bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19-Stresstest für die Sicherstellung der Notfallversorgung: Strategie und Maßnahmen der Notfallrettung in Berlin
Authors: Dahmen Janosch , Bäker Linnart , Breuer Florian , Homrighausen Karsten , Pommerenke Christopher , Stiepak Jan-Karl , Poloczek Stefan 
Published: November 2020

Zusammenfassung
Hintergrund
Die COVID-19-Pandemie stellt die Notfallversorgung in Deutschland vor eine beispiellose Belastungsprobe. Neben der klinischen Notfallversorgung in den Notaufnahmen der Krankenhäuser kommt der präklinischen Notfallrettung die entscheidende Sicherstellungsaufgabe notfallmedizinischer Gesundheitsversorgung zu. Die Berliner Feuerwehr zeigt in dem vorliegenden Beitrag für die Notfallrettung im Land Berlin neue Wege auf, dieser gewachsenen Verantwortung in der prähospitalen Patientenversorgung gerecht zu werden.

Methode
Es erfolgte eine systematische Darstellung der Herausforderungen und konzeptionellen Antworten der präklinischen Notfallmedizin auf die COVID-19-Pandemie am Beispiel der Notfallrettung im Land Berlin.

Ergebnisse
Die Berliner Feuerwehr koordiniert in einer zentralen Leitstelle für das Land Berlin alle Hilfeersuchen des Notrufs 112. Je 24 h gehen im Mittel 2565 Notrufe ein, aus denen 1271 Einsätze generiert werden. Im Rahmen der Pandemie kam es zu einer deutlichen Zunahme an Einsätzen zu Patienten mit akuten respiratorischen Erkrankungen (ARE). So erfolgten 11 % der Einsätze zu Patienten mit dem Verdacht einer COVID-19-Erkrankung. Die Notrufdauer verlängerte sich bei ergänzender Abfrage des „Pandemie-Protokolls“ im Schnitt um 1:36 min, die Einsatzdauer bei Einsätzen mit Alarmstichwort-Zusatz „akute respiratorische Erkrankung [ARE.]“ im Mittel um 17 min.

Schlussfolgerung
Die andauernde Pandemie macht deutlich, dass Aufgaben und Verantwortung der öffentlichen Träger der Notfallrettung über die unmittelbare, medizinische Gefahrenabwehr für Leib und Leben hinausgehen. Neben einer Lotsen- und Triage-Funktion in der integrierten Leitstelle der Berliner Feuerwehr (112) konnte durch umfassende Maßnahmen der Lageüberwachung, Lagedarstellung und Lagebewältigung trotz Ausfall alternativer, ambulanter Versorgungsangebote u. a. im Bereich der Haus- und Facharztpraxen die Notfall- resp. Gesundheitsversorgung sichergestellt werden.
Mental health of clinical staff working in high-risk epidemic and pandemic health emergencies a rapid review of the evidence and living meta-analysis
Authors: Bell Vaughan , Wade Dorothy 
Published: November 2020

Abstract
Purpose
The SARS-CoV-2 / COVID-19 pandemic has raised concerns about the potential mental health impact on frontline clinical staff. However, given that poor mental health is common in acute medical staff, we aimed to estimate the additional burden of work involving high exposure to infected patients.

Methods
We report a rapid review, meta-analysis, and living meta-analysis of studies using validated measures from outbreaks of COVID-19, Ebola, H1N1 influenza, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS).

Results
A random effects meta-analysis found that high-exposure work is not associated with an increased prevalence of above cut-off scoring (anxiety: RR = 1.30, 95% CI 0.87–1.93, Total N = 12,473; PTSD symptoms: RR = 1.16, 95% CI 0.75–1.78, Total N = 6604; depression: RR = 1.50, 95% CI 0.57–3.95, Total N = 12,224). For continuous scoring, high-exposure work was associated with only a small additional burden of acute mental health problems compared to low-exposure work (anxiety: SMD = 0.16, 95% CI 0.02–0.31, Total N = 6493; PTSD symptoms: SMD = 0.20, 95% CI 0.01–0.40, Total N = 5122; depression: SMD = 0.13, 95% CI -0.04–0.31, Total N = 4022). There was no evidence of publication bias.

