bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probing leptogenesis and pre-BBN universe with gravitational waves spectral shapes
Authors: Samanta Rome , Datta Satyabrata 
Published: November 2021

Abstract
On the frequency-amplitude plane, Gravitational Waves (GWs) from cosmic strings show a flat plateau at higher frequencies due to the string loop dynamics in standard radiation dominated post-inflationary epoch. The spectrum may show an abrupt upward or a downward trend beyond a turning point frequency f*, if the primordial dark age prior to the Big Bang Nucleosynthesis (BBN), exhibits non-standard cosmic histories. We argue that such a spectral break followed by a rising GW amplitude which is a consequence of a post-inflationary equation of state (ω > 1/3) stiffer than the radiation (ω = 1/3), could also be a strong hint of a leptogenesis in the seesaw model of neutrino masses. Dynamical generation of the right handed (RH) neutrino masses by a gauged U(1) symmetry breaking leads to the formation of a network of cosmic strings which emits stochastic GWs. A gravitational interaction of the lepton current by an operator of the form ∂μRjμ — which can be generated in the seesaw model at the two-loop level through RH neutrino mediation, naturally seeks a stiffer equation of state to efficiently produce baryon asymmetry proportional to 1 − 3ω. We discuss how GWs with reasonably strong amplitudes complemented by a neutrino-less double beta decay signal could probe the onset of the most recent radiation domination and lightest RH neutrino mass at the intermediate scales.
Sepsisassoziierte Todesfälle in Deutschland: Charakteristika und regionale Variation
Authors: Fleischmann-Struzek Carolin , Rose Norman , Reinhart Konrad 
Published: November 2021

Zusammenfassung
Hintergrund
Sepsis ist weltweit jährlich für geschätzt 11 Mio. Todesfälle verantwortlich. Die Epidemiologie sepsisassoziierter Todesfälle ist in Deutschland unzureichend verstanden, da Sepsis bisher nicht über die deutsche unikausale Todesursachenstatistik erfasst werden kann.

Ziel der Arbeit
Epidemiologie und Charakteristika sepsisassoziierter Krankenhaustodesfälle sollen analysiert sowie regionale Unterschiede beschrieben werden.

Material und Methoden
Retrospektive Beobachtungsstudie basierend auf der deutschlandweiten fallpauschalenbezogenen Krankenhausstatistik (DRG-Statistik) 2016. Sepsisassoziierte Krankenhaustodesfälle wurden über explizite und implizite Sepsis-ICD-10-GM(Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification)-Codierungen identifiziert. Verstorbene wurden anhand der klinischen Merkmale und ihres Wohnortes entsprechend Amtlichem Gemeindeschlüssel (AGS-5-Steller) charakterisiert. Basierend auf der Bevölkerungsstatistik wurde der Anteil an den Gesamttodesfällen ermittelt.

Ergebnisse
2016 gab es in Deutschland 58.689 mit explizit codierter Sepsis assoziierte Krankenhaustodesfälle (14,1 % aller Krankenhaustodesfälle). Die Mortalität betrug 73/100.000 Einwohner und variierte 1,8-fach zwischen den Bundesländern und 7,9-fach zwischen den Kreisen. 6,4 % der deutschlandweiten Todesfälle waren sepsisassoziierte Krankenhaustodesfälle. Dieser Anteil war am höchsten in der Altersgruppe der 40- bis 64-Jährigen (9,6 %) und höher bei Männern als bei Frauen (7,7 % vs. 5,2 %). Im Vergleich dazu betrug der Anteil von implizit codierten sepsisassoziierten Krankenhaustodesfällen 47,2 % an allen Krankenhaustodesfällen und 21,6 % an allen Todesfällen.

