bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paleocene/Eocene carbon feedbacks triggered by volcanic activity
Authors: Kender Sev , Bogus Kara , Pedersen Gunver K. , Dybkjær Karen , Mather Tamsin A. , Mariani Erica , Ridgwell Andy , Riding James B. , Wagner Thomas , Hesselbo Stephen P. , Leng Melanie J. 
Published: August 2021

AbstractThe Paleocene–Eocene Thermal Maximum (PETM) was a period of geologically-rapid carbon release and global warming ~56 million years ago. Although modelling, outcrop and proxy records suggest volcanic carbon release occurred, it has not yet been possible to identify the PETM trigger, or if multiple reservoirs of carbon were involved. Here we report elevated levels of mercury relative to organic carbon—a proxy for volcanism—directly preceding and within the early PETM from two North Sea sedimentary cores, signifying pulsed volcanism from the North Atlantic Igneous Province likely provided the trigger and subsequently sustained elevated CO2. However, the PETM onset coincides with a mercury low, suggesting at least one other carbon reservoir released significant greenhouse gases in response to initial warming. Our results support the existence of ‘tipping points’ in the Earth system, which can trigger release of additional carbon reservoirs and drive Earth’s climate into a hotter state.
Informational Masking Effects of Speech Versus Nonspeech Noise on Cortical Auditory Evoked Potentials
Authors: Vander Werff Kathy R. , Niemczak Christopher E. , Morse Kenneth 
Published: August 2021

Purpose
Background noise has been categorized as energetic masking due to spectrotemporal overlap of the target and masker on the auditory periphery or informational masking due to cognitive-level interference from relevant content such as speech. The effects of masking on cortical and sensory auditory processing can be objectively studied with the cortical auditory evoked potential (CAEP). However, whether effects on neural response morphology are due to energetic spectrotemporal differences or informational content is not fully understood. The current multi-experiment series was designed to assess the effects of speech versus nonspeech maskers on the neural encoding of speech information in the central auditory system, specifically in terms of the effects of speech babble noise maskers varying by talker number.

Method
CAEPs were recorded from normal-hearing young adults in response to speech syllables in the presence of energetic maskers (white or speech-shaped noise) and varying amounts of informational maskers (speech babble maskers). The primary manipulation of informational masking was the number of talkers in speech babble, and results on CAEPs were compared to those of nonspeech maskers with different temporal and spectral characteristics.

Results
Even when nonspeech noise maskers were spectrally shaped and temporally modulated to speech babble maskers, notable changes in the typical morphology of the CAEP in response to speech stimuli were identified in the presence of primarily energetic maskers and speech babble maskers with varying numbers of talkers.

Conclusions
While differences in CAEP outcomes did not reach significance by number of talkers, neural components were significantly affected by speech babble maskers compared to nonspeech maskers. These results suggest an informational masking influence on neural encoding of speech information at the sensory cortical level of auditory processing, even without active participation on the part of the listener.
Patientensicherheit durch Risiko- und Qualitätsmanagement im Gesundheitswesen
Authors: Netzer-Nawrocki Juliane 
Published: August 2021

ZusammenfassungDie Patientensicherheit ist ein wesentlicher Bestandteil des Gesundheitsrechts und sie ist ein Kernelement der Qualitätssicherung und des Qualitätsmanagements.1 Im Folgenden sollen ein Überblick über die Entwicklung der Patientensicherheit gegeben werden und die Elemente des Qualitätsmanagements sowie die Konkretisierung durch die Qualitätsmanagementrichtlinie des Gemeinsamen Bundesausschusses dargestellt werden.
Non compliance des Patienten als Behandlungsfehler?
Authors: Maus Christian , Makoski Kyrill 
Published: August 2021

ZusammenfassungDie Nichtbefolgung ärztlicher Ratschläge kann dem Patienten nur dann vorgeworfen werden, wenn der Arzt den Patienten vorher darüber aufgeklärt hat, welche Folgen dieses Handeln haben kann. Liegt ein Behandlungsfehler vor und verhält sich der Patient zusätzlich weiter schädigend, dann kann das eigene Verhalten des Patienten den Arzt entlasten – aber nur dann, wenn der Patient entsprechend informiert wurde.
Umbau einer Schilddrüsenpraxis
Authors: Knoop Anja 
Published: August 2021

