bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kosten der spezialisierten Palliativversorgung – eine Analyse aus Perspektive der Kostenträger
Authors: Enderlein Anne , Jülich Andreas , Schindler Caroline , Fleßa Steffen 
Published: October 2017

ZusammenfassungDie Palliativmedizin wird aufgrund des demografischen Wandels und des medizinisch-technischen Fortschritts an Bedeutung zunehmen. Es ist daher zu erwarten, dass auch die Kosten für die Palliativmedizin steigen werden, jedoch liegen bislang keine wissenschaftlichen Erkenntnisse über die Höhe der Ausgaben für Palliativversorgung für unterschiedliche Leistungsträger vor. Dies ist problematisch, da insbesondere die Kenntnis der Kosten der Kostenträger (Krankenkassen) die Grundlage für die optimale Ressourcenallokation und damit die Verbesserung der Versorgung darstellt. Die vorliegende Arbeit möchte hierzu einen Beitrag aus Perspektive der Kostenträger leisten. Mittels einer Sekundärdatenanalyse erfolgte die Ermittlung der Kosten aus der Sicht der GKV der spezialisierten Palliativversorgung in Greifswald sowohl im ambulanten als auch im stationären Bereich. Die gesamten Kosten beliefen sich auf 3 409 468,78 Euro bei 12 560 Patientenbetreuungstagen. Die täglichen Kosten von Patienten, die nur auf der Palliativstation behandelt wurden, betrugen 457,94 Euro, im Hospiz 155,11 Euro sowie in der spezialisierten ambulanten Palliativversorgung 74,51 Euro. Kosten für Patienten, die während eines stationären Aufenthaltes sowohl auf anderen Stationen des Klinikums und auf der Palliativstation behandelt wurden, betrugen 888,06 Euro. Ein Vergleich der Kosten untereinander ist nicht unproblematisch, da die Versorgungsschwerpunkte der Einrichtungen unterschiedlich ausgerichtet sind, sie stellen jedoch die Grundlage für eine Budgetanalyse dar.
Graph Theoretical Analysis, In Silico Modeling, Synthesis, Anti-Microbial and Anti-TB Evaluation of Novel Quinoxaline Derivatives
Authors: Saravanan Govindaraj , Selvam Theivendren , Alagarsamy Veerachamy , Kunjiappan Selvaraj , Joshi Shrinivas , Indhumathy Murugan , Kumar Pandurangan 
Published: October 2017

Abstract
Background We designed to synthesize a number of 2-(2-(substituted benzylidene) hydrazinyl)-N-(4-((3-(phenyl imino)-3,4-dihydro quinoxalin-2(1 H)-ylidene)amino) phenyl) acetamide S1-S13 with the hope to obtain more active and less toxic anti-microbial and anti-TB agents.
Methods A series of novel quinoxaline Schiff bases S1-S13 were synthesized from o-phenylenediamine and oxalic acid by a multistep synthesis. In present work, we are introducing graph theoretical analysis to identify drug target. In the connection of graph theoretical analysis, we utilised KEGG database and Cytoscape software. All the title compounds were evaluated for their in-vitro anti-microbial activity by using agar well diffusion method at three different concentration levels (50, 100 and 150 µg/ml). The MIC of the compounds was also determined by agar streak dilution method.
Results The identified study report through graph theoretical analysis were highlights that the key virulence factor for pathogenic mycobacteria is a eukaryotic-like serine/threonine protein kinase, termed PknG. All compounds were found to display significant activity against entire tested bacteria and fungi. In addition the synthesized scaffolds were screened for their in vitro antituberculosis (anti-TB) activity against Mycobacterium tuberculosis (Mtb) strain H37Ra using standard drug Rifampicin.
Conclusion A number of analogs found markedly potent anti-microbial and anti-TB activity. The relationship between the functional group variation and the biological activity of the evaluated compounds were well discussed. The observed study report was showing that the compound S6 (4-nitro substitution) exhibited most potent effective anti-microbial and anti-TB activity out of various tested compounds.
Zelluläre Mechanismen der systolischen Herzinsuffizienz
Authors: Maack Christoph 
Published: October 2017