Diskussion
Auch wenn die direkte Todesursache nicht sicher ableitbar ist, lässt sich aus dem hohen Anteil sepsisassoziierter Todesfälle an den Krankenhaustodesfällen der Bedarf weiterer Forschung und epidemiologischer Surveillance ableiten, zum Beispiel in Kohortenstudien oder auf Basis von multikausalen Todesursachenstatistiken.
Impact of Type of Gastrectomy on Death from Pneumonia in Elderly Patients with Gastric Cancer Over the Long Term
Authors: Eto Kojiro , Yoshida Naoya , Iwatsuki Masaaki , Iwagami Shiro , Yamashita Kohei , Nakamura Kenichi , Harada Kazuto , Sawayama Hiroshi , Ishimoto Takatsugu , Baba Yoshifumi , Miyamoto Yuji , Baba Hideo 
Published: November 2021

AbstractBackgroundGastrectomy may induce significant postoperative disabilities and worsen the quality of life in elderly patients. Without a functioning esophagogastric junction (EGJ), swallowing is impaired because of the anatomical and physiological changes after surgery, which increases the risk of postoperative pneumonia. The aim of this study was to identify the impact of the type of surgical procedure on death from pneumonia in elderly patients with gastric cancer (GC) over the long term.MethodsWe analyzed the data of 343 patients with GC who underwent curative gastrectomy in our hospital. We divided the patients into elderly and non‐elderly groups. Among them, 109 patients aged ≥ 75 years who underwent curative resection were analyzed, their clinicopathological factors and clinical outcomes were compared, and the impact of the type of surgical procedure on death from pneumonia over the long term was evaluated. The institutional scientific review board of Kumamoto University Hospital was approved for data collection and analysis (No. 1037).ResultsThere were significantly higher levels of American Society of Anesthesiologists (ASA) and poor nutrition in the elderly group; however, gender, BMI and factors related to pneumonia did not differ significantly between groups. The median duration of follow‐up time 1588 days. On the multivariate analysis, age and surgical procedure were selected as independent predictive factors for pneumonia‐related survival.ConclusionPreservation of the EGJ as much as possible while maintaining curability is useful for reducing postoperative death from pneumonia over the long term in elderly patients with gastric cancer.
Systematic review of renal denervation for the management of cardiac arrhythmias
Authors: Nantha Kumar Nakulan , Nyatsuro Kuda , Ahmad Shiraz , Fazmin Ibrahim T. , Saadeh Khalil , Tse Gary , Jeevaratnam Kamalan 
Published: November 2021

Abstract
Background
In the wake of the controversy surrounding the SYMPLICITY HTN-3 trial and data from subsequent trials, this review aims to perform an updated and more comprehensive review of the impact of renal sympathetic denervation on cardiac arrhythmias.

Methods and results
A systematic search was performed using the Medline, Scopus and Embase databases using the terms “Renal Denervation” AND “Arrhythmias or Atrial or Ventricular”, limited to Human and English language studies within the last 10 years. This search yielded 19 relevant studies (n = 6 randomised controlled trials, n = 13 non-randomised cohort studies) which comprised 783 patients. The studies show RSD is a safe procedure, not associated with increases in complications or mortality post-procedure. Importantly, there is no evidence RSD is associated with a deterioration in renal function, even in patients with chronic kidney disease. RSD with or without adjunctive pulmonary vein isolation (PVI) is associated with improvements in freedom from atrial fibrillation (AF), premature atrial complexes (PACs), ventricular arrhythmias and other echocardiographic parameters. Significant reductions in ambulatory and office blood pressure were also observed in the majority of studies.

Conclusion
This review provides evidence based on original research that ‘second generation’ RSD is safe and is associated with reductions in short-term blood pressure and AF burden. However, the authors cannot draw firm conclusions with regards to less prominent arrhythmia subtypes due to the paucity of evidence available. Large multi-centre RCTs investigating the role of RSD are necessary to comprehensively assess the efficacy of the procedure treating various arrhythmias.

Graphic abstract
Gender benefit in laparoscopic surgical performance using a 3D-display system: data from a randomized cross-over trial
Authors: Busshoff Jana , Datta Rabi R. , Bruns Thomas , Kleinert Robert , Morgenstern Bernd , Pfister David , Chiapponi Costanza , Fuchs Hans F. , Thomas Michael , Gietzelt Caroline , Hedergott Andrea , Möller Desdemona , Hellmich Martin , Bruns Christiane J. , Stippel Dirk L. , Wahba Roger 
Published: November 2021

Abstract
Background
The use of 3D technique compared to high-resolution 2D-4K-display technique has been shown to optimize spatial orientation and surgical performance in laparoscopic surgery. Since women make up an increasing amount of medical students and surgeons, this study was designed to investigate whether one gender has a greater benefit from using a 3D compared to a 4K-display system.

