bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased inferior vena cava diameter as an early marker in postpartum hemorrhage
Authors: Massalha M. , Faranish R. , Romano S. , Salim R. 
Published: June 2021

ABSTRACTObjectivesTo examine the association between inferior vena cava (IVC) diameter and postpartum blood loss and assess whether IVC diameter is a useful marker in the evaluation of intravascular volume status in women with postpartum hemorrhage (PPH).MethodsThis was a prospective case–control study conducted in a university medical teaching center in Afula, Israel, between November 2018 and March 2020. The study cohort consisted of women with a singleton pregnancy who delivered vaginally at term. The PPH group included women diagnosed with PPH based on visually estimated blood loss of 1000 mL or more at the time of enrolment. Hemodynamically unstable women or women with major bleeding at the time of diagnosis were not included. The control group consisted of women with an uneventful fourth stage of labor. IVC diameter was measured using transabdominal ultrasonography during inspiration (IVCi diameter) and expiration (IVCe diameter), and the collapsibility index was calculated ((IVCe – IVCi)/IVCe × 100). The primary outcome was the percentage difference in IVC diameter and collapsibility index between the PPH group and controls. The performance of the IVC collapsibility index in the prediction of the need for blood transfusion in women with PPH was assessed. In order to demonstrate a difference of 20% with a power of 80% and alpha of 0.05, 108 women, at a ratio of 1:2 in the study and control groups, respectively, were needed.ResultsOverall, 36 and 72 women were included in the final analysis in the PPH and control groups, respectively. IVCi and IVCe diameters were significantly smaller in the PPH group (0.93 ± 0.30 cm and 1.26 ± 0.32 cm, respectively) than in controls (1.42 ± 0.31 cm and 1.75 ± 0.28 cm, respectively) (P = 0.001 for both). The percentage reductions in IVCi and IVCe diameters in the PPH group compared with controls were 35.0% and 28.0%, respectively. IVC collapsibility index was increased significantly, by 42.9% (26.04 ± 8.67% vs 18.15 ± 5.07%; P = 0.001) in the PPH group compared with controls. IVC collapsibility index was a significant predictor of the need for blood transfusion and correctly predicted 81% of cases. Logistic regression analysis demonstrated that IVC collapsibility index was also a significant predictor of a drop in hemoglobin level of ≥ 2 g/dL (P = 0.001).ConclusionsIVC diameter changes in response to postpartum blood loss. Measurement of IVC diameter using transabdominal ultrasonography is an objective and useful non‐invasive method for the early evaluation of intravascular volume status in women with PPH and for the prediction of cases that might require blood transfusion. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Where and when to Use Induction Chemotherapy in Head and Neck Squamous Cell Cancer
Authors: Vermorken Jan B. 
Published: June 2021

AbstractThe treatment of locoregionally advanced squamous cell carcinoma of the head and neck (LA-HNSCC) is reviewed, highlighting the milestones in systemic therapy in that setting, with focus on the role of induction chemotherapy (ICT). The road to what is now considered the standard ICT regimen, i.e. the TPF (docetaxel/cisplatin/5-FU) regimen is described, and the differences between the European and the American TPF are discussed. The article describes the respective roles of ICT for larynx preservation, for treatment intensification, its role in patients with borderline resectable or unresectable oral cavity cancer, its role as a selection tool for radiotherapy dose de-escalation in patients with oropharyngeal squamous cell cancer (OPSCC) and its potential future role in strategies aiming at synchronous oligometastatic disease.ICT has an established role for organ preservation in advanced laryngeal and hypopharyngeal cancer and the TPF regimen has been validated in that setting. This approach is presently being compared in a randomized controlled trial to concurrent chemoradiotherapy (CCRT), which in many parts of the world is considered the standard organ preservation procedure. There remains uncertainty about the benefit of the sequential approach of ICT followed by CCRT, despite the fact that ICT significantly reduces the occurrence of distant metastases. It is advised that future studies should include patients who have the highest risk to develop distant metastases, in particular patients with low neck nodes and matted nodes. Moreover, further studies in patients with HPV-associated OPSCC at risk for distant failure (T4 or N3 disease) should be considered for that also. These approaches still need to be confirmed in adequately sized randomized controlled trials. Outside clinical trials, the utility of ICT is restricted to uniquely pragmatic clinical scenarios, such as unavoidable delay in radiation or in the situation that RT is not tolerated or feasible. This can happen when there is severe pain from advanced disease or there is impending airway compromise or neurologic dysfunction that necessitates rapid initiation of treatment. In all those circumstances whether within the context of trials or outside trials, it is imperative that the present backbone of ICT, the TPF regimen, is being administered by experienced oncologists, familiar with the necessary protocols and supportive care requirements to ensure patient safety and maximize adherence throughout the treatment.Future areas of research are the role of ICT in strategies whereby ICT is combined with upfront metastases-directed treatments and the usefulness of targeted agents or immune checkpoint inhibitors in the induction setting. Studies in that direction have already started. Finally, the application of radiographic, proteomic and genomic biomarkers will get attention to further define prognostic groups and guide treatment selection with greater precision.
Tracheostomy Practices for Mechanically Ventilated Patients in Malawi
Authors: Prin Meghan , Kaizer Alex , Cardenas Jesus , Mtalimanja Onias , Kadyaudzu Clement , Charles Anthony , Ginde Adit 
Published: June 2021

