bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update Vorhofflimmern – Was ist neu?
Authors: Schäffer Benjamin , Gunawardene Melanie A. , Willems Stephan 
Published: August 2021

Was ist neu?
Behandlungspfad im Management von Vorhofflimmerpatient*innen Die im vergangenen Jahr neu erschienen Vorhofflimmer-Leitlinien schlagen einen Diagnose- und Therapiealgorithmus vor, der eine strukturierte und erweiterte Charakterisierung ermöglichen soll und nach umfangreicher und „ganzheitlicher“ Einschätzung in einer gezielten Therapiestrategie mündet. Zentraler Bestandteil bleibt die Prävention thromboembolischer Komplikationen.
Therapie von Begleiterkrankungen Eine konsequente Behandlung von Begleiterkrankungen, insbesondere klassischer kardiovaskulärer Risikofaktoren, wird in einem multimodalen Therapieansatz betont.
Symptomkontrolle und die Rolle der Katheterablation Symptomatische Patient*innen sollten eine rhythmuserhaltende Therapie bekommen. Vor dem Hintergrund oft limitierter medikamentöser Optionen kommt der Katheterablation eine entscheidende Rolle zu.
Prognostische Aspekte und das richtige Timing Mit der EAST-AFNET4-Studie konnte erstmals der prognostische Vorteil einer Rhythmuskontrolle bei Patient*innen mit Begleiterkrankungen gezeigt werden. Entscheidend scheint insbesondere der frühe Therapiebeginn nach Diagnosestellung. Aktuelle Studien demonstrieren die hohe Effektivität der Katheterablation auch als Erstlinienbehandlung. Bei Herzinsuffizienz geht die Katheterablation mit einer Prognoseverbesserung einher.
Persistierende Beschwerden nach akuter COVID-19-Erkrankung: „Long-COVID“?
Authors: August Dietrich , Götz Veronika , Stete Katarina 
Published: August 2021

Was ist neu?
Prävalenz und Risikofaktoren Die Gesamthäufigkeit von Langzeitbeschwerden ist unklar. Als Risikofaktoren konnten bisher der Schweregrad der Akuterkrankung, weibliches Geschlecht und Grunderkrankungen identifiziert werden.
Klinik und Pathogenese Die Pathogenese ist nicht geklärt. Ebenso unbekannt ist die Prognose über den Verlauf der Beschwerden. Wichtig erscheint ein symptomgeleiteter Ausschluss von behandlungsbedürftigen Alternativdiagnosen. Für den Beschwerdekomplex gibt es bislang weder einen einheitlichen Begriff („Long-COVID“) noch eine einheitliche Definition. Häufig wird die Definition des NICE verwendet, das zwischen anhaltendem COVID-19 bei Beschwerden 4–12 Wochen bzw. einem Post-COVID-19-Syndrom mehr als 12 Wochen nach Akuterkrankung unterscheidet.Eine verzögerte Rekonvaleszenz oder persistierende Beschwerden scheinen nach COVID-19 häufiger als nach anderen akuten Infektionskrankheiten aufzutreten und beinhalten vor allem ein Erschöpfungssyndrom mit Belastungsintoleranz, Brustschmerzen/Belastungsdyspnoe und verschiedene neurologische bzw. neuropsychiatrische Symptome.
Diagnostik und Therapie Diagnostik und Therapie sollten interdisziplinär erfolgen. Physiotherapie, psychologische/psychosomatische Anbindung und Möglichkeiten der Rehabilitation sollten erwogen werden. Insbesondere bei persistierender pulmonaler Symptomatik können Patienten von einer Rehabilitationsmaßnahme profitieren. Daten zur Effektivität einer Impfung im Sinne eine Beschwerdelinderung bei Long- COVID fehlen.
Hospitalisierungen und Behandlungskosten von Schizophreniepatienten nach Umstellung auf Depot-Antipsychotika
Authors: Wolff-Menzler Claus , Mahlich Jörg , Olbrich Kerstin , Wilk Adrian , Wimmer Antonie 
Published: August 2021