Methods
In a randomized cross-over trial, the surgical performance of male and female medical students (MS), non-board certified surgeons (NBCS), and board certified surgeons (BCS) was compared using 3D- vs. 4K-display technique at a minimally invasive training parkour with multiple surgical tasks and repetitions.

Results
128 participants (56 women, 72 men) were included. Overall parkour time in seconds was 3D vs. 4K for all women 770.7 ± 31.9 vs. 1068.1 ± 50.0 (p < 0.001) and all men 664.5 ± 19.9 vs. 889.7 ± 31.2 (p < 0.001). Regarding overall mistakes, participants tend to commit less mistakes while using the 3D-vision system, showing 10.2 ± 1.1 vs. 13.3 ± 1.3 (p = 0.005) for all women and 9.6 ± 0.7 vs. 12.2 ± 1.0 (p = 0.001) for all men. The benefit of using a 3D system, measured by the difference in seconds, was for women 297.3 ± 41.8 (27.84%) vs. 225.2 ± 23.3 (25.31%) for men (p = 0.005). This can be confirmed in the MS group with 327.6 ± 65.5 (35.82%) vs. 249.8 ± 33.7 (32.12%), p = 0.041 and in the NBCS group 359 ± 52.4 (28.25%) vs. 198.2 ± 54.2 (18.62%), p = 0.003. There was no significant difference in the BCS group.

Conclusion
3D laparoscopic display technique optimizes surgical performance compared to the 2D-4K technique for both women and men. The greatest 3D benefit was found for women with less surgical experience. As a possible result of surgical education, this gender specific difference disappears with higher grade of experience. Using a 3D-vision system could facilitate surgical apprenticeship, especially for women.
Increase in the Prevalence of Online Pornography Use: Objective Data Analysis from the Period Between 2004 and 2016 in Poland
Authors: Lewczuk Karol , Wójcik Adrian , Gola Mateusz 
Published: November 2021

AbstractDespite the considerable amount of attention presently devoted to the high accessibility of online pornography, very little formal analyses have been carried out to show how the advent and proliferation of Internet technology has changed the prevalence of pornography use in populations. We conducted a preliminary analysis based on objective website traffic data, representing the changes in the number of (1) Internet users generally and (2) online pornography users specifically, between 2004 and 2016 in Poland. We observed a clear increase in the estimated number of people using online pornography in the analyzed period. The estimated number of general population members viewing pornography on the Internet increased over three times (310%) between October 2004 and October 2016–starting from an estimated 2.76 million in the first period to 8.54 million in the last. At the same time, we did not observe a clear increase in the percentage of Internet users who viewed online pornography in the same time period. Additionally, pornography viewership on the Internet was almost 2 times more prevalent among male (47%) than female Internet users (27%), and most popular in the 18–27 age group. Since our analysis is based on objective data, it does not share the limitations inherent in self-reports. However, our approach also has several important limitations (e.g., the analysis does not include online activity generated on mobile devices and under a private browsing mode); thus, the results should be interpreted with caution.
Overturning of the façade in single-nave churches under seismic loading
Authors: de Felice Gianmarco , Fugger Rebecca , Gobbin Francesca 
Published: November 2021

AbstractThe out-of-plane collapse of the façade represents one of the major threats and the most frequent cause of damages of churches due to strong earthquakes. Due to the slenderness of the façade and the lack of adequate connections to the side walls and the wooden roof, the seismic action can trigger the overturning. A detailed assessment is therefore required to judge whether or not to intervene. This paper presents an approach for the seismic assessment of the stability of the façade, through a discrete element model based on a photographic survey, with the aim of representing the actual geometry and arrangement of the stone units and their effects on the kinematics of the overturning. The collapse mechanism is simulated with both, quasi-static pushover and dynamic pulse-based analyses and the results compared to those of conventional rigid-body kinematics. The proposed approach is then applied to seven masonry churches that suffered severe damages during the 2009 L’Aquila (Italy) earthquake and the failure mode provided by the analyses is compared to the damages caused by the earthquake. The method is able to give a reliable estimate of the expected failure mechanism, taking into account the quality of the masonry and the connections to the side walls, while also providing the seismic acceleration required to trigger the motion and the ultimate displacement beyond which collapse occurs.
Diversity of resident plant communities could weaken their allelopathic resistance against alien and native invaders
Authors: Yuan Ling , Li Junmin , van Kleunen Mark 
Published: November 2021