ZusammenfassungBei systolischer Herzinsuffizienz verursacht die kontraktile Dysfunktion des linken Ventrikels eine neuroendokrine Aktivierung, die zu
maladaptiven Umbauprozessen des Herzens führt. Die Antagonisierung dieser neuroendokrinen Aktivierung ist daher das derzeit wichtigste
Therapiekonzept bei systolischer Herzinsuffizienz. Auf zellulärer Ebene sind neben der Expression prohypertropher Gene insbesondere
Störungen des kardiomyozytären Ca2+- und Na+-Haushalts, ein Energiedefizit und oxidativer Stress wichtige
pathologische Veränderungen. Mitochondrien spielen hierbei eine zentrale Rolle, da sie die wichtigste Quelle für ATP, aber auch reaktive
Sauerstoffspezies sind und ihre Funktion entscheidend durch Ca2+ und Na+ reguliert wird. Neuere pharmakologische
Ansätze zielen daher auf eine Verbesserung der mitochondrialen und metabolischen Dysfunktion, um hierüber den Progress der Herzinsuffizienz
abzumildern.
Eisenmangel bei chronischer Herzinsuffizienz
Authors: von Haehling Stephan , Ottenjann Henrike , Anker Stefan D. 
Published: October 2017

ZusammenfassungEisenmangel bei chronischer Herzinsuffizienz ist ein bedeutsamer Risikoparameter, der die körperliche Leistungsfähigkeit und die
Lebensqualität der Patienten negativ beeinflusst. Zahlreiche Studien bzw. Metaanalysen legen nahe, dass eine parenterale Eisensubstitution –
im Gegensatz zur oralen Therapie – einen positiven Effekt auf Morbidität, Mortalität, Hospitalisierungsraten und Lebensqualität hat. Zudem
scheint die parenterale Eisengabe auch einen ökonomischen Benefit zu haben. Einige neu aufgelegte Studien werden zusätzliche Erkenntnisse
zutage bringen und die Empfehlungen für eine intravenöse Eisengabe bei diesem speziellen Patientengut untermauern.
Depression und Angststörungen bei Herzinsuffizienz
Authors: Wedegärtner Sonja Maria , Ukena Julia , Kindermann Ingrid 
Published: October 2017

ZusammenfassungIn Deutschland ist die chronische Herzinsuffizienz der häufigste krankheitsbedingte Grund für eine stationäre Aufnahme. Depressionen und
Angststörungen sind häufige Begleiterkrankungen und nachteilig für den Verlauf der Herzschwäche. Sie sind mit einer schlechteren
Medikamentenadhärenz, häufigeren Hospitalisierung und erhöhten Sterblichkeit assoziiert. Das Erkennen einer psychischen Komorbidität ist
daher von zentraler Bedeutung in der Behandlung herzinsuffizienter Patienten und sollte in die klinische Praxis integriert werden.
Chirurgische Therapie der Herzinsuffizienz
Authors: Färber Gloria , Sandhaus Tim , Noutsias Michel , Schulze Christian , Doenst Torsten 
Published: October 2017

ZusammenfassungPatienten mit Herzinsuffizienz stellen eine besondere Herausforderung für den Herzchirurgen dar und erfordern u. a. aufgrund der großen
Erfolge der medikamentösen Therapie einen interdisziplinären und individualisierten Therapieansatz. Grundsätzlich ergibt sich die Indikation
für ein operatives Vorgehen aus symptomatischer und/oder prognostischer Sicht. Für die Therapie der Herzinsuffizienz ergeben sich folgende
chirurgische Behandlungsoptionen. Eine Bypassoperation kann das Leben verlängern und die Symptome lindern. Ein Aortenklappenersatz kann bei
hochgradigem Vitium das Leben verlängern und die Symptome lindern. Eine Mitralklappenoperation kann bei funktioneller
Mitralklappeninsuffizienz die Symptome lindern. Eine Herztransplantation oder ventrikuläre Herz­unterstützungssysteme können die Symptome
lindern und das Leben verlängern. Im Folgenden wird in kondensierter Form der aktuellen Stand der chirurgischen Therapiemöglichkeiten
beschrieben.
Standard- oder Therapieverändernde Entwicklungen in der Hämatologie
Authors: Haas Rainer 
Published: October 2017