Zusammenfassung
Ziel der Studie Aktualisierte Untersuchung von Auswirkungen einer Initiierung von Depot-Antipsychotika-Therapie (LAI, long-acting injectable antipsychotic) auf die Hospitalisierungsraten und Therapiekosten deutscher Schizophrenie-Patienten.
Methodik Retrospektive Mirror-Image-Design-Studie der Kassendaten von 1142 deutschen Schizophrenie-Patienten, die in den Jahren 2013 bis 2016 eine Behandlung mit LAIs begonnen haben. Für die eingeschlossenen Patienten wurden die Kosten und Ressourcenverwendung 12 Monate vor dem Index-Datum (Erstinitiierung des LAI) und 12 Monate nach dem Index-Datum verglichen. Zur Bewertung von Krankenhausaufenthalten und deren Kosten wurden 2 Modelle verwendet. In Modell 1 wurde der Krankenhausaufenthalt während des Indexdatums dem Prä-Index-Zeitintervall zugeordnet, in Modell 2 weder dem Prä- noch dem Post-Index-Zeitintervall.
Ergebnisse Die Medikationskosten waren nach der Umstellung auf LAIs signifikant höher (3863,9 € vs. 777,6 €; p < 0,001). Die Anzahl und Dauer der Hospitalisierungen sowie die damit assoziierten Kosten waren nach der Umstellung auf LAIs bei Berechnung nach Modell 1 signifikant niedriger als im Zeitraum vor der Umstellung (2,4 vs. 2,6; 61,1 vs. 74,8 Tage; 5515,9 € vs. 12 502,7 €, alle p < 0,001). Dadurch waren auch die Gesamtkosten signifikant geringer (10 578,6 € vs. 12 459,4 €; p < 0,001). Die Ergebnisse nach Modell 2 zeigten einen ähnlichen Trend, jedoch war hier nur die Reduktion der assoziierten Kosten statistisch signifikant.
Schlussfolgerung In der analysierten Kohorte deutscher Schizophrenie-Patienten fanden wir Hinweise darauf, dass die Umstellung der Behandlung auf LAIs mit einer signifikant geringeren Rate an Hospitalisierungen und signifikant geringeren Gesamtkosten einhergeht.
Qualitätstransparenz im Gesundheitswesen: eine gesundheitsökonomische Modellbetrachtung
Authors: Pross Christoph , Schöner Lukas , Geissler Alexander , Busse Reinhard 
Published: August 2021

ZusammenfassungEin zentrales Anliegen für ein funktionierendes Gesundheitswesen ist die Frage, ob der Wettbewerb zwischen Leistungserbringern und dessen Regulierung bestmögliche Versorgungsqualität erbringt. Aktuell wird Qualität oft uneinheitlich und unzureichend erbracht, umfassende Ansätze für die Definition und Messung von Qualität, sowohl aus klinischer als auch Patientenperspektive, existieren nicht. Zudem gilt die Gesundheitsversorgung in der Ökonomie als Vertrauensgut und ist durch starke Informationsasymmetrien zwischen Patienten, Leistungserbringern und Kostenträgern gekennzeichnet. Der vorliegende Beitrag diskutiert anhand gesundheitsökonomischer Ansätze die Einflussfaktoren auf Behandlungsqualität sowohl auf Nachfrage- als auch auf Angebotsseite und beleuchtet aktuelle gesundheitspolitische Maßnahmen zur Unterstützung bestmöglicher Ergebnisqualität im Wettbewerb zwischen Leistungserbringern.
Performance Evaluation of High-Resolution Ultrasound versus Magnetic Resonance Imaging in Diagnosing Peripheral Nerve Pathologies
Authors: Nischal Neha , Gupta Saurabh , Lal Kanhaiya , Singh Jatinder Pal 
Published: August 2021