Conclusion
Although epidemic and pandemic response work may add only a small additional burden, improving mental health through service management and provision of mental health services should be a priority given that baseline rates of poor mental health are already very high. As new studies emerge, they are being added to a living meta-analysis where all analysis code and data have been made freely available: https://osf.io/zs7ne/.
Medial stabilised total knee arthroplasty achieves comparable clinical outcomes when compared to other TKA designs: a systematic review and meta-analysis of the current literature
Authors: Nisar Sohail , Ahmad Kashif , Palan Jeya , Pandit Hemant , van Duren Bernard 
Published: November 2020

Abstract
Purpose
The purpose of this study was to perform a systematic review and meta-analysis to compare clinical and patient-reported outcome measures of medially stabilised (MS) TKA when compared to other TKA designs.

Methods
The Preferred Reporting Items for Systematic Review and Meta-Analyses algorithm was used. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and EMCARE databases were searched to June 2020. Studies with a minimum of 12 months of follow-up comparing an MS TKA design to any other TKA design were included. The statistical analysis was completed using Review Manager (RevMan), Version 5.3.

Results
The 22 studies meeting the inclusion criteria included 3011 patients and 4102 TKAs. Overall Oxford Knee Scores were significantly better (p = 0.0007) for MS TKA, but there was no difference in the Forgotten Joint Scores (FJS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS)-Knee, KSS-Function, and range of motion between MS and non-MS TKA designs. Significant differences were noted for sub-group analyses; MS TKA showed significantly worse KSS-Knee (p = 0.02) and WOMAC (p = 0.03) scores when compared to Rotating Platform (RP) TKA while significantly better FJS (p = 0.002) and KSS-knee scores (p = 0.0001) when compared to cruciate-retaining (CR) TKA.

Conclusion
This review and meta-analysis show that MS TKA designs result in both patient and clinical outcomes that are comparable to non-MS implants. These results suggest implant design alone may not provide further improvement in patient outcome following TKA, surgeons must consider other factors, such as alignment to achieve superior outcomes.

Level of evidence
III.
Determining the efficiency of residential electricity consumption
Authors: Andor Mark A. , Bernstein David H. , Sommer Stephan 
Published: November 2020

AbstractIncreasing energy efficiency is a key global policy goal for climate protection. An important step toward an optimal reduction of energy consumption is the identification of energy saving potentials in different sectors and the best strategies for increasing efficiency. This paper analyzes these potentials in the household sector by estimating the degree of inefficiency in the use of electricity and its determinants. Using stochastic frontier analysis and disaggregated household data, we estimate an input requirement function and inefficiency on a sample of 2000 German households. Our results suggest that the mean inefficiency amounts to around 20%, indicating a notable potential for energy savings. Moreover, we find that household size and income are among the main determinants of individual inefficiency. This information can be used to increase the cost-efficiency of programs aimed to enhance energy efficiency.
Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections
Authors: Sigmund Irene Katharina , Holinka Johannes , Staats Kevin , Sevelda Florian , Lass Richard , Kubista Bernd , Giurea Alexander , Windhager Reinhard 
Published: November 2020

Abstract
Purpose
Besides other diagnostic test methods, established serum inflammatory markers such as serum C-reactive protein or leukocyte count are widely used preoperatively to aid in diagnosing periprosthetic joint infections (PJI). Although low accuracies were reported, these parameters are easily accessible and routinely available. Novel biomarkers with promising results in diagnosing PJI (platelet count to mean platelet volume ratio) or other infectious conditions (percentage of neutrophils, neutrophils to lymphocytes ratio) were described. The purpose of this study was to investigate the diagnostic value of established and novel serum inflammatory biomarkers for the diagnosis of PJI so as to compare the results to find the serum inflammatory marker with the best performance.

Methods
In 177 patients with a previous total hip (n = 91) or knee (n = 86) arthroplasty and indicated revision surgery, the diagnostic value of the routinely available serum inflammatory markers C-reactive protein (CRP), white blood cell count (WBC), percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), fibrinogen and platelet count to mean platelet volume ratio (PC/mPV) were examined retrospectively via receiver operating characteristic curve analysis (AUC). The curves were compared using the z-test.