ZusammenfassungIn den letzten beiden Jahrzehnten ist es zu einem regelrechten Paradigmenwechsel in der Behandlung von Patienten mit hämatologischen
Erkrankungen gekommen. Grund dafür ist das immer besser werdende Verständnis der molekularen Pathogenese einzelner Krankheitsentitäten,
welches ein Umdenken und Änderungen in Diagnostik oder Therapie nach sich zieht. Beispielhaft soll dies an einigen malignen und nicht
malignen hämatologischen Erkrankungen gezeigt werden.
Development of a Job Exposure Matrix for Noise in the Swedish Soft Tissue Paper Industry
Authors: Neitzel Richard Lee , Andersson Marianne , Eriksson Helena , Torén Kjell , Andersson Eva 
Published: October 2017

Abstract

Objectives
Noise exposure is a common occupational hazard, but has not been sufficiently characterized in paper mills. We developed a job-exposure matrix (JEM) for noise exposure for use in estimating exposures among Swedish soft tissue paper mill workers.

Methods
We used a combination of area and personal dosimetry noise exposure measurements made at four soft tissue paper mills by industry and research staff between 1977 and 2013 to estimate noise exposures by department, location, and job title. We then utilized these estimates, in conjunction with information on process and facility changes and use of hearing protection collected via focus groups, to create a seven-category, semi-quantitative JEM for all departments, locations, and job titles spanning the years 1940–2010.

Results
The results of the 1157 area and personal dosimetry noise measurements indicated that noise levels have generally declined in Swedish paper mills over time, though these changes have been neither uniform nor monotonic within or across the four mills. Focus group results indicated that use of hearing protection has generally increased over time. The noise JEM totals 1917 cells, with each cell representing a unique combination of operation, job title, and single year. We estimated that ~50% of workers at the four mills assessed were exposed at or above the Swedish 8-h average noise exposure limit of an 85 dBA at the conclusion of the study period in 2010.

Conclusions
Our results highlight the continuing need for hearing loss prevention and noise control efforts at these and similar mills, and the completed JEM now represents a tool for use in epidemiological studies of noise-related health outcomes.
Drug–drug interaction extraction via hierarchical RNNs on sequence and shortest dependency paths
Authors: Zhang Yijia , Zheng Wei , Lin Hongfei , Wang Jian , Yang Zhihao , Dumontier Michel 
Published: October 2017

AbstractMotivationAdverse events resulting from drug-drug interactions (DDI) pose a serious health issue. The ability to automatically extract DDIs described in the biomedical literature could further efforts for ongoing pharmacovigilance. Most of neural networks-based methods typically focus on sentence sequence to identify these DDIs, however the shortest dependency path (SDP) between the two entities contains valuable syntactic and semantic information. Effectively exploiting such information may improve DDI extraction.ResultsIn this article, we present a hierarchical recurrent neural networks (RNNs)-based method to integrate the SDP and sentence sequence for DDI extraction task. Firstly, the sentence sequence is divided into three subsequences. Then, the bottom RNNs model is employed to learn the feature representation of the subsequences and SDP, and the top RNNs model is employed to learn the feature representation of both sentence sequence and SDP. Furthermore, we introduce the embedding attention mechanism to identify and enhance keywords for the DDI extraction task. We evaluate our approach using the DDI extraction 2013 corpus. Our method is competitive or superior in performance as compared with other state-of-the-art methods. Experimental results show that the sentence sequence and SDP are complementary to each other. Integrating the sentence sequence with SDP can effectively improve the DDI extraction performance.Availability and implementationThe experimental data is available at https://github.com/zhangyijia1979/hierarchical-RNNs-model-for-DDI-extraction.Supplementary informationSupplementary data are available at Bioinformatics online.
Clinical Predictors of Early Mortality in Colorectal Cancer Patients Undergoing Chemotherapy: Results From a Global Prospective Cohort Study
Authors: Sohal Davendra P S , Kuderer Nicole M , Shepherd Frances A , Pabinger Ingrid , Agnelli Giancarlo , Liebman Howard A , Meyer Guy , Kalady Matthew F , McCrae Keith , Lyman Gary H , Khorana Alok A 
Published: October 2017

Abstract

Background
Early mortality is a major problem in colorectal cancer (CRC). We have shown that Khorana Score is predictive of early mortality in other cancers. Here, we evaluated the value of this score and other prognostic variables in predicting early mortality in CRC.

Methods
CANTARISK was a prospective, noninterventional, global cohort study in patients with CRC initiating a new chemotherapy regimen. Data were collected at zero, two, four, and six months. Early mortality was defined as death within six months of enrollment. All data were compiled centrally and analyzed after the study closed. Statistically significant univariate associations were tested in multivariable models; adjusted odds ratios (ORs) are presented. Statistical tests were two-sided.

