bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Incidence and Mortality Trends for Breast Cancer in Germany
Authors: Hübner Joachim , Katalinic Alexander , Waldmann Annika , Kraywinkel Klaus 
Published: June 2020

Abstract
Introduction Changes in risk factors and the introduction of mammography screening in 2005 have led to dramatic changes in the breast cancer-associated burden of disease in Germany. This study aimed to investigate long-term disease-related incidence and mortality trends in women from East and West Germany since the reunification of Germany.
Methods Total and stage-specific incidence rates were evaluated based on data obtained from selected cancer registries. Sufficiently complete data going back to 1995 were available for 4 East German and 3 West German regions. The figures were weighted for population size, and rates were calculated for the whole of Germany based on the rates for East and West Germany. The study particularly focused on 3 different age groups: women eligible for mammography screening (50 – 69 years), younger women (30 – 49 years) and older women (70+ years). All rates were standardised for age. The mortality rates obtained from the official statistics on cause of death since 1990 were processed accordingly.
Results Incidence rates in the observation period increased, as they were affected by the increasing number of cases with early-stage cancers being diagnosed in the screening age group. The total incidence for this group, which included the incidence of non-invasive breast cancers, increased by 14.5% between 2005 and 2016. Early-stage cancers (UICC stages 0 and I) increased by 48.1% while late-stage diagnoses (UICC stages III and IV) decreased by 31.6%. Qualitatively similar changes were noted for the other age groups, although they were less pronounced. The decrease in breast cancer mortality observed since the mid-1990s ended around 2008 for the group of younger women but continued in the screening age group. After 2008, an increase in mortality was observed in the group of older women. The differences in disease burden between East and West Germany (in favour of East Germany) decreased in younger women during the observation period but tended to increase in the group of older women.
Conclusion The analysis suggests that the introduction of mammography screening contributed to a decrease in the incidence of advanced-stage breast cancers and in breast cancer-related mortality rates but also resulted in a substantial number of overdiagnoses. The relatively unfavourable incidence trend in the group of younger women, particularly in East Germany, should be interpreted in the context of lifestyle changes. The slight increase in mortality observed in the group of older women after 2008 requires further analysis.
Evaluation of a simplified Herd Health and Welfare Index for benchmarking in pig herds
Authors: Wadepohl Katharina , Blaha Thomas , Meemken Diana 
Published: June 2020

Zusammenfassung
Gegenstand und Ziel Tierwohl und Tiergesundheit rücken in der Nutztierhaltung zunehmend in den Fokus der Aufmerksamkeit. Der für das EFFORT-Projekt (Ökologie mikrobieller Arzneimittelresistenz und Transmission vom Erzeuger zum Verbraucher) entwickelte Herd Health and Welfare Index (HHWI) ermöglicht es, trotz zeitlicher Einschränkungen Tiergesundheit und Tierwohl regelmäßig semiquantitativ zu erfassen. Da die Verbesserung von Tierwohl und Tiergesundheit zur Reduktion des Antibiotikaeinsatzes beitragen kann, ist es wichtig, die Qualität dieser Parameter auf breiter Basis zu registrieren, um Maßnahmen zur Verbesserung planen und bewerten zu können.
Material und Methoden In 20 deutschen Schweineherden kam der HHWI unter Praxisbedingungen zur Anwendung. Die Ergebnisse dienten zur Beurteilung der Herden mit dem Ziel, eine kontinuierliche Verbesserung der Tiergesundheit und des Tierwohls zu fördern. Um die Nutzbarkeit des Index zu belegen, wurden die Ergebnisse des HHWI (Spannweite: 10 Punkte [sehr gut] bis 30 Punkte [sehr schlecht]) mit der Anzahl der Antibiotikabehandlungen, gemessen durch den Animal Treatment Index (ATI), verglichen.
Ergebnisse Die HHWI-Punkte in den untersuchten Herden reichten von 11 bis 25. Im Vergleich des HHWI mit der Anzahl der Behandlungen (angegeben als ATI) ergab sich eine schwache Assoziation.
Schlussfolgerungen Nach den vorläufigen Ergebnissen lässt sich der HHWI statistisch nicht direkt mit dem antimikrobiellen Einsatz in Verbindung bringen. Die Anzahl der nicht direkt mit der Tiergesundheit in Verbindung stehenden Risikofaktoren für einen erhöhten Einsatz von Antibiotika (z. B. Einstellung des Landwirts, Routine- und Gruppenbehandlungen mit Antibiotika) ist zu groß, sodass diese den möglichen Einfluss von Tierwohl und Tiergesundheit überdecken können. Den ersten Ergebnissen zufolge könnte der Index jedoch genutzt werden, um den Verlauf von Maßnahmen zur Reduktion des Antibiotikaeinsatzes in einem Betrieb zu beurteilen.
Klinische Relevanz Der HHWI hat sich als einfach nutzbares Messinstrument zur Bewertung von Veränderungen des Tiergesundheits- und Tierwohlstatus erwiesen. Dies ermöglicht eine kontinuierliche Erhebung der Daten. Langfristig könnte der HHWI zur regionalen oder nationalen Bewertung der Tiergesundheit herangezogen werden, um Schweinebestände, in denen eine Verbesserung von Tiergesundheit und Tierwohl angezeigt ist, zu identifizieren und so das Wohlbefinden der Schweine in diesen Beständen zu verbessern und folglich den Einsatz von Antibiotika zu verringern.
Gliedmaßenamputation bei 2 kleinen Wiederkäuern
Authors: Schoiswohl Julia , Degasperi Brigitte , Schieder Katrin , Ertelt Katrin , Kofler Johann 
Published: June 2020