AbstractBackgroundTracheostomy is used for patients who require prolonged mechanical ventilation. Extensive research has described the provision and optimal timing of tracheostomy, but very little describes tracheostomy utilization in low‐ and middle‐income countries, particularly in sub‐Saharan Africa.MethodsThis prospective cohort study describes patients admitted to the intensive care unit (ICU) of a tertiary hospital in Malawi who received tracheostomy versus those who did not, with a primary outcome of hospital mortality. We performed subgroup analysis of patients with severe head injuries.ResultsThe analysis included 451 patients admitted to the study ICU between September 2016 and July 2018. Overall hospital mortality was 40% for patients who received tracheostomy and 63% for patients who did not. Logistic regression modeling revealed an odds ratio (OR) of 0.34 (95% CI 0.18–0.64) for hospital mortality among patients who received tracheostomy versus those who did not (p < 0.001). Standardized mortality ratio weighting revealed an odds ratio of 0.81 (95% CI 0.65–0.99, p < 0.001) for hospital death among patients who received tracheostomy versus those who did not. In the subgroup excluding severe head injury, both ICU (50%) and hospital mortality (75%) were higher overall, but hospital mortality was not more common for patients with tracheostomy versus without (OR 1.28, 95% CI 0.94–1.74, p = 0.104).ConclusionsTracheostomy is not associated with hospital mortality in a Malawi ICU cohort, but these results are affected by the presence of head injury. Research may focus on home tracheostomy care given the lack of hospital discharge options for patients in austere settings.
68Ga-PSMA-PET screening and transponder-guided salvage radiotherapy to the prostate bed alone for biochemical recurrence following prostatectomy: interim outcomes of a phase II trial
Authors: Bowden Patrick , See Andrew W. , So Kevin , Lawrentschuk Nathan , Moon Daniel , Murphy Declan G. , Rao Ranjit , Crosthwaite Alan , King Dennis , Haxhimolla Hodo , Grummet Jeremy , Ruljancich Paul , Gyomber Dennis , Landau Adam , Campbell Nicholas , Frydenberg Mark , Smyth Lloyd M. L. , Nolan Skye , Gwini Stella M. , McKenzie Dean P. 
Published: June 2021

Abstract
Purpose
To evaluate outcomes for men with biochemically recurrent prostate cancer who were selected for transponder-guided salvage radiotherapy (SRT) to the prostate bed alone by 68Ga-labelled prostate-specific membrane antigen positron emission tomography (68Ga-PSMA-PET).

Methods
This is a single-arm, prospective study of men with a prostate-specific antigen (PSA) level rising to 0.1–2.5 ng/mL following radical prostatectomy. Patients were staged with 68Ga-PSMA-PET and those with a negative finding, or a positive finding localised to the prostate bed, continued to SRT only to the prostate bed alone with real-time target-tracking using electromagnetic transponders. The primary endpoint was freedom from biochemical relapse (FFBR, PSA > 0.2 ng/mL from the post-radiotherapy nadir). Secondary endpoints were time to biochemical relapse, toxicity and patient-reported quality of life (QoL).

Results
Ninety-two patients (median PSA of 0.18 ng/ml, IQR 0.12–0.36), were screened with 68Ga-PSMA-PET and metastatic disease was found in 20 (21.7%) patients. Sixty-nine of 72 non-metastatic patients elected to proceed with SRT. At the interim (3-year) analysis, 32 (46.4%) patients (95% CI 34.3–58.8%) were FFBR. The median time to biochemical relapse was 16.1 months. The rate of FFBR was 82.4% for ISUP grade-group 2 patients. Rates of grade 2 or higher gastrointestinal and genitourinary toxicity were 0% and 15.2%, respectively. General health and disease-specific QoL remained stable.

