bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative Care: Ausbildungslandschaft Pflege
Authors: Brandstötter Cornelia , Krutter Simon , Paal Piret , Schirnhofer Angelika , Glarcher Manela 
Published: February 2021

Zusammenfassung
Ziel der Studie Trotz gesetzlicher Regelung zu Palliative Care in der Gesundheits- und Krankenpflege in Österreich, fehlen Vorgaben zu Ausbildungsstunden, zum Praktikum und zur Qualifikation von Lehrenden. Ziel der Studie ist es, ein umfassendes Bild zu Palliative Care in der Pflegegrundausbildung zu erhalten.
Methode 2019 wurde eine deskriptive Querschnittsstudie mittels Online-Survey in 29 Institutionen durchgeführt.
Ergebnisse Die theoretische Ausbildung weist eine hohe Spannbreite pro Ausbildungsform auf und bewegt sich im Durchschnitt von 21,2 Unterrichtstunden in den Schulen für Gesundheits- und Krankenpflege bis 2,5 ECTS im Bachelorstudium. Ebenso wird die praktische Ausbildung sowie didaktische Vermittlung von Inhalten einrichtungsspezifisch gehandhabt.
Schlussfolgerung Die gesetzliche Verankerung von Palliative Care in der Grundausbildung ist ein erster Ansatz. Die Ergebnisse dieser Studie können als Ausgangspunkt zur Entwicklung eines einheitlichen Curriculums dienen.
Oxidative Dimerization of 1Н-Benzo[f]chromenes: Synthesis of Benzannulated Analogues of Spirobiflavonoids Welwitschins E and F
Authors: Osyanin Vitaly A. , Demidov Maxim R. , Osipov Dmitry V. , Klimochkin Yuri N. 
Published: February 2021

AbstractA new oxidative transformation of 1H-benzo[f]chromenes into spirodimers under the action of selenium dioxide was discovered, leading to spirodimers, which are dibenzannulated analogues of naturally occurring welwitschins E and F. In the reaction, both MnO2 and I2O5 can also be used as an oxidant. The protocol has advantages of mild reaction conditions and simple operation. At the same time, oxidation of 1H-benzo[f]chromenes with (diacetoxyiodo)benzene is accompanied by the formation of 3,3′-bibenzo[f]chromene as a dimer of a different structure. It was also found that 4H-chromenes under the action of various oxidants are cleaved to give chalcone.
An Intraoral Repair Method for Chipping Fracture of a Multi-unit Fixed Zirconia Reconstruction: A Direct Dental Technique
Authors: Mesquita Alfredo Mikail Melo , Al-Haj Husain Nadin , Molinero-Mourelle Pedro , Özcan Mutlu 
Published: February 2021

AbstractFracture or chipping of veneering ceramic is one of the most frequent clinical failures in dentistry in fixed dental and implant-borne prostheses. Due to the friable nature of the ceramic material, chippings may result in an aesthetic and functional problem for the patient requiring a rapid solution. Direct repairs have been indicated for the restoration of function, aesthetics and comfort, especially in cases where the fractured prosthesis presents good adaptation and satisfactory aesthetics. This case report aims to present and discuss the techniques of the direct reveneering method, their advantages and disadvantages, as well as the importance of adhesive procedures in the success of these restorative approaches. Success in repairing the fractured area, regardless of the technique used, is fundamental to establish a strong and stable adhesion between the repaired and the fractured areas, since the longevity of the repair will depend on the quality of the interface generated.
Use of Gelatin-thrombin Hemostatic Matrix for Control of Ruptured Cerebral Aneurysm
Authors: Umana Giuseppe Emmanuele , Scalia Gianluca , Spitaleri Angelo , Alberio Nicola , Fricia Marco , Tomasi Santino Ottavio , Nicoletti Giovanni Federico , Cicero Salvatore 
Published: February 2021