ZusammenfassungEine 2 Monate alte Ziege und ein 5 Jahre altes Schaf wurden aufgrund von hochgradiger Lahmheit vorgestellt. Bei der Ziege bestand linksseitig eine 5 Wochen alte offene, distale Metakarpustrümmerfraktur mit hochgradiger Knocheninfektion der distalen Hälfte der Metakarpalknochen. Bei dem Schaf wurden eine offene Schrägfraktur der linken Tibia sowie eine penetrierende Fesselgelenkwunde an derselben Gliedmaße diagnostiziert. In beiden Fällen erfolgte eine Amputation der Gliedmaße auf Höhe Schultergelenk bzw. Oberschenkel unter Allgemeinanästhesie und zusätzlicher Leitungsanästhesie der großen proximalen Gliedmaßennerven. Die Operation verlief jeweils erfolgreich und die Tiere wiesen postoperativ eine gute Beweglichkeit und Lebensqualität auf. Gliedmaßenamputationen bei kleinen Wiederkäuern werden in der Literatur nur selten beschrieben, stellen jedoch eine mögliche Alternative zur Euthanasie dar.
Erstbeschreibung des kaninen leproiden Granuloms in Deutschland: 2 Fallberichte
Authors: Jäger Kathrin , Gläsel Agnes , Hillemann Doris , Martin Nicole , Theuerkauff Julika 
Published: June 2020

ZusammenfassungBei 2 Hunden wurden im Rahmen der dermatologischen Untersuchung noduläre Hautläsionen im Kopf-/Ohrmuschelbereich nachgewiesen, die mittels histopathologischer, zytologischer und molekularbiologischer Untersuchungen als kanine leproide Granulome charakterisiert werden konnten. Die Erkrankung wird durch nichttuberkulöse, bisher nicht vollständig klassifizierte Mykobakterien verursacht und stellt eine im pazifischen Raum sowie in Nord- und Südamerika dokumentierte Hautläsion dar, die in Deutschland bisher nicht beschrieben wurde. Durch die in beiden Fällen erfolgte Kombination aus chirurgischer und medikamentöser Langzeittherapie (Rifampicin, Clarithromycin, Doxycyclin und lokal Clofazimin) konnten die Granulome entfernt bzw. zur Regression gebracht werden.
Retroperitoneale Lymphadenektomie bei testikulären Keimzelltumoren: Indikationen, Komplikationen und spezielle Fragestellungen
Authors: John Patricia , Albers Peter , Hiester Andreas , Heidenreich Axel 
Published: June 2020

