bluuebunny/crossref_metadata_2025_split huggingface dataset:
Langzeitverläufe depressiver Symptomlast und deren
Prädiktoren bei stationärer, tiefenpsychologisch fundierter
Psychotherapie: Befunde der STOP-D-Studie
Authors: Seidler Daniel , Altmann Uwe , Schäfer Ralf , Jenett Dörte , Franz Matthias 
Published: January 2021

Zusammenfassung
Ziel der Studie Depressive Erkrankungen zählen zu den
häufigsten psychischen Symptombildern. Bei insgesamt
bestätigter Wirksamkeit stationärer und ambulanter
Psychotherapie werden in der Literatur verschiedene Verlaufsmuster in der
Behandlung depressionstypischer Symptome beschrieben. Ziel der vorliegenden
Studie war es, typische Langzeitverläufe stationärer,
tiefenpsychologisch fundierter Psychotherapie depressiver Erkrankungen zu
identifizieren. Ferner sollten Prädiktoren für
unterschiedliche Verläufe ermittelt werden, um möglichst
früh Non-Responder zu erkennen und Behandlungsangebote differenziert
modifizieren zu können.
Methode Die Daten der naturalistischen Multizenterstudie STOP-D wurden
in 15 bundesdeutschen Psychosomatischen Klinikabteilungen mit primär
tiefenpsychologisch fundiertem Behandlungskonzept erhoben. Die Stichprobe
umfasste N=432 Patientinnen (Frauen, Alter 25–45 Jahren) mit
depressionstypischer Beeinträchtigung. Die Langzeitverläufe
wurden mittels Latent State Modell und einer Latent Class Analysis
identifiziert, potentielle Verlaufsprädiktoren wurden
regressionsanalytisch modelliert.
Ergebnisse Es wurde 3 Langzeitverläufe identifiziert:
Patientinnen, welche in bedeutendem Maße von der Behandlung
profitierten und deren Symptomrückgang sich auch in einer
6-Monats-Katamnese stabil zeigte (Responder, 76,9%), Patientinnen
ohne bedeutsamen Symptomrückgang während der Behandlung und
in der Katamnese (Non-Responder, 18,8%) sowie Patientinnen mit
signifikantem Symptomrückgang und Anstieg der Symptomatik im
Katamnesezeitraum (Rückfällige, 4,4%).
Prädiktor für den Langzeitverlauf der
Rückfälligen war die Ausprägung depressiver Symptome
zu Behandlungsbeginn. Non-Responder unterschieden sich gegenüber
Respondern durch häufigere psychosomatische Vorbehandlungen.
Diskussion Zukünftige Untersuchungen sollten u. a. bei
Rückfälligen prüfen, ob Rückfälle
durch die Symptomatik, die Behandlung oder das soziale Umfeld des Patienten
erklärt werden können. Bei Non-Respondern stellt sich vor
dem Hintergrund häufigerer, bereits wenig erfolgreicher
Vorbehandlungen die Frage, ob für diese Patienten ein anderes oder
modifiziertes Therapieangebot erwogen werden sollte.
Schlussfolgerung In der Literatur berichtete Langzeitverläufe
lassen sich teilweise bestätigen. Auch festigen sich Hinweise auf
einen Einfluss der initialen Belastungsschwere depressionstypischer
Symptomlast auf das Behandlungsergebnis im Verlauf. Zu untersuchen
wäre, wie Behandlungssettings entsprechend modifiziert werden
können.
Prävalenz, Kosten der Versorgung und Formen des dialysepflichtigen chronischen Nierenversagens in Deutschland: Vergleich der Dialyseversorgung innerhalb und außerhalb stationärer Pflegeeinrichtungen
Authors: Häckl Dennis , Kossack Nils , Schoenfelder Tonio 
Published: January 2021

