confident in making the diagnosis and in managing the patient in this situation. The prevalence and impact of vestibulotoxicity including practicality of the assessment should be considered when designing an effective vestibulotoxicity screening protocol.

Conclusion
This study provides a better understanding of cisplatin vestibulotoxicity from the perspectives of audiovestibular clinicians, which will underpin appropriate detection and management of the condition.
The embryonic expression pattern of a second, hitherto unrecognized, paralog of the pair-rule gene sloppy-paired in the beetle Tribolium castaneum
Authors: Janssen Ralf 
Published: May 2020

AbstractIn the fly Drosophila melanogaster, a hierarchic segmentation gene cascade patterns the anterior-posterior body axis of the developing embryo. Within this cascade, the pair-rule genes (PRGs) transform the more uniform patterning of the higher-level genes into a metameric pattern that first represents double-segmental units, and then, in a second step, represents a true segmental pattern. Within the PRG network, primary PRGs regulate secondary PRGs that are directly involved in the regulation of the next lower level, the segment-polarity genes (SPGs). While the complement of primary PRGs is different in Drosophila and the beetle Tribolium, another arthropod model organism, both paired (prd) and sloppy-paired (slp), acts as secondary PRGs. In earlier studies, the interaction of PRGs and the role of the single slp ortholog in Tribolium have been investigated in some detail revealing conserved and diverged aspects of PRG function. In this study, I present the identification and the analysis of embryonic expression patterns of a second slp gene (called slp2) in Tribolium. While the previously identified gene, slp, is expressed in a typical PRG pattern, expression of slp2 is more similar to that of the downstream-acting SPGs, and shows expression similarities to slp2 in Drosophila. The previously reported differences between the function of slp in Drosophila and Tribolium may partially account for the function of the newly identified second slp paralog in Tribolium, and it may therefore be advised to conduct further studies on PRG function in the beetle.
Expression of the zinc finger transcription factor Sp6–9 in the velvet worm Euperipatoides kanangrensis suggests a conserved role in appendage development in Panarthropoda
Authors: Janssen Ralf , Budd Graham E. 
Published: May 2020

AbstractThe Sp-family genes encode important transcription factors in animal development. Here we investigate the embryonic expression patterns of the complete set of Sp-genes in the velvet worm Euperipatoides kanangrensis (Onychophora), with a special focus on the Sp6–9 ortholog. In arthropods, Sp6–9, the ortholog of the Drosophila melanogaster D-Sp1 gene plays a conserved role in appendage development. Our data show that the expression of Sp6–9 during the development of the velvet worm is conserved, suggesting that the key function of the Sp6–9 gene dates back to at least the last common ancestor of arthropods and onychophorans and thus likely the last common ancestor of Panarthropoda.
The prognostic role of tissue TLR2 and TLR4 in colorectal cancer
Authors: Beilmann-Lehtonen Ines , Böckelman Camilla , Mustonen Harri , Koskensalo Selja , Hagström Jaana , Haglund Caj 
Published: May 2020

AbstractColorectal cancer (CRC), the second most common cancer globally, resulted in 881,000 deaths in 2018. Toll-like receptors (TLRs) are crucial to detecting pathogen invasion and inducing the host’s immune response. This study aimed to explore the prognostic value of TLR2 and TLR4 tumor expressions in colorectal cancer patients. We studied the immunohistochemical expressions of TLR2 and TLR4 using tissue microarray specimens from 825 patients undergoing surgery in the Department of Surgery, Helsinki University Hospital, between 1982 and 2002. We assessed the relationships between TLR2 and TLR4 expressions and clinicopathological variables and patient survival. We generated survival curves using the Kaplan-Meier method, determining significance with the log-rank test. Among patients with lymph node–positive disease and no distant metastases (Dukes C), a strong TLR2 immunoactivity associated with a better prognosis (p < 0.001). Among patients with local Dukes B disease, a strong TLR4 immunoactivity associated with a worse disease-specific survival (DSS; p = 0.017). In the multivariate survival analysis, moderate TLR4 immunoactivity compared with strong TLR4 immunoactivity (hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.49–0.89, p = 0.007) served as an independent prognostic factor. In the multivariate analysis for the Dukes subgroups, moderate TLR2 immunoactivity (HR 2.63, 95% CI 1.56–4.44, p < 0.001) compared with strong TLR2 immunoactivity served as an independent negative prognostic factor in the Dukes C subgroup. TLR2 and TLR4 might be new prognostic factors to indicate which CRC patients require adjuvant therapy and which could spare from an unnecessary follow-up, but further investigations are needed.
An evaluation of preterm kidney size and function over the first two years of life
Authors: Kandasamy Yogavijayan , Rudd Donna , Lumbers Eugenie R , Smith Roger 
Published: May 2020

Abstract
Background
We carried out a study to determine the impact of prematurity on kidney development in the first 2 years of life.