Abstract
Background The use of thrombin-based hemostatic agents (TBHAs) has become common practice in most neurosurgical procedures, both cranial and spinal.
Methods We present the case of a 40-year-old woman who was referred to our institution with intense headache and Fisher grade 3 subarachnoid hemorrhage (SAH) mainly at the level of the right sylvian fissure, caused by a 5.71-mm right middle cerebral artery (MCA) bifurcation aneurysm, with hourglass morphology and a bleb on the bottom. Cerebral angiography demonstrated aneurysm enlargement, compared with the prior angiographic computerized tomography scan.
Results A right pterional craniotomy was performed. After initial arachnoid dissection to get proximal vascular control, but before we obtained it, we witnessed profuse bleeding from the aneurysm. Floseal, a gelatin-thrombin matrix sealant, was sprayed over the breach of the aneurysm, and cottonoids were gently pressed with a self-retaining spatula, stopping the hemorrhage. After that, we obtained proximal control with an extradural clinoidectomy and temporary clipping of the right internal carotid artery (ICA) and MCA. Finally, aneurysm dissection and final clipping were performed with the application of two clips. The postoperative course was uneventful, and the patient was discharged on postoperative day 10.
Conclusion Intraoperative aneurysm rupture (IAR) is a dangerous event that carries great risks—even death. Proper use of TBHAs is a useful and safe way to stop the bleeding, take a deep breath, and achieve proximal vascular control. To the best of our knowledge, this is the first report of the use of TBHA during aneurysm clipping.
Complications Following Decompressive Craniectomy
Authors: Mraček Jan , Mork Jan , Dostal Jiri , Tupy Radek , Mrackova Jolana , Priban Vladimir 
Published: February 2021

Abstract
Background Decompressive craniectomy (DC) has become the definitive surgical procedure to manage a medically intractable rise in intracranial pressure. DC is a life-saving procedure resulting in lower mortality but also higher rates of severe disability. Although technically straightforward, DC is accompanied by many complications. It has been reported that complications are associated with worse outcome. We reviewed a series of patients who underwent DC at our department to establish the incidence and types of complications.
Methods We retrospectively evaluated the incidence of complications after DC performed in 135 patients during the time period from January 2013 to December 2018. Postoperative complications were evaluated using clinical status and CT during 6 months of follow-up. In addition, the impact of potential risk factors on the incidence of complications and the impact of complications on outcome were assessed.
Results DC was performed in 135 patients, 93 of these for trauma, 22 for subarachnoid hemorrhage, 13 for malignant middle cerebral artery infarction, and 7 for intracerebral hemorrhage. Primary DC was performed in 120 patients and secondary DC in 15 patients. At least 1 complication occurred in each of 100 patients (74%), of which 22 patients (22%) were treated surgically. The following complications were found: edema or hematoma of the temporal muscle (34 times), extracerebral hematoma (33 times), extra-axial fluid collection (31 times), hemorrhagic progression of contusions (19 times), hydrocephalus (12 times), intraoperative malignant brain edema (10 times), temporal muscle atrophy (7 times), significant intraoperative blood loss (6 times), epileptic seizures (5 times), and skin necrosis (4 times). Trauma (p = 0.0006), coagulopathy (p = 0.0099), and primary DC (p = 0.0252) were identified as risk factors for complications. There was no significant impact of complications on outcome.
Conclusions The incidence of complications following DC is high. However, we did not confirm a significant impact of complications on outcome. We emphasize that some phenomena are so frequent that they can be considered a consequence of primary injury or natural sequelae of the DC rather than its direct complication.
Impact of Postoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients
Authors: Song Xuyang , Sajak Patrick M.J. , Aneizi Ali , Alqazzaz Aymen , Burt Cameran I. , Ventimiglia Dominic J. , Meredith Sean J. , Leong Natalie L. , Packer Jonathan D. , Henn R. Frank 
Published: February 2021