Zusammenfassung
Ziel der Studie Für die Wohnbevölkerung Deutschlands stehen keine aktuellen Daten zur Prävalenz des chronischen Nierenversagens und den Versorgungskosten der Dialyse zur Verfügung. Das Ziel dieser Studie war die Erhebung der Prävalenz des dialysepflichtigen chronischen Nierenversagens und der Versorgungskosten der dialysepflichtigen Patienten sowie die Analyse von Unterschieden zwischen dialysepflichtigen Patienten in und außerhalb von stationären Pflegeeinrichtungen.
Methodik Analysiert wurden Abrechnungsdaten von gesetzlichen Krankenkassen aus der WIG2-Forschungsdatenbank, die rund 4,5 Mio. anonymisierte Versicherte enthält. Eingeschlossen wurden Patienten aller Altersgruppen, die 2017 aufgrund eines chronischen Nierenversagens eine ambulante Dialyse (EBM-Ziffer 13602) erhielten. Es erfolgte eine Hochrechnung identifizierter Versicherter für die GKV und BRD mit amtlichen Statistiken. Patienten, die in und außerhalb von stationären Pflegeeinrichtungen wohnhaft waren, wurden hinsichtlich Komorbiditäten, Leistungsinanspruchnahme und Kosten verglichen.
Ergebnisse Für 2017 wurden 87 255 Dialysepflichtige in der GKV (≙1 054 Personen/1 Mio. Einwohner, pmp) und 100.202 für die Wohnbevölkerung Deutschlands (≙1210 pmp) ermittelt. In stationären Pflegeeinrichtungen lebten rund 8% der Dialysepflichtigen (7676 Patienten). Bis 2040 ist von einem Anstieg Dialysepflichtiger von 20–23% auf ca. 120 000–123 000 zu rechnen und für Dialysepflichtige in stationären Pflegeeinrichtungen von ca. 37–44% auf ca. 10 500–11 000. Bei fast allen Dialysepflichtigen kommt die Hämodialyse zum Einsatz, die Peritonealdialyse wird kaum genutzt. Die durchschnittlichen jährlichen Versorgungskosten für dialysepflichtige Patienten, die nicht in einer Pflegeeinrichtung leben, betragen 53 996 und 57 205 € für solche in stationärer Pflege. Hieraus ergeben sich jährliche Versorgungskosten für die GKV von rund 4,73 Mrd. €.
Schlussfolgerung In dieser Studie wurde die Prävalenz des chronischen Nierenversagens für Deutschland auf einer aktuellen Datengrundlage berechnet. Die Ergebnisse bewegen sich im Rahmen von Daten anderer europäischer Länder. Es wird ein beträchtlicher Anstieg der Dialysepflichtigen bis 2040 prognostiziert, insbesondere für jene die im Heim leben. Hierdurch ist mit einer weiteren Steigerung der Versorgungskosten zu rechnen. Die häufigste Dialyseform ist die Hämodialyse, bei Patienten sowohl innerhalb als auch außerhalb stationärer Pflegeeinrichtungen, die Peritonealdialyse wird hingegen in nur geringem Maße eingesetzt.
Optimization and Evaluation of Self-nanoemulsifying Drug Delivery System for Enhanced Bioavailability of Plumbagin
Authors: Kamble Pavan Ram , Shaikh Karimunnisa Sameer 
Published: January 2021