Results
Sensitivities of serum CRP, WBC, %N, NLR, fibrinogen and PC/mPV were calculated with 68%, 36%, 66%, 63%, 69% and 43%, respectively. Specificities were 87%, 89%, 67%, 73%, 89% and 81%, respectively. Serum CRP (0.78) and fibrinogen (0.79) showed significantly better AUCs compared with serum WBC (0.63), %N (0.67), NLR (0.68) and PC/mPV (0.62) (p < 0.0001). Patients with PJI caused by a low-virulent microorganism (median CRP: 17.6 mg/L) obtained lower CRP levels compared with infections caused by high-virulent microorganisms (median CRP: 49.2 mg/L; p = 0.044). The combination of CRP and fibrinogen showed a better sensitivity (77%) with similar specificity (83%) than one method alone but not at a significant level (CRP (p = 0.200); fibrinogen (p = 0.437)).

Conclusion
Serum CRP and fibrinogen showed the best accuracies among these widely available serum inflammatory parameters. However, due to the insufficient performance, these biomarkers can only be recommended as suggestive criteria in diagnosing PJI. The preoperative workup should always be complemented by more specific tests such as synovial fluid analysis.
Overcoming the Arduous Transition for Robotic Hepatopancreatobiliary Cases: A Multi‐Procedure Learning Curve Study Utilizing CUSUM Analysis
Authors: Lim Joseph S. , Jackson Terence , Kurtz James , Cho Edward E. , Vedantam Shyam , Nagatomo Kei , Osman Houssam , Jeyarajah Dhiresh Rohan 
Published: November 2020

AbstractBackground/objectiveQuick optimization and mastery of a new technique is an important part of procedural medicine, especially in the field of minimally invasive surgery. Complex surgeries such as robotic pancreaticoduodenectomies (RPD) and robotic distal pancreatectomies (RDP) have a steep learning curve; therefore, findings that can help expedite the burdensome learning process are extremely beneficial. This single‐surgeon study aims to report the learning curves of RDP, RPD, and robotic Heller myotomy (RHM) and to review the results’ implications for the current state of robotic hepatopancreaticobiliary (HPB) surgery.Study designThis is a retrospective case series of a prospectively maintained database at a non‐university tertiary care center. Total of 175 patients underwent either RDP, RPD, or RHM with the surgeon (DRJ) from January 2014 to January 2020.ResultsStatistical significance of operating room time (ORT) was noted after 47 cases for RDP (p < 0.05), 51 cases for RPD (p < 0.0001), and 18 cases for RHM (p < 0.05). Mean ORT after the statistical mastery of the procedure for RDP, RPD, and RHM was 124, 232, 93 min, respectively. No statistical significance was noted for estimated blood loss or length of stay.ConclusionsRobotic HPB procedures have significantly higher learning curves compared to non‐HPB procedures, even for an experienced HPB surgeon with extensive laparoscopic experience. Our RPD curve, however, is quicker than the literature average. We suggest that this is because of the simultaneous implementation of HPB (RDP and RPD) and non‐HPB robotic surgeries with a shorter learning curve—especially foregut procedures such as RHM—into an experienced surgeon's practice. This may accelerate the learning process without compromising patient safety and outcomes.
On the potential and challenges of laser-induced thermal acoustics for experimental investigation of macroscopic fluid phenomena
Authors: Steinhausen Christoph , Gerber Valerie , Preusche Andreas , Weigand Bernhard , Dreizler Andreas , Lamanna Grazia 
Published: November 2020

AbstractMixing and evaporation processes play an important role in fluid injection and disintegration. Laser-induced thermal acoustics (LITA) also known as laser-induced grating spectroscopy (LIGS) is a promising four-wave mixing technique capable to acquire speed of sound and transport properties of fluids. Since the signal intensity scales with pressure, LITA is effective in high-pressure environments. By analysing the frequency of LITA signals using a direct Fourier analysis, speed of sound data can be directly determined using only geometrical parameters of the optical arrangement no equation of state or additional modelling is needed at this point. Furthermore, transport properties, like acoustic damping rate and thermal diffusivity, are acquired using an analytical expression for LITA signals with finite beam sizes. By combining both evaluations in one LITA signal, we can estimate mixing parameters, such as the mixture temperature and composition, using suitable models for speed of sound and the acquired transport properties. Finally, direct measurements of the acoustic damping rate can provide important insights on the physics of supercritical fluid behaviour.Graphic Abstract
A mendelian randomization study on causal effects of 25(OH)vitamin D levels on attention deficit/hyperactivity disorder
Authors: Libuda Lars , Naaresh Roaa , Ludwig Christine , Laabs Björn-Hergen , Antel Jochen , Föcker Manuel , Hebebrand Johannes , Hinney Anke , Peters Triinu 
Published: November 2020

Abstract
Background
While observational studies revealed an inverse association between serum 25(OH)vitamin D (25(OH)D) and the risk of attention deficit/hyperactivity disorder (ADHD), the causality of this relationship remains unclear.