Results
From 2011 to 2012, 1789 CRC patients were enrolled. The median age was 62 years; 71% were Caucasian. One-third (35%) had a rectal primary, and 65% had metastatic disease. There were 184 (10.3%) patients who died during their first six months in the study. For low, intermediate, and high Khorana Score, there were 8.1%, 11.2% and 32.5% deaths, respectively. In multivariable analyses, Khorana Score was an independent predictor of early death (OR for high/intermediate vs low score = 1.70, P = .0027), in addition to age (OR for each incremental year = 1.03, P = .0014), presence of metastatic disease (OR = 3.28, P < .0001), and Easter Cooperative Oncology Group Performance Status Score of 2 or higher (OR = 3.85, P < .0001).

Conclusions
This study demonstrates that Khorana Score is predictive of early mortality in CRC patients. Intermediate- or high-risk patients, as defined by this score, may benefit from additional interventions aimed at reducing early mortality.
No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy
Authors: Kammerer Tobias , Brettner Florian , Hilferink Sebastian , Hulde Nikolai , Klug Florian , Pagel Judith-Irina , Karl Alexander , Crispin Alexander , Hofmann-Kiefer Klaus , Conzen Peter , Rehm Markus 
Published: October 2017

Abstract

Background
The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury.

Methods
One hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0.4) as the only perioperative colloid. The primary endpoint was the ratio of serum cystatin C between the last visit at day 90 and the first preoperative visit. Secondary endpoints were estimated glomerular filtration rate and serum neutrophil gelatinase-associated lipocalin until the third postoperative day and risk, injury, failure, loss, and end-stage renal disease criteria at postoperative days 3 and 90.

Results
The median cystatin C ratio was 1.11 (interquartile range, 1.01 to 1.23) in the albumin and 1.08 (interquartile range, 1.00 to 1.20) in the hydroxyethyl starch group (median difference = 0.03; 95% CI, –0.09 to 0.08; P = 0.165). Also, there were no significant differences concerning serum cystatin C concentrations; estimated glomerular filtration rate; risk, injury, failure, loss, and end-stage renal disease criteria; and neutrophil gelatinase-associated lipocalin. Infusion requirements, transfusion rates, and perioperative hemodynamics were similar in both groups.

Conclusions
With respect to renal function and kidney injury, this study indicates that albumin 5% and balanced hydroxyethyl starch 6% have comparable safety profiles in noncritically ill patients undergoing major surgery.
Biomechanical Evaluation of Pediatric Anterior Cruciate Ligament (ACL) Reconstruction Techniques With and Without the Anterolateral Ligament (ALL)
Authors: Trentacosta Natasha , Pace James L. , Metzger Melodie , Michalski Max , Nelson Trevor , Polakof Landon , Mandelbaum Bert 
Published: October 2017

Background:
Two popular physeal-sparing procedures used in the management of anterior cruciate ligament (ACL) injuries in skeletally immature patients are the iliotibial band (ITB) ACL reconstruction (ACLR) and the all-epiphyseal (AE) ACLR. Although there has been concern for overconstraint of the lateral compartment of the knee with the ITB ACLR technique, rotational stability, as provided by the anterolateral ligament (ALL) and ACL, has not been assessed in the setting of pediatric ACLR techniques. Our hypothesis is that the ITB ACLR and AE ACLR with ALL reconstruction (ALLR) will best replicate the biomechanical profile of the intact ACL that is lost with transection of the ACL and ALL.

Methods:
Eight cadaveric legs were statically loaded with an anterior drawer force and varus, valgus, internal and external rotational moments at 0, 30, 60, and 90 degrees of flexion. Displacement and rotation were recorded in the following conditions: intact ACL/intact ALL, ACL-deficient/intact ALL, ITB ACLR/intact ALL, ITB ACLR/ALL-deficient, ACL-deficient/ALL-deficient, AE ACLR/ALL-deficient, AE ACLR/ALLR.

Results:
Both ACLR techniques reduced anterior tibial translation from the ACL-deficient state, but neither restored it to the intact state (P<0.05), except in full extension. ALL deficiency increased anterior tibial translation in the ACL-deficient state (P<0.05). In rotational testing, no significant increase was seen with transection of the ACL, but the ACL-deficient/ALL-deficient state had a significant increase in internal rotation (P<0.05). This was significantly restored to the intact state at most flexion angles with the ITB ACLR without rotational overconstraint of the lateral compartment. The AE ACLR/ALL-deficient state and AE ACLR/ALLR improved rotational stability at lower flexion angles, but not at 60 and 90 degrees. There were no significant changes in varus/valgus moments.