AbstractPlumbagin, a potential bioactive lipophilic molecule, possesses limited solubility and low oral bioavailability. The purpose of the present study was to examine the potential of the self-nanoemulsifying drug delivery system for improving solubility and oral bioavailability of plumbagin. The self-nanoemulsifying drug delivery system was formulated from Capmul MCM (oil), Tween 20 (surfactant), and propylene glycol (cosurfactant). Central composite design was employed as statistical tool to optimize the formulation variables, X1 (oil) and X2 (surfactant: co-surfactant mixture ratio), of the self-nanoemulsifying drug delivery system. The responses studied were droplet size, self-emulsification time, % of drug release in 15 min, and equilibrium solubility. The optimized liquid self-nanoemulsifying drug delivery system was adsorbed on Neusilin US2 and characterized for flow properties, X-ray diffractometry, differential scanning calorimetry, in
vitro dissolution, in vivo anti-inflammatory activity, and bioavailability study in Wistar rats, as well as ex vivo permeation study. The droplet size, polydispersity index, self-emulsification time, and equilibrium solubility of the optimized formulation were 58.500 ± 1.170 nm, 0.228 ± 0.012, 17.660 ± 1.520 s, and 34.180 ± 1.380 mg/mL, respectively. Its zeta potential, transmittance value, and cloud point were − 28.200 ± 1.200 mV, 99.200% ± 0.600, and 90 °C, respectively. Drug release was found to be 93.320% ± 1.090. In vivo anti-inflammatory study confirmed more enhanced activity from the self-nanoemulsifying drug delivery system than with pure plumbagin. Pharmacokinetic study in rats revealed that solid self-nanoemulsifying drug delivery system had 4.49-fold higher bioavailability than pure plumbagin. Ex vivo permeation study demonstrated 1.75-fold increased intestinal permeability of the self-nanoemulsifying drug delivery system than
pure plumbagin. The developed self-nanoemulsifying drug delivery system is a useful solid platform for improving solubility and oral bioavailability of plumbagin.
S2k-Leitlinie – Empfehlungen zur stationären Therapie von Patienten mit COVID-19
Authors: Kluge S. , Janssens U. , Welte T. , Weber-Carstens S. , Schälte G. , Spinner C. D. , Malin J. J. , Gastmeier P. , Langer F. , Wepler M. , Westhoff M. , Pfeifer M. , Rabe K. F. , Hoffmann F. , Böttiger B. W. , Weinmann-Menke J. , Kersten A. , Berlit P. , Haase R. , Marx G. , Karagiannidis C. 
Published: January 2021

ZusammenfassungSeit Dezember 2019 verbreitet sich das neuartige Coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome – Corona Virus-2) rasch im Sinne einer weltweiten Pandemie. Dies stellt Kliniker und Krankenhäuser vor große Herausforderungen und belastet die Gesundheitssysteme vieler Länder in einem nie dagewesenen Ausmaß. Die Mehrheit der Patienten mit Coronavirus Disease 2019 (COVID-19) zeigt lediglich milde Symptome wie Husten und Fieber. Allerdings benötigen etwa 8 % eine stationäre Behandlung. Der frühzeitigen Klärung, ob eine stationäre und ggfs. intensivmedizinische Behandlung medizinisch sinnvoll und vom Patienten gewollt ist, kommt in der Pandemie eine besondere Bedeutung zu. Die akute hypoxämische respiratorische Insuffizienz mit Dyspnoe und hoher Atemfrequenz (> 30/min) führt i. d. R. zur Aufnahme auf die Intensivstation. Oft finden sich dann bereits bilaterale pulmonale Infiltrate/Konsolidierungen oder auch Lungenembolien in der Bildgebung. Im weiteren Verlauf entwickeln einige dieser Patienten ein akutes Lungenversagen (Acute Respiratory Distress Syndrome; ARDS). Eine Sterblichkeitsreduktion einer verfügbaren medikamentösen Therapie bei schwerer COVID-19-Erkrankung ist bisher lediglich für Dexamethason in randomisiert, kontrollierten Studien nachgewiesen. Das Hauptziel der supportiven Therapie besteht in der Sicherstellung einer ausreichenden Oxygenierung. Die invasive Beatmung und wiederholte Bauchlagerung sind dabei wichtige Elemente in der Behandlung von schwer hypoxämischen COVID-19-Patienten. Die strikte Einhaltung der Basishygiene, einschließlich der Händehygiene, sowie das korrekte Tragen von adäquater persönlicher Schutzausrüstung sind im Umgang mit den Patienten unabdingbar. Medizinisch notwendige Handlungen am Patienten, die zur Aerosolbildung führen könnten, sollten mit äußerster Sorgfalt und Vorbereitung durchgeführt werden.
Comparison of Different Clinical Prognostic Scores in Patients with Pulmonary Embolism and Active Cancer
Authors: Li Xiaoqian , Hu Yuehong , Lin Ping , Zhang Jiarui , Tang Yongjiang , Yi Qun , Liang Zong'an , Zhou Haixia , Wang Maoyun 
Published: January 2021