ZusammenfassungDie retroperitoneale Lymphadenektomie ist integraler Bestandteil der stadienadaptierten Therapie von testikulären Keimzelltumoren. Verschiedene Ansätze der retroperitonealen Lymphadenektomie werden auf Basis unterschiedlicher Indikationen durchgeführt.Die nervschonende retroperitoneale Lymphadenektomie als primäre Therapieoption bei nicht seminomatösen Keimzelltumoren im klinischen Stadium I sollte risikoadaptiert erfolgen. Geringfügige perioperative Komplikationen wie Wundinfekte, Lymphozelen und paralytischer Ileus treten bei in etwa 14 % der Patienten auf. Schwerwiegendere Komplikationen wie chylärer Aszites und Lungenarterienembolien treten bei ca. 5,4 % der Patienten auf. Die häufigste Langzeitkomplikation ist hierbei das Auftreten einer Retrograden Ejakulation. Der Erhalt der antegraden Ejakulation kann jedoch bei weit über 90 % der Patienten erreicht werden.Die postchemotherapeutische retroperitoneale Lymphadenektomie ist integraler Bestandteil der multimodalen Therapie bei retroperitonealen Residualbefunden. Bei residuellen Befunden > 3 cm beim fortgeschrittenen Seminom dient das FDG PET als zuverlässige Entscheidungshilfe zur Durchführung einer retroperitonealen Lymphadenektomie.Bei ca. 30 % der Patienten mit nicht seminomatösen Keimzelltumoren finden sich residuelle retroperitoneale Tumorbefunde. Diese sollten unabhängig von der Größe der Befunde bei negativen Serumtumormarkern oder Serumtumormarkern im Plateau komplett reseziert werden. Die postchemotherapeutische retroperitoneale Lymphadenektomie stellt einen herausfordernden Eingriff dar und sollte primär an ausgewiesenen Zentren durchgeführt werden. Bei bis zu 25 % der Patienten ist im Rahmen der postchemotherapeutischen retroperitonealen Lymphadenektomie die Resektion umgebender Strukturen indiziert. Eine Beteiligung der aorta abdominalis liegt in 6 – 10 % der Fälle vor, eine Beteiligung der vena cava in ca. 2 % der Fälle. Komplikationsraten liegen bei der postchemotherapeutischen retroperitonealen Lymphadenektomie höher als bei der primären nervschonenenden Lymphadenektomie mit signifikant höherem intraoperativen Blutverlust und signifikant höherer Transfusionsrate. Mit einer Wahrscheinlichkeit von 2 – 7 % tritt chylärer Aszites nach postchemotherapeutischer retroperitonealer Lymphadenektomie häufiger auf. Jedoch kann auch im Rahmen der postchemotherapeutischen Lymphadenektomie bei bis zu 85 % der Erhalt der antegraden Ejakulation erreicht werden. Entscheidend für den Erhalt der antegraden Ejakulation und einer Verbesserung der Morbidität insgesamt ist auch hier das nach Möglichkeit das Anstreben eines nervsparenden Vorgehens durch Anpassung der Felder.
Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section
Authors: Dathan-Stumpf Anne , Winkel Katharina , Stepan Holger 
Published: June 2020

AbstractObjective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig.Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study.Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores.Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.
Donation after Circulatory Death: Potential Mechanisms of Injury and Preventative Strategies
Authors: Croome Kristopher P. 
Published: June 2020

AbstractDonation after circulatory death (DCD) donors represent a potential means to help address the disparity between the number of patients awaiting liver transplantation (LT) and the availability of donor livers. While initial enthusiasm for DCD LT was high in the early 2000s, early reports of high rates of biliary complications and inferior graft survival resulted in reluctance among many transplant centers to use DCD liver grafts. As with all innovations in transplant practice, there is undoubtedly a learning curve associated with the optimal utilization of liver grafts from DCD donors. More contemporary data has demonstrated that results with DCD LT are improving and the number of DCD LT performed annually has been steadily increasing. In this concise review, potential mechanisms of injury for DCD livers are discussed along with strategies that have been employed in clinical practice to improve DCD LT outcomes.
Lithopedion—A Rock Baby
Authors: Pradeep Kumar Chandandur Nagarajaiah , Sowmya Jagadish , Manupratap Narayan , Rajendrakumar N. L. , Nanjaraj Chakenalli Puttaraju , Sushma Hanumanthaiah , Raksha Allalasandra Ramakrishnaiah , Vinaya Manohara Gowda , Vasanth Kumar Lakshman Kumar 
Published: June 2020

AbstractLithopedion is a rare condition that occurs only in ectopic pregnancy and in <1% of all pregnancies. In this condition, the fetus dies and is not absorbed by the mother’s body but escapes the maternal immunity by forming calcified shell around it. The dead fetus remains in the maternal body for considerable period without complications.
The Gentleman’s Game Has New Rules for Concussion: Possible Impact and Controversies
Authors: Tripathi Manjul , Deora Harsh , Yagnick Nishant S. , Mohindra Sandeep , Batish Aman , Gurnaani Jenil 
Published: June 2020