Conclusion
Pre-SRT 68Ga-PSMA-PET scans detect metastatic disease in a proportion of patients at low PSA levels but fail to improve FFBR. Transponder-guided SRT to the prostate bed alone is associated with a favourable toxicity profile and preserved QoL.

Trial registration number
ACTRN12615001183572, 03/11/2015, retrospectively registered.
Independent Sets in ($$P_4+P_4$$,Triangle)-Free Graphs
Authors: Mosca Raffaele 
Published: June 2021

AbstractThe Maximum Weight Independent Set Problem (WIS) is a well-known NP-hard problem. A popular way to study WIS is to detect graph classes for which WIS can be solved in polynomial time, with particular reference to hereditary graph classes, i.e., defined by a hereditary graph property or equivalently by forbidding one or more induced subgraphs. Given two graphs G and H, $$G+H$$

G
+
H

denotes the disjoint union of G and H. This manuscript shows that (i) WIS can be solved for ($$P_4+P_4$$

P
4

+

P
4

, Triangle)-free graphs in polynomial time, where a $$P_4$$

P
4

is an induced path of four vertices and a Triangle is a cycle of three vertices, and that in particular it turns out that (ii) for every ($$P_4+P_4$$

P
4

+

P
4

, Triangle)-free graph G there is a family $${{\mathcal {S}}}$$
S
of subsets of V(G) inducing (complete) bipartite subgraphs of G, which contains polynomially many members and can be computed in polynomial time, such that every maximal independent set of G is contained in some member of $${\mathcal {S}}$$
S
. These results seem to be harmonic with respect to other polynomial results for WIS on [subclasses of] certain $$S_{i,j,k}$$

S

i
,
j
,
k

-free graphs and to other structure results on [subclasses of] Triangle-free graphs.
Skin diseases in hospitalized geriatrics: a 9-year analysis from a University Dermatology Center in Germany
Authors: Ansorge Claudia , Miocic Johannes M. , Schauer Franziska 
Published: June 2021

AbstractThe demographic trend of an ageing society is mirrored in the rising number of hospitalized geriatric patients in Germany. However, there is still a wide gap of knowledge regarding the dermatological diseases, comorbidities and performed procedures within this growingly important group of patients. The study was conducted as a retrospective monocentric data analysis of all patients 65 years or older from the Department of Dermatology, Medical Center—University of Freiburg, Germany. In total, 10,009 individual hospitalisations were included from 2009 to 2017, and there was a notable increase of geriatric patients in the study period. This study illustrates the following: leading major diagnoses included malignant neoplasm of the head and neck, ulcerated and non-ulcerated inflammatory spectrum of chronic venous insufficiency, whereas angina pectoris, type 2 diabetes and cardiac diseases were noted most frequently as secondary diagnoses. Patients with venous diseases had considerably more often cardiopulmonary minor diagnoses, whereas endocrine diagnoses peaked in the cohort of patients with psoriasis and psychiatric and muscululoskeletal disorders in patients with bullous dieseases. Moh’s surgery, dressings and multimodal dermatological treatments were the most often encoded procedures.
Workplace bullying increases the risk of anxiety through a stress-induced β2-adrenergic receptor mechanism: a multisource study employing an animal model, cell culture experiments and human data
Authors: Rajalingam Dhaksshaginy , Nymoen Ingeborg , Nyberg Henriette , Nielsen Morten Birkeland , Einarsen Ståle Valvatne , Gjerstad Johannes 
Published: June 2021

AbstractObjectivesSeveral studies show that severe social stressors, e.g., in the form of exposure to workplace bullying in humans, is associated with negative mental health effects such as depression and anxiety among those targeted. However, the understanding of the underlying biological mechanisms that may explain the relationship between exposure to bullying and such negative health outcomes is scarce. The analyses presented here focus on understanding the role of the β2-adrenergic receptors (ADRB2) on this association.MethodsFirst, a resident-intruder paradigm was used to investigate changes in circulating norepinephrine (NE) in rat serum induced by repeated social defeat and its relationship with subsequent social behavior. Second, the direct effects of the stress-hormones NE and cortisol, i.e., synthetic dexamethasone (DEX), on the ADRB2 expression (qPCR) and monocyte chemoattractant protein-1 (MCP-1) release (immunoassay) was examined in cultured EL-1 cells. Third, in a probability sample of 1052 Norwegian employees, the 9-item short version of the Negative Acts Questionnaire—Revised (S-NAQ) inventory, Hopkins Symptom Checklist and genotyping (SNP TaqMan assay) were used to examine the association between social stress in the form of workplace bullying and anxiety moderated by the ADRB2 genotype (rs1042714) in humans.ResultsThe present study showed a clear association between reduced social interaction and increased level of circulating NE in rats previously exposed to repeated social defeat. Parallel cell culture work, which was performed to examine the direct effects of NE and DEX on ADRB2, demonstrated ADRB2 downregulation and MCP-1 upregulation in cultured EL-1 cells. Genotyping with regard to the ADRB2 genotype; rs1042714 CC vs CG/GG, on human saliva samples, showed that individuals with CC reported more anxiety following exposure to bullying behaviors as compared to the G carriers.ConclusionWe conclude that workplace bullying promotes anxiety and threaten well-being through an ADRB2 associated mechanism.
Confinement, partial sleep deprivation and defined physical activity–influence on cardiorespiratory regulation and capacity
Authors: Koschate Jessica , Drescher Uwe , Hoffmann Uwe 
Published: June 2021