AbstractThe purposes of this study were to identify the patient characteristics associated with refilling a postoperative opioid prescription after knee surgery and to determine whether refilling opioids is associated with 2-year patient-reported outcomes. We hypothesized that postoperative refill of opioids would be associated with worse 2-year patient-reported outcomes. We studied 192 patients undergoing knee surgery at a single urban academic institution. Patients completed multiple patient-reported outcome measures preoperatively and 2 years postoperatively, including six Patient-Reported Outcomes Measurement Information System (PROMIS) domains, the International Knee Documentation Committee (IKDC) questionnaire, numeric pain scale scores for the operative knee and the rest of the body, Marx Activity Rating Scale, as well as measures of met expectations, improvement, and satisfaction. Total morphine equivalents (TMEs) were calculated from a regional prescription monitoring program. Patients who refilled a postoperative opioid prescription were compared with those who did not, and TMEs were calculated for those who refilled (Refill TMEs). One hundred twenty-nine patients (67%) refilled at least one postoperative opioid prescription. Black race, older age, higher average body mass index (BMI), smoking, greater medical comorbidities, preoperative opioid use, lower income, government insurance, and knee arthroplasty were associated with refilling opioids. Greater Refill TMEs was associated with black or white race, older age, higher average BMI, smoking, greater medical comorbidities, preoperative opioid use, government insurance, and unemployment. Refilling opioids and greater Refill TMEs were associated with worse postoperative scores on most patient-reported outcome measures 2 years after knee surgery. However, refilling opioids and greater Refill TMEs did not have a significant association with improvement after surgery. Multivariable analysis controlling for potential confounding variables confirmed that greater postoperative Refill TMEs independently predicted worse 2-year PROMIS Physical Function, 2-year PROMIS Pain Interference, and 2-year IKDC knee function scores. Postoperative refill of opioids was associated with worse 2-year patient-reported outcomes in a dose-dependent fashion. These findings reinforce the importance of counseling patients regarding opioid use and optimizing opioid-sparing pain management postoperatively.
Non-COVID Neurological Emergencies: A Silent Killer Going Unnoticed during COVID-19 Pandemic
Authors: Dhar Nikita , Madhaw Govind , Kumar Mritunjai , Kumar Niraj , Tiwari Ashutosh , Jatale Vinayak 
Published: February 2021

Abstract

Objective This study assesses the impact of coronavirus disease 2019 (COVID-19) on the pattern of neurological emergencies reaching a tertiary care center.

Materials and Methods This is a retrospective and single center study involving 295 patients with neurological emergencies mainly including acute stroke, status epilepticus (SE), and tubercular meningitis visiting emergency department (ED) from January 1 to April 30, 2020 and divided into pre- and during lockdown, the latter starting from March 25 onward. The primary outcome was number of neurological emergencies visiting ED per week in both periods. Secondary outcomes included disease severity at admission, need for mechanical ventilation (MV), delay in hospitalization, in-hospital mortality, and reasons for poor compliance to ongoing treatment multivariate binary logistic regression was used to find independent predictors of in-hospital mortality which included variables with p <0.1 on univariate analysis. Structural break in the time series analysis was done by using Chow test.

Results There was 53.8% reduction in number of neurological emergencies visiting ED during lockdown (22.1 visits vs. 10.2 visits per week, p = 0.001), significantly affecting rural population (p = 0.004). Presenting patients had comparatively severe illness with increased requirement of MV (p < 0.001) and significant delay in hospitalization during lockdown (p < 0.001). Poor compliance to ongoing therapy increased from 34.4% in pre-lockdown to 64.7% patients during lockdown (p < 0.001), mostly due to nonavailability of drugs (p < 0.001). Overall, 35 deaths were recorded, with 20 (8.2%) in pre-lockdown and 15 (29.4%) during lockdown (p = 0.001). Lockdown, nonavailability of local health care, delay in hospitalization, severity at admission, and need for MV emerged as independent predictors of poor outcome in stroke and delay in hospitalization in SE.

Conclusion COVID-19 pandemic and associated lockdown resulted in marked decline in non-COVID neurological emergencies reporting to ED, with more severe presentations and significant delay from onset of symptoms to hospitalization.
Reconstructive Outcomes of Multilayered Closure of Large Skull Base Dural Defects Following Open Anterior Craniofacial Resection
Authors: Shi Justin , Ayeni Tokunbo , Gallagher Kathleen Kelly , Patel Akash J. , Jalali Ali , Hernandez David J. , Haskins Angela D. , Sandulache Vlad C. , Sturgis Erich M. , Huang Andrew T. 
Published: February 2021

Abstract
Introduction Standardized reconstruction protocols for large open anterior skull base defects with dural resection are not well described. Here we report the outcomes and technique of a multilayered reconstructive algorithm utilizing local tissue, dural graft matrix, and microvascular free tissue transfer (MVFTT) for reconstruction of these deformities.
Design This study is a retrospective review.
Results Eleven patients (82% males) met inclusion criteria, with five (45%) having concurrent orbital exenteration and eight (73%) requiring maxillectomy. All patients required dural resection with or without intracranial tumor resection, with the average dural defect being 36.0 ± 25.9 cm2. Dural graft matrices and pericranial flaps were used for primary reconstruction of the dural defects, which were then reinforced with free fascia or muscle overlay by means of MVFTT. Eight (73%) patients underwent anterolateral thigh MVFTT, with the radial forearm, fibula, and vastus lateralis comprising the remainder. Average total surgical time of tumor resection and reconstruction was 14.9 ± 3.8 hours, with median length of hospitalization being 10 days (IQR: 9.5, 14). Continuous cerebrospinal fluid drainage through a lumber drain was utilized in 10 (91%) patients perioperatively, with an average length of indwelling drain of 5 days. Postoperative complications occurred in two (18%) patients who developed asymptomatic pneumocephalus that resolved with high-flow oxygen therapy.
Conclusion A standardized multilayered closure technique of dural graft matrix, pericranial flap, and MVFTT overlay in the reconstruction of large open anterior craniofacial dural defects can assist the reconstructive team in approaching these complex deformities and may help prevent postoperative complications.
Systematic Review Comparing Open versus Endoscopic Surgery in Clival Chordomas and a 10-Year Single-Center Experience
Authors: Baig Mirza Asfand , Ravindran Visagan , Okasha Mohamed , Boardman Timothy Martyn , Maratos Eleni , Sinan Barazi , Thomas Nick 
Published: February 2021