AbstractElton’s classic diversity-invasibility hypothesis posits that diversity of resident communities increases resistance against invaders. We tested whether the diversity-invasibility relationsip might be mediated by allelopathic effects of the resident species. In a large germination experiment, we exposed seeds of six alien and six native test species to leachates of one, three, six or twelve species. The leachates tended to slightly delay germination, and almost all single-species leachates reduced the proportion of germinated seeds. Nevertheless, the overall effect of the plant leachate mixtures on the proportion of germinated seeds was not significant. This was because a higher diversity of the leachates increased the proportion of germinated seeds, particularly for native test species. Among the six alien test species, it was only the most invasive one that benefited from increased diversity of the leachates, just like the natives did. Overall, our findings suggest that allelopathy of diverse communities does not provide resistance but could actually facilitate the germination of invaders.
Community-Based Support and Social Services and Their Association with Frailty Factors in Older People with Intellectual Disability and Affective and Anxiety Disorders: A Swedish National Population-Based Register Study
Authors: El Mrayyan Nadia , Bökberg Christina , Eberhard Jonas , Ahlström Gerd 
Published: November 2021

AbstractAffective and anxiety diagnoses are common in older people with intellectual disability (ID). The aim was to describe support and social services for older people with ID and affective and/or anxiety diagnoses, also to investigate in this study group the association between support and social services and frailty factors in terms of specialist healthcare utilisation, multimorbidity, polypharmacy, level of ID and behavioural impairment. Data was selected from four population-based Swedish national registries, on 871 identified persons with affective and/or anxiety diagnoses and ID. Multivariate regression analysis was used to investigate associations between frailty factors during 2002–2012 and social services in 2012. People with multimorbidity who frequently utilised specialist healthcare were less likely to utilise residential arrangements. Those with polypharmacy were more likely utilise residential arrangements, and receive personal contact. People with moderate, severe/profound levels of ID were more likely to utilise residential arrangements and to pursue daily activities.
Easier Said Than Done: The Challenge to Teach “Personal Recovery” to Mental Health Professionals Through a Short, Targeted and Structured Training Programme
Authors: Giusti Laura , Ussorio Donatella , Salza Anna , Casacchia Massimo , Roncone Rita 
Published: November 2021

AbstractThis study assesses the effectiveness of our short Personal Recovery Training Program (PRTP) for mental health professionals. Fifty-two healthcare professionals from Italian mental health services and forty students in psychiatric rehabilitation completed the Recovery Knowledge Inventory (RKI) pre- and post-training, divided into two groups: the PRTP (N = 45) and the Family Psychoeducational Training Program (FPTP; N = 47). Participants’ understanding of personal recovery improved more significantly for those in the PRTP than for those in the FPTP group in two domains, “Roles and responsibilities” and “Non-linearity of the recovery process”; the FPTP group showed a significant improvement in the “Role of self-definition and peers in recovery” domain. Two consumers were involved in the PRTP and represented a resource to help participants understand the personal recovery process. Our findings indicate that a brief PRTP supported by consumers can improve staff and students' recovery orientation. The translation of the training into clinical practice remains unevaluated.
Mental Health in Children of Immigrants in Germany: The Role of Socio-Demographic and Immigration-Related Characteristics
Authors: Runge Ronja A. , Glaesmer Heide , Schmitz Julian , Nesterko Yuriy 
Published: November 2021