Conclusions:
In this model, the ITB ACLR provided the superior biomechanical profile between our tested reconstructions. It best corrected both AP and rotatory stability without overconstraining the knee. The AE ACLR and AE ACLR/ALLR improved both parameters but not at all flexion angles and not as robustly. ACL deficiency in the knee increased anterior tibial translation, but did not affect rotatory stability. ALL deficiency in the knee increased anterior displacement and rotational moments in the ACL-deficient state.

Clinical Relevance:
Cadaveric Laboratory Study. The ITB ACLR seems to be the biomechanically superior pediatric ACLR technique to regain translational and rotational stability.
Best Practice Guidelines for Surgical Site Infection Prevention With Surgical Treatment of Early Onset Scoliosis
Authors: Glotzbecker Michael P. , St Hilaire Tricia A. , Pawelek Jeff B. , Thompson George H. , Vitale Michael G. 
Published: October 2017

Background:
Postoperative surgical site infection (SSI) is unfortunately a commonly encountered complication in the surgical treatment of children with Early Onset Scoliosis (EOS). There is documented variation in the treatment of this patient population. Previous work building consensus for the approach to high risk patients (eg, neuromuscular etiology) has been promising. The goal of the current study is to apply similar principles to develop consensus-based guidelines for the treatment of patients with EOS.

Methods:
A focus group from 2 multicenter pediatric spine deformity study groups developed a list of statements to be distributed to a larger group of EOS experts. Using the Delphi process, participants were presented with a systematic review of the literature as well as a review of current practices in growth friendly surgery. The first round was conducted using an electronic survey. Results of this survey were then discussed face-to-face and the statements were further refined. A final round was conducted using the Audience Response System, allowing participants to vote for each statement (strongly agree or agree). Agreement >80% or disagreement <20% was considered consensus.

Results:
A total of 29 of 57 statements reached consensus. Negative statements (statements of disagreement) were excluded, so the final consensus guidelines included 22 statements. The number of statements from the previously published Best Practice Guidelines (BPG) approved for insertion and lengthening growth friendly procedures were 12 of 14 and 11 of 14, respectively. The high risk BPG therefore does not cover all of the issues specific to the EOS population, and explains why 22 statements reached consensus in the current guideline. Upon completion of the surveys, 100% of the participants agreed to support its publication.

Conclusions:
Using the Delphi process several “best practices” were developed for growth friendly surgical treatment of EOS.

Level of Evidence:
Level V.
Correction of Paradoxical Ribcage Motion in Scoliosis by Noninvasive Ventilation
Authors: Kinnear William J.M. , Sovani Milind , Khanna Arun , Colt Juliet 
Published: October 2017

Study Design.
Observational study of ribcage motion in scoliosis.

Objective.
To see whether noninvasive ventilation corrected paradoxical inward motion of the ribs during inspiration.

Summary of Background Data.
Paradoxical inward motion of the ribs is observed after rib fractures, low cervical cord injury, and in chronic obstructive pulmonary disease. It is not well recognized in scoliosis and the mechanism in this group has not been studied.

Methods.
Linearized magnetometers were used to measure the diameter of the ribcage. Changes in diameter during tidal breathing were recorded during spontaneous ventilation and noninvasive ventilation in 10 subjects with idiopathic or congenital thoracic scoliosis.

Results.
During spontaneous breathing, the median change in ribcage diameter during inspiration was −1.5 (range −2.3 to −0.8) cm. The median change in ribcage diameter during noninvasive ventilation was +0.5 (range −1.1 to +1.2) cm. Noninvasive ventilation improved paradoxical motion in all subjects, completely correcting it in six.

Conclusion.
Paradoxical inward motion of the ribcage is seen in some subjects with severe scoliosis. This abnormal motion is improved or abolished by noninvasive ventilation. Since noninvasive ventilation takes over the work of breathing from the respiratory muscles, we suggest that inspiratory muscle contraction causes distortion of part of the ribcage in scoliosis, probably because of the abnormal orientation of diaphragmatic muscle fibers.

Level of Evidence: 2