Abstract
Background When Jofra Archer bowled that fateful bouncer that felled Steve Smith, arguably the best batsman in the world, the gut-churning incident revived images of the horrific Phillip Hughes tragedy. Fortunately, Smith was soon up and about, but he was forced off the ground by the medicos. Less than an hour later, the 30-year-old came back to the crease to resume his innings on 80 not out but he did not look right. He soon fell for 92—the first time he was dismissed under a hundred in the series—to a misjudgment that he would never make normally. Following this, discussions regarding concussions in sports in general and cricket in particular had been reignited throughout the world.
Methods We reviewed all available literatures on concussion in cricket and also reviewed all possible guidelines issued by the International Cricket Council and Cricket Australia on concussion. The latest guidelines issued on May 23, 2019 were kept as the basis for this article. Causes and possible methods/steps in management of the same were considered.
Discussion Sport should not be played at the cost of lives and mental well-being of the players. The guidelines issued are very exhaustive and useful but have no meaning if they are not implemented properly. Sports-related injuries are often considered trivial but considering recent events, they are not. There is a spectrum ranging from craniofacial injuries to concussion, leading to career and even life-ending injuries in professional cricket. In retrospect, most of the injuries were concussions but they had a lasting impact on the players’ career.
Conclusion Appropriate medical personnel must be present at all times to cover all matches (preferably having experience in head injuries). The decision on the medical personnel pervades any stage of the game and substitutes should be considered immediately, with return to play only after proper evaluation, and clearance has been obtained.
Low-Cost Customized Cranioplasty with Polymethyl Methacrylate Using 3D Printer Generated Mold: An Institutional Experience and Review of Literature
Authors: Chaudhary Ankit , Sinha Virendra Deo , Chopra Sanjeev , Shekhawat Jitendra , Jain Gaurav 
Published: June 2020

Abstract
Background Cranioplasty is performed to repair skull defects and to restore normal skull anatomy. Optimal reconstruction remains a topic of debate. Autologous bone flap is the standard option but it may not be available due to traumatic bone fractures, bone infection, and resorption. The authors present their experience with prefabrication of precise and low-cost polymethyl methacrylate (PMMA) mold using three-dimensional (3D) digital printing.
Methods A total of 30 patients underwent cranioplasty between March 2017 and September 2019 at Sawai Man Singh Medical College Jaipur, India. Preoperative data included diagnosis for which decompressive craniectomy was done and Glasgow coma scale score was observed. Intraoperative data included operating time. Postoperative data included cosmetic outcome in the form of cranial contour and margins, complications such as infection, seroma, implant failure, wound dehiscence, and hematoma.
Results Patient age at cranioplasty ranged from 12 to 63 years with a mean age of 36.7 years. The mean operating time was 151.6 minutes (range 130–190 minutes). The mean follow-up period was 8 months (range 6–13 months). Postoperative wound dehiscence developed in one case (3.3%). Cranial contour and approximation of the margins were excellent and aesthetic appearance improved in all patients.
Conclusion Low-cost PMMA implant made by digital 3D printer mold is associated with reconstruction of the deformed skull contour giving satisfactory results to the patient and his family members, at a low cost compared with other commercially available implants. This technique could be a breakthrough in cranioplasty.
Study of the Incidence, Clinicopathological Profile, and Management of Second Primary Tumors in Patients with Index Head and Neck Tumors
Authors: Jain Chirag , Jain Mansi , Dewan Ajay Kumar , Medisetty Pavani , Jajodia Ankush , Doval Dinesh Chandra , Koyyala Venkata Pradeep Babu 
Published: June 2020