Abstract
Background High-resolution ultrasound (HRUS) and magnetic resonance neurography (MRN) are considered complementary to clinical and neurophysiological assessment for neuropathies.
Aims The aim of our study was to compare the accuracy of HRUS and MRN for detecting various peripheral nerve pathologies, to choose the correct investigation to facilitate prompt patient management.
Materials and Methods This prospective study was done using HRUS with 14 MHz linear-transducer and 3 or 1.5T MR in cases referred for the assessment of peripheral nerve pathologies. Image interpretation was done using a scoring system (score 0–3 confidence level) to assess for nerve continuity/discontinuity, increased nerve signal/edema, fascicular change, caliber change, and neuroma/mass lesion. We determined the accuracy, sensitivity, and specificity of these modalities compared with the diagnostic standard determined by surgical and/or histopathological, if not performed then clinical and/or electrodiagnostic evaluation.
Results The overall accuracy of MRN was 89.3% (specificity: 66.6%, sensitivity: 92.6%, negative predictive value [NPV]: 57.1%, positive predictive value [PPV]: 95%) and that of HRUS was 82.9% (specificity: 100%, sensitivity: 80.4%, NPV: 42.8, PPV: 100). The confidence level for detecting nerve discontinuity and change in nerve caliber was found to be higher on ultrasonography than magnetic resonance imaging (MRI) (100 vs. 70% and 100 vs. 50%, respectively). Pathology of submillimeter caliber nerves was accurately detected by HRUS and these could not be well-visualized on MRI.
Conclusion HRUS is a powerful tool that may be used as the first-line imaging modality for the evaluation of peripheral nerve pathologies, and a better means of evaluation of peripheral nerves with submillimeter caliber.
Sagittal Maxillary Fracture: Diagnosis and Management
Authors: Kumar Umesh , Jain Pradeep 
Published: August 2021

Abstract
Background The sagittal maxillary fracture often coexists with maxillary fractures and warrants a definitive management strategy together with other maxillary fractures.
Method This study was conducted on 60 patients suffering from sagittal maxillary fracture. Palatal fractures were classified into six subgroups. During management, patients were divided into three groups. In group A, patients with type I, IV, V, and VI were managed with maxillomandibular fixation and anterior maxillary buttress stabilization. Group B patients included type II, III, and IV palatal fractures. These fractures were undisplaced and were managed with maxillomandibular fixation, anterior alveolar plating, and anterior maxillary buttress stabilization. Group C included type II and III fractures with visible gap in the palate and were managed with maxillomandibular fixation, palatal vault plating, anterior alveolar plating, and anterior maxillary buttress stabilization.
Result Sagittal maxillary fracture was more common in young males. Le Fort I and II fractures were more frequently associated with it in isolation or in combination. Parasagittal and sagittal fractures were the most common types. Sixteen patients of group A, twenty patients of group B, and twenty-four patients of group C were managed. Malocclusion (2), plate extrusion (2), and oroantral fistula (2) were the most common complications.
Conclusion Sagittal maxillary fracture can be diagnosed with clinical and radiological examination. Palatal vault plating is required in displaced palatal fractures of type II and III. Single plate fixed in posterior half of middle one-third of palate gives sufficient stability to the palatal vault.
Primary Extra-axial Glioblastoma: Case Report and Literature Review
Authors: Dabboucy Baraa , Younes Philippe , Rahbani Abdallah , Fahed Elie , Abadjian Gérard 
Published: August 2021

AbstractGlioblastoma multiforme (GBM) is the most frequent and most aggressive primary brain tumor in adults, mainly located in the cerebral hemispheres. In the literature, few cases of primary GBM have been reported to have radiographic and intraoperative features of extra-axial lesions, leading to a diagnostic dilemma. Despite the advances in imaging modalities, the diagnosis of GBM can be challenging, and it is mainly based on the histopathologic confirmation of the excised tumor. We describe the case of a 76-year-old previously healthy female patient who presented to our hospital due to speech disturbances and cognitive impairment. The diagnosis of the tumor type on magnetic resonance imaging (MRI) was difficult, as the findings were suggestive of a malignant meningioma due to the heterogeneous enhancement of a dural-based mass with a dural tail sign. Moreover, the intraoperative findings revealed an extra-axial mass attached to the dura. A histological examination confirmed the diagnosis of glioblastoma with arachnoid infiltration. The patient underwent adjuvant radiotherapy and concomitant temozolomide treatment, she had clinical improvement postoperatively, and was stable during the six months of follow-up. Glioblastoma should be considered in the differential diagnosis of primary extra-axial mass with atypical and malignant features, especially in elderly patients.
Multiple Brain Abscesses by an Air Gun Shot: A Case Report
Authors: Jamali Mohammad , Ahrari Iman , Eghbal Keyvan , Saffarrian Arash , Rakhsha Abbas , Ghahramani Sulmaz 
Published: August 2021