ZusammenfassungNuklearmedizinische Praxen bestehen oft über Jahrzehnte in der gleichen Praxisfläche. In diesen großen Zeiträumen kommt es unweigerlichen zu gesetzlichen Änderungen. Das reicht von Anforderungen im nuklearmedizinischen Sinne bis hin zu bauordnungsrelevanten Änderungen wie beispielsweise Barrierefreiheit und Arbeitsschutz. Sind Modernisierungsmaßnahmen geplant und notwendig, ist der Umfang im Vorfeld zu untersuchen.
An Extraordinary Reconstruction of a Postoperative Defect after Metatarsophalangeal Joint Arthrodesis of the Big Toe Using the “Chinese Forearm Flap”
Authors: Ring Andrej 
Published: August 2021

Abstract
Background We present an unusual technique for reconstruction of a postoperative tissue defect following hallux rigidus surgery.
Methods A complicated course after left big toe arthrodesis resulted in a soft tissue defect with bone exposure of the first ray. Amputation of the big toe was categorically rejected by the patient. There was advanced arteriosclerosis with single-vessel supply to the foot via the posterior tibial artery.
Outcome To preserve the big toe, the defect was covered by a fasciocutaneous radial free flap with a 15 cm long vascular pedicle which was microanastomosed to the posterior tibial artery and its accompanying vein at the level of the medial malleolus.
Conclusion In certain extreme situations, the free “Chinese” radial flap can be quite effective in covering forefoot defects and allowing satisfactory and aesthetically pleasing soft tissue reconstruction.
Versorgungsbedarf in einer psychosomatischen Spezialambulanz für Geflüchtete an einem Universitätsklinikum
Authors: Beyer Thomas , Morawa Eva , Graemer Katrin , Erim Yesim 
Published: August 2021

ZUSAMMENFASSUNG
Hintergrund Nach der Fluchtbewegung von 2015 wurde vielfach festgestellt, dass die psychotherapeutischen Angebote nicht für den anzunehmenden Bedarf ausreichen können.
Fragestellung Ziel dieser Studie war es, anhand eines Fragebogens, die in einer Spezialambulanz an einer Regelversorgungseinrichtung durchgeführten Behandlungen zu untersuchen und deren spezifischen Aspekte festzustellen.
Material und Methoden Ablauf und Inhalte der psychotherapeutischen Behandlungen mit Geflüchteten wurden im Forscherteam diskutiert. Auf dieser Grundlage wurden die zu erwartenden Rahmenbedingungen und Interventionen in einem Fragebogen zusammengefasst. Dieser diente der retrospektiven Untersuchung der Behandlungen. Die Auswertung der Daten erfolgte rein deskriptiv.
Ergebnisse 60 Behandlungen von Geflüchteten konnten ausgewertet werden. Die Inhalte der untersuchten Behandlungen können in Interventionen, besondere Rahmenbedingungen, ärztlich-psychotherapeutische Maßnahmen und Beachtung kultureller sowie religiöser Aspekte gegliedert werden. Unsere Ergebnisse geben einen differenzierten Überblick über die Inhalte der Behandlungen bei einer psychisch hochbelasteten Patientengruppe. Das Festlegen der Sitzordnung in einem gedolmetschten Gespräch erfolgte bei 56, Psychoedukation bei 43, Affekt- und Stressregulation bei 32, die Thematisierung religiöser Aspekte bei 28 und die Behandlung mit Psychopharmaka bei 24 Geflüchteten.
Diskussion Unsere Ergebnisse zeigen, dass in den untersuchten Behandlungen stabilisierende Interventionen erfolgten, aber auch interkulturelle und religiöse Aspekte thematisiert wurden. Das Herstellen einer stabilen Beziehung zu den Geflüchteten wird vor allem beeinflusst durch interkulturelle sowie religiöse Aspekte und die Besonderheiten der Anwesenheit eines Dolmetschers und des Übersetzungsprozesses.
Gemeindepsychiatrische Krisenhilfen
Authors: Greve Nils 
Published: August 2021

ZUSAMMENFASSUNGDer Beitrag beschreibt die Grundprinzipien und die praktische Funktionsweise regionaler, in das gemeindepsychiatrische Versorgungssystem eingegliederter Krisendienste. In Deutschland gab es lange Zeit nur einzelne Pilotprojekte, die anhand eines Beispiels kurz beschrieben werden. Selektivverträge mit einigen Krankenkassen und zuletzt die Verankerung regionaler Krisendienste in den Psychisch-Kranken-Gesetzen von Berlin und Bayern eröffnen zukünftig die Perspektive einer flächendeckenden ambulant-aufsuchenden Krisenintervention in Deutschland.
Synthesis of Nitrile-Functionalized Polydentate N-Heterocycles as Building Blocks for Covalent Triazine Frameworks
Authors: Stevens Christian V. , Everaert Jonas , Debruyne Maarten , Vanden Bussche Flore , Van Hecke Kristof , Heugebaert Thomas S. A. , Van Der Voort Pascal , Van Speybroeck Veronique 
Published: August 2021