Abstract
Introduction
Adequate cardiorespiratory fitness is of utmost importance during spaceflight and should be assessable via moderate work rate intensities, e.g., using kinetics parameters. The combination of restricted sleep, and defined physical exercise during a 45-day simulated space mission is expected to slow heart rate (HR) kinetics without changes in oxygen uptake ($${\dot{\text{V}}\text{O}}_{{2}}$$

V
˙

O

2

) kinetics.

Methods
Overall, 14 crew members (9 males, 5 females, 37 ± 7 yrs, 23.4 ± 3.5 kg m−2) simulated a 45-d-mission to an asteroid. During the mission, the sleep schedule included 5 nights of 5 h and 2 nights of 8 h sleep. The crew members were tested on a cycle ergometer, using pseudo-random binary sequences, changing between 30 and 80 W on day 8 before (MD-8), day 22 (MD22) and 42 (MD42) after the beginning and day 4 (MD + 4) following the end of the mission. Kinetics information was assessed using the maxima of cross-correlation functions (CCFmax). Higher CCFmax indicates faster responses.

Results
CCFmax(HR) was significantly (p = 0.008) slower at MD-8 (0.30 ± 0.06) compared with MD22 (0.36 ± 0.06), MD42 (0.38 ± 0.06) and MD + 4 (0.35 ± 0.06). Mean HR values during the different work rate steps were higher at MD-8 and MD + 4 compared to MD22 and MD42 (p < 0.001).

Discussion
The physical training during the mission accelerated HR kinetics, but had no impact on mean HR values post mission. Thus, HR kinetics seem to be sensitive to changes in cardiorespiratory fitness and may be a valuable parameter to monitor fitness. Kinetics and capacities adapt independently in response to confinement in combination with defined physical activity and sleep.
Diversitätsmanagement in Organisationen des Gesundheitswesens – Effizienz kontra Gerechtigkeit?
Authors: Brand Cordula 
Published: June 2021

Zusammenfassung„Diversität“ wird im Management als ein Schlüssel gesehen, um in Anbetracht einer globalisierten Welt als Unternehmen oder soziale Organisation wettbewerbsfähig zu bleiben, wirtschaftlich zu arbeiten oder Gewinnsteigerungen zu erzielen. Dieser unternehmerischen Perspektive auf Diversität stehen Konzepte gegenüber, die die ethischen Aspekte von Vielfalt im Hinblick auf Gerechtigkeit in den Mittelpunkt stellen. Beide Perspektiven werden im sogenannten „Diversitätsmanagement“ verortet, das in die organisationalen Strukturen, meist in die Personalabteilung, eingebettet ist. Es zeigt sich jedoch, dass diese Verortung nicht umfassend und zentral genug ist, um ein systematisches Diversitätsmanagement mit strukturierten Maßnahmen aufzubauen. Zudem liegen dem Diversitätsmanagement verschiedene Wertekonstellationen zugrunde, die konfligieren können. Eine priorisierte wirtschaftlich orientierte Perspektive, so die These, führt dazu, dass häufig nur Einzelmaßnahmen zum Umgang mit Vielfalt umgesetzt werden. So können aber weder die Chancen von Diversität noch die konkreten Herausforderungen im Arbeitsalltag tatsächlich ergriffen oder angegangen werden. Diversitätsmanagement, so das Argument, kann nur dann erfolgreich im Sinne der Mitarbeiter*innen und Patient*innen sein, wenn es auch von Gerechtigkeitsaspekten geleitet wird. Dies gilt sowohl für die Entscheidung, welche Diversitätskonzepte und/oder Merkmale relevant sind, als auch für die Auswahl und Evaluation von Maßnahmen. Das bedeutet schließlich, dass bei Abwägungen im Umgang mit Vielfalt im Kontext von Organisationen im Gesundheitswesen die soziale Gerechtigkeit mehr wiegen sollte als rein wirtschaftliche Überlegungen. Letztere habe ihre Berechtigung bei der Einschätzung von Maßnahmen, sie sind aber ein Mittel zum Zweck und kein Selbstzweck.
Potenzial und Grenzen statistischer Unfallzahlen im österreichischen Berg- und Tunnelbau
Authors: Haider Katharina , Halwachs Michael , Sifferlinger Nikolaus August 
Published: June 2021