Abstract
Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types of microorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in non-traumatic patients. Multiple brain abscesses are not common.
Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition.
Conclusion Brain injury with air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.
Difficult Biliary Cannulation for Intradiverticular Papilla: Forceps Technique Revisited
Authors: Goenka Mahesh Kumar , Rodge Gajanan Ashokrao , Shah Bhavik Bharat , Afzalpurkar Shivaraj 
Published: August 2021

AbstractPeriampullary diverticula (PAD) have been encountered in 5.9 to 18.5% of patients during all the endoscopic retrograde cholangiopancreatography (ERCP). Cannulation in the presence of PAD can sometimes be difficult, time consuming, and often requires a higher level of endoscopic skills.Several techniques have been reported to facilitate and increase the chances of successful bile duct cannulation in the presence of PAD. The two-devices in one-channel method has been sparingly used. It involves the simultaneous use of a biopsy forceps and another instrument, either a cannula or sphincterotome through the same working channel. We successfully performed ERCP in three cases, where bile duct cannulation was performed in the setting of intradiverticular papilla using two-devices in one-channel method.We feel that the two-devices in one-channel method can be very useful and positioned higher up in the algorithm for successful cannulation in patients with PAD.
Challenges during Electroconvulsive Therapy—A Review
Authors: Bansal Sonia , Surve Rohini M. , Dayananda Rajeev 
Published: August 2021

AbstractElectroconvulsive therapy (ECT) is one of the most successful treatment techniques employed in psychiatric practice. ECT is usually administered as a last resort to a patient who fails to respond to medical management or on an urgent basis as a life-saving procedure when immediate response is desired. It is performed under general anesthesia and is often associated with autonomic changes. All attempts should be made to minimize the resulting hemodynamic disturbances in all the patients using various pharmacological methods. Anesthesiologists providing anesthesia for ECT frequently encounter patients with diverse risk factors. Concurrent cardiovascular, neurological, respiratory, and endocrine disorders may require modification of anesthetic technique. It is ideal to optimize patients before ECT. In this review, the authors discuss the optimization, management, and modification of anesthesia care for patients with various cardiac, neurological, respiratory, and endocrine disorders presenting for ECT to improve the safety of the procedure. It is not infrequent that an anesthesiologist also plays an important role in inducing a seizure. Proconvulsants such as caffeine, adjuvants like opioids, hyperventilation, and appropriate choice of anesthetic agent for induction such as etomidate or ketamine can help. The use of BIS monitoring to guide the timing of electric stimulation is also elaborated in this review.
Synovial Sarcoma of Ethmoidal Sinus
Authors: Dhiman Sapna , Negi Sarita , Moudgil Sandeep , Thakur Jagdeep S. , Azad Ramesh K. 
Published: August 2021

Abstract
Background Synovial sarcoma is an aggressive soft tissue cancer of extremities mainly and rare in head and neck region, whereas rarest in ethmoidal sinus as only three cases have been reported till date.
Case Reports We managed two cases of synovial sarcoma who presented with nasal obstruction, epistaxis, and swelling around the nasofacial region. Endoscopic nasal biopsy and immunohistochemistry markers confirmed synovial sarcoma in both the cases. While one case was managed by surgery and chemoradiation, the second patient received two cycles of ifosfamide-based chemotherapy and succumbed after 6 weeks of diagnosis.
Conclusion Head and neck sarcomas are aggressive and carry a poor prognosis. Surgical resection with postoperative radiotherapy is the standard treatment. However, they have a high risk of recurrence and hence aggressive management and close follow-up is warranted for the optimal outcome.
Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease
Authors: Rohwedder Thomas , Böttcher Peter 
Published: August 2021

AbstractObjective This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking.Study Design This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs).Materials and Methods Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk.Results Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772–1.8824). Mean dRUI in controls (−0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918–2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. −0.4 mm; p = 0.0138; CI: 0.1820–1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963).Conclusion In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to −0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.
Near-perfect transmission of a low-profile resonant structure with artificial magnetic conductor metamaterials
Authors: Lu Guang , Li Xianglv , Zhao Yunpeng , Zhang Kaiyuan , Yan Fabao , Wu Zhao 
Published: August 2021