AbstractCovalent triazine frameworks (CTFs) based on polydentate ligands are highly promising supports to anchor catalytic metal complexes. The modular nature of CTFs allows to tailor the composition, structure, and function to its specific application. Access to a broad range of chelating building blocks is therefore essential. In this respect, we extended the current available set of CTF building blocks with new nitrile-functionalized N-heterocyclic ligands. This paper presents the synthesis of the six ligands which vary in the extent of the aromatic system and the denticity. The new building blocks may help in a rational design of enhanced support materials in catalysis.
A-9 Representing the Underrepresented: An Examination of Racial/Ethnic Differences in TBI-Related Outcomes in U.S. Veterans Enrolled in the Million Veteran Program
Authors: Sakamoto McKenna S , Chanfreau-Coffinier Catherine , Delano-Wood Lisa , Program V A Million Veteran , Merritt Victoria C 
Published: August 2021

Abstract

Objective
Traumatic brain injury (TBI) research in Veterans is based primarily on non-Hispanic White samples, which does not reflect the diversity of the current military population. We examined the relationship between race/ethnicity and clinical outcomes in a large sample of Iraq/Afghanistan-era Veterans within the Million Veteran Program.

Method
Primary outcomes included injury characteristics, neurobehavioral-related symptoms, and employment status gleaned from the Comprehensive TBI Evaluation (CTBIE) for 7006 Veterans with a clinician-confirmed history of TBI. Logistic regressions adjusting for age, sex, and education examined the effect of race/ethnicity on CTBIE outcomes.

Results
Racial/ethnic groups included non-Hispanic White (n = 4203), Hispanic (¬n = 1302), non-Hispanic Black (n = 951), Asian (¬n = 205), Multiracial (¬n = 157), Native Hawaiian/Pacific Islander (−n = 91), and American Indian/Alaska Native (¬n = 79). Race/ethnicity was significantly associated with 5/10 CTBIE variables after applying Bonferroni-correction: blast exposure, loss of consciousness, post-traumatic amnesia (PTA), affective neurobehavioral symptoms, and unemployment (p’s &lt; 0.0001). Relative to non-Hispanic Whites, Veterans self-identifying as Asian, non-Hispanic Black, and Hispanic were less likely to experience certain injury-related characteristics (e.g., blast exposure, PTA). Additionally, Asian and Native Hawaiian/Pacific Islander groups were less likely to endorse severe affective symptoms compared to White Veterans, whereas Black Veterans were more likely to endorse severe affective symptoms.

Conclusions
Results highlight that certain TBI outcomes—particularly those related to injury characteristics and affective symptoms—vary by race/ethnicity. An enhanced understanding of how outcomes are modified by race/ethnicity is vital so that clinical care can be appropriately tailored to the unique needs of racially and ethnically diverse Veterans. Future studies should further elucidate the relationship between race/ethnicity and TBI outcomes.
A-94 Characterization of Million Veteran Program (MVP) Enrollees with Comprehensive TBI Evaluation (CTBIE) Data: An Analysis of Neurobehavioral Symptoms
Authors: Ozturk Erin , Chanfreau-Coffinier Catherine , Sakamoto McKenna S , Merritt Victoria C , Delano-Wood Lisa 
Published: August 2021

Abstract

Objective
Using a large sample of U.S. Veterans enrolled in the Million Veteran Program (MVP), we sought to evaluate neurobehavioral symptoms obtained from the Veterans Health Administration’s Comprehensive Traumatic Brain Injury Evaluation (CTBIE).

Method
Eligible participants (N = 12,144) included MVP-enrolled Veterans who completed the CTBIE, a clinician-administered interview that assesses for historical, deployment-related TBIs and evaluates current symptoms using the Neurobehavioral Symptom Inventory (NSI). Clinicians completing the CTBIE made clinical determinations about each participant’s TBI diagnostic status (n = 7631 CTBIE+, n = 4513 CTBIE-) as well as likely symptom etiology (TBI: n = 612, Behavioral Health: n = 4965, Combination TBI and Behavioral Health [Comorbid]: n = 2773, Symptom Resolution; n = 750; and Other: n = 1282). We evaluated the association of TBI diagnostic group and symptom etiology group with neurobehavioral symptoms using ANCOVAs adjusted for sociodemographic characteristics.