Methods
We conducted a bidirectional two-sample Mendelian Randomization (MR) study to examine whether 25(OH)D has an effect on the risk to develop ADHD or vice versa. Information on single nucleotide polymorphisms (SNP) associated with serum 25(OH)D was obtained from a genome-wide association study (GWAS) considering phenotype data from 79,366 individuals of European ancestry. Data on risk for ADHD were derived from a GWAS analysis with 20,183 individuals diagnosed with ADHD and 35,191 controls. For our analysis, we considered effect sizes based on the European participants (19,099 cases and 34,194 controls).

Results
Single SNP analyses showed a causal effect of vitamin D on ADHD risk for only one SNP (rs12785878, p = 0.024). The overall MR estimates did not reveal a causal effect of 25(OH)D on risk for ADHD. In the reverse analysis, neither any single nor the multi-SNP MR analyses showed a causal effect of ADHD on 25(OH)D.

Conclusion
Results from this two-sample MR study did not confirm a causal effect of 25(OH)D on ADHD or vice versa. Accordingly, our study does not provide evidence that improving 25(OH)D via supplementation could reduce the risk of developing ADHD.
TP53 germline mutations in the context of families with hereditary breast and ovarian cancer: a clinical challenge
Authors: Grill Sabine , Ramser Juliane , Hellebrand Heide , Pfarr Nicole , Boxberg Melanie , Brambs Christine , Ditsch Nina , Meindl Alfons , Groß Eva , Meitinger Thomas , Kiechle Marion , Quante Anne S. 
Published: November 2020

Abstract
Purpose
TP53germline (g) mutations, associated with the Li-Fraumeni syndrome (LFS), have rarely been reported in the context of hereditary breast and ovarian cancer (HBOC). The prevalence and cancer risks in this target group are unknown and counseling remains challenging. Notably an extensive high-risk surveillance program is implemented, which evokes substantial psychological discomfort. Emphasizing the lack of consensus about clinical implications, we aim to further characterize TP53g mutations in HBOC families.

Methods
Next-generation sequencing was conducted on 1876 breast cancer (BC) patients who fulfilled the inclusion criteria for HBOC.

Results
(Likely) pathogenic variants in TP53 gene were present in 0.6% of the BC cohort with higher occurrence in early onset BC < 36 years. (1.1%) and bilateral vs. unilateral BC (1.1% vs. 0.3%). Two out of eleven patients with a (likely) pathogenic TP53g variant (c.542G > A; c.375G > A) did not comply with classic LFS/Chompret criteria. Albeit located in the DNA-binding domain of the p53-protein and therefore revealing no difference to LFS-related variants, they only displayed a medium transactivity reduction constituting a retainment of wildtype-like anti-proliferative functionality.

Conclusion
Among our cohort of HBOC families, we were able to describe a clinical subgroup, which is distinct from the classic LFS-families. Strikingly, two families did not adhere to the LFS criteria, and functional analysis revealed a reduced impact on TP53 activity, which may suit to the attenuated phenotype. This is an approach that could be useful in developing individualized screening efforts for TP53g mutation carrier in HBOC families. Due to the low incidence, national/international cooperation is necessary to further explore clinical implications. This might allow providing directions for clinical recommendations in the future.
Preventing tuberculosis in paediatric kidney transplant recipients: is there a role for BCG immunisation pre-transplantation in low tuberculosis incidence countries?
Authors: Bamford Alasdair , Dixon Garth , Klein Nigel , Marks Stephen D. , Ritz Nicole , Welch Steven B. , Tebruegge Marc 
Published: November 2020