In this paper, we present a low-profile selective-transmittance resonant structure developed with artificial magnetic conductor (AMC) metamaterials. A planar AMC is used for the two reflectors of the structure. The two reflectors cause no phase shift on reflection at the resonance frequency. The cavity can have zero thickness due to this in-phase reflection. The overall thickness of the structure is only 1.626 mm, which is less than 1/18 of the resonance wavelength. The electromagnetic characteristics of the resonant structure were simulated using simulation software. The simulated maximum transmittance was 0.999 at 9.72 GHz, with the electric field being localized at the interface of the two AMC layers. The measured maximum transmittance was 0.941 at 9.64 GHz. The experimental results are therefore in good agreement with the simulation results. The developed system can excite the interface mode at the resonance frequency and achieve near-perfect transmission of electromagnetic waves.
Detailed photoluminescence study of Cu2Ge(SSe)3 microcrystals
Authors: Krustok J. , Kaupmees R. , Li X. , Kauk-Kuusik M. , Grossberg M. 
Published: August 2021

We present a detailed temperature and laser power dependent photoluminescence (PL) study of Cu2Ge(S0.4Se0.6)3 microcrystals. At T = 20 K, two relatively narrow PL peaks were detected at about 1.16 eV (peak No. 1) and 1.12 eV (peak No. 2) and a weak, broad PL band was detected at about 0.82 eV (peak No. 3). The temperature and laser power dependencies indicate that at T = 20 K, the properties of PL peak Nos. 1 and 2 can be explained by the distant donor–acceptor (DA) pair model where a donor defect has a depth of ED ≈ 20 meV and ED ≈ 60 meV for peak Nos. 1 and 2, respectively. The depth of acceptor defects was 57 and 76 meV for peak Nos. 1 and 2, respectively. At around T = 90 K, the DA pair recombination of peak No. 1 gradually starts to transform into the conduction band–acceptor recombination, but peak No. 2 shows a DA pair recombination even at room temperature. The estimated bandgap energy of this compound at room temperature was Eg = 1.225 eV.
Molecular simulation of C2H4/CO2/N2/O2 adsorption characteristics in lignite and anthracite
Authors: Zhang Jing , Wang Jiren , Zhang Chunhua , Li Zongxiang , Lu Bing , Zhu Jinchao 
Published: August 2021

As an index gas of spontaneous combustion, C2H4 has been used in several coal mines, but its adsorption on residual coal during the process from generation to sampling has an impact on evaluation. The molecular structure models of lignite and anthracite were constructed through molecular mechanics and dynamics, and the Grand Canonical Monte Carlo systems were used to simulate the adsorption of C2H4 and other common gases on lignite and anthracite at temperatures of 288.15–318.15 K. The order of adsorption capacity was CO2 &gt; C2H4 &gt; O2 &gt; N2 in the lignite and anthracite molecular models within the low-pressure zone. When the pressure increases, the adsorption capacity of O2 and N2 exceeded that of C2H4. The C2H4 and CO2 have similar and concentrated adsorption sites, and it is easier to reach the limit adsorption capacity; O2 and N2 have similar adsorption sites, the number of sites is much more than that of C2H4 and CO2, and their limit adsorption capacities are larger than those of C2H4 and CO2. When C2H4 is monitored in a goaf, its concentration is not quite accurate because of the adsorption of residual coal, which is different from the detected temperature of the C2H4 concentration obtained from the experiment. This is of great significance to further experiments and more on-site data statistics to fix the problem for coal mines.
Sleep loss drives acetylcholine- and somatostatin interneuron–mediated gating of hippocampal activity to inhibit memory consolidation
Authors: Delorme James , Wang Lijing , Kuhn Femke Roig , Kodoth Varna , Ma Jingqun , Martinez Jessy D. , Raven Frank , Toth Brandon A. , Balendran Vinodh , Vega Medina Alexis , Jiang Sha , Aton Sara J. 
Published: August 2021

Significance
Sleep loss disrupts long-term storage of episodic and spatial memories that require activity in the hippocampus. We find that sleep deprivation in mice leads to selective disruption of activity-dependent phosphorylation of ribosomal protein S6 in the hippocampus, which is normally increased in the hippocampus after learning. We used an unbiased approach to profile messenger RNAs associated with phosphorylated ribosomes and found evidence that cholinergic hippocampal inputs and somatostatin-containing hippocampal neurons are selectively activated with sleep deprivation. We find functional evidence supporting the idea that during sleep loss, activity in these two cell populations may act as an inhibitory gate, reducing the activity of dentate gyrus neurons. We find that this inhibitory gating mechanism is capable of disrupting memory consolidation.