Abstract
Objective This article aimed to validate and compare the prognostic performance of generic scores (Pulmonary Embolism Severity Index [PESI] and Hestia) and cancer-specific pulmonary embolism (PE)/venous thromboembolism (VTE) scales (Registro Informatizado de la Enfermedad TromboEmbólica [RIETE], POMPE-C, and modified Ottawa) in PE patients with active cancer.
Methods A retrospective study was conducted among 460 patients with PE and active cancer. The primary outcome was 30-day overall mortality. Secondary outcomes were 30-day PE-related death and overall adverse outcomes. The prognostic accuracy of clinical scores was determined using receiver operating characteristic (ROC) curve analysis.
Results Within 30 days, 18.0% of patients died, 2.0% suffered major bleeding, and 0.2% presented recurrence of VTE. All scales showed a high area under the ROC curve (AUC) for predicting 30-day overall mortality except modified Ottawa (0.74 [0.70–0.78] for PESI, Hestia, and RIETE; 0.78 (0.74–0.81) for POMPE-C; 0.64 (0.59–0.68) for modified Ottawa]. PESI divided the least patients (9.1%) into low risk, followed by modified Ottawa (17.0%). Hestia stratified the most patients (65.4%) as low risk. But overall mortality of low-risk patients based on these three scales is high (>5%). RIETE and POMPE-C both classified 30.9% of patients as low risk, and low-risk patients stratified by these two scales presented a low overall mortality (1.4 and 3.5%). Similar predictive performance was found for 30-day PE-related death and overall adverse outcomes in these scores.
Conclusion Cancer-specific PE prognostic scores (RIETE and POMPE-C) performed better than generic scales (PESI and Hestia) and a cancer-specific VTE prognostic scale (modified Ottawa) in identifying low-risk PE patients with active cancer who may be suitable for outpatient treatment.
Transfusion with Cryoprecipitate for Very Low Fibrinogen Levels Does Not Affect Bleeding or Survival in Critically Ill Cirrhosis Patients
Authors: Budnick Isadore M. , Davis Jessica P.E. , Sundararaghavan Anirudh , Konkol Samuel B. , Lau Chelsea E. , Alsobrooks James P. , Stotts Matthew J. , Intagliata Nicolas M. , Lisman Ton , Northup Patrick G. 
Published: January 2021

Abstract
Background Fibrinogen (FIB) levels less than 150 mg/dL have been associated with increased rates of bleeding and lower survival in critically ill cirrhosis patients.
Objective We aimed to determine if treatment with cryoprecipitate (CRYO) for low FIB levels is associated with bleeding outcomes or survival.
Methods A total of 237 cirrhosis patients admitted to an intensive care unit at a tertiary care liver transplant center with initial FIB levels less than 150 mg/dL were retrospectively assessed for CRYO transfusion, bleeding events, and survival outcomes.
Results The mean MELD score was 27.2 (95% confidence interval [CI]: 26.0–28.3) and CLIF-C acute on chronic liver failure score was 53.4 (51.9–54.8). Ninety-nine (41.8%) were admitted for acute bleeding and the remainder were admitted for nonbleeding illnesses. FIB level on admission correlated strongly with disease severity. After adjusting for disease severity, FIB on admission was not an independent predictor of 30-day survival (hazard ratio [HR]: 0.99, 95% CI: 0.99–1.01, p = 0.68). CRYO transfusion increased FIB levels but had no independent effect on mortality or bleeding complications (HR: 1.10, 95% CI: 0.72–1.70, p = 0.65).
Conclusion In cirrhosis patients with critical illness, low FIB levels on presentation reflect severity of illness but are not independently associated with 30-day mortality. Treatment of low FIB with CRYO also does not affect survival or bleeding complications, suggesting FIB is an additional marker of severity of illness but is not itself a direct factor in the pathophysiology of bleeding in critically ill cirrhosis patients.
Preoperative Factors Affecting the Patient-Reported Outcome Measures following Total Knee Replacement: Socioeconomic Factors and Preoperative OKS Have a Clinically Meaningful Effect
Authors: Demetriou Charis , Webb Jeremy , Sedgwick Philip , Afzal Irrum , Field Richard , Kader Deiary 
Published: January 2021