Results
Results showed a significant effect of TBI on the NSI total score (p &lt; 0.001, ηp2 = 0.02), with CTBIE+ Veterans endorsing greater symptoms than CTBIE- Veterans. There was also a significant association of symptom etiology group with the NSI total score (p &lt; 0.001, ηp2 = 0.07). Post-hoc analyses showed that the Behavioral Health and Comorbid groups endorsed significantly greater symptoms compared to the TBI, Symptom Resolution, and Other groups. A similar pattern of results was found for all NSI symptom domain scores (vestibular, somatic, cognitive, and affective) and symptom breadth scores.

Conclusions
Findings from this large epidemiologic MVP study bolster prior work suggesting that behavioral health (e.g., depression, PTSD) greatly contributes to post-concussive symptom endorsement in chronic TBI. Results further highlight the importance of prioritizing mental health treatment in this vulnerable population.
A-95 The Relationship between Attention Deficit Hyperactivity Disorder (ADHD) and Vestibular Impairments Following Adolescent Sports-Related Concussion (SRC)
Authors: Gilliland Taylor , Reynolds Erin , Covert Kayla , Bennett Monica , Driver Simon 
Published: August 2021

Abstract

Objective
Athletes with ADHD may experience longer and/or more complicated recoveries following SRC; however, previous research has focused on neurocognitive outcomes. The objective of this study was to investigate the relationship between a history of ADHD among adolescent athletes and vestibular impairments following SRC.

Method
Participants included 166 athletes aged 15.9 +/− 1.5 who sustained an SRC, including 25 with a documented history of ADHD. Appropriate summary statistics were used to describe the data. ADHD and non-ADHD groups were compared using t-tests and Mann–Whitney U tests for continuous variables and Chi-square tests for categorical variables. A linear regression model analyzed the relationship between a history of ADHD and vestibular outcomes including horizontal and vertical vestibulo-ocular reflex (hVOR; vVOR), visual motion sensitivity (VMS), and Dizziness Handicap Index (DHI), while referral to vestibular therapy (VT) was analyzed using logistic regression.

Results
Athletes with ADHD experienced significantly higher rates of on-field dizziness, (p = 0.039) and dizziness following vVOR testing on the Vestibular/Ocular Motor Screening (VOMS; p = 0.041). Athletes with ADHD were more likely to be referred to vestibular therapy (VT) (p = 0.033) and displayed abnormal vVOR test during the initial VT visit (p = 0.040).

Conclusions
Adolescent athletes with a history of ADHD are more likely to report on-field dizziness following SRC and increased dizziness with vVOR testing on VOMS, thus resulting in more frequent referrals to VT, where they also display abnormal vVOR results. Additional research is needed to improve treatment strategies and recovery outcomes in athletes after SRC.
A-96 Stability of ImPACT’s Latent Structure from Baseline to Post Concussion Assessment
Authors: Goodwin Grace J , Maietta Julia E , Ahmed Anthony O , Hopkins Nia A , Moore Sara A , Rodrigues Jessica , Pascual Melanie S , Kuwabara Hana C , Kinsora Thomas F , Ross Staci R , Allen Daniel N 
Published: August 2021

Abstract

Objective
ImPACT is commonly used for sport-concussion management. Baseline and post-concussion tests serve as within-athlete comparisons for return-to-play decision-making. Previous literature has questioned whether ImPACT’s five composites accurately represent the internal structure of its cognitive scores. A recent alternative four-factor structure has strong confirmatory evidence for baseline scores (Maietta et al., doi:10.1037/pas0001014). The present study examined the stability of these constructs post-concussion.

Method
The current study utilized a case-matched design (age, sex, sport category) to select a sample of 3560 high school athletes’ baseline (n = 1780) and post-concussion (n = 1780) assessments. Multi-group CFA of first-order, hierarchical, and bifactor models was conducted to assess measurement invariance (configural, metric, scalar, and residual invariance) between baseline and post-concussion samples. Change in comparative fit indices was interpreted as the primary indicator of model invariance.

Results
ImPACT’s five composite structure, as well as the hierarchical and bifactor models, exhibited inadequate fit to the baseline and post-concussion data. The four-factor model demonstrated superior fit in the baseline sample and good fit in the post-concussion sample. The four-factor structure demonstrated invariance across injury status (baseline to post-concussion).