Methods
In this prospective study, extremely preterm neonates (gestation < 28 weeks) were recruited and underwent assessments at 6, 12, and 24 months of age. A cohort of neonates born term were also recruited and followed up for 24 months. The primary outcomes measured in this study were total kidney volume (TKV) and estimated glomerular filtration rate (eGFR); albuminuria and blood pressure measurements (all provided as mean (standard deviation)) were the secondary outcomes.

Results
Fifty-three premature and 31 term neonates (control) were recruited. At the age of 24 months (corrected age), infants born preterm had significantly smaller TKV (56.1 (9.4) vs. 64.8 (10.2) mL; P = 0.006). There was no difference in eGFR. These preterm infants were smaller (11.25 (1.53) vs. 12.9 (1.8) kg; P = 0.002) and shorter (83.8 (3.0) vs. 86.3 (3.4) cm; P = 0.02) when compared with the control group. At 6, 12, and 18 months respectively, preterm infants had, relative to their height, significantly smaller kidney volumes (0.54 (0.1) vs. 0.59 (0.1) mL/cm, P = 0.05; 0.61 (0.1) vs.0.71 (0.1) mL/cm, P = 0.003; and 0.67 (0.1) vs.0.76 (0.1) mL/cm, P = 0.006).

Conclusions
Relative to body length, TKV in premature infants is smaller. Since length reflects adult body proportions more accurately than BSA, TKV to height ratio may be a more important measure in the child. Despite smaller TKV (and therefore fewer nephrons), infants born prematurely achieve similar eGFRs in the first 24 months of life, probably due to single-nephron hyperfiltration.
Transiente Spannungsmodellierung in umrichtergespeisten Niederspannungsmaschinen mit Steckwicklungen
Authors: Pauli Florian , Wu Yixuan , Driendl Niklas , Schröder Michael , Hameyer Kay 
Published: May 2020

ZusammenfassungDas Isolierstoffsystem von umrichtergespeisten elektrischen Maschinen ist transienten elektrischen Spannungen ausgesetzt. Diese entstehen aufgrund der endlichen Ausbreitungsgeschwindigkeit der Spannung sowie Induktivitäts- und Kapazitätsbelägen der Wicklung. Durch schnell schaltende Umrichter und den damit verbundenen höheren Spannungsanstiegsgeschwindigkeiten $\mathrm{d}u/\mathrm{d}t$
d
u
/
d
t
wird der Einfluss der transienten Spannungen auf das Wicklungssystem weiter erhöht. Eine besondere elektrische Belastung erfährt die Windungsisolierung, welche in Niederspannungsmaschinen häufig als Kupferlackdraht ausgeführt ist. In Steckwicklungen ist die Position jedes Leiters bekannt. Mit einem transienten Modell, das den Spannungsverlauf an jedem Ort der Wicklung abbilden kann, ist es möglich, das Isolierstoffsystem gezielt auszulegen und zu dimensionieren.
Analytische Ermittlung des Stirnraumanteils der Wicklung-Stator-Kapazität in elektrischen Maschinen zur Vorausberechnung des hochfrequenten Common-Mode-Stroms
Authors: Stockbrügger Jan Ole , Ponick Bernd 
Published: May 2020

ZusammenfassungBeim Betrieb von schnellschaltenden Umrichtern treten in elektrischen Antrieben parasitäre, hochfrequente Effekte auf. Bei einem Zweipunkt-Wechselrichter ist der Mittelwert der drei Ausgangsspannungen aufgrund der diskreten Schaltzustände der Leistungstransitoren eine von Null verschiedene Gleichtaktspannung. Die Common-Mode-Spannung wird durch den Umrichter in die Motorwicklung eingeprägt und verursacht einen kapazitiven, hochfrequenten Common-Mode-Strom, der als Umladestrom der Kapazität zwischen Wicklung und Statorblechpaket und –gehäuse verstanden werden kann.Die Wicklung-Stator-Kapazität setzt sich aus einem Nut- und einem Stirnraumanteil zusammen. In diesem Artikel wird eine analytische Bestimmung des Stirnraumanteils der Wicklung-Stator-Kapazität vorgestellt, welche neben der Stirnraumgeometrie den Einfluss von Materialien mit unterschiedlichen Permittivitäten berücksichtigt. Die Ermittlung des Stirnraumanteils der Wicklung-Stator-Kapazität basiert auf der Berechnung des skalaren Potenzialfelds unterhalb und oberhalb des Wicklungskopfs der Statorwicklung. Das vorgestellte Modell wird mit Hilfe von FEM-Simulationen für verschiedene Geometrien und Materialien validiert.