AbstractThe risk of tuberculosis (TB) disease is increased in children with chronic kidney disease (CKD), even higher in stage 5 CKD/kidney failure and especially high after kidney transplantation due to immunosuppression. TB disease may follow recent primary infection, or result from reactivation of latent infection. Reactivation is more common in adults, while progression following primary infection makes up a greater proportion of disease in children. Recommendations for preventing TB disease in some low TB incidence countries have previously included offering Bacillus Calmette-Guérin (BCG) vaccine to all children listed for kidney transplant if they had not received this as part of previous national immunisation programmes. Based on the available evidence, we recommend modifying this practice, focusing instead on awareness of risk factors for TB exposure, infection and disease and the use of appropriate testing strategies to identify and treat TB infection and disease.
Unravelling the lithospheric-scale thermal field of the North Patagonian Massif plateau (Argentina) and its relations to the topographic evolution of the area
Authors: Gomez Dacal Maria Laura , Scheck-Wenderoth Magdalena , Aragón Eugenio , Bott Judith , Cacace Mauro , Tocho Claudia 
Published: November 2020

AbstractThe North Patagonian Massif (NPM) area in Argentina includes a plateau of 1200 m a.s.l. (meters above sea level) average height, which is 500–700 m higher than its surrounding areas. The plateau shows no evidence of internal deformation, while the surrounding basins have been deformed during Cenozoic orogenic events. Previous works suggested that the plateau formation was caused by a lithospheric uplift event during the Paleogene. However, the causative processes responsible for the plateau origin and its current state remain speculative. To address some of these questions, we carried out 3D lithospheric-scale steady-state and transient thermal simulations of the NPM and its surroundings, as based on an existing 3D geological model of the area. Our results are indicative of a thicker and warmer lithosphere below the NPM plateau compared with its surroundings, suggesting that the plateau is still isostatically buoyant and thus explaining its present-day elevation. The transient thermal simulations agree with a heating event in the mantle during the Paleogene as the causative process leading to lithospheric uplift in the region and indicate that the thermo-mechanical effects of such an event would still be influencing the plateau evolution today. Although the elevation related to the heating would not be enough to reach the present plateau topography, we discuss other mechanisms, also connected with the mantle heating, that may have caused the observed relief. Lithosphere cooling in the plateau is ongoing, being delayed by the presence of a thick crust enriched in radiogenic minerals as compared to its sides, resulting in a thermal configuration that has yet to reach thermodynamic equilibrium.
Implementation and experiment of a novel piezoelectric-spring stage for rapid high-precision micromotion
Authors: Zhang Lanyu , Gao Jian 
Published: November 2020

AbstractA precision micromotion stage is significant in the microelectronics-manufacturing field to realize high-performance tasks. The output position error and limited frequency response influence the working performance and efficiency of the micromotion stage. A novel piezoelectric-based (PZT) reciprocating micromotion stage with a special spring-PZT structure is proposed in this paper to cater to the high manufacturing demands and achieve rapid precision micromotion performance. This structure is designed to use a high-stiffness spring element as the flexure deformation structure, by utilizing the linearity of the spring, for achieving precise output/input ratio and high-frequency response. The feasibility of the micromotion stage is explored through theoretical analyses, including a dynamic response analysis, frequency response analysis, output displacement, and rapidity analysis of the specialized spring-PZT structure. For the inherent hysteresis challenge of the PZT-based structure, a feedforward subdivided proportional–integral–derivative method is adopted for system implementation. Subsequently, an optimal design of the stage is established, and the expected motion performance is verified experimentally. Finally, a series of experiments in terms of output ratio property analysis, dynamic hysteresis characterization, tracking error performance, and response rapidity are conducted for different micromotion frequencies and strokes. It is indicated that the stage can achieve nanometre-level precision and high-frequency micromotion simultaneously, which could be applied in the microelectronics manufacturing for rapid precision micromotion operations.
Randomized controlled trials and real-world evidence for market access and surveillance of high-risk products—The example of paclitaxel
Authors:   Kommission PAVK und Diabetischer Fuß der DGG e. V., Behrendt C.‑A. , Rother U. , Rümenapf G. , Uhl C. , Görtz H. , Böckler D. 
Published: November 2020

AbstractIn 2018 and 2020, two meta-analyses using summary-level data from randomized controlled trials reported worse mortality following the application of paclitaxel-coated stents and balloons in femoropopliteal and crural arteries. These results initiated a heated global discussion concerning the validity of this association, while various observational studies using clinical and administrative registries proved the safety of coated devices. This article aimed to summarize the development and adoption of paclitaxel-coated balloons and stents for the treatment of peripheral arterial occlusive disease in clinical practice, research, and practice guidelines. It especially focusses on the European Unionʼs medical device regulation, which has far-reaching implications for the market approval and monitoring of high-risk medical devices.