AbstractThe Oxford Knee Score (OKS) is a patient-reported outcome questionnaire typically used to assess function and pain in patients undergoing total knee replacement (TKR). However, research is inconclusive as to which preoperative factors are important in explaining variation in outcome following TKR. The operative records of 12,709 patients who underwent primary TKR over a 9-year period were analyzed. The following variables were collected for each patient: age, sex, body mass index (BMI), Index of Multiple Deprivation decile rank, side of operation, diagnosis, the American Society of Anaesthesiologists (ASA) grade, preoperative OKS, EQ-5D index score, EuroQol visual analog scale (EQ-VAS) score, the postoperative OKS at 1 and 2 years. Generalized linear regression models were performed at 1 and 2 years to investigate the effect of the preoperative variables on the postoperative OKS. The effect of age, sex, BMI, Index of Multiple Deprivation decile rank, diagnosis, ASA grade, preoperative OKS, EuroQoL five-dimensional (EQ-5D) index score, and EQ-VAS score were all statistically significant in explaining the variation in OKS at 1 and 2 years postoperatively, with critical level of significance of 0.05 (5%). Being male aged 60 to 69 years of normal BMI, ASA grade I (fit and healthy), living in an affluent area, not reporting preoperative anxiety/depression, were associated with an enhanced mean postoperative OKS at both 1 and 2 years. When adjusted for potential confounding, age of 60–69 years, male sex, normal BMI, lower ASA grade, higher Index of Multiple Deprivation and higher pre-operative EQ-5D, EQ-VAS and OKS were identified as factors that resulted in higher post-operative OKS after primary TKR.
Tibial Cut Accuracy in Mechanically Aligned Total Knee Arthroplasty Using Extensor Hallucis Longus Tendon to Determine Extramedullary Tibial Guide Position
Authors: Besa Pablo , Vega Rafael , Ledermann Gerardo , Calvo Claudio , Angulo Manuela , Lira María Jesús , Vidal Catalina , Orrego Mario , Irribarra Luis , Espinosa Julio , Vial Raimundo , Irarrázaval Sebastián 
Published: January 2021

AbstractThis study aimed to determine the tibial cut (TC) accuracy using extensor hallucis longus (EHL) tendon as an anatomical landmark to position the total knee arthroplasty (TKA) extramedullary tibial guide (EMTG), and its impact on the TKA mechanical alignment (MA). We retrospectively studied 96 TKA, performed by a single surgeon, using a femoral tailored intramedullary guide technique. Seventeen were prior to the use of the EHL and 79 used the EHL tendon to position the EMTG. We analyzed preoperative and postoperative standing total lower extremity radiographs to determine the tibial component angle (TCA) and the correction in MA, comparing pre-EHL use and post-EHL technique incorporation. Mean TCA was 88.89 degrees and postoperative MA was neutral in 81% of patients. Pre- and postoperative MAs were not correlated. As a conclusion of this study, using the EHL provides a safe and easy way to determine the position of EMTG.
2.2 Samarium-Mediated Reductions
Authors: Flowers R. A. , Chciuk T. V. , Bartulovich C. O. 
Published: January 2021

AbstractSamarium(II)-based reductants have been shown to be a group of very powerful reagents whose reactivity can be tuned significantly by the use of additives. The use of additives has been shown to greatly impact the rate, diastereoselectivity, chemoselectivity, and mechanism by which these reactions proceed, making these systems extremely useful and versatile. These reagents have been shown to promote several reactions including reductions of a range of functional groups and a variety of carbon–carbon bond forming reactions. More recently, initial work has demonstrated catalytic reactions of samarium(II)-based reductants. This chapter focuses on the chemistry of samarium diiodide (SmI2) and a few other samarium(II)-based reductants, with examples of the reactions they promote, both with and without the use of additives. Additionally, recent work on the mechanistic understanding of catalytic reactions using terminal reductants and a novel example of an approach employing radical relay that negates the use of a terminal reductant are presented.
2.3 Single-Electron-Transfer Oxidation and Reduction Involving Metal Complexes other than Samarium
Authors: Cormier M. , Goddard J.-P. 
Published: January 2021

AbstractRecent advances in the field of radical organic chemistry involving single-electron transfer (SET) are highlighted in this chapter. The focus is on processes between organic molecules and metal complexes that facilitate the creation of challenging covalent bonds. A selection of oxidation and reduction reactions is reported, with special attention paid to enantioselective reactions. Mechanistic discussions are also provided.
2.4 Redox-Active Ligands in Catalysis for Single-Electron-Transfer Processes
Authors: Ren Y. , Das A. , Hessin C. , Desage-El Murr M. 
Published: January 2021