Introduction This study was performed to study the incidence and clinicopathological profile of second primary tumors (SPTs) in patients with squamous cell carcinoma of head and neck at our institute.
Materials and Methods In this study, we included the data of 120 patients who developed an SPT of the upper aerodigestive tract following treatment of their index tumor (IT). Since the online data of cancer patients in our cancer registry was available from January 2005, we started the study retrospectively from that time. At our institute, Rajiv Gandhi Cancer Institute and Research Centre, the incidence was found to be 8.4%. Warren and Gates criteria were followed for defining a second tumor.
Results Our study results showed an incidence of 8.4% of SPTs among patients of head and neck squamous cell carcinoma (HNSCC). The mean age of the patients was 56.47 ± 10.42 years with a male predominance. The mean period of addiction in patients was 18.48 ± 4.63 years. It was found that patients with SPT had significant history of tobacco and alcohol use. The most common location for ITs and SPT was tongue and buccal mucosa. The main modality of treatment was surgery in all patient groups. Patients were followed up at three-month intervals for the first 2 years. The SPT was diagnosed with a confirmation biopsy. Majority of patients with SPT again underwent surgery with reconstruction with either free flaps or local flaps. Recurrence after SPT treatment was seen in 16.67% cases, and primarily, it was a locoregional recurrence. Only patients with at least 6 months follow-up posttreatment of SPT were included in this study. At the end of the study, 62.5% patients were disease free, 20.83% patients were alive with disease, and 16.67% patients were dead. Some of the patients who are alive with disease developed a third primary tumor which was managed as per guidelines.
Conclusion The incidence of SPTs is 8.4% in our institute. This study adds to the theory of field cancerization proposed by Slaughter et al. We found a significant history of tobacco chewing in our patients who developed SPT. The clinical significance of this study is identifying the features of SPT in patients with HNSCC and allowing for a rational follow-up schedule. The most important part of treatment although still lies with the patient by quitting use of alcohol and tobacco.
Endothelial cell‐derived extracellular vesicles alter vascular smooth muscle cell phenotype through high‐mobility group box proteins
Authors: Boyer Michael J. , Kimura Yayoi , Akiyama Tomoko , Baggett Ariele Y. , Preston Kyle J. , Scalia Rosario , Eguchi Satoru , Rizzo Victor 
Published: June 2020

ABSTRACTThe vascular endothelium and smooth muscle form adjacent cellular layers that comprise part of the vascular wall. Each cell type can regulate the other's structure and function through a variety of paracrine effectors. Extracellular vesicles (EVs) are released from and transit between cells constituting a novel means of cell–cell communication. Here, we characterized the proteome of EVs released from each vascular cell type and examined the extent to which these vesicles participate in endothelial‐vascular smooth muscle cell (VSMC) communication. EVs were collected by ultracentrifugation from media of rat aortic endothelial and smooth muscle cells cultured under serum‐free conditions. Vesicle morphology, size and concentration were evaluated by transmission electron microscopy and nanoparticle tracking analysis. Western blot as well as shot gun proteomic analyses revealed sets of proteins common to both endothelial‐ and smooth muscle‐derived EVs as well as proteins unique to each vascular cell type. Functionally, endothelial‐derived EVs stimulated vascular cell adhesion molecule‐1 (VCAM‐1) expression and enhanced leukocyte adhesion in VSMCs while smooth muscle EVs did not elicit similar effects in endothelial cells (ECs). EVs from ECs also induced protein synthesis and senescence in VSMCs. Proteomic analysis of VSMCs following exposure to EC‐derived EVs revealed upregulation of several proteins including pro‐inflammatory molecules, high‐mobility group box (HMGB) 1 and HMGB2. Pharmacological blockade HMGB1 and HMGB2 and siRNA depletion of HMGB1 in smooth muscle cells attenuated VCAM‐1 expression and leukocyte adhesion induced by EC EVs. These data suggest that EC‐derived EVs can enhance signalling pathways which influence smooth muscle cell phenotype.
Performance analysis of NOMA in pedestrian and vehicular environments
Authors: Ahmad Hasyimah , Mohd Ali Darmawaty , Norsyafizan Wan Muhamad Wan , Syarhan Idris Mohd 
Published: June 2020

Abstract
The ability to serve many users with high-speed transmission has made 5G as the promising candidate for the future generation of the wireless communication system. LTE could no longer support future demand with its current transmission rates. Various multiple access schemes have been proposed for 5G and NOMA as one of the candidates. Thus, this study has analysed the performance of NOMA in comparison to OMA in pedestrian and vehicular environments. To assure the Quality of Service (QoS), the metric of throughput is evaluated. The simulation was done using The Vienna 5G Link Level Simulator (LLS) and the result shows that NOMA cell centred user performed 50% better than OMA. Meanwhile, OMA outperformed NOMA in terms of cell edge user by 56%. The finding is in line with the characteristics of NOMA and OMA where NOMA users have to be in pair and share the same subcarrier while OMA users have their dedicated subcarrier for transmission.