Conclusion
Given that ImPACT’s scores are used for return-to-play decision-making, it is important that they are psychometrically sound. Recent literature suggests that ImPACT’s five composites are not an adequate representation of the cognitive constructs. Findings support validity of the four-factor structure despite injury status, suggesting these cognitive constructs are assessable at both pre- and post-concussion. Additional research is needed to determine implications of these findings for tracking cognitive change following sport-related concussion and making return-to-play decisions.
A-100 Examining Spanish-English Bilingual Boston Naming Test Norms in Traumatic Brain Injury Survivors
Authors: Baez Abril , Lopez-Hernandez Daniel W , Olmos Winter , Rough-Fraser Rachel A , Smith Kristina E , Bueno Alexis , Munoz Isabel C , Saravia Sarah , Budding Deborah , Vespa Paul , Hovda David A , Litvin Pavel Y , Graub Nick , McArthur David l , Plurad David , Fatoorechi Sarah , Woo Ellen , Hardy David J , Wright Matthew J 
Published: August 2021

Abstract

Objective
We examined two established Spanish-English bilingual norms to assess if traumatic brain injury (TBI) deficits were still found if language was no longer a variable influencing Boston Naming Test (BNT) performance.

Method
The sample consisted of 47 healthy comparison (HC; 24 English-Monolinguals; 23 Spanish-English Bilinguals), 33 acute TBI (ATBI; 20 English-Monolinguals; 13 Spanish-English Bilinguals), and 25 Chronic TBI (CTBI: 13 English-Monolinguals; 12 Spanish-English Bilinguals) participants. Raw scores and adjusted demographic T-scores (Roberts et al., 2002; Rosselli et al., 1997) were used to evaluate BNT performance.

Results
An ANCOVA controlling for age, revealed the HC group outperformed the TBI group on the BNT (raw score), p = 0.003, ηp2 = 0.11. We also found monolinguals outperformed bilinguals on the BNT, p = 0.000, ηp2 = 0.24. Using the Roberts et al., (2002) norms, we found the HC group outperformed the TBI group, p = 0.003, ηp2 = 0.11, but no language differences were found. Next, using Rosselli et al., (1997) norms, we found the HC group outperformed the TBI group on the BNT, p = 0.003, ηp2 = 0.11, and monolingual speakers outperformed bilingual speakers, p = 0.014, ηp2 = 0.06. No interactions were found.

Conclusions
As expected, the TBI group demonstrated worse BNT performance compared to HC group on both language norms. However, when using Roberts et al., (2002) Spanish-English bilingual norms, no language group differences were found. Our data indicates that when examining BNT performance in a Spanish-English bilingual and English-monolingual TBI sample, Roberts et al., (2002) normative data may be better suited to evaluate BNT deficits in a TBI while taking language into account.
A-101 Reaction Time and Reaction Time Variability with the Brain Gauge Somatosensory Device in Service Members with and without Acute Concussion
Authors: Cole Wesley , Ivins Brian J , Arrieux Jacques P , Crawford Haley R , Tommerdahl Mark , Jorgensen-Wagers Kendra 
Published: August 2021

Abstract

Objective
Research has demonstrated reaction time variability (RTV) as a potentially sensitive metric for post-concussion assessments. The Brain Gauge Clinical Metrics battery (BG) device uses tactile sensory stimulation to elicit a response, increasing accuracy to &lt;1 msec versus 30–100 msec in visually-based reaction time (RT) measures. We sought to determine if BG RTV could adequately identify individuals with acute concussion.

Methods
We administered BG to 98 healthy control service members (SMs) and 64 SMs within 7 days of a medically diagnosed concussion. The battery includes simple RT and repeated simple RT subtests with RT variability (RTV) for each test calculated as the sd of mean RT for each participant. We used t-tests and gamma regression to compare group RT and RTV means. “Cutoffs” based on percentiles of the control group RTV distribution were calculated and the proportion of each group falling below these cutoffs was determined.

Results
There were statistically significant differences with large effect sizes between groups across all four metrics. The proportion of participants in the concussion group falling below the cutoffs was higher than among controls, with large effect sizes. T-tests and gamma regression showed that group mean RT and RTV differed significantly under multiple distributional assumptions.

Conclusions
Both RT and RTV using the BG somatosensory device demonstrated the ability to discriminate between healthy control SMs and SMs with acute concussion. This is further evidence that RTV is a sensitive measure for acute concussion and the use of a tactile sensory stimulus may represent an improvement over a visual stimulus.