AbstractOver the last decades, the number of immigrants in Germany has been rising steadily. One result of this is that currently, around 40% of children in the country have immigrant parents. Existing studies report rather mixed results concerning their mental health outcomes. The present study provides some insight into factors that affect the mental health of this population. We compared emotional and behavioral problems (assessed via the SOEP-SDQ) in 5- to 10- year-old children of immigrants and their native German peers (N = 2441). We considered socioeconomic status as well as immigration-related characteristics of parents (age at immigration, country of origin, perceived discrimination, host country language skills, and immigrant generation). We examined the mental health status of the parents as a possible mediator between these characteristics and the children’s mental health outcomes. We did not find a difference in emotional and behavioral problems between immigrant and native children living in Germany. Low socioeconomic status was associated with more emotional and behavioral problems in both immigrant and native German children. Younger age at immigration to Germany in fathers and poorer German language skills among mothers were found to be directly associated with poorer mental health in children of immigrants. Mothers’ mental health status mediated the effects of perceived discrimination and mothers’ German language skills. The results underline the urgent need for a more detailed examination of immigration-related characteristics in immigrants living in Germany in order to better understand and prevent possible mental health-related disadvantages among their children.
Modeling Magnetic Particle Imaging for Dynamic Tracer Distributions
Authors: Brandt Christina , Schmidt Christiane 
Published: November 2021

AbstractMagnetic Particle Imaging (MPI) is a promising tracer-based, functional medical imaging technique which measures the non-linear magnetization response of magnetic nanoparticles to a dynamic magnetic field. For image reconstruction, system matrices from time-consuming calibration scans are used predominantly. Finding modeled forward operators for magnetic particle imaging, which are able to compete with measured matrices in practice, is an ongoing topic of research. The existing models for magnetic particle imaging are by design not suitable for arbitrary dynamic tracer concentrations. Neither modeled nor measured system matrices account for changes in the concentration during a single scanning cycle. In this paper we present a new MPI forward model for dynamic concentrations. A static model will be introduced briefly, followed by the changes due to the dynamic behavior of the tracer concentration. Furthermore, the relevance of this new extended model is examined by investigating the influence of the extension and example reconstructions with the new and the standard model.
Towards Optimized Bioavailability of 99mTc-Labeled Barbiturates for Non-invasive Imaging of Matrix Metalloproteinase Activity
Authors: Honold Lisa , Austrup Melanie , Faust Andreas , Konken Christian Paul , Schwegmann Katrin , Zinnhardt Bastian , Daniliuc Constantin Gabriel , Haufe Günter , Schäfers Michael , Kopka Klaus , Hermann Sven 
Published: November 2021

Abstract

Introduction

Dysregulated activity of matrix metalloproteinases (MMPs) drives a variety of pathophysiological conditions. Non-invasive imaging of MMP activity in vivo promises diagnostic and prognostic value. However, current targeting strategies by small molecules are typically limited with respect to the bioavailability of the labeled MMP binders in vivo. To this end, we here introduce and compare three chemical modifications of a recently developed barbiturate-based radiotracer with respect to bioavailability and potential to image MMP activity in vivo.

Methods
Barbiturate-based MMP inhibitors with an identical targeting unit but varying hydrophilicity were synthesized, labeled with technetium-99m, and evaluated in vitro and in vivo. Biodistribution and radiotracer elimination were determined in C57/BL6 mice by serial SPECT imaging. MMP activity was imaged in a MMP-positive subcutaneous xenograft model of human K1 papillary thyroid tumors. In vivo data were validated by scintillation counting, autoradiography, and MMP immunohistochemistry.

Results
We prepared three new 99mTc‐labeled MMP inhibitors, bearing either a glycine ([99mTc]MEA39), lysine ([99mTc]MEA61), or the ligand HYNIC with the ionic co-ligand TPPTS ([99mTc]MEA223) yielding gradually increasing hydrophilicity. [99mTc]MEA39 and [99mTc]MEA61 were rapidly eliminated via hepatobiliary pathways. In contrast, [99mTc]MEA223 showed delayed in vivo clearance and primary renal elimination. In a thyroid tumor xenograft model, only [99mTc]MEA223 exhibited a high tumor-to-blood ratio that could easily be delineated in SPECT images.

Conclusion
Introduction of HYNIC/TPPTS into the barbiturate lead structure ([99mTc]MEA223) results in delayed renal elimination and allows non-invasive MMP imaging with high signal-to-noise ratios in a papillary thyroid tumor xenograft model.