Abstract
Objectives Chordomas are rare, slow-growing, and osteo-destructive tumors of the primitive notochord. There is still contention in the literature as to the optimal management of chordoma. We conducted a systematic review of the surgical management of chordoma along with our 10-year institutional experience.
Design A systematic search of the literature was performed in October 2020 by using MEDLINE and EMBASE for articles relating to the surgical management of clival chordomas. We also searched for all adult patients surgically treated for primary clival chordomas at our institute between 2009 and 2019.
Participants Only articles describing chordomas arising from the clivus were included in the analysis. For our institution experience, only adult primary clival chordoma cases were included.
Main Outcome Measures Patients were divided into endoscopic or open surgery. Rate of gross total resection (GTR), recurrence, and complications were measured.
Results Our literature search yielded 24 articles to include in the study. Mean GTR rate among endoscopic cases was 51.9% versus 41.7% for open surgery. Among the eight cases in our institutional experience, we found similar GTR rates between endoscopic and open surgery.
Conclusion Although there is clear evidence in the literature that endoscopic approaches provide better rates of GTR with fewer overall complications compared to open surgery. However, there are still situations where endoscopy is not viable, and thus, open surgery should still be considered if required.
Anatomic Considerations of Microvascular Free Tissue Transfer in Endoscopic Endonasal Skull Base Surgery
Authors: Mady Leila J. , Kaffenberger Thomas M. , Baddour Khalil , Melder Katie , Godse Neal R. , Gardner Paul , Snyderman Carl H. , Solari Mario G. , Kubik Mark W. , Wang Eric W. , Sridharan Shaum 
Published: February 2021

Abstract
Objective Though microvascular free tissue transfer is well established for open skull base reconstruction, normative data regarding flap design and inset after endoscopic endonasal skull base surgery (ESBS) is lacking. We aim to describe anatomical considerations of endoscopic endonasal inset of free tissue transfer of transclival (TC) and anterior cranial base resection (ACBR) defects.
Design and Setting Radial forearm free tissue transfer (RFFTT) model.
Participants Six cadaveric specimens.
Main Outcome Measures Pedicle orientation, pedicle length, and recipient vessel intraluminal diameter.
Results TC and ACBR defects averaged 17.2 and 11.7 cm2, respectively. Anterior and lateral maxillotomies and endoscopic medial maxillectomies were prepared as corridors for flap and pedicle passage. Premasseteric space tunnels were created for pedicle tunneling to recipient facial vessels. For TC defects, the RFFTT pedicle was oriented cranially with the flap placed against the clival defect (mean pedicle length 13.1 ± 0.6 cm). For ACBR defects, the RFFTT pedicle was examined in three orientations with respect to anterior–posterior axis of the RFFTT: anteriorly, posteriorly, and laterally. Lateral orientation offered the shortest average pedicle length required for anastomosis in the neck (11.6 ± 1.29 cm), followed by posterior (13.4 ± 0.7cm) and anterior orientations (14.4 ± 1.1cm) (p < 0.00001, analysis of variance).
Conclusions In ACBR reconstruction using RFFTT, our data suggests lateral pedicle orientation shortens the length required to safely anastomose facial vessels and protects the frontal sinus outflow anteriorly while limiting pedicle exposure through a maxillary corridor within the nasal cavity. With greater understanding of anatomical factors related to successful preoperative flap planning, free tissue transfer may be added to the ESBS reconstruction ladder.
The improvement of CoZrTaB thin films on different substrates for flexible device applications
Authors: Wu Yanze , Yeng I-Chen , Yu Hongbin 
Published: February 2021