AbstractRedox-active ligands are well known for their ability to stabilize electronic density on their scaffolds, and coordination complexes with such ligands are often stable, open-shell species. This property can be used as a means to favor single-electron transfer (SET) with external sources and devise catalytic radical manifolds. This chapter highlights selected representative reactions resulting in efficient and broad-scope catalytic methodologies. It covers nitrene and carbene radical reactivity, as well as radical trifluoromethylation.
2.6 Generation of Carbon-Centered Radicals by Photochemical Methods
Authors: Fagnoni M. , Ravelli D. , Protti S. 
Published: January 2021

AbstractA selection of the recent literature describing the light-driven generation and subsequent exploitation of carbon-centered radicals for synthetic purposes is presented in this chapter. The aim is to showcase to organic (photo)chemistry practitioners the impressive potential of photocatalytic and photochemical strategies in terms of versatility, efficiency, and sustainability.
2.8 Selective Radical Fluorinations
Authors: Bolduc T. G. , Thomson B. , Sammis G. M. 
Published: January 2021

AbstractFluorine atoms are found in numerous industrially relevant materials, including pharmaceuticals, agrochemicals, and plastics. In the pharmaceutical industry alone, more than 20% of all therapeutics and a majority of the top-grossing drugs contain fluorine. The ubiquity of fluorinated compounds in industry has necessitated the development of new methods for selective fluorination. Historically, selective fluorination has relied upon electrophilic or nucleophilic processes. Recent breakthroughs in the discovery of mild radical fluorine-transfer reagents have led to a renaissance in selective radical fluorinations. This review provides a brief overview of the known fluorine-transfer reagents, including molecular fluorine, hypofluorites, xenon difluoride, electrophilic N–F reagents, and metal–F reagents. A survey of a range of radical fluorination reactions is covered, including fluorodecarboxylation, fluorination of alkenes, fluorination of boronic acid derivatives, C—H activation and fluorination, C—C activation and fluorination, deoxyfluorination, and halogen-exchange reactions. This review primarily focuses on advances in the last ten years, with an emphasis on the most practical methods.
2.9 Electrochemical Organic Synthesis via Radical Species
Authors: Mitsudo K. , Suga S. 
Published: January 2021

AbstractAn electrochemical single-electron-transfer reaction is a promising method to generate reactive radical species in organic synthesis. One-electron oxidation of a neutral compound gives a radical cation, which usually breaks down into a radical and a cationic species; conversely, one-electron reduction of a neutral compound affords a radical anion, which forms a radical and an anionic species. The radical species generated in this way can be used for a variety of transformations. In this chapter, selected recent electrochemical transformations that involve electrogenerated radical species are collected and described.
2.10 Radical Chemistry in Flow
Authors: Sumino S. , Fukuyama T. , Ryu I. 
Published: January 2021

AbstractThe past two decades have witnessed a rapid growth in flow-based organic synthesis and synthesis involving radical reactions in flow systems is no exception. Flow microreactors have large surface-to-volume ratios that become available by the employment of tiny channels, and this allows radical reactions to occur with efficient heat transfer and diffusion. Flow photomicroreactors with thin, glass-made channels allow for efficient light penetration, which enables highly efficient photo-radical reactions. This chapter highlights recent advances in both thermal and photo-induced radical reactions, which have achieved increased efficiency by using flow reaction systems.
2.11 Radical–Radical Cross-Coupling Reactions
Authors: Zhou M. , Qin T. 
Published: January 2021

AbstractDue to nearly diffusion-limited radical–radical coupling, synthetically useful, selective radical–radical cross-coupling reactions remain challenging. However, different radical lifetimes and various radical initiation approaches now provide the possibility for radical–radical cross-coupling. In this chapter, recent advances in radical–radical cross-coupling reactions are described. In the first part, a basic kinetic phenomenon called the persistent radical effect is briefly reviewed and explained. The remainder of the chapter presents a series of case studies, illustrating several types of radical–radical cross couplings in a variety of disparate settings.