ZusammenfassungArbeits- und Gesundheitsschutz hat in allen Bereichen höchste Priorität. Um Maßnahmen zur Unfallvermeidung stetig zu verbessern, müssen diese ständig anhand des tatsächlichen Unfallgeschehens analysiert und evaluiert werden. Die wichtigsten Ansatzpunkte einer aktiven und wirksamen Unfallprävention können in einem ersten Schritt durch eine Auswertung von statistischen Unfallzahlen identifiziert werden.In diesem Artikel werden die Grundlagen der Methodik der Europäischen Statistik über Arbeitsunfälle (ESAW) dargelegt und Datensätze der Allgemeinen Unfallversicherungsanstalt (AUVA) zur statistischen Darstellung des Unfallgeschehens im österreichischen Berg- und Tunnelbau herangezogen.Das daraus generierte Unfallspektrum wird für den Bergbau mit den Daten aus den Montanhandbüchern verglichen. Zudem werden die Daten des Berg- und Tunnelbaus gegenübergestellt. Es zeigt sich, dass aus den zusammengefassten Daten der statistischen Unfallzahlen kein signifikanter Zuwachs an Wissen über Unfallursachen gewonnen werden kann. Die meisten Unfälle betreffen die oberen und unteren Extremitäten und werden durch Verlust der Kontrolle über Arbeitsmittel, Sturz/Absturz von Personen und Bewegung des Körpers ohne und mit körperlicher Belastung verursacht.Der Fokus wird daher darauf gelegt, wie die Datensätze und die Variablen für statistische Auswertungen handzuhaben und zu filtern sind. Es wird diskutiert, welche Möglichkeiten und Probleme sich aus der Zuordnung von Unfällen zu Wirtschaftsklassen ergeben. Als Alternative wird untersucht, ob die Codierung der ESAW genutzt werden kann, um Unfälle nach bestimmten Arbeitsumgebungen zu filtern und den Bereichen „über Tage“ und „unter Tage“ zuzuordnen. Dabei ergeben sich keine eindeutigen Ergebnisse der Korrelation zwischen den Wirtschaftsklassen des Berg- und Tunnelbaus und den Arbeitsumgebungen.Letztendlich können konkrete Maßnahmen nur dann gesetzt werden, wenn der genaue Unfallhergang mit all den beteiligten Faktoren, Gegenständen, Ursachen und Kausalitäten bekannt ist.
MUL 4.0 – Digitalisierung der Wertschöpfungskette vom Rohmaterial bis hin zum Recycling
Authors: Woschank Manuel , Ralph Benjamin James , Kaiblinger Alexander , Miklautsch Philipp , Pacher Corina , Sorger Marcel , Zsifkovits Helmut , Stockinger Martin , Pogatscher Stefan , Antretter Thomas , Antrekowitsch Helmut 
Published: June 2021

ZusammenfassungDas Forschungsprojekt „MUL 4.0“ beschäftigt sich mit der Anwendung von Industrie 4.0 Technologien zur Digitalisierung respektive zur digitalen Transformation einer gesamten Wertschöpfungskette vom Rohmaterial bis hin zum Recycling. Der Fokus liegt hierbei auf der Erstellung von digitalen Zwillingen sowohl aus werkstoff-wissenschaftlicher als auch aus produktions-technischer Perspektive. Im Rahmen der Entwicklung einer neuartigen Lernfabrik können so in realistischen Anwendungsszenarien zukunftsweisende Technologien entwickelt, getestet und verbessert werden. Zusätzlich legen neue Lehr- und Lernkonzepte den Grundstein zur nachhaltigen Entwicklung der notwendigen Schlüsselkompetenzen im Umfeld der digitalen (Lern‑)Fabrik sowie zur Professionalisierung der Ingenieursausbildung der Zukunft.