In this paper, the CoZrTaB thin films are fabricated using sputtering on different substrates and characterized comprehensively. The CoZrTaB thin films have been fabricated in the single-layer and multi-layer structures with SiO2 as the insulator layer, of which the vibrating sample magnetometer results suggest that the saturation field and the coercivity change of the multi-layer structure can be minimized while the lamination structure can suppress the eddy current at high working frequency. Compared with the continuously sputtered 400 nm CoZrTaB thin film, the multi-layer thin film shows a hysteresis loop with a single domain and small coercivity. The surface roughness of each CoZrTaB thin film and two kinds of polyimide substrates is extracted by the atomic force microscope instrument. Besides, material characterization such as X-ray powder diffraction and Rutherford backscattering spectrometry have been conducted to acquire the information of phase and element ratio of the CoZrTaB thin film. Also, the different process conditions that could affect the magnetic properties are investigated and verified. A comparison is made with the previously reported results, sustaining the improvement of the CoZrTaB thin film on different substrates.
Raising productivity of cereal crops in dry and heat stress environments remains a breeding challenge
Authors: Dwivedi Sangam L. , Ortiz Rodomiro 
Published: February 2021

Abstract
‘Green Revolution’ genes have led to the release of input-responsive cultivars, resulting in multifold productivity increases in rice and wheat. Declining precipitation, increased intensity of drought and rising temperature are casting uncertainty over agricultural production. As noted in this minireview, plant genes when overexpressed allow cereals to produce grains in drought- and heat-prone sites.
Panama’s Camino Real, a Historic Walking Trail
Authors: Torres Issa 
Published: February 2021

Abstract
Throughout the long history of South and Central America, the major trade routes have been of huge strategic importance. This case study provides an overview of some of the most iconic; then focuses more particularly on Panama’s Camino Real, which was once a commercial highway that linked the Atlantic to the Pacific.

Information

Adapted from ‘Chapter 1: Tourism Routes and their Identity’. In: Ward-Perkins, D., Beckmann, C., Ellis, J. (eds)
Tourism routes and trails theory and practice
. CAB International, pp. 10-15.

© CAB International 2020
Smart aerial monitoring system to prevent human wildlife intervention
Authors: Sri Harsha M , Sai Teja P , Mahapatra Punyasloka , Anand R 
Published: February 2021

AbstractIn India, agriculture is one of the crucial factors for inspecting India’s economy. Proper supervision ofthis sector leads to an exceptional yield. India, being a densely populated country, hasencountered frequent and often fatal conflicts due to the share of land and other natural resources among humans and the elephants, in specific. Recent statistics have exhibited that approximately 28000 elephants are distributed over 3% over India’s geographical area.Humanencroachment continues to grow around elephant habitats which results in colossal damage to the crop yield and human life. Technologies like AI and ML are prominent in unraveling the distinct challenges of the modern society. This paper focuses on the design and implementation of a IoT and ML enabled smart drone to intervene the association between humans and elephants to protect both human life as well as the crop yield.
Probiotic Activity and Antibiotic Sensitivity of Lactic Acid Bacteria Isolated from Healthy Breastfed Newborn Baby Feces
Authors: Lase E , Davidson A L , Lister I N E , Fachrial E 
Published: February 2021

Abstract
Breast milk is a very nutritional food that helps with the production of good microbiota in the gut of an infant. Generally, two lactic acid bacteria (LAB), namely Lactobacillus and Bifidobacterium, are related to infant gut microbiota. LAB is often used as a probiotic agent, but some conditions required for every bacterium to be utilized for this purpose. This study aimed to investigate the acid and bile salt tolerance as a criterion of probiotic agent and antibiotic sensitivity of LAB isolated from the feces of a healthy breastfed newborn baby. The sample was obtained from the feces of the aforementioned subject (baby). The result showed that the total colony of LAB from the feces was 10.2 x 108 CFU/mL. In an acidic condition at pH 3, there was one isolate that had 100% viability in the first hour period, but all of them had 100% at bile salt tolerance. However, sensitivity test of the isolated LAB indicated resistance to 6 types of antibiotics namely Erythromycin 5 µg, Gentamicin 10 µg, Oxacillin 5 µg, Ofloxacin 5 µg, Amoxycillin 25 µg, and Cefotaxime 30 µg. The study showed that LAB isolated from healthy newborn baby feces have potency as a probiotic.